http://www.rssboard.org/rss-specification 720 https://escholarship.org/uc/ucsf/rss Recent eScholarship items from UCSF Sat, 19 Sep 2026 04:54:52 +0000 https://escholarship.org/uc/item/9hh9k18m Objective The number of missed school days attributable to secondhand smoke (SHS) exposure at home among U.S. children has not been quantified. We estimated the association between SHS exposure at home and school absenteeism and derived national estimates of SHS-attributable missed school days. Methods We analyzed data from the 2016–2024 National Survey of Children's Health for U.S. children aged 6–11 years. Propensity score weighting and two-part models were used to estimate the association between SHS exposure at home and school absenteeism. National estimates of SHS-attributable missed school days were derived by combining model-based attributable fractions with national public school enrollment data. Results SHS exposure at home was associated with both a higher likelihood of missing school and a greater number of missed school days among children with any absence. In 2024, an estimated 266,008 (95% CI: 139,627, 392,390) missed school days were attributable to SHS exposure... https://escholarship.org/uc/item/9hh9k18m Fri, 18 Sep 2026 00:00:00 +0000 Wang, Yingning Sung, Hai-Yen Max, Wendy Halpern-Felsher, Bonnie Gu, Dian Planche, Sarah Wang, Chunxia https://escholarship.org/uc/item/7px8n0qv Background: Patients with schizophrenia experience gaps in the human immunodeficiency virus (HIV) care continuum. We examined the impact of dual enrollment in Medicare upon HIV testing and retention among Medicaid-enrolled patients with schizophrenia. Methods: Using Medicaid Analytic eXtract and Medicare files from 2008 to 2012, we examined adult participants with schizophrenia enrolled in Medicaid or dually enrolled in Medicare and Medicaid. Our outcomes were (a) HIV testing probability among participants without HIV and (b) retention in HIV care among people living with HIV (PLWH) (two HIV viral loads or CD4+ counts &gt;90&nbsp;days apart and within 1&nbsp;year). Results: The average annual HIV testing probability was 4.9% among dually enrolled and 7.4% among Medicaid-enrolled patients (<i>p</i>&nbsp;&lt;&nbsp;0.001). Compared to Medicaid-only, HIV testing for dually enrolled patients were highest among those with opioid use disorder or sexually transmitted infection (STI);... https://escholarship.org/uc/item/7px8n0qv Thu, 17 Sep 2026 00:00:00 +0000 Murphy, Karly https://orcid.org/0000-0001-5576-8859 Thomas, Marilyn D https://orcid.org/0000-0003-3245-6363 Alonso‐Fraire, Paola Bazazi, Alexander R Dahiya, Priya Olfson, Mark Cournos, Francine Arnold, Emily Dilley, James Wesson, Paul Hermida, Richard Walkup, James Crystal, Stephen Mangurian, Christina https://escholarship.org/uc/item/49j0g5m9 What sustains us—our bodies, our communities, our sense of who we are? In this inaugural volume of the <em>University of California Health Humanities Review</em>, writers, artists, scholars, clinicians, and students from across the University of California explore <strong>Sustenance</strong> in its many forms. Through essays, poetry, art, and creative nonfiction, contributors consider nourishment not simply as food, but as memory, language, caregiving, community, resilience, and human connection. Together, these works illuminate the cultural, historical, social, and ecological dimensions of health, while engaging urgent questions of justice, identity, migration, technology, and healing. Bringing creative expression into conversation with critical inquiry, this volume invites readers to consider what enables individuals and communities not only to survive, but to flourish. https://escholarship.org/uc/item/49j0g5m9 Tue, 15 Sep 2026 00:00:00 +0000 Dolan, Brian Bucknor, Matthew Whang, Audrey https://escholarship.org/uc/item/2wf404xb BackgroundGeneral medicine (GM) research fellowships facilitate health care professionals to obtain the skills and mentored research experience needed for a research career. Yet, little is known about the experience and outcomes of recent graduates of GM fellowships.ObjectiveTo survey (1) GM research fellows and recent graduates and (2) program directors to learn about the opportunities and challenges facing GM research fellowships.DesignCross-sectional retrospective survey study.ParticipantsIndividuals who were enrolled in or completed a GM research fellowship (identified through prior fellow lists, advertising from the Society of General Internal Medicine, and fellowship program directors) between 2012 and 2022 in which ≥ 50% of effort was devoted to training and conducting research; 2022 program directors were recruited separately.Main MeasuresRespondents were asked to rate factors motivating them to pursue a research fellowship and their experiences during fellowship and to... https://escholarship.org/uc/item/2wf404xb Tue, 15 Sep 2026 00:00:00 +0000 Maruthur, Nisa M Ryskina, Kira L Weerahandi, Himali Block, Lauren Cordasco, Kristina M Gilliam, Elizabeth A Kwolek, Deborah Gomez Nelson, Karin Paasche-Orlow, Michael K Schwarz, Eleanor Bimla https://orcid.org/0000-0002-9912-8236 Windish, Donna M Schonberg, Mara A https://escholarship.org/uc/item/1fq951g2 Purpose To assess image quality and detection performance of 0.55-T MRI for common lung pathologies in a multireader study. Materials and Methods Twenty-eight participants were prospectively enrolled at a tertiary academic medical center between January 1, 2023, and August 31, 2023, and underwent same-day chest CT and 0.55-T MRI with respiratory-triggered T2-weighted axial BLADE and T1-weighted ultrashort echo time sequences. Six radiologists evaluated the quality of the MRI using a Likert-type scale and assessed common lung abnormalities. Sensitivity was calculated as the proportion of CT-confirmed lesions detected on MRI and was compared between readers by training status using the Kruskal-Wallis test. Fleiss κ values were calculated for interreader agreement. Nodule measurements were compared between modalities using the Pearson correlation coefficient. Results Twenty-eight participants (mean age ± SD, 59 years ± 19; 17 female) were included. The overall quality of 80% (134... https://escholarship.org/uc/item/1fq951g2 Tue, 15 Sep 2026 00:00:00 +0000 Tang, Felicia Chen, Timothy Ebrahimzadeh, Sayedomid Fields, Brandon KK https://orcid.org/0000-0002-1727-2091 Lee, Yoo Jin Liu, Jonathan Yen, Adam Bowers, Kiara Schonour, Richard B Su, Pan Itriago Leon, Pedro Darwish, Omar Larson, Peder Yang, Yang Sohn, Jae Ho https://escholarship.org/uc/item/1c01465f Background and Objectives: Uterine fibroids are common in women and can lead to symptoms of abnormal uterine bleeding, pelvic pain and bulk symptoms. Treatment can be medical or surgical. This study aims to describe characteristics and outcomes of women undergoing combined laparoscopic radiofrequency ablation (lap-RFA) and laparoscopic myomectomy (lap-MYO) to treat symptomatic uterine fibroids. Methods: This is a multicenter prospective cohort study including both academic centers and private practices. Women in the Uterine Leiomyoma Treatment by Radiofrequency Ablation (ULTRA) Study who were scheduled to undergo surgical management of fibroids underwent a combined lap-RFA and lap-MYO. We assessed quality of life and sexual function changes from before to 12 months after surgery using validated questionnaires. Results: Of the 480 participants in ULTRA, 49 underwent a combined lap-RFA and lap-MYO procedure between 2014 and 2022. The mean number of fibroids treated was 3.6 (standard... https://escholarship.org/uc/item/1c01465f Tue, 15 Sep 2026 00:00:00 +0000 Sendukas, Emily A Shields, Jessica K Kho, Kimberly A Latham, Marisa Jacoby, Vanessa Schembri, Michael Waetjen, L Elaine https://escholarship.org/uc/item/104905t3 INTRODUCTION: The authors' objective was to assess knowledge of and perceived access to long-acting reversible contraceptives (LARC) among individuals in the United States considering tubal sterilization. METHODS: Using online convenience sampling through social media advertisements, the authors recruited 442 US-born individuals considering tubal sterilization for this cross-sectional study. Eligibility criteria included age 21-45 years, female sex, premenopausal, desire to avoid future pregnancy, and no history of tubal sterilization, hysterectomy, or infertility treatment. After confirming eligibility, participants completed a 45-item online survey assessing sociodemographic characteristics, contraceptive and pregnancy history, and awareness of LARC. Chi-square tests and multivariate linear regression were used to identify sociodemographic variables associated with knowledge of and perceived access to LARC. RESULTS: Among these diverse (39% Black, 36% White, 10% Hispanic and... https://escholarship.org/uc/item/104905t3 Tue, 15 Sep 2026 00:00:00 +0000 Treder, Kelly Chiang, Amy Okobi, Agatha Schwarz, Eleanor Bimla https://orcid.org/0000-0002-9912-8236 https://escholarship.org/uc/item/4z9515xw BACKGROUND: Despite increasing incidence of stroke among younger adults, the associations of social determinants of health (SDOH) and stroke among younger adults are not well known. This study investigates the associations between SDOH from early adulthood and stroke in a prospective longitudinal cohort. METHODS: We studied participants enrolled in the CARDIA study (Coronary Artery Risk Development in Young Adults). Participants aged 18 to 30 years were enrolled in 1985 and followed through 2022. We investigated longitudinal, time-varying measures of SDOH classified into 5 distinct domains: economic (6 measures), education (1 measure), healthcare (4 measures), neighborhood (2 measures), and social/community (5 measures). The outcome was incident stroke or transient ischemic attack. We evaluated associations between individual SDOH and stroke using unadjusted Cox models. We then evaluated whether a greater cumulative number of adverse SDOH domains (each represented by 1 exposure... https://escholarship.org/uc/item/4z9515xw Mon, 14 Sep 2026 00:00:00 +0000 Fleming, Nathaniel https://orcid.org/0000-0001-8130-9189 Dintica, Christina https://orcid.org/0000-0001-8186-8140 Arynchyn, Alexander Lloyd-Jones, Donald M Lackland, Daniel Yaffe, Kristine https://escholarship.org/uc/item/5kp6n177 Background: The European Bone and Joint Infection Society (EBJIS)/Musculoskeletal Infection Society (MSIS) criteria provide a framework for diagnosing hip periprosthetic joint infection, yet daily clinical application lacks a standardized algorithm. Since these criteria rely heavily on synovial fluid markers, surgeons encounter 2 primary dilemmas: the reliability of aspiration techniques (ultrasound vs fluoroscopy) and the economic trade-off between higher-cost proprietary assays and standard institutional laboratories. This cost-effectiveness analysis was conducted to identify the diagnostic pathway that maximizes clinical benefit while minimizing expenditure within the EBJIS/MSIS framework. Methods: A decision tree model simulated the diagnostic workup of a 67-year-old patient with suspected hip periprosthetic joint infection. Ten strategies were evaluated, comparing aspiration modality and laboratory method (institutional, point-of-care, and third-party analysis). The model... https://escholarship.org/uc/item/5kp6n177 Sat, 12 Sep 2026 00:00:00 +0000 Diaz-Ledezma, Claudio Zedan, Ahmad M Xiao, Angel Barber, Thomas https://escholarship.org/uc/item/5344n2jm Background Osteoporosis is a well-established risk factor for early femoral failure following cementless total hip arthroplasty (THA). The performance of cementless collared triple-taper stems (CTTSs) in patients with a confirmed diagnosis of osteoporosis remains poorly defined. This study aimed to evaluate early clinico-radiographic outcomes of CTTS in osteoporotic patients undergoing elective THA. Methods We retrospectively reviewed 96 patients (87.5% women; mean age 69.5 ± 7.4 years) who underwent elective THA with a CTTS between 2018 and 2025. Osteoporosis was confirmed by either dual-energy x-ray absorptiometry T-score ≤ −2.5 or history of fragility fracture. Preoperative morphology and postoperative canal fill ratios, alignment, and subsidence (&gt;3 mm) were assessed. Femoral failure was defined as periprosthetic fracture or aseptic loosening. Results Preoperative morphology demonstrated a predominance of wide canals (Dorr B: 67.5%, Dorr C: 26%) and a mean morphological... https://escholarship.org/uc/item/5344n2jm Sat, 12 Sep 2026 00:00:00 +0000 Zedan, Ahmad M Abrolat, Jessica L Diaz, Maithily Zhong, Alan Barry, Jeffrey J Hansen, Erik N Bini, Stefano A Diaz-Ledezma, Claudio https://escholarship.org/uc/item/9zt439nr Comment sections on social media websites such as YouTube provide a unique venue to observe contemporaneous audience interpretation and discussion of entertainment television content. While entertainment-education research has largely examined whether and how exposure to television content influences viewer knowledge, attitudes, and beliefs, analyzing comment sections provides an opportunity to observe how audiences interpret and discuss these plotlines in an organic setting. We examined comments posted to YouTube clips of entertainment television abortion plotlines to document how these comments explicitly discussed the plotlines depicted and what themes emerged in these discussions. We identified 15 YouTube clips of abortion plotlines posted between 2018 