Digital Commons Network^™

Subcutaneous Nodules On The Elbows Of A Teenager, Arman Haveric, Jayci G. Rhein, Jason B. Lee, Shayan Waseh, Sylvia Hsu, Afton R. Metkowski

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Spatially Dissecting Drivers Of Inter-And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro

Pathology, East Africa

Despite growing evidence on the impact of intra-tumoral heterogeneity (ITH) in breast cancer (BC), its biological drivers and clinically relevant mitigation strategies remain poorly characterized, particularly in low-resource settings where spatial profiling is rarely applied. To address this gap, we conducted a comprehensive, multiplatform spatial profiling study of BC in a Kenyan population. Using the NanoString GeoMx™ Digital Spatial Profiler, we quantified 44 protein markers across 707 spatially defined, PanCK-segmented Areas of Illumination (AOIs) from 31 tumors. All tumors exhibited measurable ITH, with one-third showing marked heterogeneity. Sixteen patients exhibited two or more intrinsic subtypes within their tumors, three of …

Endovascular Thrombectomy In Medium And Distal Vessel Occlusions: A Focused Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Shahram Majidi, Amol Mehta, Sami Al-Kasab, Kaustubh Limaye, Adam A. Dmytriw, Adam De Havenon, Farhan Siddiq, Robin Novakovic, Alexandra L. Czap, Ameer E. Hassan

School of Medicine Publications

Background: The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke from distal- and medium-vessel occlusion (DMVO) for endovascular thrombectomy (EVT). The intended audiences are prehospital care providers, physicians, and allied health professionals.

Methods: The Society of Vascular and Interventional Neurology Guidelines and Practice Standards committee formed a writing group to conduct a structured literature review on EVT for DMVO-related acute ischemic stroke and to draft practice recommendations in accordance with the Society of Vascular and Interventional Neurology Guidelines and Practice Algorithm. A structured literature search was conducted …

Explosive Weapons Trauma Care Collective (Extracct) Clinical Practice Guideline: Transfer Of Critically Injured Casualties, Emma Butterfield, Gavin Wooldridge, Solomon Asfaw, Mervat Alhilal, Mardi Steere, Benjamin Wachira, Paul Reavley, Roman Shtybel, Marius Rehn

Emergency Medicine, East Africa

Introduction Blast-injured patients often present to healthcare facilities which cannot definitively meet their clinical needs. This clinical practice guideline (CPG) reviews and describes best practice for inter-facility transfer of casualties in resource limited and conflict-afflicted contexts where there may not be a formal referral pathway or specialized inter-facility transfer service.

Methods A narrative literature review and synthesis of expert opinion were used to develop this CPG.

Results The guideline describes current standards and best practice in inter-facility transfer in a low resource context—particularly during conflict when referral and transfer pathways may be overwhelmed—and advises on the selection and preparation of …

Hiding In Plain Sight: A Case Of Intestinal Tuberculosis Masquerading As Benign Lower Gi Bleeding, Lavender Otom, Priyanka Panwar, Gerald Odong, Fatma Kassim, Patricia Okiro, Christopher Opio, Saleem Abdulkarim

Internal Medicine, East Africa

Background Intestinal tuberculosis (TB) represents the most common form of abdominal TB, often affecting the ileocaecal region. Lower gastrointestinal bleeding is an uncommon presentation and may create significant diagnostic uncertainty, particularly in immunocompromised patients and in settings where inflammatory bowel disease is also encountered.

Case Presentation A woman in her sixties from Africa presented with recurrent diarrhoea and intermittent haematochezia over a 6-month period. Initial endoscopic evaluation was nondiagnostic. Cross-sectional imaging later demonstrated multifocal bowel involvement affecting both the small and large bowel, including ileocaecal and rectoanal disease, with associated abdominopelvic lymphadenopathy. Histopathology from repeat colonoscopy biopsy showed caseating granulomas …

May Measurement Month 2023: Results Of An Opportunistic Blood Pressure Screening Campaign In Kenya, Mzee Ngunga, Thomas Beaney, Gabriele Kerr, Bernard Samia, Lilian Mbau, Neil Poulter, Hellen Nguchu, Jeilan Mohamed, Elijah Ogola

