“Testing this device marks a major step toward advancing heart health. Our technology could help clinicians better understand atherosclerotic cardiovascular disease progression and personalize treatment,” said Laura Marcu, founding director of NCIBT. Marcu holds the Endowed Professorship in Neurosurgical Research and is a professor in the Departments of Neurological Surgery and Biomedical Engineering.

The device uses fluorescence lifetime imaging (FLIm) and polarization-sensitive optical coherence tomography (PS-OCT) to simultaneously identify the microstructure and biochemical composition of plaque in coronary arteries.

Now, a UC Davis clinical nurse scientist is helping lead a national effort to better define nursing’s impact on patients and families.

Lori S. Kennedy, director of the Center for Nursing Science at UC Davis Health, has published a new framework Oct. 19 in JAMA Internal Medicine that identifies nine domains of nursing practice and proposes new ways to measure nurses’ contributions to patient outcomes.

By appearing in one of the nation's leading physician journals, the Viewpoint article brings the conversation to doctors, health system leaders and policymakers whose decisions help shape how quality of care is measured and evaluated. In addition to her leadership role, Kennedy is also an associate professor at the Betty Irene Moore School of Nursing at UC Davis.

New research from the UC Davis School of Medicine reveals that the receptor does not respond to every trigger in the same way. Instead, different stimuli appear to place TRPV1 into distinct functional states. The finding opens new possibilities for more targeted pain treatments.

The study, published in PNAS (Proceedings of the National Academy of Sciences), was led by researchers in the UC Davis Department of Physiology and Membrane Biology. The findings challenge a longstanding assumption that TRPV1 adopts a single activated state regardless of what triggers it.

TRPV1 as a potential target for pain medicine

TRPV1 is often called the body's capsaicin receptor. Located on pain-sensing nerve cells, it detects heat, tissue injury, inflammation and chemical compounds — including the capsaicin in hot peppers.

Because TRPV1 plays a central role in pain pathways and does not involve opioid signaling, it has long been considered a potential target for developing nonaddictive pain medicines. However, efforts to block the receptor have been complicated by its equally important role in regulating body temperature.

"Researchers have generally assumed that once TRPV1 is activated, the channel enters essentially the same open state regardless of what stimulus triggered it," said first author Bo Hyun Lee, a former researcher in the Zheng Lab at UC Davis. "Our findings show that the receptor is more sophisticated than that. Different stimuli appear to stabilize different open states, each with distinct functional properties."

Methods measured receptor’s response to different stimuli

To investigate how TRPV1 responds to different stimuli, the researchers measured electrical currents passing through individual channels activated by:

• Capsaicin, the compound that gives chili peppers their heat
• Resiniferatoxin, an extremely hot compound derived from a succulent plant
• Hydrogen ions (protons), which create acidic conditions commonly associated with tissue injury and inflammation
• 2-APB, a chemical commonly used to modify ion channel activity
• Heat

They found that different activators consistently produced different conductance levels. This finding suggests the channel opens in distinct ways rather than entering a common activated state.

The team then combined several approaches to see if those different conductance levels reflected structural differences in the receptor itself.

Using sensitive ion-permeation measurements (which measure how quickly charged particles move across a barrier), the researchers detected evidence that different activators altered the shape of the channel pore. They also used a fluorescence-based technique in living cells that allowed them to watch different parts of the channel protein shift position as it responded to different stimuli.

Finally, computational modeling helped visualize how the receptor's structure changed when activated by different stimuli.

Together, these approaches pointed to the existence of multiple distinct open configurations of TRPV1.

"We were able to see consistent evidence from several independent experimental methods that the pore of the channel does not look exactly the same when activated by different stimuli," said senior author Jie Zheng, professor in the Department of Physiology and Membrane Biology. "That convergence of evidence gave us confidence that these are genuine functional states rather than experimental artifacts."

The researchers also made another unexpected discovery. When two stimuli were applied together, the channel opened more slowly instead of more quickly. The finding suggests that different activation mechanisms may sometimes interfere with one another, revealing an additional layer of complexity in how pain signals are processed.

Findings may have implications for pain and basic research

Previous attempts to target TRPV1 with drugs for pain relief have often caused unwanted side effects, including major disruptions in body temperature regulation. The new study suggests it may someday be possible to selectively target receptor states associated with painful stimuli while preserving those involved in normal heat sensation.

"Our study provides a conceptual framework for thinking about TRPV1 in a much more nuanced way," said Vladimir Yarov-Yarovoy, co-author and professor in the Department of Physiology and Membrane Biology. "If different forms of activation produce different functional states, we may eventually be able to design therapies that selectively affect pain-related activity while leaving other essential functions intact."

The study also offers insight into how proteins function when encountering nontypical stimuli.

The work provides a new understanding of one of the body's most important pain sensors. It offers a potential roadmap for developing safer, more precise analgesic therapies. More research is needed to translate the study’s findings into new treatments.

Additional authors include Shisheng Li, Simon Vu, and Zhihao Yao from UC Davis and Yuhua Tian from UC Davis and Qingdao University.

Funding

This study was funded by the National Institutes of Health (R01NS103954) and the Basic Science Research Program through the National Research Foundation of Korea (RS-2023-00212567, RS-2023-00219399).

Resources

• Read the study in PNAS
• Zheng Lab
• UC Davis Department of Physiology and Membrane Biology
• Read more about federal research at UC Davis

The program enrolled 20 youths with type 1 diabetes who had elevated hemoglobin A1C levels (above 8%) and were already using continuous glucose monitoring (CGM) technology. Over four months, clinicians reviewed CGM data weekly and reached out when patients met criteria indicating a need for additional support.