and 2023 on official network accounts. We used thematic analysis techniques to qualitatively assess the top 20 comments and replies for each video (n = 162). Twenty-six percent of all comments referenced the content of the clip.... https://escholarship.org/uc/item/9zt439nr Fri, 11 Sep 2026 00:00:00 +0000 Herold, Stephanie https://orcid.org/0000-0003-2592-3883 Narendorf, Piper Hoffman, Beth https://escholarship.org/uc/item/6qp8s2dz Importance: Afghans are one of the world's largest refugee populations. Afghan women face compounded health risks due to sociocultural restrictions, low literacy, forced displacement, and limited health care access, yet little is known about their experiences with health care after resettlement in the US. Objective: To explore health and health care access issues of Afghan refugee women in the US. Design, Setting, and Participants: This qualitative study was part of an ongoing community-based participatory research project started in July 2020. Bilingual investigators conducted semistructured interviews with Afghan refugee women in Dari or English. Dari interviews were interpreted to English by a fluent bilingual investigator, validated by a separate bilingual investigator, and then reviewed with an Afghan immigrant community member for accuracy. Transcribed interviews were analyzed using grounded theory from July 2023 to July 2024. Participants who self-identified as Afghan,... https://escholarship.org/uc/item/6qp8s2dz Fri, 11 Sep 2026 00:00:00 +0000 Kandahari, Nazineen Kayhani, Nilufar N Zada, Fareha Moulana Kayhani, Zahra Noor, Zarin Nelson, Nicholas Ivey, Susan L https://orcid.org/0000-0002-8921-7032 https://escholarship.org/uc/item/52q0s9rb Analyzing a growing body of epidemiological research that considers coronavirus disease 2019 (COVID-19) as an occupational disease situates teaching (eg, pre-kindergarten, elementary, secondary) among the more vulnerable occupations. Teachers have experienced a higher risk of COVID-19 infection, hospitalization, death, and Long COVID than people from many other occupations. More research attending to occupational patterns and risk mitigation is needed. Taking an occupational epidemiology approach for teachers can inform a wide array of policy solutions, including school environment improvements that can support infection control, like air cleaning and ventilation, as well as supporting teachers experiencing disproportionate burdens of COVID-19, including those living with Long COVID. https://escholarship.org/uc/item/52q0s9rb Fri, 11 Sep 2026 00:00:00 +0000 Cohen, Alison K Bartlett, Lora https://escholarship.org/uc/item/394289p1 The capsaicin receptor, TRPV1, mediates the detection of noxious chemical and thermal stimuli by nociceptors, primary sensory neurons of the pain pathway. Overactivation of TRPV1 leads to cellular damage or death through calcium entry and excitotoxicity. We have exploited this phenomenon to conduct a systematic analysis of excitotoxicity through a genome-wide CRISPRi screen, thereby revealing a comprehensive network of regulatory pathways. We show that decreased expression of mitochondrial electron transport chain (ETC) components protects against capsaicin-induced toxicity and other challenges by mitigating both calcium imbalance and the generation of mitochondrial reactive oxygen species via distinct pathways. Moreover, we confirm the regulatory roles of the ETC in sensory neurons through gain-of-function and loss-of-function experiments. Interestingly, TRPV1⁺ sensory neurons maintain lower expression of ETC components and can better tolerate excitotoxicity and oxidative... https://escholarship.org/uc/item/394289p1 Fri, 11 Sep 2026 00:00:00 +0000 Yuan, Lin Chandel, Navdeep S Julius, David https://orcid.org/0000-0002-6365-4867 https://escholarship.org/uc/item/05z3w83h Challenges in Communicating and Understanding Predictive Biomarker Imaging for Alzheimer Disease https://escholarship.org/uc/item/05z3w83h Fri, 11 Sep 2026 00:00:00 +0000 Chiong, Winston https://orcid.org/0000-0001-9188-1920 https://escholarship.org/uc/item/0587203b The frontal lobes play an integral role in human socioemotional and cognitive function. Sense of self, moral decisions, empathy, and behavioral monitoring of goal-states all depend on key nodes within frontal cortex. While several neurodegenerative diseases can affect frontal function, frontotemporal dementia (FTD) has particularly serious and specific effects, which thus provide insights into the role of frontal circuits in homeostasis and adaptive behavior. FTD represents a collection of disorders with specific clinical-pathologic correlates, imaging, and genetics. Patients with FTD and initial prefrontal degeneration often present with neuropsychiatric symptoms such as loss of social decorum, new obsessions, or lack of empathy. In those patients with early anterior temporal degeneration, language (particularly in patients with left-predominant disease) and socioemotional changes (particularly in patients with right-predominant disease) precede eventual frontal dysregulation.... https://escholarship.org/uc/item/0587203b Fri, 11 Sep 2026 00:00:00 +0000 Butler, P Monroe Chiong, Winston https://orcid.org/0000-0001-9188-1920 https://escholarship.org/uc/item/9nv35104 We review the evidence linking gender to dishonesty and conclude that men are often more dishonest than women, especially in competitive settings where lies advance self-interest. However, gender differences in dishonesty are often small and mutable across situations. We propose that attending to self-regulatory constructs such as moral identity might help researchers move beyond the evolutionary-cultural debates over the origin of gender differences toward identifying factors that promote honesty from both genders. https://escholarship.org/uc/item/9nv35104 Thu, 10 Sep 2026 00:00:00 +0000 Kennedy, Jessica A Kray, Laura J https://orcid.org/0000-0003-3428-4454 https://escholarship.org/uc/item/9dz656mv Mask mandates for children were implemented at schools and childcare centers during the COVID-19 pandemic, and the US continues to recommend masking down to the age of two in certain settings. Medical interventions should be informed by high-quality evidence and consider the possibility of harm (i.e., include harm-benefit analyses). In this review, we weigh the existing evidence for the effectiveness of mask mandates to protect against COVID-19 and other viral respiratory infections and the harms associated with face mask wearing in children. There is a lack of robust evidence of benefit from masking children to reduce transmission of SARS-CoV-2 or other respiratory viruses. The highest quality evidence available for masking children for COVID-19 or other viral respiratory infections has failed to find a beneficial impact against transmission. Mechanistic studies showing reduced viral transmission from use of face masks and respirators have not translated to real world effectiveness.... https://escholarship.org/uc/item/9dz656mv Thu, 10 Sep 2026 00:00:00 +0000 Sandlund, Johanna Duriseti, Ram Ladhani, Shamez N Stuart, Kelly Noble, Jeanne https://orcid.org/0009-0005-4544-6510 Beth Høeg, Tracy https://escholarship.org/uc/item/9cg9z8z2 BACKGROUND: Coccidioidomycosis is an emerging fungal disease caused by inhaling Coccidioides spp spores. As spores reside in soil, activities that disturb soil and generate dust can aerosolise and transport the pathogen. The oil and gas industry has been extensively developed in some regions that are endemic for Coccidioides spp and has been associated with dust emissions. Although several adverse health outcomes have previously been associated with oil and gas development, its impact on coccidioidomycosis risk has not been investigated. We aimed to estimate the association between exposure to oil and gas well development (ie, wells in preproduction) and risk of coccidioidomycosis among residents living near new wells. METHODS: In this case-crossover study, we obtained information on reported coccidioidomycosis cases and oil and gas well development between 2007 and 2022 in Kern County, CA, USA. We then compared exposure to preproduction wells within 5 km of each individual's... https://escholarship.org/uc/item/9cg9z8z2 Thu, 10 Sep 2026 00:00:00 +0000 Couper, Lisa I González, David JX Camponuri, Simon K Weaver, Amanda K Sondermeyer Cooksey, Gail L Vugia, Duc Jain, Seema Taylor, John Balmes, John https://orcid.org/0000-0002-2246-7002 Eisen, Ellen A Remais, Justin V https://orcid.org/0000-0002-0223-4615 Head, Jennifer R https://escholarship.org/uc/item/89z7t8xs Clinical problem solving (CPS) conferences provide a real-time view into diagnostic reasoning, yet faculty who serve as discussants often do so without formal guidance. This article offers a practical framework for clinicians preparing to take on the CPS discussant role, emphasizing that success&nbsp;depends less on reaching the correct&nbsp;diagnosis and more on structured reasoning. Preparatory steps include strengthening clinical analytical skills, observing experienced discussants, and practicing in low-stakes settings that foster comfort with speaking and thinking aloud. During the CPS session, discussants must balance concise reasoning with attention to pacing, audience engagement, and evolving information. Key skills include framing the problem, articulating diagnostic schemas, refining hypotheses, managing uncertainty, and conducting a cognitive autopsy. Reflection and feedback after the conference and planning for future sessions reinforce growth. Although large language... https://escholarship.org/uc/item/89z7t8xs Thu, 10 Sep 2026 00:00:00 +0000 Dhaliwal, Gurpreet Goglin, Sarah Sofair, Andre N https://escholarship.org/uc/item/83m66738 While gender and economic outcomes in negotiation have been studied for decades, much less is known about gender differences in subjective outcomes, such as trust, rapport, and willingness to negotiate again, despite their importance for long-term success. In a series of studies with over 2,000 participants, we find that people consistently report better subjective outcomes when negotiating with women. This preference persists even in anonymous negotiations where gender is unknown and cannot be inferred from behavior, as well as in conditions where negotiation partner gender is randomly assigned. Importantly, we find no gender difference in economic outcomes. To understand why, we analyzed transcripts of real negotiations for any behavioral differences. These findings reveal an overlooked gender dynamic: While men and women achieve similar economic results, women foster stronger interpersonal relationships, which in turn lead to greater satisfaction and greater desire for future... https://escholarship.org/uc/item/83m66738 Thu, 10 Sep 2026 00:00:00 +0000 Townsend, Charlotte H Kray, Laura J https://orcid.org/0000-0003-3428-4454 Delecourt, Solène https://orcid.org/0000-0002-5917-3526 https://escholarship.org/uc/item/7b7984x6 Visceral pain disorders, such as irritable bowel syndrome, exhibit a marked female prevalence. Enhanced signaling between enterochromaffin (EC) cells in the gut epithelium and mucosal sensory nerve fibers likely contributes to this sex bias. We identified an estrogen-responsive paracrine pathway in which two enteroendocrine cell types, peptide YY (PYY)-expressing L cells and serotonergic EC cells, communicate to increase gut sensitivity in females. We demonstrate that estrogen signaling up-regulates the bacterial metabolite short-chain fatty acid receptor <i>Olfr78</i> on colonic L cells, increasing PYY release and their sensitivity to acetate. Elevated PYY acts on neighboring EC cells by means of NPY1R, thereby enhancing serotonin release and gut pain. We propose that hormonal fluctuations, in conjunction with internal (stress) or environmental (diet) factors, amplify this local estrogen-responsive colonic circuit, resulting in maladaptive gut sensitivity. https://escholarship.org/uc/item/7b7984x6 Thu, 10 Sep 2026 00:00:00 +0000 Venkataraman, Archana Figueroa, Eric E Castro, Joel Navarro, Fernanda Castro Soota, Deepanshu Brierley, Stuart M Julius, David https://orcid.org/0000-0002-6365-4867 Ingraham, Holly A https://orcid.org/0000-0001-6739-2967 https://escholarship.org/uc/item/7694n231 Toward Individualized Deep Brain Stimulation: A Stereoelectroencephalography-Based Workflow for Neurostimulation Target Identification - COMMENTS https://escholarship.org/uc/item/7694n231 Thu, 10 Sep 2026 00:00:00 +0000 Saal, Jeremy Kadlec, Kelly Allawala, Anusha B Johnston, Lucille Leriche, Ryan B Vatsyayan, Ritwik Han, Yiyuan Kist, Audrey Di Ianni, Tommaso Dawes, Heather E Chang, Edward F Lee, A Moses Krystal, Andrew D Moussawi, Khaled Shirvalkar, Prasad https://orcid.org/0000-0002-4977-7975 Sellers, Kristin K https://escholarship.org/uc/item/6pt2g5c5 Background and Objectives: Antiamyloid immunotherapies are associated with increased risk of intracerebral hemorrhage, particularly in the setting of <i>APOE</i>-ε4 carriership, anticoagulation, thrombolytics, and other lesions at risk of hemorrhagic conversion. It is not known whether patients with cavernous malformations are at increased risk of complication because patients with these lesions were excluded from clinical trials. Methods: We describe a case of a patient with Alzheimer disease (AD) with an incidental cavernous malformation treated with lecanemab. Results: A 73-year-old <i>APOE</i> ε4 heterozygous woman with mild cognitive