Internal Medicine, East Africa

The May Measurement Month (MMM) is a global screening campaign launched in 2017 to raise awareness of raised blood pressure (BP). Kenya has participated in all previous MMM campaigns. Adults aged ≥18 years were recruited through convenience sampling in nine counties of Kenya. Three seated BP readings were taken on each participant, and a questionnaire collected information on demographics, lifestyle factors, and comorbidities. Hypertension was defined as a systolic BP ≥140mmHg or diastolic BP ≥90mmHg or being on BP-lowering medication. Controlled BP was defined as being on BP-lowering medication with a BP < 140/90mmHg. Multiple imputation was used to estimate missing BP readings. In total, 4,601 were screened, with a mean age of 41.7 years and 42.7% were female. Of all participants, 1,176 (25.6%) had hypertension, of whom 198 (16.8%) were aware, and 190 (16.2%) were on antihypertensive medication. Of those on antihypertensive medication, 65 (34.2%) had controlled BP, and of all participants with hypertension, 5.5% had controlled BP. The mean systolic and diastolic BPs of those on treatment was significantly higher than those without hypertension. Hypertensive disease in a previous pregnancy was associated with higher BP amongst female participants.

The MMM campaign in Kenya identified a substantial …

Performance Of Road-Traffic-Based Exposure Proxies Against Personal Pm2.5 Measurements In Three Sub-Saharan African Countries, Handsome Nyoni, Terence Mushore, Laura Munthali, Sibusisiwe Makhanya, Laurine Chikoko, Stanley Luchters, Matthew Chersich, Fortunate Machingura, Liberty Makacha, Benjamin Barratt

Centre of Excellence in Women and Child Health

Particulate Matter (PM2.5) exposure contributes to the global disease burden, yet its monitoring remains sparse and uneven, with limited ground sensor infrastructure. Road-traffic proxy indicators can provide indirect estimates of PM2.5 where measurements are limited but require context-specific validation. We evaluated three PM2.5 road-traffic-related proxies: (i) population-Weighted Road Network Density (wRND), (ii) Euclidean (straight line) distance from highways (EH), and (iii) Euclidean distance from main roads (EM). We validated these proxies using high-resolution outdoor filtered PM2.5 personal exposure measurements collected over 1 year from 343 postpartum participants in The Gambia, Kenya, and Mozambique. Proxy-PM2.5 associations were assessed using Spearman correlation, …

Neonatal Admissions And Mortality: A Statistical Adjustment Approach Using Birthweight-Specific Curves To Address Bias Due To Underreporting In 65 Hospitals In Four African Countries, Lucas Malla, Siu Wong, Samuel Ngwala, Evelyn Zimba, Msandeni Chiume, Norman Lufesi, Kondwani Kawaza, Honorati Masanja, Josephine Shabani, William Macharia

Paediatrics and Child Health, East Africa

Background Underreporting of neonatal admissions and deaths – particularly among <  1000 g newborns – compromises the plausibility of in-patient neonatal mortality rate (iNMR) estimates. This limits progress tracking, since 2.3 million neonatal deaths occur annually, and 65 countries are projected to miss the Sustainable Development Goal (SDG) 3.2 target of fewer than 12 deaths per 1000 live births by 2030. Reliable iNMR estimates are essential for national and hospital-level monitoring. This study assessed birthweight-specific adjustment curves developed using simulated data, and extended the approach to routine data from 172,809 neonatal admissions across four African countries in the NEST360 network.

Methods Simulated data were generated using birthweight intervals of 500 g from 500 to 5000 g, with 1000 values per category representing 1000 hospitals. Admissions were drawn from a negative binomial distribution and mortality rates from a beta distribution based on published birthweight-specific iNMRs. Adjustment functions were developed using data from 500 hospitals without underreporting and tested on 500 with induced underreporting. This approach was then extended to real data from 65 NEST360 partnering hospitals. The adjustment functions were derived from 26 hospitals with plausible reporting (iNMR ≥ 700 per …

Unlocking The Potential Of Sub-Saharan Africa In Globalized Cancer Clinical Trials: A Perspective From The 2024 Aortic-Asco Stakeholder Meeting, Abiola Ibraheem, Adedayo Joseph, Miriam Mutebi, Mansoor Saleh, Sitna Mwanzi, Olusegun Alatise

