Infographic comparing suboptimal versus optimal surgical decision-making using electronic health record (EHR) data and artificial intelligence (AI) across patient care phases. Top panel – Suboptimal surgical decision making: A clinician and patient icons appear beside a laptop and hospital bed. Limited EHR data feeds into a simple additive model. Text notes that only a few data elements manually feed coarse models with suboptimal accuracy. Consequences listed include low patient compliance and satisfaction, decision fatigue, and bias, error, and preventable harm. Middle panel – Optimal surgical decision making: Expanded EHR data, including streaming vital signs, laboratory results, waveforms, and images, feed into an AI model represented by a neural network diagram. This approach produces accurate, autonomous assessments. Benefits listed include patient–surgeon synergy, efficient and accurate assessments, and better outcomes. Bottom panel – Patient care phases and applications: Three stages of surgical care are shown with icons and arrows: Preoperative phase: personalized risk assessment and optimization. Intraoperative phase: patient-specific resuscitation strategies during surgery. Postoperative phase: early detection and treatment of complications.

dedicated to finding New solutions for sepsis

The UF Sepsis and Critical Illness Research Center (SCIRC) is the first of its kind in the nation and studies long-term outcomes in patients treated for sepsis in the UF Health Shands Hospital’s surgical and trauma intensive care units. With a focus on innovation, collaboration, and academic excellence, the center aims to address some of the most pressing challenges facing society. We are a team of researchers and scholars who work tirelessly to push the boundaries of knowledge and drive positive change. Our goals are to develop clinical solutions for sepsis, as well as illnesses that stem from it and their enduring effects.

learn about our ongoing projects

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Unveiling the Science Behind Sepsis

Dr. Nicole Iovine and Dr. Philip Efron discuss Sepsis, including medical terminology, pathophysiology, risk factors, and its critical implications within the medical field.

See our newest publications:

A Murine Model of Sepsis Induces Age- and Sex-Specific Chromatin Remodeling in Myeloid-Derived Suppressor Cells
Authors: Charles AM, Rodhouse CE, Darden DB, Gauthier M-PL, Zhou M, Hernandez-Rios M, Wang D, Casadesus G, Bible L, Mohr AM, Xiao F, Cai G, Brant JO, Wallet SM, Mathews CE, Moldawer LL, Chakrabarty P, Bacher RL, Efron PA, Maile R, Kladde MP.
Journal: Front Immunol. 2026;17:1750174. doi:10.3389/fimmu.2026.1750174. PMID: 41953016.

The Bitter Lesson and its Implications for Surgical Artificial Intelligence
Authors: Balch JA, Shickel B, Loftus TJ.
Journal: Ann Surg. 2026. Online ahead of print. doi:10.1097/SLA.0000000000007054. PMID: 41881839

Dysbiosis and the Gut-Brain Axis Impairment in the Pathophysiology of Alzheimerâ€™s Disease and Related Dementias: Is â€œPathobiomeâ€ an Etiological Element?
Authors: Park G, Chakrabarty P, Efron PA, Nagpal R.
Journal: Essays Biochem. 2025;69(6):EBC20253055. doi:10.1042/EBC20253055. PMID: 41874395

Surgical Patrescence: The Challenge of Becoming a Surgeon-Parent
Authors: Rodhouse CE, Hess PC, Cochran A.
Journal: JAMA Surg. 2026. Online ahead of print. doi:10.1001/jamasurg.2026.0194. PMID: 41811341

Preterm Birth Skews the Developmental Trajectory of Myeloid-Derived Suppressor Cells in the First 48 Hours of Life: Single-Cell Transcriptomics and Inferred Intercellular Communication
Authors: HernÃ¡ndez-RÃos M, Rincon J, Balzano-Nogueira L, Polcz V, Wang D, Wiggins W, Rodhouse C, Yoham A, Xiao F, Ungaro R, Dirain M, Moldawer L, Maile R, Cai G, Efron P, Larson S.
Journal: Mol Med. 2026. Online ahead of print. doi:10.1186/s10020-026-01459-8. PMID: 41888646

Artificial Intelligence in Emergency Surgery: A Scoping Review Within the Artificial Intelligence in Emergency and Trauma Surgery (ARIES) Project
Authors: De Simone B, Kasongo L, Gumbs AA, Vecchio F, De Franceschi A, DÃ¨Angelis N, Kirkpatrick AW, Wachs JP, Loftus TJ, Abu-Zidan FM, Latifi R, Deeken G, Chouillard E, Litvin A, Sartelli M, Pantalone D, LeppÃ¤niemi A, Eryilmaz M, Rasa K, Isik A, Kaafarani HM, Fraga G, Coimbra R, Moore EE, Biffl WL, Catena F.
Journal: World J Emerg Surg. 2026;21(1):12. doi:10.1186/s13017-026-00674-2. PMID: 41654983

