About

Dr. Megan Nguyen is an infectious diseases pharmacist, researcher, and educator at the University of California, Irvine. She holds a B.S. in Biological Sciences from UC Irvine and a Pharm.D. from Western University of Health Sciences. Her training includes a Pharmacy Practice Residency at the Veterans Administration Palo Alto Health Care System and an Infectious Diseases Specialty Residency at Huntington Memorial Hospital. Dr. Nguyen has been instrumental in establishing and implementing pharmacist-driven protocols and antimicrobial stewardship initiatives to optimize antimicrobial use through interprofessional collaborations. Her responsibilities extend into academic administration, focusing on evidence-based analytics to improve admissions processes and the development of the PharmD program, including recruitment, admissions, and student affairs policies. She has held various appointments, including Faculty in Residence at UC Irvine Medical Center and previous roles such as Assistant Dean of Enrollment Management and Director of Enrollment Management at Western University of Health Sciences. Her research interests encompass antimicrobial stewardship, infectious diseases pharmacotherapy, COVID-19, and clinical pharmacy. Dr. Nguyen has contributed to numerous publications and is actively involved in professional societies such as AACP, CSHP, IDSA, ASM, and the California Pharmacists Association.

Research topics

• Computer Science
• Sociology
• Medicine
• Nursing
• Knowledge management
• Family medicine

Selected publications

• Development and Validation of Minimal Disease Activity, Disease Flare, and Minimal Clinically Important Difference for Children with Chronic Nonbacterial Osteomyelitis Using a Consensus and Data-Driven Approach

  medRxiv · 2025-12-04

  articleOpen access

  Abstract Objectives To create definitions for minimal disease activity (MDA), flare, and minimal clinically important difference (MCID) for chronic nonbacterial osteomyelitis (CNO). It is necessary to establish these criteria prior to starting clinical effectiveness trials for therapies in CNO. Methods Three separate cohorts samples from an international observational CNO registry were presented to a panel of twenty experts in CNO, including 7 patients/caregivers via online and in-person voting using nominal group technique to define MDA, flare, and MCID, respectively. Experts classified the cases in each cohort as meeting the state for that specific cohort, ie. MDA or not, or flare or not, or meeting MCID or not. A consensus of ⩾80% was required. Results General surveys identified the most important variables to include to define MDA, flare, and MCID. Clinical improvement of 30% or more in these critical parameters and improvement of CNO Clinical Disease Activity Score (CDAS) by at least 3 were considered meaningful by providers and consensus data. Conclusions This study provides the preliminary definitions of MDA, disease flare, and MCID in CNO which can serve as targets and potential outcomes from treatments. These definitions must now be validated in other cohorts and tested in clinical trials. Key Messages WHAT IS ALREADY KNOWN ON THIS TOPIC Measurements of minimal disease activity (MDA), worsening disease activity (‘flare’), and minimally clinically important differences (MCID) in CNO are not well-established. For successful execution of clinical trials to identify effective treatment strategies in patients with CNO, standardized definitions of these terms are necessary. WHAT THIS STUDY ADDS Using data from an international real-world registry of CNO patients, we developed and validated quantitative definitions for MDA, flare, and MCID. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY Definitions of MDA, flare, and MCID will serve as potential outcomes in future clinical trials to study effectiveness of therapies in CNO.

  PublisherDOI

• Impact of Paralytic Agent Choice on Time to Post-Intubation Sedation in the Emergency Department