impairment and CSF biomarker evidence of AD underwent treatment with intravenous lecanemab. Baseline MRI revealed 3 lobar microhemorrhages and an asymptomatic left orbitofrontal cavernous malformation. This cavernous malformation exhibited gross radiologic stability at surveillance brain MRI before the 5th and 7th infusions, but on surveillance... https://escholarship.org/uc/item/6pt2g5c5 Thu, 10 Sep 2026 00:00:00 +0000 Schwartz, Nicholas U Dietz, Connor D Prufer Araújo, Igor Villanueva-Meyer, Javier E Chiong, Winston https://orcid.org/0000-0001-9188-1920 Lane-Donovan, Courtney Vandevrede, Lawren https://orcid.org/0000-0002-8304-6711 Ljubenkov, Peter A Wang, Yingbing Soleimani-Meigooni, David N La Joie, Renaud Rojas, Julio C https://escholarship.org/uc/item/6n51r53r Across four studies (<i>N</i> = 816 U.S. adults), we uncovered a gender stereotype about dual pathways to social hierarchy: Men were associated with power, and women were associated with status. We detected this pattern both explicitly and implicitly in perceptions of individuals drawn from <i>Forbes</i> magazine's powerful people lists in undergraduate and online samples. We examined social-cognitive implications, including prominent people's degree of recognition by individuals and society, and the formation of men's and women's self-concepts. We found that power (status) ratings predicted greater recognition of men (women) and lesser recognition of women (men). In terms of the self-concept, we found that women internalized the stereotype associating women with status more than power implicitly and explicitly. Although men explicitly reported having less status and more power than women, men implicitly associated the self with status as much as power. No gender differences emerged... https://escholarship.org/uc/item/6n51r53r Thu, 10 Sep 2026 00:00:00 +0000 Townsend, Charlotte H Mishra, Sonya Kray, Laura J https://orcid.org/0000-0003-3428-4454 https://escholarship.org/uc/item/6gv623x6 Congenital heart disease (CHD), a structural malformation of the heart or great vessels, is associated with brain abnormalities and an elevated risk of neurodevelopmental deficits. The mechanisms underlying these abnormalities remain incompletely characterized. The glymphatic system, the primary waste clearance system for the central nervous system, is driven by arterial pulsatility and dependent on systemic venous pressure. The glymphatic system may be impaired in CHD due to altered vascular pulsatility and systemic venous pressure resulting from abnormal cardiac physiology and surgical palliations. Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) is an MRI-based non-invasive metric that is used to evaluate glymphatic function and has not been previously applied to adolescents with CHD. This study includes 34 adolescents with critical CHD (Transposition of great arteries (TGA): n = 17, Single-ventricle physiology (SVP): n = 9, Other CHD: n = 8) and 99... https://escholarship.org/uc/item/6gv623x6 Thu, 10 Sep 2026 00:00:00 +0000 Jerome, Linda Angelina https://orcid.org/0009-0007-2515-5024 https://escholarship.org/uc/item/6cd4r2ns Justifying Patient Risks Associated With Medical Education https://escholarship.org/uc/item/6cd4r2ns Thu, 10 Sep 2026 00:00:00 +0000 Chiong, Winston https://orcid.org/0000-0001-9188-1920 https://escholarship.org/uc/item/6330q704 BACKGROUND: Diversifying the medical student body without striving for equity in the clerkship (first full-time clinical training year) learning environment disadvantages under-represented in medicine (UIM) students and undermines the educational process. CONTEXT: To characterise and address inequities within an internal medicine clerkship, we conducted a multi-phased process to promote equity in the clerkship learning environment at an urban medical school with multiple sites. … we conducted a multi-phased process to promote equity in the clerkship learning environment … INNOVATION: The process to improve the learning environment and equity in the clerkship included: (i) a literature review and needs assessment (focus group) with UIM students; (ii) a medicine clerkship retreat with school leaders and diversity experts to reflect on the needs assessment data and generate interventions to improve equity; (iii) a member checking session with UIM students to ensure that the proposed... https://escholarship.org/uc/item/6330q704 Thu, 10 Sep 2026 00:00:00 +0000 Lai, Cindy J Jackson, Andrea V Wheeler, Margaret Dhaliwal, Gurpreet Ziv, Tal Ann Kryzhanovskaya, Irina Teherani, Arianne https://escholarship.org/uc/item/5zg2w1mj Failures to discuss and document preferences https://escholarship.org/uc/item/5zg2w1mj Thu, 10 Sep 2026 00:00:00 +0000 Xian, Ying Chiong, Winston https://orcid.org/0000-0001-9188-1920 https://escholarship.org/uc/item/5sk3b40x Despite decades of progress, gender inequalities in workplace authority and compensation persist. This review reveals recent advances in understanding how gendered careers emerge through three psychological mechanisms prevalent in organizations: (i) intrapersonal gender biases, (ii) interpersonal power dynamics, and (iii) intergroup gender relations. Because power is perceived as masculine, women in authority face systematic backlash. While status offers women an alternative leadership route, it proves less valuable than power - lacking resource control and requiring constant social validation rather than conferring formal authority. We suggest that mindsets about human malleability moderate these dynamics: fixed mindsets amplify stereotyping and power-based challenges for women leaders, while growth mindsets attenuate barriers. Our framework aims to illuminate gender disparities and to suggest promising intervention pathways. https://escholarship.org/uc/item/5sk3b40x Thu, 10 Sep 2026 00:00:00 +0000 Kray, Laura J https://orcid.org/0000-0003-3428-4454 Mishra, Sonya Townsend, Charlotte H Kennedy, Jessica A https://escholarship.org/uc/item/5fs7s3rt Sepsis is the leading cause of acute kidney injury in critically ill patients, and this complication carries a high risk of death. The biology underlying it varies between patients, which may explain why treatments have not succeeded. Here we show, using an ensemble method that groups patients by patterns across hundreds of blood proteins in three independent groups of patients, that sepsis-associated acute kidney injury comprises two reproducible subphenotypes. One subphenotype shows widespread activation of inflammation, metabolism, and oxidative stress; the other shows a quieter profile. Patients in the inflammatory subtype have higher mortality, more complications, and fewer days alive and out of the intensive care unit. A simple seven-protein test reproduces these groupings and identifies them accurately in separate cohorts. In a randomized trial, the drug ilofotase alfa appears to benefit the inflammatory subtype but not the other, suggesting that this classification could... https://escholarship.org/uc/item/5fs7s3rt Thu, 10 Sep 2026 00:00:00 +0000 Legrand, Matthieu https://orcid.org/0000-0001-9788-5316 Nguyen, Hanh Calfee, Carolyn S Lu, Yingying Harhay, Michael Liu, Kathleen Chen, David Bernholz, Juliane Matthay, Michael Mebazaa, Alexandre Pickkers, Peter Rojas, Ernesto Perez, Alexendar R https://escholarship.org/uc/item/5dm728g9 Diffuse midline gliomas (DMGs) have infiltrative, poorly defined boundaries that make tumor measurement difficult and variable. Volumetric assessment may be more informative than bidimensional response measurements, but manual volumetry is time-consuming and automated methods typically provide a single volume without indicating reliability. We evaluated whether evidential deep learning (EDL) with model ensembling could generate calibrated 95% uncertainty intervals for automated DMG volumes.Two five-model EDL ensembles based on SegResNet and nnU-Net v2 were evaluated. Voxel-wise probability distributions were propagated into tumor-volume estimates and 95% intervals. Analyses included voxel-wise calibration, true-volume coverage, relative interval width, and comparison of SegResNet uncertainty with physician difficulty ratings and spatial uncertainty annotations.The EDL nnU-Net v2 Ensemble approached 95% coverage but produced intervals likely too broad for clinical use, whereas... https://escholarship.org/uc/item/5dm728g9 Thu, 10 Sep 2026 00:00:00 +0000 Kasi, Karthik https://orcid.org/0009-0005-3592-0960 https://escholarship.org/uc/item/5cg628rf The rapid expansion of CRISPR-Cas gene editing enables new therapeutic strategies but complicates assessment of unintended editing risks due to emerging modalities and unclear analytical standards. We present UNCOVERseq (Unbiased Nomination of CRISPR Off-target Variants using Enhanced RhPCR), an improved in cellulo off-target nomination workflow that sensitively identifies rare off-target events using defined inputs and analytical process controls. Using an inter-method off-target confirmation benchmarking dataset, UNCOVERseq demonstrates high analytical sensitivity (97.6%) and precision (78%), outperforming published nomination methods. We apply UNCOVERseq across 192 guide RNAs and identify six guides spanning a broad specificity range, enabling relative risk assessment across S. pyogenes Cas9, high-fidelity variants, and base editors in hematopoietic stem and progenitor cells. We further show that double-strand break nomination sites retain strong rank-order concordance with... https://escholarship.org/uc/item/5cg628rf Thu, 10 Sep 2026 00:00:00 +0000 Kinney, Kyle J Jia, Kun Zhang, He Schmaljohn, Ellen Osborne, Thomas Thommandru, Bernice Murugan, Karthik Sánchez-Peña, Andrea West, Sean Chen, Shengyao Codipilly, Roshani Sturgeon, Morgan Turk, Rolf McNeill, Matthew S Behlke, Mark Jacobi, Ashley Cromer, M Kyle https://orcid.org/0000-0002-8198-5010 Rettig, Garrett Kurgan, Gavin L https://escholarship.org/uc/item/51j6f3b4 Plasma neurofilament light chain (NfL) is a sensitive blood-based biomarker of neuroaxonal injury with potential value for predicting Alzheimer’s disease (AD)-related neurodegeneration. However, plasma NfL is influenced by physiological factors, including age, body mass index (BMI), and renal function. Besides, it remains unclear whether adjusted NfL measurements can predict subsequent structural brain changes during the preclinical stage of AD. Using data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), this study developed individualized plasma NfL reference distributions and evaluated their ability to predict longitudinal MRI-measured neurodegeneration. Generalized Additive Models for Location, Scale, and Shape were fitted in CU Aβ− reference participants with valid eGFR data (n=378) to derive age-, BMI-, and eGFR-adjusted NfL Z-scores. Linear mixed-effects models were then used to test whether baseline and longitudinal NfL Z-scores were associated with changes... https://escholarship.org/uc/item/51j6f3b4 Thu, 10 Sep 2026 00:00:00 +0000 Liu, Shutong https://orcid.org/0009-0009-8738-613X https://escholarship.org/uc/item/50h8j4bm ABSTRACT Why do women remain underrepresented in positions of power? The present work leverages four studies ( N = 99,293) spanning archival, qualitative, and experimental methods to surface one novel antecedent to this gender gap. Men (vs. women) tend to perceive their organizations as more meritocratic as a function of their structural power (Studies 1–2). This gender difference is statistically accounted for by the fact that men's power is more often accompanied by perceived resource sufficiency , or the appraisal that one has adequate instrumental and material resources to meet role demands and exercise authority effectively (Studies 1–3). A preregistered experiment finds that higher (vs. lower) perceived resource sufficiency increases meritocracy perceptions, which in turn increase career investment intentions but weaken support for equity‐enhancing initiatives (Study 4). Together, these findings reveal that structural power's psychological consequences are not uniform across... https://escholarship.org/uc/item/50h8j4bm Thu, 10 Sep 2026 00:00:00 +0000 Mishra, Sonya Melin, Julia Kray, Laura J https://orcid.org/0000-0003-3428-4454 Anderson, Cameron https://escholarship.org/uc/item/4dk6p7hc Lies often go undetected, and we know little about the psychological and relational consequences of successfully deceiving others. While the evidence to date indicates that undetected dishonesty induces positive affect in independent decision contexts, we propose that it may elicit guilt and undermine satisfaction in negotiations despite facilitating better deals for deceivers. Across four studies, we find support for a <i>deceiver's guilt account</i>, whereby dishonesty triggers guilt and lessens negotiators' satisfaction with the bargaining experience. This pattern is robust to several factors, including the size of negotiators' incentives and individual differences in negotiators' moral character. It holds for both lies issued of negotiators' own volition and in compliance with others' orders. Large incentives also exacerbated dishonesty-induced guilt. Further, dissatisfaction stemming from dishonesty-induced guilt had downstream relational consequences. Despite going undetected,... https://escholarship.org/uc/item/4dk6p7hc Thu, 10 Sep 2026 00:00:00 +0000 Van Zant, Alex B Kennedy, Jessica A Kray, Laura J https://orcid.org/0000-0003-3428-4454 https://escholarship.org/uc/item/3t50s3z0 The Art of the Deal: Negotiating Consult Conflict https://escholarship.org/uc/item/3t50s3z0 Thu, 10 Sep 2026 00:00:00 +0000 Wray, Charlie M Dhruva, Sanket S Dhaliwal, Gurpreet https://escholarship.org/uc/item/3d23b92c Digital single-session interventions (SSIs) have been shown to be effective in reducing myriad mental health conditions. However, it is unclear which components of digital SSIs drive their therapeutic effects. In this study, we divided a well-evaluated behavioral activation-based SSI into three candidate components-<i>PSYCHOEDUCATION</i>, <i>TESTIMONIALS</i>, and <i>ACTION PLAN</i>-each hypothesized to have independent therapeutic value. We conducted a 2³ factorial experiment (N=889) to evaluate effects of the individual components on depressive symptoms. Our results showed that only the <i>ACTION PLAN</i> candidate component had a significant main effect on depressive symptoms at 2-week (<i>s.m.d</i>=-0.18) and 8-week (<i>s.m.d</i>=-0.12) follow-ups. Additionally, user's perceptions of the intervention's credibility and their expectations of improvement immediately after completing it were significantly associated with a reduction in depressive symptoms at both time... https://escholarship.org/uc/item/3d23b92c Thu, 10 Sep 2026 00:00:00 +0000 Ghosh, Arka Kaveladze, Benjamin T Schleider, Jessica L https://escholarship.org/uc/item/32q1b70q Pair Production Tomography (P2T) is an emerging imaging modality that detects pair production events from high-energy photon beams, providing unique atomic-number-based contrast. A fundamental challenge in P2T image reconstruction is positron range — the finite distance positrons travel before annihilating — which causes spatial blurring between the true pair production distribution and the reconstructed annihilation image. Unlike in Positron Emission Tomography (PET), the directed photon beam in P2T breaks the isotropy of positron emission, requiring a beam-direction-dependent correction approach. No positron range correction method has previously been developed for P2T.In this work, two positron range correction methods are developed and evaluated for P2T imaging: Richardson-Lucy deconvolution and a total variation (TV)-regularized optimization framework solved using the Fast Iterative Shrinkage-Thresholding Algorithm (FISTA). Beamlet-specific positron range kernels were constructed... https://escholarship.org/uc/item/32q1b70q Thu, 10 Sep 2026 00:00:00 +0000 Thoreson, Isha https://orcid.org/0009-0000-6766-1266 https://escholarship.org/uc/item/2z83c21b Artificial intelligence is driving unprecedented investment in data centers, yet the local costs and benefits of these facilities remain largely unmeasured. We estimate how households value nearby data center development using a newly constructed database of U.S. data centers and housing transaction data. Our statistical analysis uses a matched stacked event study design that compares housing transactions near newly announced large data centers with transactions in observably similar areas near data centers that are announced later. Large data centers reduce housing values within 3 miles by 3% on average over the following 5 years. The effect is highly localized: prices within 1 mile fall by 7.2% on average, with smaller effects beyond 1 mile. Price declines persist for at least 5 years and are larger for hyperscale and high-capacity data centers, urban locations, and the first large data center in an area. Consistent with increasing public awareness of data center externalities,... https://escholarship.org/uc/item/2z83c21b Thu, 10 Sep 2026 00:00:00 +0000 Schlauch, Garrison Greenhill, Simon https://escholarship.org/uc/item/2x6939mx We discuss the consequences of undetected lies for professional relationships. Lying is common in various professional contexts and typically goes undetected. However, recent research on deception in negotiation reveals that, despite potential economic benefits, undetected lies have hidden relational costs. In our studies, lies were designed to enable lucrative economic deals, and lies typically remained hidden from unsuspecting targets. Nevertheless, lying undermined negotiators’ satisfaction with their own deals and reduced their desire to interact with their counterpart again. We conclude that despite the potential short‐term benefits of deception in negotiation, encouraging honesty in the workplace is crucial for building high‐quality relationships and promoting employee engagement. https://escholarship.org/uc/item/2x6939mx Thu, 10 Sep 2026 00:00:00 +0000 Van Zant, AB Kennedy, JA Kray, LJ https://orcid.org/0000-0003-3428-4454 https://escholarship.org/uc/item/27w4b3zs Changes in personality and judgment in dementia raise both practical and philosophic problems concerning personal identity. For example, if a patient's values and preference have been altered by disease, should caregivers' decisions for the patient be guided by their understanding of the patient's premorbid values and preferences, or of the patient's current values and preferences? Some authors have argued, based on philosophic accounts of personal identity, that the previously healthy person and the demented patient should be regarded as two different people; therefore, previous values and preferences lose their authority. Meanwhile, others have argued that when patients lose their ability to act autonomously, their "precedent autonomy" must be respected by following their earlier wishes. These debates can inform our thinking about the proper interpretation of advance directives, as well as other practical questions such as how carriers of dementia gene mutations should think... https://escholarship.org/uc/item/27w4b3zs Thu, 10 Sep 2026 00:00:00 +0000 Chiong, Winston https://orcid.org/0000-0001-9188-1920 https://escholarship.org/uc/item/27c69097 Return to Home, Days Spend at Home and Mortality in the Year Following Critical Illness: A Nationwide State Sequence Analysis in France https://escholarship.org/uc/item/27c69097 Thu, 10 Sep 2026 00:00:00 +0000 Martin, Guillaume Atramont, Alice Mazars, Marjorie Tajahmady, Ayden Agamaliyev, Emin Singer, Mervyn Leone, Marc Legrand, Matthieu https://orcid.org/0000-0001-9788-5316 https://escholarship.org/uc/item/26v390nw AI Use in Dementia Care Requires Engagement with Patient and Caregiver Perspectives https://escholarship.org/uc/item/26v390nw Thu, 10 Sep 2026 00:00:00 +0000 Friend, Juliana Black, Valerie Chiong, Winston https://orcid.org/0000-0001-9188-1920 https://escholarship.org/uc/item/1t28h238 “Feminine” strengths, “masculine” costs: Rethinking gender gaps in negotiation research https://escholarship.org/uc/item/1t28h238 Thu, 10 Sep 2026 00:00:00 +0000 Townsend, Charlotte H Kray, Laura J https://orcid.org/0000-0003-3428-4454 https://escholarship.org/uc/item/0mn07722 ObjectiveLung cancer chemoprevention modalities are gaining wide attention as it is the second most diagnosed cancer type and the leading cause of cancer-related deaths. Our previous studies reported unique lung cancer chemoprevention capability with a repurposed drug combination of sulfasalazine (SAS) and disulfiram (DSF). However, their efficacy is limited by poor bioavailability. To overcome this challenge, we developed bioenhanced oil-in-water (o/w) nano self-emulsifying drug delivery system (Nano-SEDDS) formulations of SAS and DSF.MethodsUnique isotropic Nano-SEDDS of SAS and DSF were developed and optimized using a single-step mix method followed by in vitro physicochemical characterization and stability studies. An in vivo pharmacokinetic and tissue-biodistribution study was undertaken to test the proposed hypothesis of bioavailability enhancement with Nano-SEDDS of SAS and DSF.ResultsThe optimal Nano-SEDDS formulation exhibited low nanodroplet sizes (&lt; 200&nbsp;nm),... https://escholarship.org/uc/item/0mn07722 Thu, 10 Sep 2026 00:00:00 +0000 Desai, Preshita Bang, Katherine Chowdhury, Mohammed Riaz Hasan Wang, Zhijun Kevin Wang, Jeffrey Prabhu, Sunil Liang, Xueqing Kassie, Fekadu https://escholarship.org/uc/item/0g64725g For over two decades, gender differences in the propensity to negotiate have been thought to explain the gender pay gap. We ask whether a “women don’t ask” pattern holds today among working adults. We compare estimates of gender differences in negotiation propensity (Study 1) with actual patterns from master’s in business administration students (n 5 1,435) and alumni (n 5 1,939) from a top U.S. business school (Studies 2A and 2B). Contrary to lay beliefs, women report negotiating their salaries more (not less) often than men. We then reanalyze meta-analytic data on self-reported initiation of salary negotiations to reconcile our findings with prior work (Study 2C). While men reported higher negotiation propensity than women prior to the 21st century, the gender difference has grown neutral and then reversed since then. Negotiation propensity rose across time for both men and women, although to differing degrees. Finally, we explore the consequences of the now-outdated belief... https://escholarship.org/uc/item/0g64725g Thu, 10 Sep 2026 00:00:00 +0000 Kray, Laura J https://orcid.org/0000-0003-3428-4454 Kennedy, Jessica A Lee, Margaret https://escholarship.org/uc/item/0f886269 PD-1/PD-L1 in Myocarditis Transcriptional Signals, Functional Questions https://escholarship.org/uc/item/0f886269 Thu, 10 Sep 2026 00:00:00 +0000 Durai, Vivek Moslehi, Javid J https://orcid.org/0000-0001-5443-4312 https://escholarship.org/uc/item/06j1q289 The Dementia Care Ecosystem: Preliminary findings from a comprehensive telephone-based dementia care trial https://escholarship.org/uc/item/06j1q289 Thu, 10 Sep 2026 00:00:00 +0000 Possin, KL Dulaney, S Merrilees, J Bonasera, S Chiong, W Lee, K Wilson, L Chodos, AH Hooper, S Schaffer, M Braley, T Ong, P Rah, E Ritchie, C Bindman, A Miller, B https://escholarship.org/uc/item/9t05c98f Genetic association studies have identified numerous genes harboring protein-disrupting variants in individuals with profound autism, but identifying convergent points of vulnerability remains challenging. We discuss how brain transcriptomic resources help decode the cellular consequences of these rare gene-disrupting variants. The functional interpretation of genetic associations has largely relied on gene ontologies and protein-interaction networks, with newer approaches leveraging single-cell expression to estimate cellular enrichment. However, the broad expression of many autism-associated genes confounds cell-type-specific effects. We therefore propose a framework quantifying the trade-off between a genes cell-type specificity and sensitivity. The limited overlap between genetic associations and transcriptomic alterations in autistic brains prompts a discussion about causality. We examine whether foundation models linking genetic variation to cell-type transcriptomes could... https://escholarship.org/uc/item/9t05c98f Tue, 8 Sep 2026 00:00:00 +0000 Dubuc, Alma Renne, Thomas Huguet, Guillaume Jacquemont, Sébastien Nowakowski, Tomasz https://escholarship.org/uc/item/9pm4p9zn Alzheimer’s disease is the most common cause of progressive, age-associated memory loss and neuronal death. Despite recent advances in slowing disease progression, the underlying factors that confer cognitive resilience or accelerated decline remain poorly understood. Here, two potential determinants of resilience are investigated: the intrinsic energetic and metabolic profile of neurons, and the genetic context that governs the brain’s response to injury. To characterize the intrinsic metabolic landscape, we began with metabolomic profiling of iPSC-derived human neurons, which revealed a substantial contribution of the physiologic ketone β-hydroxybutyrate to energetic pathways. Subsequent studies revealed that neurons are capable of rapidly rewiring their metabolism under ketogenic conditions and preferentially oxidize the ketone acetoacetate in place of glucose. Physiologic ketone metabolism was, in fact, essential for maximum mitochondrial respiration and neuronal function.... https://escholarship.org/uc/item/9pm4p9zn Fri, 4 Sep 2026 00:00:00 +0000 Yang, Joyce https://orcid.org/0000-0001-7341-7403 https://escholarship.org/uc/item/9m96g9bt Patient-specific three-dimensional (3D) models can support surgical planning for complex congenital heart disease (CHD), but manual segmentation of cardiac computed tomography (CT) is time intensive. This thesis evaluated nnU-Net v2 for multi-structure CHD CT segmentation in three phases. Phase 1 screened nnU-Net configurations on the public CHD68 dataset and selected a 1,250-epoch model with learning rate 0.01. The resulting CHD68 model (M0) achieved mean case-level Dice 0.846 on 14 validation cases. Phase 2 applied M0 without additional training to 41 UCSF CT cases to establish a local baseline. Across six shared blood-pool structures, mean Dice decreased from 0.845 on CHD68 to 0.389 on UCSF, with substantial case heterogeneity and several complete structure omissions. Phase 3 trained a UCSF blood-pool model (M1), a UCSF + CHD68 blood-pool model (M2), and a ten-label UCSF hollow model (M3). On the same nine held-out UCSF blood-pool cases, mean Dice was 0.488 for M0, 0.754 for... https://escholarship.org/uc/item/9m96g9bt Fri, 4 Sep 2026 00:00:00 +0000 Outtrim, Connor Erickson https://orcid.org/0009-0002-5953-4886 https://escholarship.org/uc/item/9h59786m Determination of changes in the volume of a cerebral aneurysm over time is important as increased growth rates are