General Surgery, East Africa

Sub-Saharan Africa (SSA) remains significantly underrepresented in global cancer clinical trials, despite having the largest population of individuals of African descent, an essential demographic for ensuring diversity in clinical research. This study, developed from the 2024 African Organization for Research and Training in Cancer (AORTIC)-ASCO stakeholder meeting, addresses the critical need to involve SSA in cancer trials to improve global trial diversity and patient outcomes. Although globalization of trials has shifted research sites to regions like Eastern Europe and Asia, < 1% occur in Africa. This report highlights emerging solutions such as regional alliances, decentralized trial models, capacity-building initiatives, and public-private partnerships. The role of AORTIC and its Clinical Trial Special Interest Group in advancing training, infrastructure development, and international collaboration is discussed, with notable clinical trial networks, such as HypoAfrica, ARETTA, African Research Group for Oncology, and regional consortia, illustrating growing momentum and capability. This study advocates for a coordinated strategy to integrate SSA into global trials, ensuring more inclusive, effective, and equitable cancer treatment outcomes.

Pyogenic Liver Abscess Associated With Acute Hepatitis A And Burkholderia Cepacia Sepsis In A Child: A Rare Case Report, Anjali M, Poonam Wade, Snehal Sahebrao Kasbe, Neha Bhongale

Digital Journal of Clinical Medicine

Pyogenic liver abscess is an uncommon but potentially life-threatening infection in children. Although it is usually associated with underlying predisposing conditions, its occurrence in association with acute hepatitis A is infrequently reported.

We report a case of a 4-year-old male child who presented with fever, jaundice, and abdominal distension and was diagnosed with pyogenic liver abscess associated with concurrent hepatitis A infection and Burkholderia cepacia complex sepsis.

This case underscores the need to consider secondary bacterial infection in children with hepatitis A who have persistent fever or an unexpected clinical course despite appropriate supportive care. Although jaundice may initially be …

Social Phobia, Coping Strategies, And Socio-Demographic Associations Among Late Adolescents: A Cross-Sectional Study, Ezhilan B U, Jesymol Joy, Smitha Chandrashekarappa Dr.

Digital Journal of Clinical Medicine

Background: Adolescence is a transitional period from childhood to adulthood, often marked by psychological challenges such as social anxiety, also known as social phobia. It is characterized by excessive fear of social interactions and can lead to impaired functioning or depression. Globally, its prevalence ranges from 6-10% in developed countries and 10-44% in developing countries. Coping strategies play a crucial role in managing social phobia, varying by individual characteristics. This study aimed to determine the prevalence of social phobia, identify coping strategies, and evaluate their association with socio-demographic factors among late adolescents.

Methodology: A cross-sectional study was conducted …

Health Systems Interventions For Prevention Of Maternal Peripartum Infection In Low And Middle-Income Countries: A Systematic Review, Roseline Abwao, Job Mapesa, Wanja Tenambergen, David Odada, Nasra Gathoni, Felix Riunga

Internal Medicine, East Africa

Background Globally, there is growing recognition that a functional health system is key to improving maternal health and reducing maternal mortality. Maternal peripartum infection remains a major cause of maternal morbidity and mortality, particularly in low- and middle-income countries. This infection is a multifaceted problem with many players. Adopting a health systems approach could help avert this preventable infection by addressing the gaps across all the components of care.

Objective The aim of this systematic review was to identify and evaluate interventions to prevent maternal peripartum infection in LMICs.

Methods A systematic search was conducted in Cochrane Library, CINAHL, MEDLINE …

Just Opt For Caesarean Section And Pick The Birthdate': A Qualitative Study Exploring Women's Delivery Preferences After Caesarean Section In Urban Tanzania, Daudi Gidion, Columba Mbekenga, Miriam Mgonja, Marleen Temmerman, Muzdalfat Abeid

Obstetrics and Gynaecology, East Africa

Objectives To explore perspectives, preferences and decision-making regarding mode of delivery after a previous caesarean section among women in urban Tanzania.

Design A descriptive qualitative study using semi-structured in-depth interviews. Data were analysed using thematic analysis.

Setting A private tertiary hospital in Dar es Salaam, Tanzania.

Participants 11 women with one previous caesarean section who delivered at the study site were interviewed on the third day after delivery. Participants were purposively sampled to include both modes of delivery: five women underwent repeat caesarean section and six attempted a trial of labour after caesarean (TOLAC).