  Preprints.org · 2025-10-13

  preprintOpen access

  Background/Objectives: Rapid sequence intubation (RSI) involves nearly simultaneous administration of a rapid-acting induction agent and a neuromuscular blocking agent (NMBA) to facilitate ideal intubation conditions. The NMBAs most commonly used for RSI are succinylcholine and rocuronium, which cause paralysis for 5-15 minutes and 45-70 minutes, respectively. Awareness with paralysis can occur in patients given longer-acting NMBAs with delayed initiation of post-intubation sedation or insufficient sedation depth. Previous literature has associated the use of rocuronium with a significantly longer time to sedation and analgesia. However, a recent study found no difference. The purpose of this study was to assess the association between paralytic agent choice and time to initiation of analgesia and/or sedation after RSI in the emergency department (ED) of a large tertiary care hospital. Methods: This study was an institutional review board-approved, single center, retrospective cohort evaluation of adult patients (≥ 18 years of age) who received succinylcholine or rocuronium following administration of an induction agent in the ED for RSI during the study time period. The primary outcome was time to initiation of post-intubation analgesia and/or sedation. Continuous data was analyzed using Mann Whitney U or student’s T-test, and categorical data was analyzed using Chi Square test or Fisher’s Exact test. Results: A total of 400 patients were included in this study. The median time to sedation with succinylcholine was 9 minutes compared to 14 minutes with rocuronium (p<0.01). No significant differences were identified in baseline characteristics or secondary outcomes related to induction agent choice or ED length of stay. Conclusions: The results of this study further support that the use of rocuronium for RSI is associated with a significantly longer time to sedation and/or analgesia, making emergency medicine provider awareness essential towards minimizing the risks associated with inadequate post-intubation sedation.

  PublisherOA PDFDOI

• Signal Integrity Analysis of Parasitic Coupling between Through Silicon Vias and Metal Wires in High-Speed Server Systems

  2025-10-19

  article
  PublisherDOI

• Association Between Paralytic Agent Choice and Time to Post-Intubation Sedation in the Emergency Department

  Emergency Care and Medicine · 2025-12-31

  articleOpen access

  Background/Objectives: Rapid sequence intubation (RSI) involves nearly simultaneous administration of a rapid-acting induction agent and a neuromuscular blocking agent (NMBA) to facilitate ideal intubation conditions. The NMBAs most commonly used for RSI are succinylcholine and rocuronium, which cause paralysis for 5–15 min and 45–70 min, respectively. Awareness with paralysis can occur in patients who are given longer-acting NMBAs with delayed initiation of post-intubation sedation or insufficient sedation depth. The previous literature has associated the use of rocuronium with a significantly longer time to sedation and analgesia. However, a recent study found no difference. The purpose of this study was to assess the association between paralytic agent choice and time to initiation of analgesia and/or sedation after RSI in the emergency department (ED) of a large tertiary care hospital. Methods: This study was an institutional review board (IRB)-approved, single-center, retrospective cohort evaluation of adult patients (≥18 years of age) who received succinylcholine or rocuronium following administration of an induction agent in the ED for RSI during the study time period. The primary outcome was time to initiation of post-intubation analgesia and/or sedation. Continuous data were analyzed by using Mann–Whitney U or Student’s t-test, and categorical data were analyzed using the Chi Square test or Fisher’s Exact test. Results: A total of 400 patients were included in this study. The median time to sedation with succinylcholine was 9 min compared to 14 min with rocuronium (p < 0.01). No significant differences were identified in the baseline characteristics or secondary outcomes related to induction agent choice or ED length of stay. Conclusions: The results of this study further support that the use of rocuronium for RSI is associated with a significantly longer time to sedation and/or analgesia, making emergency medicine provider awareness essential for minimizing the risks associated with inadequate post-intubation sedation.

  PublisherOA PDFDOI

• Timely initiation of adjuvant therapy and survival in head and neck cancer: Post hoc analysis of the NDURE RCT.