indicators of elevated rupture risk. Two major magnetic resonance (MR) angiographic options are available for defining the contours of cerebral aneurysms: time-of-flight (TOF) MRA and Contrast-Enhanced (CE) MRA. Past work aimed to assess the reliability of contrast-enhanced MRA in monitoring serial volumetric changes of unruptured intracranial aneurysms but less has been reported for TOF methods. The relative performance of these two methods is poorly established. In the past, comparisons between the two techniques have used single time point patient data. In this project, we used patient data from multiple time points to compare and evaluate the degree of reproducibility between TOF-MRA and CE-MRA using co-registration techniques to see which method has better consistency. Using a standardized protocol for non-invasive MRI, specifically TOF and CE, a preliminary... https://escholarship.org/uc/item/9h59786m Fri, 4 Sep 2026 00:00:00 +0000 Tantry, Siri Venkatesh https://orcid.org/0009-0002-5330-4318 https://escholarship.org/uc/item/9cq6g6rn Cone-beam computed tomography (CBCT) has become integral to image-guided interventions and radiotherapy owing to its compact geometry and capacity for in-room volumetric imaging. Its broad-beam acquisition, however, generates substantial scattered radiation that violates the line-integral assumption underlying reconstruction, biasing attenuation estimates and degrading Hounsfield-unit (HU) accuracy, contrast-to-noise ratio (CNR), and spatial resolution. Existing scatter-correction strategies each impose characteristic penalties: hardware rejection methods such as anti-scatter grids attenuate primary fluence and raise dose; beam-stop arrays sacrifice primary signal and often require dual scans; and software approaches based on analytical kernels, Monte Carlo simulation, or machine learning trade computational cost, prior-knowledge requirements, or robustness for accuracy. This thesis introduces sparse primary sampling (SPS), a hybrid scatter estimation and correction strategy designed... https://escholarship.org/uc/item/9cq6g6rn Fri, 4 Sep 2026 00:00:00 +0000 Li, Alan R https://orcid.org/0000-0003-2414-6517 https://escholarship.org/uc/item/8z0859xh The nucleus reticularis thalami (nRT) is a sheet of GABAergic neurons that surrounds the thalamus and plays critical roles in sensory processing, attention, and sleep. Despite its central position within thalamocortical circuits, the mechanisms by which GABAergic signals converge and integrate within the nRT remain incompletely understood. The goal of this dissertation was to investigate the organization and functional consequences of GABAergic signaling in the nRT, particularly that originating from the external globus pallidus (GPe), across circuit and behavior. In Chapter 2, we characterized a previously underappreciated projection from the GPe to the nRT. We found that GPe input exerts opposing effects across nRT subregions due to regional differences in chloride homeostasis, resulting in either inhibitory or excitatory responses to GPe stimulation. These opposing effects produce distinct downstream consequences in thalamocortical (TC) circuits with a potential role in motor... https://escholarship.org/uc/item/8z0859xh Fri, 4 Sep 2026 00:00:00 +0000 Chang, Isaac Yau Ming https://orcid.org/0000-0003-1087-6025 https://escholarship.org/uc/item/7zx9w68k Development of the human cortex is a complex process that requires tightly controlled spatiotemporal regulation of gene expression. Genetic variation or altered regulatory dynamics can impact downstream protein function, which often leads to neurodevelopmental disorders (NDDs). These NDDs are widespread in genetic etiology and trait presentation, and often are sex biased in diagnosis. While the last few decades have identified hundreds of high confidence risk genes implicated in these NDDs, the convergent protein biological functions impacted by mutations in these genes, as well as the sex bias in risk, is still unclear. Here, I present two main chapters aimed at understanding the complex genetic mechanisms that give rise to NDDs. First, I show that genetic variation across risk genes gives rise to convergent rewiring of protein-protein interactions, using the FOXP1-FOXP4 interaction as an example. I highlight a novel, necessary role for FOXP4 in driving the developmental phenotypes... https://escholarship.org/uc/item/7zx9w68k Fri, 4 Sep 2026 00:00:00 +0000 Hennick, Kelsey https://orcid.org/0000-0002-6127-2400 https://escholarship.org/uc/item/7x10s3kz The basement membranes surrounding human pancreatic islets and their vasculature are essential to β cell survival, polarity, and insulin secretion, yet the cells that build and maintain this extracellular matrix in the adult human pancreas, and the way it is remodeled in type 2 diabetes, have remained poorly defined. The prevailing model holds that endothelial cells are the principal source of the vascular basement membrane, but the close physical association of endothelial cells, pericytes, and fibroblasts has made it difficult to assign secreted matrix proteins to a cellular source, because conventional histology cannot identify the producing cell and dissociation-based sequencing discards spatial context. To resolve these questions, this work combined computational re-integration of publicly available human pancreas single-cell RNA-sequencing data with donor-resolved MERFISH spatial transcriptomics of non-diabetic and type 2 diabetic human pancreas, using a custom 300-gene... https://escholarship.org/uc/item/7x10s3kz Fri, 4 Sep 2026 00:00:00 +0000 Meneses, Luisa Kimberly https://orcid.org/0000-0002-8782-5528 https://escholarship.org/uc/item/7kq593c3 Actin is a supremely conserved cytoskeletal protein whose homologs can be found across eukaryotes, archaea, and bacteria. Polymerized into micrometer-scale filaments, actin networks organize within the cell to accomplish several critical functions such as motility, division, and mechanosensing. To perform these functions, the actin cytoskeleton must adopt a variety of morphologies with spatial precision, which is all controlled by a vast menagerie of actin-regulating proteins. The Mullins Lab is broadly interested in delineating the structure-function relationships of these proteins in the context of cellular and molecular biology. A key tool for studying the structure and function of actin and actin-regulators is cryo-electron microscopy (cryo-EM), which enables near-atomic resolution visualization of in vitro and in vivo systems of proteins in hydrated environments. In this dissertation, we will explore the unique insights gained into several actin cytoskeleton systems through... https://escholarship.org/uc/item/7kq593c3 Fri, 4 Sep 2026 00:00:00 +0000 Nie, Chuankai https://orcid.org/0000-0002-9689-4146 https://escholarship.org/uc/item/7f34s545 The nuclear periphery is critical to establishing eukaryotic cell fate. The inner nuclear membrane (INM) protein emerin has been shown to play a role in cardiac and skeletal muscle development and maintenance. Mutations in the protein lead to X-linked Emery-Dreifuss Muscular Dystrophy, a degenerative disease characterized by both muscle wasting and cardiomyopathy. However, emerin-null mice do not develop muscular dystrophy phenotypes, making in vivo murine models impractical. To gain insight into emerin’s functions in human cardiac and skeletal muscle, we need a tractable human model system. Here, we have adapted an induced skeletal muscle (iSM) model system to efficiently direct skeletal muscle differentiation from human induced pluripotent stem cells (hiPSCs).Chapter 1 provides an overview of the nuclear periphery, skeletal muscle development, and current understanding of emerin function. Chapter 2 describes the use of iSMs to define the role of emerin in myogenesis. Chapter... https://escholarship.org/uc/item/7f34s545 Fri, 4 Sep 2026 00:00:00 +0000 Knight, Tracy https://orcid.org/0000-0001-8172-3857 https://escholarship.org/uc/item/6pw311q6 Understanding how white matter pathways in the brain, or the structural connectome (SC), shape and constrain functional dynamics is a central problem in neuroscience known as the structure-function problem. Using diffusion MRI and functional MRI from large publicly available datasets, including the Human Connectome Project, I developed a framework for studying the graph Laplacian of the SC and its relationship to brain function. First, I investigated the group-level properties of graph Laplacian harmonics, including which are shared across subjects versus unique to individuals, and their relationships to resting-state brain organization. I found that these harmonics form an integration-to-segregation spectrum, in which the ends of the spectrum are shared across subjects and localize to sensory regions, whereas the center is more individualized and relates to multimodal brain regions. Second, to better understand how observed brain function embeds an underlying notion of SC, I... https://escholarship.org/uc/item/6pw311q6 Fri, 4 Sep 2026 00:00:00 +0000 Sipes, Benjamin Snow https://orcid.org/0000-0002-8266-2213 https://escholarship.org/uc/item/6m87d0nn Extremely premature infants exhibit substantial biological heterogeneity that contributes to differences in neonatal outcomes, including bronchopulmonary dysplasia (BPD), one of the most common complications among this population. However, the biological processes underlying this heterogeneity remain incompletely understood. While omics approaches provide powerful tools for investigating these processes, their application in extremely premature infants remains limited. This dissertation used metabolomic and genomic approaches to investigate the urinary metabolome of extremely premature infants at high risk of developing BPD by identifying metabolic dysregulation associated with BPD and determining how genetic variation captured by genomic ancestry proportions contributes to variation in metabolite levels. Metabolome-wide association analyses during the second and fourth weeks of life identified suggestive metabolite associations with BPD, leading to the enrichment of metabolic... https://escholarship.org/uc/item/6m87d0nn Fri, 4 Sep 2026 00:00:00 +0000 Malave-Mendez, Thaybeth I. https://orcid.org/0000-0002-5352-4903 https://escholarship.org/uc/item/6gm6284m Lysosomes are membrane-bound organelles that maintain cellular homeostasis by degrading intracellular waste as the endpoint of autophagic pathways. Impaired lysosomal function contributes to the disruption of proteostasis that characterizes aging and neurodegenerative diseases, and a growing body of evidence indicates that lysosomal alkalinization is a common feature of these conditions. Because lysosomal hydrolases require an acidic luminal environment for optimal activity, dysregulation of lysosomal pH is increasingly recognized as an important contributor to disease pathogenesis. Chapter 1 of this thesis reviews current understanding of lysosomal pH dysregulation in aging and neurodegeneration, with emphasis on the mechanisms underlying lysosomal alkalinization and the effects of restoring lysosomal acidity. Chapter 2 describes a phenotypic high-throughput screen that ultimately identified two novel lysosomal acidification compounds, WNK463 and WNK-IN-11, that are inhibitors... https://escholarship.org/uc/item/6gm6284m Fri, 4 Sep 2026 00:00:00 +0000 Garda, Virginia Grazia https://orcid.org/0000-0002-3699-9122 https://escholarship.org/uc/item/5ss506zv The ventricular-subventricular zone (V-SVZ) has long been a region of great interest due to the invaluable role that it plays in generating neurons throughout development. Studies in rodents have shown that the quantity and identity of neurons born within the V-SVZ change not only temporally but spatially, with different regions of the mouse V-SVZ giving rise to distinct neuronal subtypes. In the human brain, however, certain regions of the V-SVZ have expanded to accommodate a need for greater cell numbers, including the addition of an outer sub-ventricular zone and the presence of the Arc, a three-tiered structure present during the perinatal period of development that is located at the dorsal horn of the lateral ventricle. Given the novelty of these findings, it remains unclear how these expansions change the local cytoarchitecture of different parts of the V-SVZ and how these changes may affect the local proliferating cell population. To explore these questions, we use the... https://escholarship.org/uc/item/5ss506zv Fri, 4 Sep 2026 00:00:00 +0000 Sandoval Gutierrez, Kadellyn Linneth https://orcid.org/0000-0001-5923-8337 https://escholarship.org/uc/item/4zx6p179 The oxazolidinone antibiotic linezolid binds to the peptidyl transferase center of the ribosome, where it inhibits a subset of peptide bond formation events. This context-specificity of translation inhibition is dictated by the nature of the amino acid at the penultimate position of the nascent peptide. It remains unknown whether this is a general feature of oxazolidinones and whether it can be modulated by their structural alterations. Here, we show that the oxazolidinone tedizolid also inhibits translation in a context-specific manner, but with dramatically altered selectivity, favoring Ile, His, and Gln as the penultimate (-1) residues. Delpazolid, which shares the C5-hydroxymethyl moiety with tedizolid, shows a similar preference. Structural analysis of ribosomes stalled by