“Continuous glucose monitoring provides a wealth of health information, but the data often goes largely unreviewed between office visits,” said UC Davis pediatric endocrinologist Stephanie Crossen, who led the initiative. “This pilot demonstrates how remote monitoring can help us proactively identify patients who may be struggling and offer personalized guidance when they need it most.”

During the program, clinicians monitored measures such as:

• Time-in-range (the percentage of time a patient’s glucose level stays within a target range)
• Changes in glucose control
• Hypoglycemia (low blood sugar)
• CGM wear time (the maximum number of days a single continuous glucose monitor can be worn before it must be removed and replaced with a new one).

Participants received support through phone calls, text messages or electronic medical record messaging when intervention was needed.

Remote patient monitoring supports better glycemic control

The pilot produced meaningful improvements in glycemic control. Average time-in-range, a key measure of diabetes management, increased from 34.4% at baseline to 40% by the end of the program.

Participants also experienced a significant reduction in time spent above target glucose levels, decreasing from 64.8% to 58.9%. Most notably, 35% of participants achieved a time-in-range improvement of 10% or greater, a change that correlates with an estimated 0.5% to 0.8% improvement in hemoglobin A1C.

Participants also reported high satisfaction with the program. Nearly half (44%) of the patients described RPM as “very helpful,” while 56% said it was “a little helpful.”

Eighty-three percent of participants indicated that remote monitoring should continue as part of their diabetes care. Frequently cited benefits included helping patients stay focused on diabetes management between appointments and making it easier to receive support from their care team.

Insight from the pilot program

The pilot program also identified important opportunities for future refinement. Clinicians found that outreach often required repeated attempts, with phone calls proving more effective than text messaging alone. Researchers also observed considerable variation in reimbursement of RPM services across public and private insurance plans, highlighting ongoing challenges in creating sustainable care models.

Based on the pilot’s success, the team plans to expand its remote monitoring capabilities by:

• Integrating the diabetes data platform Tidepool into the hospital’s electronic medical record software
• Refining documentation and billing workflows
• Providing additional staff training
• Studying RPM in newly diagnosed Type 1 diabetes patients through a multi-site research grant.

In fiscal year 2025-26, UC Davis received a total of $953 million in external funding. The medical school received around 46% of this funding, making it the top recipient among all UC Davis colleges and schools.

In total, the school’s researchers received 2,042 grant awards — a 29% increase from the year before.

“Funding research remains critical to advancing promising discoveries and transforming them into real-world breakthroughs that could save lives and improve quality of life,” said Kim Barrett, vice dean for research at UC Davis School of Medicine. “Kudos to our university community, who stepped up in this time of challenge, submitted a record number of grant applications, and led numerous research studies and clinical trials.”

Federal, state and industry funding

Public and private investments in university-based research have been a cornerstone of American prosperity, security and innovative leadership.

One key source of funding is the federal government. The medical school received around $234.7 million in federal funding, a 45% increase over the year before. According to the latest ranking by Blue Ridge Institute for Medical Research, the UC Davis School of Medicine is among the nation’s leading medical schools in National Institutes of Health (NIH) research funding.

Professor Rachel Whitmer is leading the two largest federal grants (total of $19.8 million) at UC Davis. Her studies, funded by the NIH, focus on age-related dementia and cognitive impairment and brain pathology among different ethnic groups. Whitmer is a professor of public health sciences and neurology and co-directs the Alzheimer’s Disease Research Center.

This year also marked the federal grant renewals to multiple UC Davis centers, including the Clinical and Translational Science Center (CTSC) ($10.8 million), Comprehensive Cancer Center($7.1 million) and the Alzheimer’s Disease Research Center ($6.4 million). These centers continue pursuing basic and translational science, developing treatments for cancer, dementia and other diseases, and mentoring the next generation of scientists.

Funding from the state of California reached $30.3 million this year. The top state funding source was a grant of $15.8 million for the Statewide California Cancer Registry. This grant is led by Professor Ted Wun, director of CTSC.

This year marks a significant increase in industry funding (around 61%) with a total of $112.6 million. These funds mainly support clinical trials and studies to test potential treatments for various diseases and conditions. For example, Jonathan Riess is the site principal investigator of a $6.2 million grant for a cancer clinical trial sponsored by BridgeBio Oncology Therapeutics. Riess is the medical director of Thoracic Oncology and an associate professor in the Department of Internal Medicine, Division of Hematology and Oncology.

The medical school also received $61.1 million in funding from other sources.

Supporting early researchers and collaborations

This year, the school received 36 Research Career Development Awards (K-awards), an unprecedented number. These NIH awards help faculty develop careers as outstanding teacher-scholars and achieve independent research funding in the biomedical, behavioral or clinical sciences.

The school also made significant investments in supporting interdisciplinary research and promoting research seed funding.

“UC Davis School of Medicine has vastly expanded its pilot award programs to support early career researchers and interdisciplinary collaborations among our internationally recognized research community," said School of Medicine Dean Susan Murin. "Over the last five years, we've launched new initiatives fostering innovative research, offering seed funding programs, collaborations with the VA Northern California Health Care System, symposia support, bridge funding and many others." 

UC Davis extramural funding

Research investments allowed UC Davis to produce a wide range of scientific breakthroughs to improve health, enhance food supplies, protect the environment and empower a more resilient society. For example, last year, UC Davis researchers submitted 201 invention disclosures.

“UC Davis researchers continue to attract substantial investments based on deep expertise, unique collaborations and a long history of delivering impactful insight and solutions,” said Simon J. Atkinson, vice chancellor for research at UC Davis. “Despite significant funding uncertainty and regulatory change, our faculty and staff have drawn on their passion and ingenuity to keep their important — often life-changing — work moving forward.” 

Learn more about how public investment in UC Davis research powers innovation, strengthens the economy and advances human health in From Labs to Lives.  A detailed breakdown of the funding sources can be viewed in 2026 Annual Research Impact Report.