Interaction of Sepsis, Disuse, and Aging on Skeletal Muscle Function and Remodeling in Male and Female Mice
Authors: Muller DC, Boeno FP, Reis G, Azam A, Ashley M, Zhou Y, Yue F, Ryan TE, Efron PA, Laitano O.
Journal: Acta Physiologica. 2026. doi:10.1111/apha.70195. Watch our video about our latest work on Sepsis Induced Myopathy with Disuse in Aging

Macrophage Polarization as a Potential Driver and a Therapeutic Target for Sepsis-Induced Cognitive Impairment in Older Adults
Authors: Zeidan RS, Reinhard S, Sykes S, Price C, Wallet SM, Maile R, Efron PA, Mankowski RT, Anton S.
Journal: Shock. 2025. doi:10.1097/SHK.0000000000002723. PMID: 41115112

Trauma-induced Alterations in Bone Marrow Exosome microRNA Profiles
Authors: Yoham AL, Peethala A, Bible LE, Kannan KB, Wheeler C, Hernández-Ríos M, Rodhouse CE, Maile R, Efron PA, Mohr AM.
Journal: Journal of Trauma and Acute Care Surgery. 2025. doi:10.1097/TA.0000000000004831. PMID: 41247314

DAMP-driven Trained Immunity: Metabolic and Epigenetic Reprogramming in Critical Illness and Chronic Inflammation
Authors: Kim HG, Rincon JC, Efron PA, Maile R.
Journal: Frontiers in Immunology. 2025;16. doi:10.3389/fimmu.2025.1669054

Chromatin Remodeling and Transcriptional Silencing Define the Dynamic Innate Immune Response of Tissue Resident Macrophages After Burn Injury
Authors: Kim HG, Gauthier M-PL, Higgs A, Hernandez DA, Zhou M, Brant JO, Bacher RL, Darden DB, Wallet SM, Mathews CE, Moldawer LL, Efron PA, Kladde MP, Maile R.
Journal: Shock. 2025. doi:10.1097/SHK.0000000000002746 (online ahead of print). PMID: 41166121

Optimization of Pre-Clinical Rodent Research Models of Human Shock: Part 1 Intra-abdominal Sepsis
Authors: Rodhouse C, Michael Z, Byskosh A, Boeno FP, Hernández-Rios M, Park G, Dumitrescu S, Fisler GM, Taylor MD, Abraham MN, Vo Q, Charles A, Lederer J, Laitano O, Rincon J, Nagpal R, Chakrabarty P, Casadesus G, Osuchowski MF, Deutschman CS, Bible L.
Journal: Shock. 2025. Advance online publication. doi:10.1097/SHK.0000000000002742. PMID: 41166157

Quantifying Nuance within Sepsis-Associated Immune Suppression toward Diagnostic Certainty
Authors: Caldwell CC, Maile R, Mazer MB, McGonagill PW, Bergmann CB, Gould RW, Rao M, Hernández-Ríos M, Ungaro RF, Loftus TJ, Efron PA, Remy KE, Brakenridge SC, Badovinac VP, Griffith TS, Hotchkiss RS, Moldawer LL.
Journal: Shock. 2025. doi:10.1097/SHK.0000000000002745. PMID: 41166166

Monocyte Anisocytosis Can Discriminate Between Sepsis and Sterile Inflammation, but not Mortality, in Critically Ill Surgical/Trauma Patients: A Secondary Prospective Analysis
Authors: Hernández-Rios M, Wu R, Polcz VA, Burnside RD, Yonker LM, Irimia D, Xiao F, Rincon JC, Loftus TJ, Moldawer LL, Maile R, Efron PA, Liang M.
Journal: Critical Care Explorations. 2025;7(9):e1309. doi:10.1097/CCE.0000000000001309. PMID: 40924914

A Consensus Immune Dysregulation Framework for Sepsis and Critical Illnesses
Authors: Moore AR, Zheng H, Ganesan A, Hasin-Brumshtein Y, Maddali MV, Levitt JE, van der Poll T, Lu J, Bouma HR, Scicluna BP, Giamarellos-Bourboulis EJ, Kotsaki A, Martin-Loeches I, Garduno A, Rothman RE, Sevransky J, Wright DW, Atreya MR, Moldawer LL, Efron PA, Kralovcova M, Karvunidis T, Giannini HM, Meyer NJ, Sweeney TE, Rogers AJ, Khatri P.
Journal: Nature Medicine. 2025. doi:10.1038/s41591-025-03956-5. PMID: 41028543

Microbiome-based Therapeutics Towards Healthier Aging and Longevity
Authors: Kadyan S, Park G, Singh TP, Patoine C, Singar S, Heise T, Domeier C, Ray C, Kumar M, Behare PV, Chakrabarty P, Efron PA, Sheffler J, Nagpal R.
Journal: Genome Medicine. 2025;17(1):52. doi:10.1186/s13073-025-01493-x. PMID: 40597414