tedizolid or delpazolid revealed differences in nascent peptide conformation as a function of the penultimate amino acid, with Ile(-1) peptide adopting a compacted, helical conformation induced by the drug,... https://escholarship.org/uc/item/4zx6p179 Fri, 4 Sep 2026 00:00:00 +0000 Kleinman, Jordan Isabelle https://orcid.org/0000-0001-7146-824X https://escholarship.org/uc/item/4qr1s0vh Macrophage (MØ) identities are coupled to specialized functions and local niches of residence. The diverse roles of macrophages in the breast, including epithelial development and remodeling, immune surveillance, and angiogenesis, imply a spatial organization of distinct transcriptional states. Yet, how this heterogeneity is spatially arranged in the normal human breast at microanatomical resolution remains largely uncharacterized. Here, we leveraged Xenium in situ to delineate two discrete macrophage populations. We identify a TREM2+ population intercalated between basal-myoepithelial cells and analogous to previously identified ductal niche macrophages in the mouse mammary gland. FOLR2+ macrophages broadly distribute across the interlobular stroma, and unbiased niche analyses further resolved a periepithelial subpopulation that localized to the intralobular stroma. Spatially weighted communication inference highlights differentially enriched signaling patterns between TREM2+... https://escholarship.org/uc/item/4qr1s0vh Fri, 4 Sep 2026 00:00:00 +0000 Kim, Eun https://orcid.org/0000-0002-8806-4337 https://escholarship.org/uc/item/4k23z0mp Alzheimer’s disease (AD) is the most prevalent form of dementia associated with impaired cognitive ability and abnormal neural synchrony. Electrophysiological studies done by magnetoencephalography (MEG) reveal abnormal neural synchrony, reflected in brain signals with elevated power in the delta-theta band (1-7 Hz) and reduced power in the alpha-beta-gamma band (8-51 Hz), accompanied by altered neural driving activity that is scale-free in nature due to the lack of a dominant temporal scale. However, despite being a fundamental component of brain activity, the role of scale-free neural driving dynamics and their influence on altering brain network organization in AD remains poorly understood. To address this, a biophysical modeling framework called the Spectral Graph Model (SGM) is used in this study to deconvolve the scale-driving signals, analyze how they are altered in AD compared with healthy controls, and examine their effects on excitatory-inhibitory (E/I) neuronal dynamics.... https://escholarship.org/uc/item/4k23z0mp Fri, 4 Sep 2026 00:00:00 +0000 Debnath, Apurba https://orcid.org/0009-0009-5058-8539 https://escholarship.org/uc/item/37s6s4cw It has been hypothesized that while random sequences are unlikely to fold into proteins of the length of globular proteins, repeated random sequences are more likely to adopt stably folded structures, with implications for molecular evolution. We used structure prediction methods to determine the foldability of approximately 120-residue sequences composed of 5- to 60-residue random repeats. With repeats of less than 30-residues, sequences were frequently discovered (1– 12%) that fold with high confidence. For less than 60-residue repeats, we frequently observe β-solenoids, similar to those seen in natural proteins. We observe solenoids stabilized by apolar packing as well as ones stabilized by polar interactions with Ca2+ in the core of the structure as in natural RTX domains. Helical bundles were observed with high frequency when insertions or deletions (INDELs) were included between blocks of repeating sequences. We also observed a new super-secondary structure consisting of... https://escholarship.org/uc/item/37s6s4cw Fri, 4 Sep 2026 00:00:00 +0000 Yang, Rose https://orcid.org/0000-0002-2534-0242 https://escholarship.org/uc/item/34d819dq On the Caribbean island of St. Kitts, people and invasive green monkeys both suffer from food insecurity, a phenomenon locally known as “the monkey problem.” This dissertation argues that the monkey problem is sustained by the persistent logics of the former plantation economy and mismatched sensorial attunements between those who experience the daily discontents of the island and those who govern it from positions of transnational power. I utilize an eco-horror framework to analyze the monkey problem as an uncanny affective infrastructure that shifts my interlocutors' subjective experiences into a stressful site of anxiety, vigilance, and frustration. Central to this work is the development of the framework “affective consent.” Diverging from Joseph Fischel’s (2019) proposition to “screw consent” due to its inherent ableist and anthropocentric limitations, I delineate affective consent as an alternative descriptive category to capture the non-verbal mediations of agreement and... https://escholarship.org/uc/item/34d819dq Fri, 4 Sep 2026 00:00:00 +0000 Matusovsky, Bri https://orcid.org/0000-0001-5615-2335 https://escholarship.org/uc/item/2s5690mr Understanding which genes are reproducibly dysregulated in which cell types is foundational knowledge for efforts to slow or reverse pathologies. For neuropathologies, such efforts rely primarily on differential expression analysis of single-nucleus RNA-seq (snRNA-seq) data. However, this strategy suffers from experimental and statistical challenges that limit marker gene reproducibility. We describe a novel strategy called Covariation Projection Analysis (CoPA) that combines the power of bulk sampling with the precision of single-cell methods. By ‘projecting’ bulk gene coexpression modules onto pseudobulked snRNA-seq cell types, CoPA reveals the cellular origins of highly reproducible genomic programs and their relative importance among cell types. By comparing CoPA projection patterns between normal and pathological human brain samples using differential CoPA (dCoPA), we identify gene coexpression modules that are uniformly and reproducibly dysregulated in specific neocortical... https://escholarship.org/uc/item/2s5690mr Fri, 4 Sep 2026 00:00:00 +0000 Kang, Gugene https://orcid.org/0000-0002-2960-7434 https://escholarship.org/uc/item/1q0248v5 The ability of proteins to recognize and bind small molecules underlies numerous biological processes and has broad applications in biotechnology and medicine. In this dissertation, I investigate the de novo design of proteins that recognize chemically complex small molecules. Chapter 1 introduces the principles of molecular recognition and de novo protein design that motivate this work. Chapter 2 describes the computational design, experimental optimization, and structural validation of de novo proteins that bind the anthracycline chemotherapeutic doxorubicin, resulting in a compact 85-residue protein with nanomolar affinity and a novel protein fold. Chapter 3 explores the translational potential of these proteins through engineering of an albumin-binding fusion that preserves doxorubicin binding while introducing recognition of human serum albumin. Together, these studies demonstrate that de novo protein design can create structurally novel proteins with programmable molecular... https://escholarship.org/uc/item/1q0248v5 Fri, 4 Sep 2026 00:00:00 +0000 Ouchida, Stephanie Tomoyo https://orcid.org/0000-0001-8555-6232 https://escholarship.org/uc/item/1kd450dn Changes in peripheral CD8+ T cells are a hallmark of immune aging. However, the role of aged non-infiltrating CD8+ T cells in brain aging remains to be fully defined. Here, we show that aged circulating CD8+ T cells and their secreted factors drive hippocampal-dependent cognitive decline. Using heterochronic parabiosis and transcriptomics analysis we observed that peripheral CD8+ T cells maintain properties intrinsic to their age. Systemic exposure of young mice to aged CD8+ T cells elicited synaptic-related hippocampal changes and impaired cognition, while inhibiting activation, rather than infiltration, mitigated their pro-aging effects. Conversely, targeting aged circulating CD8+ T cells restored youthful signatures and rescued cognition. Mechanistically, we identified Granzyme K (GZMK) as a secreted pro-aging CD8+ T cell-derived factor in plasma, inhibition of which rescues cognition in aged animals. Together, our data identify activated aged CD8+ T cell-derived circulating... https://escholarship.org/uc/item/1kd450dn Fri, 4 Sep 2026 00:00:00 +0000 Sucharov, Juliana https://orcid.org/0000-0002-0979-3903 https://escholarship.org/uc/item/18r5z6wd The infrapatellar fat pad (IFP) has gained considerable attention in research on knee osteoarthritis (OA) for its substantial inflammatory role in knee joint health beyond simple mechanical shock-absorption. Despite increased efforts to investigate the structure, a consensus on whether the IFP contributes a pro- or anti-inflammatory role is lacking. The IFP is a highly innervated structure that contains immune cells, which highlight the candidacy of the IFP to contribute to knee OA pain. However, minimal research has evaluated the relationship between the IFP and knee OA pain. Furthermore, despite evidence that the IFP demonstrates morphological and compositional changes based on BMI-derived obesity and sex in knee OA, investigation into the sensitivity of the IFP to such factors that relate to high-risk of knee OA and greater pain severity have yet to be explored. This dissertation leveraged multidisciplinary scientific approaches to investigate tissue abnormality at the IFP... https://escholarship.org/uc/item/18r5z6wd Fri, 4 Sep 2026 00:00:00 +0000 Wagner, Jessica Grace https://orcid.org/0009-0008-4603-0519 https://escholarship.org/uc/item/0w83072s Breast cancer is a heterogeneous disease in which a single oncogenic driver can give rise to divergent tumor phenotypes. Yet, how oncogenic mutations generate epithelial state plasticity and coordinately remodel the surrounding tissue remains incompletely understood. Here, we applied longitudinal single cell RNA-sequencing to trace the mammary landscape during Pik3ca(H1047R)-driven tumor progression in the mouse. We identify an expansion of the epithelial transcriptional state space, in which luminal cells lose lineage fidelity and acquire ciliated, basal, and squamous-like gene expression programs. While oncogenic cells lose features of luminal identity, they retain expression of hormone-sensing genes such as Esr1, Pgr, and Foxa1. These cell states are established early, and rather than reflecting further epithelial transformation, the transition to overt tumors is instead marked by the emergence of cancer-associated fibroblasts. We identify a Postn+ fibroblast population enriched... https://escholarship.org/uc/item/0w83072s Fri, 4 Sep 2026 00:00:00 +0000 Le, Jennifer Thao https://orcid.org/0000-0002-1041-3875 https://escholarship.org/uc/item/0md8x8bf Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder, currently affecting more than 7 million Americans aged 65 years and older, with disproportionately higher incidence rates observed among women and Black and Latinx populations. AD is a complex, polygenic, and multifactorial disease that arises through the interaction of genomic susceptibility and exposomic factors, including clinical, lifestyle, and environmental risk exposures experienced across the life course. Recent advances in biomarker research have enabled earlier detection of AD-related processes through plasma and cerebrospinal fluid assays and neuroimaging modalities, supporting preventative intervention during preclinical and prodromal stages. However, the predictive accuracy and generalizability of biomarkers and existing AD risk prediction tools often vary across demographic groups, highlighting the need for analytical validation of these tools in diverse populations. Addressing this gap is... https://escholarship.org/uc/item/0md8x8bf Fri, 4 Sep 2026 00:00:00 +0000 Okorie, Meri https://orcid.org/0000-0002-0487-3031 https://escholarship.org/uc/item/0hj4b1s2 In this dissertation, we demonstrate how clinical cohort studies of allergic disease can be paired with current sequencing and experimental technologies to identify microbial targets for disease prevention. The first year of life is a critical window during which the microbiome is shaped by, and shapes, the host immune and epithelial systems. This work is organized around the two organ systems most directly implicated in this process: the upper airway, where microbial interactions have a more direct influence on airway-specific disease, and the gut, where the microbiome shapes the baseline immune tolerance established in the first year of life and with it the overall capacity to develop allergic disease.In the upper airway, we show that genetic risk alleles long associated with asthma, GSDMB and ORMDL3, interact with the airway microbiome at 1 year of age to influence early-life wheeze risk. Infants carrying these risk alleles who are dominated by Moraxella, Streptococcus, or... https://escholarship.org/uc/item/0hj4b1s2 Fri, 4 Sep 2026 00:00:00 +0000 Steininger, Holly Michelle https://orcid.org/0000-0001-8098-3753 https://escholarship.org/uc/item/05k4447m The implementation of laboratory automation systems has yielded significant benefits in life science research settings due to reductions in operator induced errors and improvements in assay reproducibility; however, commercial platforms often impose substantial barriers that limit adoptability due to their prohibitive costs and black box