Discover more School of Medicine research stories.

The new findings come from one of the largest studies to examine the impact of donor smoking on kidney transplant outcomes.

The study, published this month in Kidney360, analyzed data from 88,490 living donor kidney transplant recipients in the United States. The recipients underwent transplantation between 2004 and 2022 and are part of the Organ Procurement and Transplantation Network database.

Researchers found that recipients of kidneys from donors with any history of smoking experienced a 13% higher risk of all-cause graft loss compared with recipients of kidneys from donors who never smoked. Also, donor smoking history was associated with an 18% increase in the odds of acute rejection during the first year after transplant.

The greatest risks were observed among donors with more than 20 pack-years of smoking exposure. A pack-year is the equivalent of smoking one pack of cigarettes a day for one year.

Compared with recipients of kidneys from never-smokers, recipients of these organs from heavy users faced a:

• 29% higher risk of graft loss
• 24% higher risk of delayed graft function
• 32% higher risk of acute rejection

“Our findings suggest that smoking history, particularly heavy smoking exposure, should be considered during living donor evaluation and counseling,” said UC Davis pediatric nephrologist Machi Kaneko McBee, the lead author of the study. “At the same time, living donor transplantation remains a highly beneficial treatment option and smoking history alone should not automatically disqualify an otherwise suitable donor.”

The study also found that kidneys from former smokers performed better than those from active smokers. This suggests that smoking cessation prior to donation may help reduce transplant risks. However, the duration of smoking abstinence did not significantly alter long-term graft survival outcomes.

Study co-authors are Daniel Tancredi and Lavjay Butani of UC Davis Health.

Read the study.

But her daughter who lives in a nearby neighborhood isn’t quite as carefree when it comes to her mom’s well-being: Patty Soulsby often worries about whether her mother is keeping up with her medication.

“Mom’s pretty good about taking her morning pills, but sometimes she won’t take them until 2 p.m. or not at all. The evening pills are the harder ones to remember to take,” Soulsby said. “She forgets, then she says she doesn’t feel good, it’s a vicious circle.”

Blake recognizes her memory is not what it once was, but she is convinced she has it under control.

“Ask me what I did yesterday and I couldn't tell you,” Blake said. “But I feel I still have the mental capacity, I'm comfortable in my home and I feel I can keep on living here.”

Researchers estimate that 4.3 million older Americans live alone and have memory and thinking problems, representing about a quarter of older adults with dementia or mild cognitive impairment. Researchers worry that these challenges can lead to a heightened risk of medication errors, which has been shown to increase the odds of being hospitalized by 71%.

For families like the Soulsbys, the constant uncertainty often revolves around a single question: Did Mom take her medication?

A new UC Davis Health clinical trial is testing whether leading-edge technology can provide the answers — and peace of mind.

Addressing one of dementia care's biggest challenges

Neuropsychologists Alyssa Weakley and Sarah Tomaszewski Farias want to learn whether an AI-assisted, home-based medication device can help people with mild cognitive impairment and dementia take their prescription drugs while reassuring caregivers that the medications were actually taken.

The study is funded by a $2.48 million grant from the National Institute on Aging (NIA) Phase II Small Business Innovation Research (SBIR) program.

Medication management is one of the most common challenges facing older adults with cognitive impairment. A national study found that more than 13% of older adults with dementia had difficulty managing medications. 

Technology that goes beyond reminders

The device used in the study is roughly 17 inches high, sits on a countertop and fits easily beneath standard kitchen cabinets. It contains a 90-day supply of as many as seven different medications.

Created by HiDO Health, it goes beyond simple reminders or electronic pillboxes. It is designed to give the right medication at the right time, confirm who is taking it and record that it was taken, all while keeping approved caregivers informed.

Many low-tech medication tools already help people organize pills or remember when it's time to take them. Some sound alarms. Others, like the plastic pillbox Blake uses, only tell caregivers that medication has been removed.

But those systems may leave one critical question unanswered: Did the person actually take the medication?

The HiDO device is designed to close that gap.

“I feel like this is the biggest miss in health care. It's the last mile of care,” said HiDO CEO Charles Gellman. “We don't know how many medication errors are happening in the home because no one's monitoring anything.”

By giving approved caregivers a way to check medication use remotely, the system may reduce reminder calls, pillbox checks and worry about missed doses, while helping older adults remain independent.

For caregivers like Soulsby, who may live miles away, that information could reduce the daily uncertainty that often accompanies supporting a loved one with memory loss.

"If we can have a medication device deliver that medication and, as a caregiver, know it was taken at the right time, that's huge," Weakley said.

Why researchers want evidence, not marketing claims

The UC Davis trial will enroll 50 people with mild cognitive impairment, a condition associated with early changes in memory and thinking that can make some everyday tasks harder, to moderate dementia, which is when memory and thinking problems interfere with daily life and require more help from others.

Half will use the HiDO device along with training and support. The other half will continue their usual medication routine.

Researchers will follow participants for one year, measuring medication adherence, cognition and daily functioning. They will also collect blood samples to monitor health indicators for conditions treated with their medications such as cholesterol and glucose levels.

A UC Davis Health pharmacy team will carefully review the participants’ medications as a safety measure before they begin the study.

Rigorous testing is essential because consumers are increasingly being asked to trust technology without clear evidence that it works, said Tomaszewski Farias.

"There are a lot of devices out there to support lots of aspects of daily function or promote better cognition, but many are sold to the public with no evidence that they actually work," she added.

Peer-reviewed research shows early evidence that HiDO is practical, accurate and easy to use for people living with dementia and their caregivers. This study will help researchers determine not only whether the device helps people take medications as prescribed, but also which patients benefit most and how caregivers can be supported to use it most effectively.

Can the technology deliver?