Temporal Changes in the Protein Cargo of Extracellular Vesicles and Resultant Immune Reprogramming After Severe Burn Injury in Humans and Mice
Authors: Willis ML, Seim RF, Herring LE, Mordant AL, Webb TS, Upchurch GR, Sharma AK, Cairns BA, Efron PA, Wallet SM, Coleman LG Jr, Maile R.
Journal: Frontiers in Immunology. 2025;16:1596598. PMID: 40534873

Organizational Structure for Surgical Critical Care Advanced Practice Providers in an Academic Teaching Hospital
Authors: Venegas BO, Sickler K, Becker TK, Maybauer MO, McDowell LD, Upchurch GR, Efron PA.
Journal: The Nurse Practitioner. 2025;50(5):43-47. PMID: 40269351

Determining Potential Immunomodulatory Drug Efficacy in Sepsis Using ELISpot
Authors: Walton AH, Mazer MB, Remy KE, Osborne DF, Davitt EB, Griffith TS, Gould RW, Badovinac VP, Brakenridge SC, Drewry AM, Ungaro RF, Rocha IL, Loftus TJ, Efron PA, Moldawer LL, Caldwell CC, Hotchkiss RS.
Journal: Scientific Reports. 2025;15(1):13464. PMID: 40251188

Honoring Advance Directives: A Scoping Review of Adherence and Impact on Value of Care
Authors: Chatham AH, Balch JA, Hong P, Baskaran N, Manganiello L, Abbott KL, Brown M, Bihorac A, Efron PA, Shickel B, Moseley R, Loftus TJ.
Journal: Journal of Palliative Medicine. 2025 (online ahead of print). PMID: 40197904

Innate Immune Training in the Neonatal Response to Sepsis
Authors: Rincon JC, Wang D, Polcz VE, Barrios EL, Dirain ML, Ungaro RF, Nacionales DC, Zeumer-Spataro L, Xiao F, Efron PA, Moldawer LL, Cai G, Larson SD.
Journal: Molecular Medicine. 2025;31(1):159. PMID: 40307728

Corrigendum to “Functional Connectivity Within Sensorimotor Cortical and Striatal Regions Is Regulated by Sepsis in a Sex-Dependent Manner”
Authors: Vo Q, Simon ZD, Park G, Nacionales DC, Gorski C, Barrios EL, Casadesus G, Efron PA, Moldawer LL, Nagpal R, Chakrabarty P, Febo M.
Journal: NeuroImage. 2025;308:121025. PMID: 39828487

Antibiotic Prophylaxis for Elective Pediatric Laparoscopic Cholecystectomies
Authors: Rodhouse C, Raymond R, Neal D, Loftus TJ, Khan FA, Do AR, Taylor JA, Efron PA, Larson SD, Raymond SL.
Journal: Journal of Pediatric Surgery. 2025;60(3):162055. PMID: 39549681

Nonselective Beta Blockade Enhances Gut Microbiome Diversity in a Rodent Model of Trauma, Hemorrhage, and Chronic Stress
Authors: Munley JA, Kelly LS, Park G, Pons EE, Apple CG, Kannan KB, Bible LE, Efron PA, Nagpal R, Mohr AM.
Journal: Journal of Trauma and Acute Care Surgery. 2025;98(2):309-318. PMID: 39813154

Functional Immunophenotyping for Precision Therapies in Sepsis
Authors: Rao M, McGonagill PW, Brackenridge S, Remy KE, Caldwell CC, Hotchkiss RS, Moldawer LL, Griffith TS, Badovinac VP.
Journal: Shock. 2025;63(2):189-201. PMID: 39617419

A Randomized, Double-Blind, Placebo-Controlled Trial of IL-7 in Critically Ill Patients with COVID-19
Authors: Shankar-Hari M, Francois B, Remy KE, Gutierrez C, Pastores S, Daix T, Jeannet R, Blood J, Walton AH, Salomao R, Auzinger G, Striker D, Martin RS, Anand NJ, Bosanquet J, Blood T, Brakenridge S, Moldawer LL, Vachharajani V, Yee C, Dal-Pizzol F, Morre M, Berbille F, van den Brink M, Hotchkiss R.
Journal: JCI Insight. 2025;10(6):e189150. PMID: 39903535

Functional Connectivity Within Sensorimotor Cortical and Striatal Regions Is Regulated by Sepsis in a Sex-Dependent Manner
Authors: Vo Q, Simon ZD, Park G, Nacionales DC, Gorski C, Barrios EL, Casadesus G, Efron PA, Moldawer LL, Nagpal R, Chakrabarty P, Febo M.
Journal: NeuroImage. 2025;305:120995. PMID: 39753162