  JCO Oncology Practice · 2025-10-01

  article1st authorCorresponding

  182 Background: Initiation of postoperative radiation therapy (PORT) ≤ 6 weeks of surgery for head and neck squamous cell carcinoma (HNSCC) is a component of National Comprehensive Cancer Network Guidelines and a Commission on Cancer quality metric. Despite the radiobiologic principle of accelerated repopulation, the association between starting guideline-adherent PORT and oncologic outcomes have been derived primarily from retrospective studies, leading to uncertainty about the metric’s oncologic importance. Within the setting of the NDURE RCT, we hypothesize that initiation of timely, guideline-adherent PORT is associated with improved recurrence-free survival (RFS) among patients with HNSCC. Methods: Adults with HNSCC planning to undergo surgery and PORT were randomly assigned 1:1 to a multilevel, enhanced navigation-based intervention (NDURE) or usual care (UC) patient navigation. In this post-hoc analysis, patients were grouped according to guideline-adherence for time from surgery to PORT (≤ 6 weeks vs > 6 weeks) regardless of allocation to NDURE or UC. The primary endpoint was recurrence free survival (RFS). Secondary endpoints included overall survival (OS) and locoregional (LR) failure. Landmark (LM; surgery + 6 weeks) multivariable Cox proportional hazards (CPH) regression analysis evaluated the association of timely PORT with RFS and OS adjusted for age, race, Charlson Deyo Comorbidity score, ECOG performance status, HPV status, and AJCC pathologic stage. Locoregional failure (LRF) was analyzed using a univariate Fine and Gray competing risk LM regression approach with death as a competing event. Results: There were 143 patients who underwent surgery, had a pathologic indication for PORT, and were eligible for the RFS analysis (no RFS event prior to LM and still in follow-up at LM). Fifty nine percent of patients started PORT ≤6 weeks of surgery. For the RFS analysis, there were 27 events among those with timely PORT and 32 events among those without timely PORT with a median follow-up of 36 (IQR 20 to 46) months. Patients who started PORT ≤ 6 weeks of surgery had improved RFS relative to those who did not on adjusted CPH analysis (aHR 0.58; 95% CI 0.34 to 0.99; p = 0.048). The 2-year RFS was 74% (95% CI 65% to 84%) among those with timely PORT and 47% (95% CI 36% to 62%) among those without timely PORT. Patients who initiated PORT ≤ 6 weeks of surgery had improved OS relative to those who did not on adjusted CPH analysis (aHR 0.43; 95% CI 0.24 to 0.78; p = 0.005). The risk of LRF did not differ between those with and without timely PORT (LRF subdistribution HR = 0.79; 95% CI 0.31 to 2.06; Fine and Gray p = 0.63). Conclusions: Initiation of PORT ≤ 6 weeks of surgery was associated with improved RFS and OS but not LRF. These data support the oncologic benefit of timely, guideline-adherent PORT in this population and the therapeutic benefit of cancer care delivery interventions to improve initiation of timely PORT. Clinical trial information: NCT04030130 .

  PublisherDOI

• Mechanisms underlying an enhanced navigation-based intervention to improve timely adjuvant radiotherapy in head and neck cancer: Secondary outcomes from the NDURE RCT.

  JCO Oncology Practice · 2025-10-01

  article

  95 Background: Initiation of postoperative radiation therapy (PORT) ≤ 6 weeks of surgery is part of NCCN Guidelines for head and neck squamous cell carcinoma (HNSCC) and a Commission on Cancer quality metric, yet more than 50% of patients experience a delay. Our randomized clinical trial (RCT) demonstrated that NDURE, an enhanced navigation-based intervention, improved timely PORT for patients with HNSCC relative to usual care (UC) patient navigation (PN). This planned secondary analysis tests the hypothesis that NDURE improves initiation of PORT ≤ 6 weeks of surgery relative to UC by improving the delivery of underlying processes of care related to timely PORT. Methods: Adults with HNSCC planning to undergo surgery and PORT were randomly assigned 1:1 to NDURE, a multilevel navigation-based intervention to enhance key processes of care and overcome barriers to timely PORT, or UC, which consisted of standard PN. The primary endpoint was initiation of timely PORT (≤ 6 weeks postoperatively). Hypothesized process of care mediators included: 1) preoperative (pre-op) consultation with a radiation oncologist, 2) pre-op dental evaluation and extractions during the ablative surgery, 3) timely postoperative evaluation by the radiation oncologist ( < 21 days of surgery), 4) timely CT simulation ( < 7 days after the radiation oncology appointment), and 5) timely radiation planning (starting PORT < 14 days after CT simulation). Causal mediation analysis was performed to determine the effects of hypothesized mediating process of care variables on initiation of timely PORT. All binary endpoints were modeled using a generalized linear model approach in R Studio version 4.4.1 with mediation package 4.5.0. Results: Among 145 (NDURE, n = 67; UC, n = 78) patients evaluable for the primary endpoint, NDURE increased the probability of attending a pre-op consultation with a radiation oncologist (79.1% vs 43.6%; p < 0.001), pre-op dental evaluation and extractions during the ablative surgery (80.6% vs 55.1%; p < 0.001), timely postoperative evaluation by the radiation oncologist (56.7% vs 20.5%; p < 0.001), and timely radiation planning (65.7% vs 47.4%; p = 0.02) relative to UC. In a causal mediation analysis, the effect of NDURE on initiation of timely PORT relative to UC was most strongly mediated through improving timely postoperative evaluation by the radiation oncologist (proportion of total effect mediated = 0.24; 95% CI 0.08 to 0.65) and timely radiation planning (proportion of total effect mediated = 0.14; 95% CI -0.03 to 0.45). Conclusions: In this RCT, NDURE improved numerous processes of care relative to UC. The primary mechanisms by which NDURE improved timely PORT were enhancing timely postoperative evaluation by a radiation oncologist and timely radiation planning after simulation. These data may help optimize strategies to improve timely PORT. Clinical trial information: NCT04030130 .