For HiDO’s Gellman, the study is about more than evaluating a single device. It is an opportunity to generate rigorous evidence about whether technology can help people with cognitive impairment manage medications and remain independent longer.

"I think a lot of people are definitely very skeptical of whether or not this actually works," Gellman said. "So, it'll be a very, very good, strong data source."

Gellman said the UC Davis team is uniquely positioned to evaluate whether the technology can make a measurable difference in the daily lives of people with cognitive impairment.

"Together, this research has the potential of demonstrating that these folks can actually use it over a long period of time," he said.

Helping older adults stay independent longer

Weakley is excited about the study because her research focuses on people with cognitive impairment who live alone, and whose family members try to support them from a distance.

“This could help people with cognitive impairment remain more functional and even stay in their homes longer potentially,” Tomaszewski Farias added.

For Soulsby, the hope is simple: She wants her mother to continue living where she feels most comfortable without constantly wondering whether she's taking her medication.

“Right now, I have to go over there at least once a week to fill her pill case, and that's really the only way I know whether she's taking her medication," Soulsby explained. "If I could know she was taking it without constantly checking, that would be a huge relief."

For the millions of families helping older adults navigate memory loss, the study may help answer an increasingly urgent question: Can technology provide enough support to preserve both independence and peace of mind?

From Labs to Lives

This work was supported by federal research funding, which helps transform promising discoveries into real-world breakthroughs that save lives and improve quality of life. 

Learn more about how public investment in UC Davis research powers innovation, strengthens the economy and advances human health in From Labs to Lives.

For decades, health experts would gain insight into the disease only after a person died, when they could study the brain tissue and make a definite diagnosis.

Today, biomarker tests, including amyloid PET scans, can detect hallmark amyloid plaques in living patients and help guide diagnosis and care.

But the scientific progress has created a new question: What happens when patients and families receive that potentially life-altering information about what is happening in their brains?

Jennifer Lingler, associate dean for research at the Betty Irene Moore School of Nursing at UC Davis, has spent years seeking answers.

“We need to understand what this means in the real world,” Lingler said. “We still don’t know how this information affects your everyday patient and family.”

To better understand, mitigate and prevent the health impacts of wildfire smoke exposure, a team of investigators from UC Davis launched a multidisciplinary program. It’s called WE-CAIR (Wildfire Exposure: Cardiovascular and Airway Inflammation Research).

The initiative is supported by a five-year Program Project Grant (P01) from the National Heart, Lung, and Blood Institute of the National Institutes of Health. The award is expected to total $14.05 million.

“Wildfire smoke is becoming a recurring environmental health threat for millions of people,” said Angela Haczku, director of the UC Davis Lung Center and contact program director of the WE-CAIR study. “We want to understand why some individuals are more susceptible than others and what mechanisms are responsible for health decline after long-term exposure. Ultimately, we hope to identify biomarkers of risk and biological pathways that could lead to better prevention strategies and new treatments.”

Comprehensive research and systems level integration

Wildfire smoke exposure acutely worsens cardiovascular and pulmonary disease but the long-term health effects are poorly understood. 

The WE-CAIR team designed four closely integrated projects supported by bioinformatics, epigenetics, clinical and mouse exposure-simulator cores to investigate how immune and epigenetic pathways psychosocial stress and social vulnerability drive health decline over time. 

• Project 1: Focuses on a novel subgroup of immune cells (group 2 innate lymphoid cells, ILC2s) that were shown by the Haczku Lab to abnormally produce the highly inflammatory cytokines IL-13 and IL-17 when triggered by wildfire smoke. 
• Project 2: Led by Christoph Vogel, studies the role of the environmental sensor aryl hydrocarbon receptor (AhR) in mediating wildfire smoke-induced cardiovascular inflammation. 
• Project 3: Led by Hong Ji, investigates how the epigenetic regulator TET1 may protect against airway and cardiovascular inflammation.
• Project 4: Under the leadership of Clare Cannon and Jill Silverman, explores how psychosocial stress and social vulnerability influence the health effects of wildfire smoke exposure.

The program will combine a human clinical studies core (led by Amir Zeki and Barton Wise) with controlled wildfire smoke exposure models core (developed by Keith Bein), and molecular and epigenetic core (directed by Janine LaSalle). All collected data will undergo systems-level data integration (led by Miriam Nuño). 

OSA can disrupt sleep, affect daytime functioning and lead to long-term health complications. While CPAP can be highly effective, adherence among pediatric patients has historically remained below 50% nationwide.

The clinic was launched at UC Davis Health in January 2024 to provide individualized support, identify barriers to treatment and help families build sustainable habits around CPAP use. Rather than focusing solely on equipment, the clinic works closely with pediatric patients and caregivers to troubleshoot issues such as mask fit, pressure settings, sensory sensitivities, irregular sleep schedules and family dynamics that can affect treatment success.

More than two years after opening, the clinic has brought new insights to what helps children succeed with CPAP.

 “The biggest lesson we’ve learned is that CPAP use is truly a family affair,” said Audrey Chikalla, a respiratory therapist who spearheaded the clinic. “Success depends not only on the child, but also on caregiver engagement, education and support. When families understand what to expect and how to navigate barriers, children are much more likely to succeed.”

The clinic has also been the subject of a research study by Chikalla and UC Davis Health pediatric pulmonologists Kiran Nandalike and Ambika Chidambaram.

During the clinic’s first year, the researchers evaluated 58 pediatric patients receiving CPAP therapy. The study found that half of the patients met adherence goals, which were defined as using CPAP for more than four hours per night on at least 70% of nights. In addition, children who adhered to CPAP therapy tended to have more frequent respiratory therapist visits than those who did not, reinforcing the value of ongoing follow-up and personalized coaching.