Results Thematic analysis identified four key …

Health Beliefs And Lung Cancer Screening Uptake Among Eligible Asian Americans In Philadelphia, Pennsylvania, United States, Julia G. Katcher, Kuang-Yi Wen, Christine S. Shusted, Jessica Liang, Kyunghee Koh, Hee-Soon Juon, Julie Barta

Department of Medical Oncology Faculty Papers

OBJECTIVE: Asian Americans experience disproportionately late-stage lung cancer diagnoses and lower lung cancer screening (LCS) rates than other racial groups. This study evaluated the association between the

METHODS: This pilot randomized controlled trial, conducted April 2023-January 2024 within a Philadelphia health system, tested a culturally and linguistically tailored intervention led by community health workers. LCS completion and LCS-Health Belief Scale (LCS-HBS) responses were compared between control and intervention participants (

RESULTS: LCS completion was higher in the intervention group (45%) than in the control (31.3%). Control participants who completed LCS reported higher perceived lung cancer risk, greater perceived benefits, and …

Development And Implementation Of Educational Modules On Management Of Neonates With Critical Congenital Heart Disease In The Delivery Room (Learn-Chd)., Noorjahan Ali, Brenda Law, Alyssa R. Thomas, Philip T. Levy, Ruby Gupta, Summer Elshenawy, Danielle Reed, Leeann R. Pavlek, Jennifer Shepherd, Sharada H. Gowda, Molly K. Ball, Beth Ann Johnson, Chloe Joynt

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Neonates with congenital heart disease may require delivery room interventions beyond standard care. Because existing guidelines and educational programs rarely address these needs, we developed and evaluated targeted educational modules.

METHODS: Teams were randomized to online eLearning modules or directed readings. Individual pre-/post-knowledge scores were compared. Team performance was tested in simulated delivery scenarios including abruption, hypoplastic left heart syndrome, d-transposition of great arteries and congenital complete heart block.

RESULTS: 32 teams from 9 centers participated. The module group had improved knowledge scores (mean change 6% vs -0.3% e-Learning group, p = 0.01). Simulation performance was similar between groups …

Hepatitis B In The Vaccine Era: Persistent Burden And Clinical Implications, Cherechi Nwabueze, Eunice Omeludike, Ridwan Ademola Lawal, Kedife Nwabueze

School of Medicine Publications

Hepatitis B virus (HBV) infection remains a leading global cause of advanced liver disease and imposes a substantial economic burden. Early prevention is critical, as perinatally acquired HBV carries a high risk of progression to cirrhosis or hepatocellular carcinoma (HCC). Hepatitis B vaccination has been proven effective in preventing cancer, yet coverage of the complete vaccine series remains suboptimal. This implementation gap perpetuates the clinical burden, manifesting decades later as hepatic decompensation and liver cancer. This narrative review synthesizes the current HBV landscape, highlighting how gaps in vaccination policy and delivery contribute to real-world gastrointestinal outcomes. By reframing HBV vaccination …

New-Onset Cognitive Impairment After Delirium Among Hospitalised Older Ghanaians: A Pilot Study, John-Paul Omuojine, Richard Dei-Asamoa, Caleb Otu-Ansah, Gertrude Aboah, Belinda Opoku, George Amponsah, Stella Afeti, Leah Ratner, Ruth Owusu-Antwi, Cyprian Mostert

Population Health, East Africa

Background Delirium is a potentially modifiable risk factor for dementia. However, post-delirium cognition has hardly been studied in Africa, where the burden of both disorders is rising disproportionately.

Objective We estimated the incidence of new-onset cognitive impairment (NCI) 6 months after hospitalisation with non-stroke delirium among older Ghanaians.

Methods This was a prospective observational pilot study conducted among 60 previously cognitively unimpaired (retrospective proxy assessment) adults aged ≥60 years, hospitalised with non-stroke prevalent delirium in a Tertiary Hospital. Delirium was confirmed and rated using the Confusion Assessment Method (CAM) and Severity Scale (CAM-S) within 24–72 hours of admission and reassessed …

Spatially Dissecting Drivers Of Inter- And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro

Pathology, East Africa

Despite growing evidence on the impact of intra-tumoral heterogeneity (ITH) in breast cancer (BC), its biological drivers and clinically relevant mitigation strategies remain poorly characterized, particularly in low-resource settings where spatial profiling is rarely applied. To address this gap, we conducted a comprehensive, multiplatform spatial profiling study of BC in a Kenyan population. Using the NanoString GeoMx™ Digital Spatial Profiler, we quantified 44 protein markers across 707 spatially defined, PanCK-segmented Areas of Illumination (AOIs) from 31 tumors. All tumors exhibited measurable ITH, with one-third showing marked heterogeneity. Sixteen patients exhibited two or more intrinsic subtypes within their tumors, three of …