ecosystems. In particular, current systems for protein purification and microfluidic control often lack the adaptability and extensibility required to broadly enable high throughput research. Consequently, there remains a critical need for accessible instrumentation that can bridge the gap between complex, labor intensive protocols and standardized, automated workflows. The work described here details the development of several fluidic platforms designed to facilitate laboratory automation and streamline molecular diagnostics. One system is a four-channel parallel fast protein liquid chromatography system capable of parallelized milligram scale... https://escholarship.org/uc/item/05k4447m Fri, 4 Sep 2026 00:00:00 +0000 Puccinelli, Robert Russell https://orcid.org/0000-0002-8614-8326 https://escholarship.org/uc/item/4pd9c2xs BACKGROUND: Cigarette smoking presents a salient risk for HIV-positive populations. This study is among the first to examine smoking prevalence, nicotine dependence, and associated factors in a large sample of HIV-positive patients receiving antiretroviral therapy (ART) in Vietnam. METHODS: A cross-sectional study of 1133 HIV-positive people was conducted from January to September 2013 at 8 ART clinics in Hanoi (the capital) and Nam Dinh (a rural area). Smoking history and nicotine dependence (Fagerstrom Test of Nicotine Dependence-FTND) were assessed by participant self-report. Logistic regression and Tobit linear regression were performed to identify factors significantly associated with smoking outcomes. RESULTS: Prevalence of current, former, and never smokers in the sample was 36.1%, 9.5%, and 54.4%, respectively. The current smoking proportion was higher in males (59.7%) than females (2.6%). The mean FTND score was 3.6 (SD = 2.1). Males were more likely to currently smoke... https://escholarship.org/uc/item/4pd9c2xs Thu, 3 Sep 2026 00:00:00 +0000 Nguyen, Nhung Phuong Thi https://orcid.org/0000-0002-8661-9597 Tran, Bach Xuan Hwang, Lu Y Markham, Christine M Swartz, Michael D Phan, Huong Thu Thi Nong, Vuong Minh Nguyen, Cuong Tat Nguyen, Anh Hue Latkin, Carl A Vidrine, Damon J https://escholarship.org/uc/item/2nm8384x BackgroundVeterans have a unique health profile and risk for substance use, but few studies compare cannabis use patterns among US military Veterans and non-veteran civilians.ObjectiveTo examine differences in age-specific patterns, modes of use, and sociodemographic correlates of cannabis use between Veterans and non-Veterans.Design, Participants, MeasuresWe conducted a cross-sectional analysis of Behavioral Risk Factor Surveillance System data from 2016 to 2023. The analytic sample included 907,136 adults aged 18 to 80&nbsp;years with complete data on self-reported veteran status and cannabis use. Primary outcomes were past 30-day cannabis use (yes/no), frequency of use in the past 30&nbsp;days, and inhalational vs. non-inhalational use methods. Multivariable logistic regressions were used to assess sociodemographic and behavioral correlates of cannabis use. Analyses were conducted from March to June 2025.ResultsAmong participants, 114,193 (12.6%) were Veterans. Although overall... https://escholarship.org/uc/item/2nm8384x Thu, 3 Sep 2026 00:00:00 +0000 Do, Vuong V https://orcid.org/0000-0003-2140-9772 Nguyen, Nhung https://orcid.org/0000-0002-8661-9597 Ling, Pamela M Keyhani, Salomeh Rustagi, Alison S https://escholarship.org/uc/item/29n9z8m0 OBJECTIVE: Nicotine and cannabis vaping are increasingly prevalent among young adults, and aiding sleep is a common reason for cannabis use. This study examined relationships between daily nicotine/cannabis vaping patterns and sleep. METHODS: From 2023 to 2024, 111 California young adults (aged 18-29; mean age = 23.9±3.0; 64% female; 31.5% non-Hispanic White) who vaped nicotine/cannabis ≥20 days/month completed 30 consecutive days of smartphone-based surveys. Self-reported sleep outcomes included 1) sleep duration (inadequate &lt;7 versus adequate ≥7 hours) and 2) sleep quality (0=terrible to 10=excellent). Daily vaping patterns were non-vaping, nicotine-only vaping, cannabis-only vaping, or same-day co-vaping. Generalized mixed-effects models examined day-level associations between vaping patterns and sleep that night, adjusting for other substance use and baseline covariates. RESULTS: Of 2147 daily assessments, 51.7% reported inadequate sleep; mean sleep quality was 6.1±2.1.... https://escholarship.org/uc/item/29n9z8m0 Thu, 3 Sep 2026 00:00:00 +0000 Li, Wei Tran, Thi Phuong Thao Krishnan-Sarin, Suchitra Ling, Pamela M https://orcid.org/0000-0001-6166-9347 Nguyen, Nhung https://orcid.org/0000-0002-8661-9597 https://escholarship.org/uc/item/28w9t119 INTRODUCTION: Using multiple tobacco and cannabis products is common among young adults and raises concerns about addiction and health risks. Few studies address daily use patterns of multiple products on the same day. We used daily diaries to identify patterns of substance use and associated factors among young adults who reported vaping nicotine and cannabis. METHODS: We collected smartphone-based daily diaries from 113 California young adults (mean age=23.8) who vaped nicotine or cannabis for 20 +  days in the past month. For 30 consecutive days, participants reported their daily use of nicotine/tobacco, cannabis, alcohol, craving for nicotine and cannabis vaping, and mood. We used multilevel latent class analysis to identify daily substance use patterns and mixed-effects logistic regression to identify factors associated with these patterns, controlling for baseline covariates (e.g., demographics, nicotine/cannabis dependence). RESULTS: Three latent classes emerged: Class... https://escholarship.org/uc/item/28w9t119 Thu, 3 Sep 2026 00:00:00 +0000 Halliday, Deanna M Lund, Lisbeth Ling, Pamela M https://orcid.org/0000-0001-6166-9347 Nguyen, Nhung https://orcid.org/0000-0002-8661-9597 https://escholarship.org/uc/item/0vb8t21d BackgroundSmoking cessation is emerging as an important component in current HIV care to reduce smoking-related adverse health outcomes. This study aimed to examine motivation to quit and its associated factors in a sample of 409 HIV-positive smokers in Vietnam.MethodsA cross-sectional survey was conducted from January to September 2013 in Hanoi (the capital) and Nam Dinh (a rural city). Motivation to quit was measured by a 4-point single item, and was dichotomized as having any motivation versus no motivation. Smoking history, nicotine dependence (Fagerstrom Test of Nicotine Dependence), and other covariates were self-reported by participants. Multivariate logistic regression was performed to identify correlates of motivation to quit.ResultsThe sample was mostly male (97%). Mean age was 36&nbsp;years (SD = 5.8). Approximately 37% and 69% of the sample were hazardous drinkers and ever drug users, respectively. The mean duration of HIV infection and ART treatment were 6&nbsp;years... https://escholarship.org/uc/item/0vb8t21d Thu, 3 Sep 2026 00:00:00 +0000 Nguyen, Nhung Thi Phuong https://orcid.org/0000-0002-8661-9597 Tran, Bach Xuan Hwang, Lu Y Markham, Christine M Swartz, Michael D Vidrine, Jennifer I Phan, Huong Thu Thi Latkin, Carl A Vidrine, Damon J https://escholarship.org/uc/item/05v512hj INTRODUCTION: Little is known whether cannabis and tobacco use are indicators of suicide-related risks. This longitudinal study examined the associations of cannabis and tobacco use with risks of suicide attempt/death and overdose death over a 2-year follow-up in a cohort of veterans prescribed opioids. METHODS: This study analyzed data in 2024 using a national cohort of 923,291 veterans receiving opioid analgesics in Veterans Health Administration clinics collected during 2014-2019. Cannabis and tobacco use were assessed at cohort entry. Outcomes (suicide attempts, suicide death, overdose death) were obtained at follow-up through 2021. Cause-specific hazard models were used to examine the associations of cannabis and tobacco use with each outcome, adjusting for well-established risk factors for suicide/overdose (e.g., substance use disorders, mental health, sociodemographics). RESULTS: At baseline, 5.4% of the cohort used cannabis, and 39.4% used tobacco. At the end of follow-up... https://escholarship.org/uc/item/05v512hj Thu, 3 Sep 2026 00:00:00 +0000 Nguyen, Nhung https://orcid.org/0000-0002-8661-9597 Leonard, Samuel Byers, Amy L Austin, Peter C Krebs, Erin E Sandbrink, Friedhelm Bravata, Dawn M Keyhani, Salomeh https://orcid.org/0000-0001-9124-9618 https://escholarship.org/uc/item/00r0r6gz OBJECTIVES: Opioid therapy for chronic pain complicates post-operative pain management. This study evaluated the incidence of failed epidural analgesia, defined as epidural catheter replacement, in opioid-treated chronic pain patients vs. pain-free opioid-naïve controls undergoing elective upper laparotomy. METHODS: We conducted a retrospective case-control cohort study of adult patients undergoing elective upper laparotomy with epidural anesthesia (EA) for postoperative pain management. The intervention group comprised chronic pain patients, defined as pain lasting &gt;3&nbsp;months with stable daily opioid use. Controls were pain-free opioid-naïve patients. Patients with known illegal opioid use were excluded. A sample size of 75 chronic opioid-treated pain patients and 75&nbsp;pain-free patients would allow for detection of a 15 % between group difference in epidural catheter replacement at a 0.05 significance&nbsp;level. RESULTS: Seventy-five chronic pain patients and 75&nbsp;pain-free... https://escholarship.org/uc/item/00r0r6gz Thu, 3 Sep 2026 00:00:00 +0000 Andersen, Johnny Dohn Holmgren Khridina, Iryna Kristensen, Danja Lykke Holler, Christine Puck Rowbotham, Michael Aasvang, Eske Kvanner https://escholarship.org/uc/item/9ng991dz https://ucsf.app.box.com/s/of45k8niq759k2vxycwit4ddhc376gfu https://escholarship.org/uc/item/9ng991dz Tue, 1 Sep 2026 00:00:00 +0000 Sengupta, Trisha Tran, Sophia Munoz, Magdalena Malekzadeh, Sam Alejo, Alex Cantera, Alexa Kwon, Jessica Arroyo, Lizeth Hernandez, Sophie Ayong, Abigail Kaplan, Irina Belkora, Jeff https://escholarship.org/uc/item/2wh366wx INTRODUCTION: The United States faces persistent perinatal health care inequities, and there is growing recognition that midwifery care, including community-based care offered outside of hospital settings, could address these challenges. Medicaid finances half of the births in the United States, but state policies notably limit access to community midwifery care for people insured through Medicaid. METHODS: To understand barriers to Medicaid participation and how community midwives navigate these barriers in practice, we conducted a qualitative, interview-based study with midwives (n = 62) and nonmidwife birth center administrators (n = 2) in independent home birth practices and freestanding birth centers in California; data were collected between 2022 and 2025. RESULTS: The main barriers community midwives face to becoming Medicaid providers in California include: (1) extremely low reimbursement rates for the extensive continuity of care community midwives provide; (2) liability... https://escholarship.org/uc/item/2wh366wx Tue, 1 Sep 2026 00:00:00 +0000 Harrison, Jessica M Thompson‐Lastad, Ariana Williams, Chanda Jhanjar, Sara Parimi, Mounika Dunn, Jennifer T Chao, Maria T James, Jennifer Donnelly, Liz Smith, Holly Taiwo, Tanya Khemet https://escholarship.org/uc/item/6ps091p1 Ambient artificial intelligence (AI) documentation tools, known as AI scribes, have entered psychiatric clinical practice, bundling at least three operations into a single workflow, without sufficient attention to the differences among them. In this Personal View, we argue that AI-generated clinical narrative (history of present illness), AI-generated clinical observation (mental status examination), and AI-generated diagnostic reasoning (assessment and plan) are functionally distinct operations that stand in qualitatively different relationships to their shared input, with distinct failure modes and oversight demands. We describe why psychiatric practice exposes these distinctions with particular clarity and examine their implications for liability, informed consent, and regulation. Psychiatry is uniquely positioned to surface distinctions among these operations because of the therapeutic and legal weight of word choice, the unnarrated structure of the mental status exam, and... https://escholarship.org/uc/item/6ps091p1 Mon, 31 Aug 2026 00:00:00 +0000 Roth, Alexander S https://orcid.org/0000-0002-8827-8802 Ayers, Nolan B https://escholarship.org/uc/item/9b08s27c In 2024, the Centers for Medicare and Medicaid Services (CMS) added a novel Age-Friendly Hospital Inpatient Quality Reporting (IQR) Measure, composed of 10 attestation statements in 5 domains. The measure is designed to improve care for older adults through promoting care processes and structural capabilities drawn from evidence-based standards included in the 4Ms Framework (What Matters, Medication, Mentation, and Mobility) and operationalized in 3 programs: Geriatric Surgery Verification, Geriatric Emergency Department Accreditation, and the Institute for Healthcare Improvement's Age-Friendly Health System recognition. We highlight synergies and gaps between these programs and the CMS Age-Friendly IQR measure to guide hospital efforts as they prepare for their first attestation in 2026. In addition, we make recommendations to CMS to improve measure validity through better specifications that ensure meaningful impact on care for older adults and to reduce associated reporting... https://escholarship.org/uc/item/9b08s27c Fri, 28 Aug 2026 00:00:00 +0000 Adler-Milstein, Julia https://orcid.org/0000-0002-0262-6491 Rosenthal, Sarah W Thombley, Robert Rogers, Stephanie https://orcid.org/0000-0003-4227-8927 Rosner, Benjamin https://orcid.org/0000-0003-3609-6481 Yeh, Jarmin Harrison, James D https://escholarship.org/uc/item/960558gj <h4>Background</h4>Lung ischemia-reperfusion (IR) injury drives early morbidity after lung transplantation and cardiothoracic surgery, yet targeted preventive therapies are lacking. The gut-lung axis and microbiota-derived tryptophan metabolites, including indole-3-propionate (IPA), may regulate pulmonary immunity and inflammation. We investigated whether a tryptophan-rich (Trp-Rich) diet attenuates sterile lung IR injury by increasing microbiota-derived indole metabolites and reprogramming alveolar macrophage (AM) inflammatory responses.