Helping children with neurodevelopmental and genetic conditions

The clinic expanded in 2025 to focus on children with neurodevelopmental and genetic conditions, including autism, Trisomy 21 and other chromosome abnormalities. Clinicians wanted to better understand whether the support model could help children who often face additional challenges with medical devices and treatment routines.

More than half of neurodiverse patients achieved CPAP compliance. The study revealed that these patients often benefited from more intensive follow-up. On average, neurodiverse children required more than twice as many respiratory therapist visits as neurotypical patients to achieve adherence, highlighting the importance of specialized support.

“One of our most exciting discoveries is that neurodiverse children can be incredibly successful with CPAP therapy when they receive the right support,” said Nandalike, chief of the UC Davis Division of Pediatric Pulmonology and Sleep Medicine. “Overcoming sensory barriers can take time, patience and persistence, but many families achieve remarkable results.”

The team plans to continue refining the clinic by developing standardized CPAP implementation and desensitization programs, offering group visits for patients and families and collaborating with pediatric endocrinology specialists who care for adolescents with obesity and OSA. 

In a study published in Proceedings of the National Academy of Sciences, the researchers whittled away at LSD’s core multi-ring structure and synthesized new, simplified versions of it to probe its functionality. The researchers successfully developed several compounds with reduced hallucinogenic and cardiotoxic effects while also identifying one compound that produced antipsychotic-like effects.

“By systematically deconstructing LSD, we have identified simplified cores that are better starting points for medicinal chemistry efforts,” said study corresponding author David E. Olson, director of the Institute for Psychedelics and Neurotherapeutics and a professor of chemistry, and biochemistry and molecular medicine at UC Davis.

LSD is among the many psychedelic drugs that researchers are investigating due to its ability to spur growth of neurons and strengthen connections between them. A host of neuropsychiatric and neurodegenerative diseases are characterized by these connections withering.

“We’ve known the structure of LSD for a long time, but the complexity of its core has really limited our ability to engineer optimized drugs based on its structure,” said Olson. “If you can only modify a couple of spots, you’re limited in what you can do.” 

The study provides the psychedelic science research community with new launchpads for drug discovery. 

A team of researchers has now developed a framework to help healthcare organizations better measure and improve their environmental performance. Their findings were published in The Lancet: Planetary Health.

“Hospitals need to track their environmental impact,” said corresponding author Patrick Romano. “Our team is advocating for the inclusion of environmental sustainability measures in healthcare quality reporting.”

Romano is a professor of internal medicine and pediatrics at UC Davis Health and is affiliated with the Center for Healthcare Policy and Research.

The researchers emphasize that measuring and reporting the environmental impacts of hospital operations is essential for making meaningful progress. Consistent tracking can help hospitals identify priorities, evaluate improvements and integrate sustainability into routine decision-making.

Sustainability efforts remain fragmented

Although many healthcare organizations have pledged to reduce their environmental footprint, progress has been uneven. One challenge is the lack of standardized methods for measuring and tracking sustainability, which makes it difficult to compare performance and identify areas for improvement.

“A standard set of measures could help healthcare organizations reduce their environmental footprint and make sustainability a core part of their quality mission,” Romano said.

Evaluating key sustainability measures

The team evaluated environmental measures commonly used in healthcare. They grouped the most frequently reported measures into five categories:

• Greenhouse gas emissions
• Water use
• Energy use
• Travel
• Solid waste

Their analysis showed that all six measures were important, but some had limitations. For example, tracking travel by patients and staff, as well as calculating greenhouse gas emissions across supply chains, can be challenging because reliable data are often unavailable.

Recommended reporting standards

Based on their findings, the authors proposed a minimum set of sustainability measures for hospitals. They recommended three metrics:

• Greenhouse gas emissions from direct operations and purchased energy
• Water consumption
• Solid waste production

They also recommended adjusting the data based on patient activity so hospitals of different sizes can be compared fairly.

Sustainability as part of healthcare quality

The researchers argued that sustainability should be treated as an essential part of healthcare quality, similar to patient safety.

“Measuring and reporting patient safety has helped drive major improvements in care over the past two decades,” Romano said. “A similar approach could help healthcare organizations reduce their environmental impact while improving the health of communities and the planet.”

The authors believe the framework could help quality and accreditation organizations incorporate sustainability into existing healthcare performance standards.

The study is led by the University of Wisconsin School of Medicine and Public Health. It examines environmental factors such as poverty, education, housing, employment and toxins — also known as the social exposome — and their link to Alzheimer’s disease and related dementias (ADRD). It is the largest in the world to connect the social exposome with brain tissues and their disease biomarkers. 

The Neighborhoods Study will assess lead-contaminated infrastructure exposure, job-related toxin exposures and heavy metals in brain tissue to better understand what makes certain populations more vulnerable to ADRD. 

The study is expected to lead to ADRD prevention measures that are precisely tailored to populations at highest risk based on exposures. Its work focuses on risk mitigation and new interventions in ADRD, advancing knowledge of the relationship between exposome and dementia to improve health for all. 

About The Neighborhoods Study

The Neighborhoods Study was started in 2021. It has supported the development of the Area Deprivation Index (ADI), a powerful tool used by the University of Wisconsin’s Center for Health Disparities Research to develop thousands of health interventions and policies. 

ADI aimed at achieving better health outcomes for people living in rural and urban neighborhoods with greatest need. It has demonstrated an association between neighborhood disadvantage increased odds of neurodegeneration, ADRD biomarkers and post-mortem ADRD neuropathology. It has also linked residency in high ADI neighborhoods across one’s lifetime with increased risk of neurodegeneration and brain disease.

“We have known for some time the genetic and biological factors that contribute to ADRD, but growing evidence suggests that community and neighborhood-level factors may also influence ADRD risk,” said Oanh Meyer, professor of neurology and Neighborhoods Study site principal investigator for UC Davis Health. “These factors are potentially modifiable, and thus important targets for prevention and intervention.”