  PublisherDOI

• Patient and Therapist Perceptions of a Publicly Funded Internet-Based Cognitive Behavioral Therapy (iCBT) Program for Ontario Adults During the COVID-19 Pandemic: Qualitative Study

  JMIR Formative Research · 2024-02-19 · 8 citations

  articleOpen access

  BACKGROUND: To address the anticipated rise in mental health symptoms experienced at the population level during the COVID-19 pandemic, the Ontario government provided 2 therapist-assisted internet-delivered cognitive behavioral therapy (iCBT) programs to adults free of charge at the point of service. OBJECTIVE: The study aims to explore the facilitators of and barriers to implementing iCBT at the population level in Ontario, Canada, from the perspective of patients and therapists to better understand how therapist-assisted iCBT programs can be effectively implemented at the population level and inform strategies for enhancing service delivery and integration into the health care system. METHODS: Using a convenience sampling methodology, semistructured interviews were conducted with 10 therapists who delivered iCBT and 20 patients who received iCBT through either of the publicly funded programs to explore their perspectives of the program. Interview data were analyzed using inductive thematic analysis to generate themes. RESULTS: Six salient themes were identified. Facilitators included the therapist-assisted nature of the program; the ease of registration and the lack of cost; and the feasibility of completing the psychoeducational modules given the online and self-paced nature of the program. Barriers included challenges with the online remote modality for developing the therapeutic alliance; the program's generalized nature, which limited customization to individual needs; and a lack of formal integration between the iCBT program and the health care system. CONCLUSIONS: Although the program was generally well-received by patients and therapists due to its accessibility and feasibility, the digital format of the program presented both benefits and unique challenges. Strategies for improving the quality of service delivery include opportunities for synchronous communication between therapists and patients, options for increased customization, and the formal integration of iCBT into a broader stepped-care model that centralizes patient referrals between care providers and promotes continuity of care.

  PublisherOA PDFDOI

• Reach, uptake, and psychological outcomes of two publicly funded internet-based cognitive behavioural therapy programs in Ontario, Canada: an observational study

  International Journal of Mental Health Systems · 2024-11-07 · 5 citations

  articleOpen access

  BACKGROUND: Access to traditional mental health services in Canada remains limited, prompting exploration into digital alternatives. The Government of Ontario initiated access to two internet-based cognitive behavioral therapy (iCBT) programs, LifeWorks AbilitiCBT and MindBeacon TAiCBT, for adults with mental health issues. METHODS: An uncontrolled observational study utilizing secondary retrospective program data was conducted to evaluate the reach, uptake, and psychological symptom changes among participants engaging with either iCBT program. RESULTS: Between May 2020 and September 2021, 56,769 individuals enrolled in LifeWorks AbilitiCBT, and 73,356 in MindBeacon TAiCBT. However, substantial exclusions were made: 56% of LifeWorks participants and 68% of MindBeacon participants were ineligible or failed to initiate treatment. Consequently, 25,154 LifeWorks participants and 23,795 MindBeacon participants were included in the analysis. Of these, 22% of LifeWorks and 26% of MindBeacon participants completed over 75% of iCBT treatment. On average, LifeWorks participants received 13 ± SD 7.1 therapist messages and sent 5 ± SD 10.3 messages, while MindBeacon participants received 25 ± SD 20.7 therapist messages and sent 13 ± SD 16.4 messages. LifeWorks included synchronous therapist contact averaging 1.4 ± SD 1.9 h per participant, while MindBeacon was purely asynchronous. Baseline severity of anxiety (37%) and depression symptoms (22%) was higher for LifeWorks participants compared to MindBeacon participants (24% and 10%, respectively). Clinically significant changes in anxiety and depression scores were observed: 22% of LifeWorks and 31% of MindBeacon participants exhibited reliable recovery in PHQ-9 scores, while 26% of LifeWorks and 25% of MindBeacon participants demonstrated reliable recovery in GAD-7 scores. CONCLUSION: In conclusion, iCBT programs show promise for engaged participants with varying levels of severity in anxiety and depression symptoms. Future iterations of iCBT should consider adopting a broad entry criterion to iCBT programming to increase accessibility, especially for those with severe symptoms, alongside integrated intake care pathways, and potential payment structure adjustments for iCBT service providers. Taken all together, these factors could temper high dropout rates post-intake assessment. This evaluation underscores the potential and value of digital mental health interventions for individuals with mild to severe anxiety or depression symptoms, emphasizing the importance of addressing participant dropout.