A Phase-Ii Randomized Controlled Pilot Study Of Nicotinamide Riboside Supplementation In Older Adults With Amnestic Mild Cognitive Impairment, Christopher Martens, Kevin Decker, Theodore Deconne, Faria Sanjana, Fiona Horvat, Nicholas Rizzi, Catherine Awad, Elizabeth Habash, Joshua Hobson, Mary Kramer, Michael Armstrong, Nichole Reisdorph, Ryan Pohlig, Alyssa Lanzi, Curtis Johnson, Matthew Cohen, James Ellison

Department of Psychiatry and Human Behavior Faculty Papers

INTRODUCTION: Declining nicotinamide adenine dinucleotide (NAD+) may elevate risk of Alzheimer's disease.

METHODS: We conducted a 12-week double-blind, randomized, placebo-controlled pilot study to evaluate the safety, tolerability, and preliminary efficacy of the NAD+ precursor, nicotinamide riboside (NR), for enhancing cognitive function and cerebral blood flow (CBF) in adults with amnestic mild cognitive impairment (aMCI).

RESULTS: 42 participants completed the study (NR = 22, placebo = 20). Adherence was similar between groups with no serious adverse effects. Blood NAD+ increased twofold in the NR group. There were no improvements in cognitive function (primary outcome), total CBF, or blood pressure (secondary outcomes). …

Plasma Proteomic Profiles Of Alzheimer's Disease And Neurodegeneration In African Cohorts, Ilaria Pola, Tolulope Akinyemi, Kubra Tan, Oladotun Olalusi, Wiebke Traichel, Giulia Giacomucci, Joseph Yaria, Nesrine Rahmouni, Gabriel Ogunde, Chinedu Momoh

Brain and Mind Institute

Alzheimer’s disease and related dementia (ADRD) represents a growing public health burden, especially in low- and middle-income countries. Yet, most studies focus on Non-Hispanic white (NHW) populations from high-income countries. This study investigates plasma proteomic signatures associated with amyloid pathology in African populations. Nigerian older adults from the VALIANT study and participants from a Tanzanian study, with available biomarker quantification in plasma are employed. For proteomic comparison, participants from the Canadian TRIAD cohort are included, capturing a distinct population. Here, we show that multiple proteins are differentially abundant in the plasma of p-tau217-positive individuals and in the different cognitive groups, …

A Rare Manifestation Of Mycobacterium Kansasii As A Cutaneous Infection: A Case Report, Wandera Carey, Antony Kimani, Zamanali Khakhar, Dheer Kalaiya, Alok Iyer, Sayed Karar

Internal Medicine, East Africa

Nontuberculous mycobacteria (NTM) are environmental organisms increasingly recognized as opportunistic pathogens, particularly in immunocompromised individuals. Mycobacterium kansasii, a slow-growing photochromogen (Runyon group I), is primarily associated with pulmonary disease; however, extrapulmonary and cutaneous manifestations are uncommon and often underdiagnosed. Given the rising incidence of NTM infections, cutaneous disease should be considered in the differential diagnosis of skin lesions, especially in immunocompromised patients. Early microbiological confirmation is crucial for appropriate therapy, as M. kansasii is intrinsically resistant to pyrazinamide. Herein, we present a case of pathologically confirmed cutaneous M. kansasii infection occurring in isolation, illustrating the diagnostic challenges and therapeutic outcomes.

Psychological And Neuromechanical Recovery After Concussion: Dual-Task Stability And Kinesiophobia From Return To Play To Six Months., Melissa Anderson, Daniel Le, Mallory Faherty, Carolyn Killelea, Jeffrey Bytomski, Corina Martinez, Michael Bergeron, Timothy Sell

OhioHealth Research Institute Articles

BACKGROUND: Sport-related concussion (SRC) increases the risk of subsequent musculoskeletal injury, yet the mechanisms underlying this vulnerability remain unclear. Fear of movement (kinesiophobia) may contribute to impaired motor control.

PURPOSE: This study examined kinesiophobia and postural stability in adolescent athletes at return-to-play (RTP) after SRC and evaluated changes six months later.