Meyer is research faculty with the Alzheimer’s Disease Research Center and leads Vietnamese Insights into Cognitive Aging Program, or VIP. 

“UC Davis is pleased to be one of the sites participating in this incredibly important research program,” said co-director of the Alzheimer’s Disease Research Center and epidemiologist Rachel Whitmer. “The Neighborhoods Study leverages numerous Alzheimer’s research centers. By combining data from the different sites, we could uniquely achieve the statistical power to determine how factors related to people’s context and life experiences contribute to biological indicators of both dementia and healthy brain aging.”

Whitmer is the co-investigator at the UC Davis site. She is professor of public health sciences and neurology and chief of epidemiology at UC Davis Health.

The Neighborhoods Study is the largest of its kind linking brain tissue to life-long exposures to more fully examine the precise mechanisms by which the social exposome impacts ADRD risk and outcomes.

The trial is evaluating the investigational CARLEN System, a transcatheter device designed to support the heart’s natural mitral valve without permanently altering its structure. Unlike other transcatheter mitral valve repair procedures, this device aims to preserve the valve’s anatomy while improving function.

UC Davis Medical Center is the only hospital in Northern California participating in the trial and currently offering eligible patients access to this investigational treatment option. 

“We are honored to be the first U.S. hospital participating in this clinical trial and to play a role in advancing this innovative treatment option for patients,” said Gagan Singh, director of the Structural Heart Program at UC Davis Health. “Making this possible for our patient took a large team working behind the scenes for months.”

“I learned how to work with mice and do a bunch of experiments, and I really liked it,” Clarke said of her undergraduate experience at UC Davis.

After graduating with a degree in neurobiology, physiology and behavior, she took a job conducting research at UCSF, and four years later got into the UC Davis School of Medicine. She’s now in the ARC-MD pathway program, short for Academic Research Careers for Medical Doctors. Clarke, who recently completed her third year of medical school, has been named the 2026 recipient of the Daniel T. O’Connor, M.D. Memorial Research Grant (DTOC).

The prestigious grant, named for a 1974 alumnus, is given annually to a research-minded medical student who embodies O’Connor’s values: High-quality research in translational medicine, through a multi-disciplinary, highly collaborative, “bench to bedside” approach. After graduating from the UC Davis School of Medicine, O’Connor became a distinguished professor of medicine and pharmacology at UC San Diego. He was internationally known and published more than 400 journal articles before his death in 2014.

His widow Kellie Evans-O’Connor helps administer the DTOC award. The grant provides a stipend and health insurance for an academic year.

An ‘exceptional student’ with a promising future

“Maria is an exceptional student physician-scientist whose accomplishments, professionalism, drive and clear vision for a career in translational research distinguish her from her peers,” said Jennifer Rosenthal, the UC Davis School of Medicine’s executive director of research, training and development.

The award seemed perfectly timed for Clarke.

Medical students who aspire to be physician-scientists usually step aside from the classroom and conduct unpaid research for at least a year. Clarke was about to complete her third year of medical school and anxious about entering a research year she couldn’t afford.

Researchers at UC Davis Health and Kaiser Permanente have helped fill this knowledge gap by tracking a large group of 90+ year-olds since 2018 — the LifeAfter90 study. Their most recent findings, which were published in The Lancet Healthy Longevity, delineate dementia risk disparities between genders and racial and ethnic groups. The study also revealed how older brains respond to genetic variables.

“We know from other studies, done in people 65 and older, that there are differences in dementia rates, and women tend to have higher risk, but nobody knew if that was true after 90,” said Rachel Whitmer, UC Davis Health professor of public health sciences and neurology, chief of epidemiology and senior author on the study. “We need to understand who is most affected by dementia after 90 and how the main Alzheimer's risk gene (APOE) factors in.”

LifeAfter90

LifeAfter90 participants are Kaiser Permanente members, 90 or older, who enrolled before they had any signs of dementia. Led by Whitmer, researchers have closely followed these patients, examining them every six months to track their cognitive health.

Because participants are long-term Kaiser Permanente members, the LifeAfter90 team has access to decades of health information, in some cases dating back to the 1960s. The Lancet study examined medical records from over 800 participants, median age 92. This is the first effort to investigate dementia after 90 in a highly diverse cohort.

The researchers found that, like their younger counterparts, women 90 and older are at higher risk for dementia — two-fold greater than men. There were also racial and ethnic risk disparities, similar to those of younger groups. Black participants had a 75% greater risk than Asian participants.

“It is striking that the racial and ethnic disparities in dementia risk observed in younger adults continue into the tenth decade of life,” said Hilary Colbeth, a UC Davis postdoctoral scholar in public health sciences and first author on the paper. “Specifically, Black and Hispanic participants had significantly higher dementia incidence rates than white and Asian participants.”

Researchers examined how four lifestyle factors — sleep quality, screen time, physical activity and diet — influenced the relationship between mental health symptoms and academic and social functioning in children ages 10 to 13. They found that sleep was the strongest factor associated with better grades and fewer social problems. Screen time was the second strongest factor.

"This finding surprised us," said Jason Smucny, the study's first author and a computational neuroscientist in the Department of Psychiatry and Behavioral Sciences. "We expected sleep to be important, but we didn't expect it to stand out so clearly above other lifestyle factors, particularly screen time.”

The biotherapeutic metabolite, 10-hydroxystearic acid (10-HSA), is produced by the beneficial gut bacterium Lactiplantibacillus plantarum. L. plantarum is a common lactic acid bacterium found in many over-the-counter probiotics and fermented foods. It also occurs naturally in the human gut.

The findings were published in Nature Microbiology.