<h4>Methods</h4>C57BL/6 mice receiving isocaloric tryptophan-standard (Trp-Std) or tryptophan-rich (Trp-Rich) diets underwent lung IR injury. Oxygen saturation, lung cytokines, and aryl hydrocarbon receptor (AhR) signaling readouts were evaluated. Gut microbiota was profiled by 16S rRNA sequencing, and targeted metabolomics quantified tryptophan metabolites in feces, portal vein (PV) plasma, and lung tissue. To further assess inflammatory priming... https://escholarship.org/uc/item/960558gj Fri, 28 Aug 2026 00:00:00 +0000 Chaki, Tomohiro Maruyama, Daisuke Doan, Thien NM Tian, Xiaoli Prakash, Arun https://escholarship.org/uc/item/6zm062jj OBJECTIVE: This study describes the implementation of a brief tobacco cessation intervention (Ask, Advise, Refer: AAR) into routine vaccination workflows. METHODS: Using a convergent mixed methods approach, data were collected from 10 community pharmacies in (independent, hospital outpatient, and chain locations) via electronic documentation during vaccine administration and semi-structured interviews with pharmacy staff. The Consolidated Framework for Implementation Research served as a framework to guide qualitative interview coding and analyses, and quantitative data were analyzed descriptively. Findings were triangulated following the analyses. RESULTS: Pharmacy staff members (14 pharmacists, 3 pharmacy technicians) participated in interviews and electronic intervention documentation was submitted by 8 of the 10 pharmacies. Participants found the AAR intervention to be appropriate, feasible, and compatible with existing vaccination workflows. Seven of the 10 pharmacies included... https://escholarship.org/uc/item/6zm062jj Fri, 28 Aug 2026 00:00:00 +0000 Kampman, Haleigh Elkhadragy, Nervana Randall, David King, Hannah Corelli, Robin L Hudmon, Karen Suchanek Hilts, Katy Ellis https://escholarship.org/uc/item/6pz3n3vn Diagnostic errors are a substantial source of patient harm. As artificial intelligence (AI) integrates into clinical workflows, opportunities are emerging to assess their impacts on diagnostic excellence (DxEx). The Coordinating Center for Diagnostic Excellence (CODEX) at the University of California San Francisco established the Action Incubator to translate research advances in DxEx into tangible strategies for improving diagnosis. The September 2025&nbsp;in-person inaugural Action Incubator convened 30 multidisciplinary stakeholders representing health systems, patient advocacy, industry, and policy groups. Through structured discussions and breakout sessions, participants identified AI scribes as a near-term, scalable use case for evaluating AI's impact on diagnosis not only because of their widespread adoption, but&nbsp;-&nbsp;as supported by cognitive load theory&nbsp;-&nbsp;because of their potential to reduce cognitive burden and allow clinicians to focus more on diagnosis.... https://escholarship.org/uc/item/6pz3n3vn Fri, 28 Aug 2026 00:00:00 +0000 Rosner, Benjamin https://orcid.org/0000-0003-3609-6481 Hammer, Molly Tabacco, Aaron Adler-Milstein, Julia https://orcid.org/0000-0002-0262-6491 Ranji, Sumant R https://escholarship.org/uc/item/6k3209c4 Advancing Toward Clinical Deployment of AI-Generated Discharge Summaries—Beyond the Bench https://escholarship.org/uc/item/6k3209c4 Fri, 28 Aug 2026 00:00:00 +0000 Subramanian, Charumathi Raghu Rosner, Benjamin I https://escholarship.org/uc/item/5mw5f0dd Coccidioidomycosis (Valley fever) is a growing public health concern in the western U.S., with California reporting more than an eightfold rise in cases over the past two decades. As climate change, groundwater regulation, and prolonged drought drive major agricultural land-use shifts in the state, including widespread retirement of cultivated lands (i.e., fallowing), understanding their effects on this soil-borne fungal infection is critical. We linked 65,657 confirmed, geolocated cases (2008-2021) to high-resolution maps distinguishing natural vegetation, crop types, and fallowed fields to quantify how land use and land cover were associated with disease rates. Flexible statistical models showed that natural land covers, shrubland, barren ground, and grassland, were associated with higher incidence. Some agricultural uses (grain/hay, field crops, corn, and cotton) were associated with higher incidence, whereas others (orchards, rice, and truck crops/berries) were associated... https://escholarship.org/uc/item/5mw5f0dd Fri, 28 Aug 2026 00:00:00 +0000 Heaney, Alexandra K Jones, Isabel J Camponuri, Simon K Head, Jennifer R Weaver, Amanda K Collender, Philip A Cooksey, Gail Sondermeyer Jain, Seema Vugia, Duc Balmes, John https://orcid.org/0000-0002-2246-7002 Eisen, Ellen A https://orcid.org/0000-0002-5114-5264 Adebiyi, Adeyemi https://orcid.org/0000-0001-7091-6872 Taylor, John Bhattachan, Abinash Remais, Justin V https://orcid.org/0000-0002-0223-4615 https://escholarship.org/uc/item/3tq9026q Community pharmacies are increasingly providing health care services like tobacco treatment and disease-related management but need sustainable models for implementation. As several state Medicaid programs reimburse for community health worker (CHW) services, one promising model is to have pharmacy technicians engage with patients as designated CHWs. This qualitative study interviewed staff in seven California pharmacies about their experience with and perspectives on implementing community pharmacy technicians as CHWs. Guided by implementation science frameworks, data were hand-coded and analyzed iteratively using thematic analysis. Relative advantage and compatibility of CHWs was high across all pharmacies. Pharmacy culture aligned with CHW values, and CHW integration helped formalize the work that pharmacy staff were already doing. Challenges included the complexity of billing and obtaining payment for services provided. Despite these barriers, pharmacies successfully integrated... https://escholarship.org/uc/item/3tq9026q Fri, 28 Aug 2026 00:00:00 +0000 Valencia, Cindy V Corelli, Robin L Tu, Shin-Ping Gosdin, Melissa M Tong, Elisa K https://escholarship.org/uc/item/26x7j18n <h4>Background</h4>The 4Ms (what matters, medication, mentation, and mobility) is a widely adopted age-friendly care framework. However, there is no evidence on inpatient 4Ms adherence thresholds associated with improved outcomes.<h4>Methods</h4>In a retrospective cross-sectional analysis, we measured encounter-level adherence to the 4Ms for inpatients 65+ at the University of California San Francisco between January 1, 2021 and December 31, 2024. Outcomes included 30-day unplanned readmissions, 30-day emergency department (ED) visits, length of stay (LOS), and community admissions discharged to a facility. Using fixed effects regression models, we estimated the effect on outcomes of adherence to 100% of 4Ms assessments (what matters, medication, mentation, and mobility screening) plus 25%, 50%, and 75% of shifts with full adherence to 4Ms Act Ons (actions, such as de-prescribing high-risk medications, ambulating). We conducted subgroup analyses by age and medical versus surgical... https://escholarship.org/uc/item/26x7j18n Fri, 28 Aug 2026 00:00:00 +0000 Rosner, Benjamin I https://orcid.org/0000-0003-3609-6481 Thombley, Robert L https://orcid.org/0000-0003-1933-1494 Rogers, Stephanie E https://orcid.org/0000-0003-4227-8927 Adler-Milstein, Julia https://orcid.org/0000-0002-0262-6491 https://escholarship.org/uc/item/1kz0j2x7 Antiviral immune systems diversify by integrating new genes into existing pathways, creating new mechanisms of viral resistance. We identified genes encoding a predicted nuclease paired with a trypsin-like protease repeatedly acquired by multiple, otherwise unrelated antiviral immune systems in bacteria. Cell-based and biochemical assays revealed that the nuclease is a proenzyme that cleaves DNA only after activation by its partner protease. Two distinct immune systems, Hachiman and AVAST (antiviral adenosine triphosphatase/nucleoside triphosphatase of the STAND superfamily, Avs), use the same mechanism of proteolytic activation despite their independent evolutionary origins. Examination of nuclease-protease inheritance patterns identified caspase-nuclease (<i>canu</i>) genomic loci that confer antiviral defense in a pathway reminiscent of eukaryotic caspase activation. These results uncover the coordinated activities of pronucleases and their activating proteases within different... https://escholarship.org/uc/item/1kz0j2x7 Fri, 28 Aug 2026 00:00:00 +0000 Tuck, Owen T Hu, Jason J Lopez, Santiago C Adler, Benjamin A O’Brien, Claire E Hsieh, Kendall Meredith, Charlotte Loi, Kenneth J Yoon, Peter H Doherty, Erin E https://orcid.org/0000-0002-1555-4124 Lahiri, Arushi Doudna, Jennifer A https://escholarship.org/uc/item/9ts251c5 The Hirschsprung disease (HSCR) is a complex congenital disorder, arising from abnormalities in enteric nervous system (ENS) development. There is a gender disparity among the patients, with the male to female ratio as high as 5 : 1. Loss-of-function mutations of HSCR genes and haploinsufficiency of their gene products are the primary pathogenic mechanisms for disease development. Recent studies identified over half of the HSCR disease susceptibility genes as targets for the sex-determining factor SRY, suggesting that this Y-encoded transcription factor could be involved in sexual dimorphism in HSCR. Among the SRY targets, the tyrosine kinase receptor RET represents the most important disease gene, whose mutations account for half of the familial and up to one-third of the sporadic forms of HSCR. RET is regulated by a distal and a proximal enhancer at its promoter, in which PAX3 and NKX2-1 are the resident transcription factors respectively. We show that the SRY-box 10 (SOX10)... https://escholarship.org/uc/item/9ts251c5 Thu, 27 Aug 2026 00:00:00 +0000 Li, Yunmin Kido, Tatsuo Garcia-Barcelo, Maria M Tam, Paul KH Tabatabai, Z Laura Lau, Yun-Fai Chris https://escholarship.org/uc/item/9nn061z9 Ten simple rules for effective use of generative AI for code development in environmental science https://escholarship.org/uc/item/9nn061z9 Thu, 27 Aug 2026 00:00:00 +0000 King, Rachel A https://orcid.org/0000-0002-3274-1263 Abowd, Laurel Broderick, Carlo W Bradley, Lm Czapanskiy, Max F Farnisa, Mona M Ferrer, Erica M Garcia, Carmen Galaz Gill, Darian Greco, Nicole M Jacquemont, Juliette Kadi, Justin A Kui, Li LeBuhn, Gretchen Li, Liying Meyer, Abigail Morse, Marisa Patrick, Evan Shanny-Csik, Samantha Tucker, Nicholas AC Wang, Zhe Fong, Caitlin R https://escholarship.org/uc/item/9b5949fn IN MEMORIAM - Irwin Feinberg, MD https://escholarship.org/uc/item/9b5949fn Thu, 27 Aug 2026 00:00:00 +0000 Campbell, Ian G Rosenlicht, Nicholas March, Jonathan D https://escholarship.org/uc/item/94r7x06r Two articles published by the research groups led by You-Shuo Liu of the Central South University, Changsha, Hunan, and Min Fang of the Huazhong University of Science and Technology, Wuhan, China have been selected as the recipients of the 2019 Ming K. Jeang Award for Excellence in Cell &amp; Bioscience. https://escholarship.org/uc/item/94r7x06r Thu, 27 Aug 2026 00:00:00 +0000 Lau, Yun-Fai Chris https://escholarship.org/uc/item/8t52j15x <h4>Importance</h4>Anti-immigration policies in 2025 may influence outpatient care and telehealth among immigrant communities. Understanding visit patterns is essential for health systems leaders to prepare for shifts in health care use and ensure preventive care.<h4>Objective</h4>To compare outpatient in-person and telehealth visit completion rates among patients classified as likely undocumented and those likely with legal status, before and after 2025 federal immigration policy changes.<h4>Design, setting, and participants</h4>This cross-sectional study analyzed electronic health record data from outpatient encounters in a public safety-net system. Documentation status was approximated using non-English primary language without a Social Security number (SSN) to classify patients with likely undocumented status and using English primary language with SSN for patients likely with legal status. Analyses compared visits from January to June 2024 and January to June 2025.<h4>Main... https://escholarship.org/uc/item/8t52j15x Thu, 27 Aug 2026 00:00:00 +0000 Borchers, Rahael Sergi, Francesco Rodriguez, Robert https://orcid.org/0000-0003-1354-1773 Ge, Shaokui Khoong, Elaine C https://orcid.org/0000-0002-2514-3572 Molina, Melanie