  PublisherOA PDFDOI

• Guardians Looking From Outside: Gendered Experiences of Labor Migration and Psychosocial Health Among Nepalese Migrant Fathers and Left-Behind Mothers

  Qualitative Health Research · 2024-09-18 · 8 citations

  article1st author

  Nepalese migrant workers are at heightened risk of adverse mental health problems. However, the social mechanisms by which experiences of labor migration create such vulnerabilities are not well understood. Moreover, limited attention has been paid to the experiences of left-behind spouses. This study explores how migrant fathers and left-behind mothers experience labor migration and how migration affects mental health across migrant household members, paying special attention to the role of gender. We conducted 29 in-depth interviews with Nepalese migrant fathers ( N = 18) in South Korea and left-behind mothers ( N = 11) in Nepal. Labor migration imposes substantial stress on the entire family. Migrant fathers discussed their feelings of guilt and worry regarding their relationships with their children due to physical and emotional distance. Left-behind mothers indicated loneliness and caregiver stress due to additional responsibilities as a single parent. Migrant fathers reported that they felt respected by their communities for their work, while left-behind mothers felt heavily scrutinized. Our findings highlight how labor migration reinforces gender inequalities in domestic responsibilities and norms regarding the expected roles of migrating men and left-behind women. These findings suggest that psychosocial services must be tailored to the unique needs of migrant workers and left-behind families.

  PublisherDOI

• Predictors of seropositivity to SARS-CoV-2 among employees at a large urban medical center

  BMC Public Health · 2024-10-09

  articleOpen access

  BACKGROUND: Before SARS-CoV-2 vaccination availability, medical center employees were at high risk of COVID-19. However, risk factors for SARS-CoV-2 infection in medical center employees, both healthcare and non-healthcare workers, are poorly understood. METHODS: From September-December 2020, free IgG antibody testing was offered to all employees at a large urban medical center. Participants were asked to complete a questionnaire on work and non-work related risk factors for COVID-19 infection. RESULTS: SARS-CoV-2 seropositivity was found in 4.7%. Seropositivity was associated with close contact with COVID-19 cases with or without the use of adequate personal protective equipment (PPE), (OR 3.1 [95% CI 1.4-6.9] and OR 4.7 [95% CI 2.0-11.0] respectively), never wearing a mask outside of work (OR 10.1 [95% CI 1.9-57]), and Native Hawaiian/Pacific Islander race (OR 6.3 95% CI (1.6-25)]. CONCLUSIONS: Among workers in a large urban medical center, SARS-CoV-2 seropositivity was associated with work-related COVID-19 close contacts and low mask use outside of work, suggesting that non-workplace close contacts are also relevant routes of COVID-19 spread among healthcare workers.

  PublisherOA PDFDOI

Frequent coauthors

• Cassandra Decker

  Memorial Hospital

  49 shared

• Hasan B. Alam

  Northwestern University

  49 shared

• Eric M. Campion

  Denver Health Medical Center

  49 shared

• Saad Liaqat Sahi

  University of Colorado Boulder

  49 shared

• Clay Cothren Burlew

  49 shared

• Ben E. Biesterveld

  University of Wisconsin–Madison

  49 shared

• Areg Grigorian

  University of California, Irvine

  49 shared

• Mitchell J. Cohen

  University of Colorado Denver

  49 shared

Education

• B.S., Biological Sciences

  University of California, Irvine

• Other

  Western University of Health Sciences

Awards & honors

• Faculty Service Award (2010), Western University of Health S…
• Preceptor of the Year (2007), Western University of Health S…
• Excellence in Patient Care (2000), Western University of Hea…
• Medical Staff Award: Clinical Skills Contribution (1999), Hu…