"Current HIV therapies are remarkably effective at controlling viral replication, but they do not fully repair the profound damage HIV causes in the gut," said Satya Dandekar, senior author of the study and a distinguished professor in the Department of Medical Microbiology and Immunology at UC Davis Health. "Our findings suggest that restoring the gut's structural and immune health can enhance antiretroviral treatment and opens an entirely new avenue for achieving more durable control of HIV.”

HIV and the late stage of the infection, AIDS, remain major global public health issues. In 2025, an estimated 40.9 million people were living with HIV, and approximately 1.2 million people acquired new HIV infections. In 2025, around 570,000 people died from AIDS-related illnesses worldwide.

HIV damages gut immune system

Gut-associated lymphoid tissue, the body’s largest immune tissue and key regulator of the body's immune system, is an early target of HIV. The virus severely damages the immune and epithelial cells in the gut’s lining. This damage leads to an inflamed, leaky gut, a weakened defense system and decreased nutrient absorption. The virus also disrupts mitochondrial function (mitochondria are organelles that generate energy within the cells). 

Even with strict adherence to ART, many people living with HIV have persistent gut inflammation caused by the virus. Previous research from Dandekar’s lab showed L. plantarum could quickly heal the chronically inflamed leaky gut associated with HIV.

For this study, the researchers identified metabolites produced by L. plantarum in the virally inflamed gut environment in the non-human primate model of HIV/AIDS. Among the hundreds of molecules created by L. plantarum, one metabolite, 10-HSA, emerged as the strongest candidate for repairing the gut barrier and reducing inflammation.

Using X-ray crystallography to visualize 10-HSA interactions at the atomic level, researchers demonstrated that 10-HSA directly binds to PPAR-alpha, a nuclear receptor that regulates key biological processes.

This binding promoted histone crotonylation, an epigenetic modification that helps regulate gene activity. The resulting cascade of cellular events reprogrammed gene expression to restore mitochondrial function and energy metabolism while supporting repair of the gut lining.

Researchers also found that 10-HSA increased mitochondrial respiration of gut epithelial cells during HIV inflammatory conditions, boosting energy-generating capacity and reducing harmful reactive oxygen species.

Testing the approach in nonhuman primates

To determine whether the benefits of 10-HSA translate to living organisms, the team conducted two independent studies at the UC Davis National Biomedical Research Institute in non-human primates infected with simian immunodeficiency virus (SIV), a close relative of HIV.

• The first study evaluated 10-HSA alone without ART. This led to intestinal repair, improved key markers of gut function, improved mitochondrial health, reduced inflammatory signaling and partially restored the gut microbiota.

• The second study evaluated 10-HSA in combination with ART. Significantly, the combined treatment showed faster clearance of viral burden than ART alone. The combination also promoted faster recovery of gut immune cells, reduced immune activation, restored epithelial barrier integrity and restored beneficial gut microbiota and microbial diversity.

“The findings suggest repairing the tissue damage caused by HIV may be as important as suppressing the virus itself with antiretroviral therapy,” said Dylan Kramer, first author of the study and recent Ph.D. graduate from the Dandekar Lab. “By rebuilding the gut barrier, restoring mitochondrial function and reducing inflammation, 10-HSA helps create conditions that support stronger immune recovery and more effective antiviral therapy for HIV.”

The authors caution that the results are from preclinical models. The studies showed no adverse effects. The research supports testing the safety and effectiveness of 10-HSA in humans.

"Our research shows that host health, microbial health and viral control are deeply interconnected," Dandekar said. She noted that treating the damaged gut ecosystem facilitates recovery of the immune system, leading to regained functions that have been lost during HIV infection. Additionally, treating the damaged gut during HIV infection can improve outcomes beyond what antiviral drugs can achieve alone.

“The restoration of gut barrier integrity and microbial balance through 10-HSA supplementation may represent a promising therapeutic strategy, with implications that extend beyond HIV to other chronic inflammatory diseases of the gastrointestinal tract,” Dandekar said.

A full list of authors appears in the journal article.

This research was supported by funding from the National Institutes of Health (U42OD010990, AI123105, R37 AI 153025, T32 AI060555, P51 OD011107, R01 ES036174) and the UC Davis School of Medicine.

The University of California has filed a patent application related to therapeutic treatment strategies involving 10-HSA.

Resources

Read the study in Nature Microbiology

Mapping the pathway to gut health in HIV and SIV infections

The study, published in The Lancet, found that patients who received deramiocel experienced significantly slower disease progression compared with those receiving a placebo, demonstrating benefits across multiple measures of muscle and cardiac function.

Duchenne muscular dystrophy affects approximately 1 in 3,500 to 5,000 boys worldwide and progressively weakens skeletal, respiratory and cardiac muscles. While advances in care have improved survival, there remains a critical need for therapies to address multiple aspects of the disease, particularly in non-ambulatory patients with advanced disease.

In the HOPE-3 study, 106 participants with advanced DMD were randomized to receive quarterly infusions of deramiocel or placebo over 12 months. Patients treated with deramiocel showed significantly less decline in upper limb function, a critical measure of independence that affects activities such as feeding, grooming and using technology. The treatment also demonstrated advantages on measures of cardiac function and disease-related heart scarring, two major causes of illness and premature death in DMD.

“What makes these findings especially meaningful is that deramiocel demonstrated effects across multiple systems impacted by Duchenne muscular dystrophy,” said Craig McDonald, chair of the Department of Physical Medicine and Rehabilitation at UC Davis Health and lead study investigator. “Preserving arm and hand function is critically important for maintaining independence and quality of life in people living with Duchenne. At the same time, protecting heart function is essential for long-term health. Seeing evidence of the benefit in both areas is a game changer and represents a potentially important advance for patients and families.”

A different approach to treating Duchenne

Unlike therapies that target a specific genetic mutation, deramiocel is designed to address disease processes common to many people with DMD — including inflammation and fibrosis, or scarring — that progressively damages muscles and the heart.

