This project situates contemporary childbirth practices within the historical context of increasing medicalization throughout the 20th century which significantly improved maternal and infant mortality outcomes while also increasing access to pharmacological pain management. However, these advancements have been associated with increasing healthcare costs and rates of intervention, often at the expense of patient-centered care. In response, there has been a resurgence of doulas and midwives, who provide non-medical support through techniques such as guided breathing, non-pharmacological pain management, and continuous emotional care. Social platforms and AI tools frequently present idealized versions of both medicated and unmedicated births which can contribute to misinformed expectations. To address this gap, this project draws on qualitative data from a diverse set of perspectives, including individuals who have experienced home and hospital births, doulas, perinatal health workers, and an obstetrician-gynecologist to analyze a range of socioeconomic and clinical contexts. Our findings show that the midwifery model of care offers a clinically safe, cost-effective alternative that increases patient autonomy and significantly reduces disparities in both pain experience and financial burden during childbirth. All these components not only relieve the burden on insurers, such as Kaiser Permanente and the Medicaid system, but specifically benefit those who have historically been marginalized within hospital systems.

The social environment in which a child grows up can be extremely influential to their mental health. Rural areas are often associated with limited access to healthcare and higher exposure to risk factors associated with poorer health, while urban areas have more access to healthcare and are often associated with higher rates of psychiatric, anxiety, and mood disorders. Previous studies have been inconclusive as to whether or not there is a difference between the prevalence of mental health disorders in urban and rural areas. This literature review aims to investigate the differences between mental health in urban and rural areas, as well as differences in access to healthcare in the two areas. Understanding the specifics of the differences will help in finding solutions specific to each region when trying to improve overall mental health. Data for assessing mental health were collected using self-reported surveys, questionnaires, and mortality data from the NIH HDPulse database. The results suggested no clear difference between mental health in rural and urban areas, as both have their own issues contributing to the high rates of mental health disorder. As this topic of research is further analyzed, it can potentially contribute towards raising awareness and finding solutions that are effective to the specific issues in each setting. Future research should focus on simultaneously addressing the specific conditions that shape the mental health issues in each setting separately since there are different circumstances in both.

Background: FBXO11 is implicated in regulating cell signaling pathways that influence inflammatory responses and skeletal tissue homeostasis. Because immune cells play key roles in bone remodeling and inflammation, changes in their distribution may reflect altered activity within skeletal microenvironments. Research Question: This project investigates differences in immune cell presence in murine bone tissues by comparing wild-type (WT) mice to conditional knockout (cKO) mice of FBXO11. Methods: To examine these differences, immunohistochemistry (IHC) was performed on bone tissue sections using antibodies targeting myeloperoxidase (MPO), CD68, CD8, and FOXP3 to identify neutrophils, macrophages, cytotoxic T cells, and regulatory T cells. Results/Conclusions: CD68 and MPO staining increased in FBXO11 conditional knockout specimens relative to wild-type controls, suggesting elevated macrophage and neutrophil presence in knockout bone microenvironments. In contrast, CD8 and FOXP3 staining showed no significant difference between WT and knockout samples. Together, these findings suggest FBXO11 may regulate innate immune activity within skeletal tissues while having a more limited effect on adaptive immune cell localization. These findings contribute to understanding immune–skeletal interactions and may inform investigations into inflammatory mechanisms underlying craniofacial bone remodeling and oral disease.

The United States (U.S) spends the most on healthcare globally, yet underperforms on health outcomes. In 2024, U.S. healthcare expenditures reached approximately 17.2% of GDP, far exceeding healthier peer nations. This indicates that healthcare performance may be driven more by system design than spending alone. This review presents a comparative, systems-level analysis of the U.S. healthcare system relative to three top‑performing peer systems—Taiwan, South Korea, and Australia—as ranked by the 2025 CEOWORLD Health Care Index. Using Organisation for Economic Co-operation and Development (OECD), World Health Organization (WHO), World Bank, and peer‑reviewed literature data, healthcare systems were evaluated using standardized, cross-country indicators across five domains: access and innovation, infrastructure, health outcomes, cost efficiency, and crisis response. Despite leadership in biomedical innovation, the U.S. underperformed across all other domains, demonstrating higher unmet healthcare needs, greater financial barriers, weaker preventive care, limited digital interoperability, and fragmented crisis coordination: adding up to poorer health outcomes. In contrast, peer systems achieved superior outcomes through nationally coordinated, accessible models and preventative care investment. Although cross-national variation limits direct comparability, findings suggest that U.S. underperformance is structural. Thus, future work ought to prioritize national coordination, prevention investment, and systemic integration.

Varicose veins are characterized by enlarged and twisted veins found in the lower body. They affect roughly 30 million adults in the United States and are associated with an increased risk for cardiovascular disease. Although there have been advances in therapies used to treat varicose veins such as endoscopic vein ablation, sclerotherapy, and surgery, there are currently no known restorative treatments for varicose veins. Varicose veins are caused by venous hypertension, venous valvular insufficiency, and structural changes in the venous wall. They are also known to disrupt the function of endothelial cells (ECs), smooth muscle cells (SMCs), the extracellular matrix, and microvasculature. The walls of varicose veins vary in thickness, including hypertrophic and atrophic segments, due to a lack of SMCs and connective tissue. The goal of this project is to examine how vascular ECs can have a positive impact in preventing varicose vein formation. We hypothesize that when the regulation of ECs is disrupted, there will be capillary growth in the vein which causes SMCs to either relocate or to concentrate in one area. Our data has shown that there is substantial change in the venous wall that is characterized by an increased concentration of SMCs in hypertrophic segments, leading to increased capillary growth and a thickened venous wall. Furthermore, these segments have intimal thickening and increased fibrosis which disrupts EC signaling through endothelial-mesenchymal transitions and extracellular matrix remodeling.

Background: Human Papillomavirus (HPV) is a sexually transmitted virus that has increased risk in communities where there are a large number of men who have sex with men (MSM). While some studies have investigated disparities between self-reported vaccination status in HPV versus public health records (Antonnson 2023), none have investigated high-risk communities like Los Angeles (LA). To address this, this study was designed to investigate the disparities in self-reported HPV vaccination status and public health records for MSM aged 18-45 in LA. Objectives: To examine and understand the discrepancies in the self-reported vaccination status of men in LA as compared to their public health records. Methods: Cross-sectional data from 750 men who have sex with men in LA were collected through an online Qualtrics survey from April 2025 to Jan/Feb 2026. Study participants were also asked to submit their digital vaccine records held in the California Immunization Registry (CAIR) through an online survey. For individuals who did not have or could not access their CAIR records, we accepted alternatives, such as immunization records from their doctor or clinic or list of immunizations recorded in their health app. Results: Of 751 total participants, 427 answered yes to being vaccinated. Of those 427, when cross-referenced with public health record data, 121 were actually not vaccinated. Significance: Documenting the vaccination status of MSM's in LA for HPV is imperative in providing care and education about HPV risk factors.