The therapy consists of cardiosphere-derived cells, which are obtained from donated human heart tissue and act through biological signaling mechanisms that help reduce fibrosis and modulate harmful inflammation.

The oral medication was approved by the U.S. Food and Drug Administration in 2024 to treat anemia caused by chronic kidney disease in adults. The drug is currently approved for once-daily use.

The new trial evaluated the safety of administering it three times a week rather than daily, aligning treatment with a typical patient’s dialysis clinic visits.

“Offering patients a treatment that aligns with their regularly scheduled dialysis sessions ensures adherence and reduces the burden of managing yet another medication at home,” said Shuchi Anand, a kidney specialist and professor in the Department of Internal Medicine at UC Davis Health.

Anand served on the executive steering committee for the clinical trial, helping to design the study, oversee its implementation and evaluate its outcomes.

Need for new treatment options

Many patients on dialysis develop anemia because damaged kidneys produce less erythropoietin (EPO), the hormone that stimulates red blood cell production. Frequent blood draws and iron loss during dialysis sessions can further lower blood counts. 

Treatment typically includes iron supplementation, EPO-stimulating injections and, more recently, oral medications to help reduce fatigue and prevent complications associated with low red blood cell levels.

“The goal of this trial was to broaden the range of treatment options available to patients,” said Anand. “We haven't seen a new anemia therapy for people on dialysis in more than two decades. That makes it especially important to develop safe and effective alternatives.”

The UC Davis-led study of more than 500 older Vietnamese Americans captured the scope of war, displacement and immigration trauma that occurred in the late 1970’s and early 1980’s. The findings suggest resilience may help soften the long-term mental health effects of war-related trauma, offering insight that could inform healthier aging strategies for other trauma-exposed communities.

Now, new research further examines how the trauma, resilience and other life experiences interact to affect brain health and aging.

“We know that adversity and hardship are a part of life, and this is especially true for Vietnamese Americans who have faced war,” said Oanh Meyer, senior author and leader of a pioneering Vietnamese American cognitive aging study. “We want to know how these experiences affect later life cognitive and mental health.”

Meyer is part of UC Davis Health’sDepartment of Neurology and research faculty with the Alzheimer’s Disease Research Center. She also leads the landmark study, known as Vietnamese Insights into Cognitive Aging Program, or VIP. Funded by the National Institute on Aging, the effort examines how life experiences, resilience and cultural factors shape cognitive aging and dementia risk.

The new study is titled, “Aging and resilience in Vietnamese American older adults: Evidence from the Vietnamese Insights into Cognitive Aging Program.” Researchers examined whether resilience may help protect mental health later in life among older Vietnamese Americans who experienced early adversity and war-related trauma.

“If we can understand what contributes to resilience or protects against depression in later life, this could have implications for brain health,” Meyer explained.

The findings may have broader implications for aging research. As dementia rates rise, scientists are looking beyond genetics to understand how experiences across the lifespan — from education and stress to trauma, social support and mental health — influence cognitive aging.

When resilience becomes protective

In interviews for the earlier study, participants described fleeing danger, enduring hunger, living through imprisonment and being separated from loved ones. Yet alongside those memories, many spoke about faith, family, gratitude and the ability to adapt.

The newer, 2026 study, published in International Psychogeriatrics, analyzed data from 511 Vietnamese American adults aged 65 and older who are part of VIP. Researchers examined depression symptoms, stress and global cognition, a measure of overall thinking and memory.

The study, “Aesthetic Surgery Complications in Private Practice Settings: Insights to Optimize Patient Access and Outcomes,” examined patients who visited UC Davis Medical Center between 2020 and 2023 with complications following cosmetic procedures performed at other facilities. Researchers evaluated patient demographics, complication patterns, healthcare utilization and the financial impact on patients, insurers and healthcare systems.

Among the study's key findings:

• Patients with reported complications were disproportionately Black, Hispanic and Medicaid-insured compared with the overall emergency department population.
• Nearly half of procedures had been performed outside traditional United States surgical settings, most commonly in Mexico and the Dominican Republic.
• Tobacco and cannabis use were associated with significantly higher rates of infection and a greater likelihood of requiring additional intervention.
• Complications generated substantial healthcare costs for government sponsored insurance programs. The median hospital charge for patients being treated for the complications exceeded $43,000 per person and surpassed $125,000 among those who ultimately required a new surgery.

These findings highlight the often-overlooked downstream costs associated with aesthetic surgery complications and the burden they place on patients, healthcare systems and public payors.

The study noted that patients with lower incomes may be more likely to seek low-cost procedures without adequate consideration of surgeon qualifications, facility accreditation, or complication risks.

“As demand for aesthetic surgery continues to grow, ensuring that patients have access to safe, high-quality care is increasingly important,” said co-author Scott Levin, chief resident in Plastic and Reconstructive Surgery at UC Davis Health. “Our findings suggest that complications from cosmetic procedures disproportionately affect vulnerable patient populations, creating challenges not only for patients themselves but also for the healthcare systems that care for them. Improving access to safe aesthetic care is ultimately both a patient safety and health equity priority.”

Lead author Nina Yu noted that the findings underscore the importance of understanding the social and economic factors that influence patient decision-making and postoperative outcomes.

“Our study highlights that complications from aesthetic surgery extend beyond the operating room,” Yu said. “Improving patient education, optimizing preoperative risk assessment and expanding access to qualified providers may help reduce preventable complications and improve outcomes for patients.”

The researchers conclude that interventions focused on patient education, risk stratification, access to qualified surgeons and health equity may help reduce complications while alleviating financial burdens on patients and healthcare systems alike.

Granger B. Wong, chief of the Division of Plastic and Reconstructive Surgery at UC Davis Health was also a co-author of the study.