DESIGN: Observational analytical study with cross-sectional (case-control) and prospective cohort components.

METHODS: Thirty-seven concussed athletes (15.7 ± 1.3 years, 45.9% female) and 17 matched controls (16.4 ± 2.1 years, 52.9% female) completed static single-leg stance and dynamic single-leg landing tasks under single- and dual-task (Stroop) conditions. Fear of movement …

Healthcare Professionals’ Experiences And Perspectives On Self-Management Education For Breast Cancer Survivors In Australian Primary Care: A Qualitative Study, Meng Yuan Li, Tao Wang, Daniel Terry, Haiying Wang, Isabella Zhao, Jing Yu Tan

Research outputs 2022 to 2026

Purpose: Breast cancer has been recognised as a chronic condition, with survivors experiencing long-term physical and psychosocial effects following treatment. Supporting breast cancer survivors to self-manage their health can optimise health-related quality of life and reduce symptom burden. Self-management education (SME) has been advocated at the policy and programme level in Australian primary care, but its uptake is often limited. This study explores healthcare professionals’ (HCPs) experiences and perceptions of SME in primary care, aiming to identify factors influencing its implementation and to support survivorship care for breast cancer survivors in Australia.

Methods: A qualitative descriptive approach was adopted involving …

Muscle–Tumor Crosstalk In Exercise Oncology: Exercise-Induced Myokines And Cancer Cachexia, Amirhossein Ahmadi Hekmatikar, Francesco Bettariga, Álvaro López Llorente, Diego Fernández-Lázaro, Katsuhiko Suzuki, D. Maryama Awang Daud

Research outputs 2022 to 2026

Exercise-induced myokines, such as IL-6, irisin, and myostatin, play crucial roles in mediating systemic adaptations and modulating tumor progression. This narrative review synthesizes evidence on how regular moderate-intensity exercise affects the myokine network within the tumor microenvironment (TME) of solid tumors. Results from the 86 included studies indicate that structured training (aerobic: 45–65% VO2 max; resistance: 45–70% 1RM) enhances the expression of beneficial myokines that support immune surveillance, reduce inflammation, and improve muscle–tumor cross-talk. IL-6 demonstrates a dual modulatory effect on inflammation and immunity; irisin contributes to tumor apoptosis, while myostatin downregulation supports muscle integrity and metabolic balance. Evidence suggests …

Molecular Classification And Association With Survival Outcomes In High-Intermediate And High-Risk Early-Stage Endometrial Cancers: Ancillary Analysis Of Gog-0249., Lindsay M Kuroki, Danielle M Enserro, Heather A Lankes, Kyle C Strickland, Rebecca Previs, Aine Clements, Matthew A Powell, Ann Klopp, Elena Ratner, Paul Disilvestro, Casey Cosgrove, Guilherme Henrique Cantuaria, Nicola M Spirtos, Michael Carney, Mitchell Edelson, Gottfried Konecny, Penny Anderson, Christopher Tarney, Britt K Erickson, Meredith Newton, Krishnansu S Tewari, Premal H Thaker, David Warshal, Amy Armstrong, Xun Clare Zhou, Angeles Alvarez Secord

Women’s Health Articles

OBJECTIVE: Determine whether mismatch repair (MMR) and p53 expression predict recurrence-free survival (RFS) and overall survival (OS) in early-stage endometrial cancer (EC) patients treated with vaginal cuff brachytherapy plus chemotherapy (VCB/C) versus pelvic radiation therapy (RT).

METHODS: In the GOG-0249 trial, 601 patients with high-intermediate risk (HIR) early-stage EC were randomized to VCB/C (carboplatin/paclitaxel for 3 cycles) or pelvic RT. Molecular subgroups, deficient MMR (dMMR), p53 wildtype (p53wt), p53 abnormal (p53abn), were determined by immunohistochemistry. Five-year RFS and OS were analyzed using Kaplan-Meier curves and Cox proportional hazards models, adjusting for lymphadenectomy, planned VCB, and treatment group.

RESULTS: Among 315 …

The Role Of Apparent Diffusion Coefficient Value Measurement In The Differentiation Of Ischemic Stroke From Multiple Sclerosis In The Brain, Jenan Mohammed Khalid, Amer Murad Gebur

Iraqi Postgraduate Medical Journal

Differentiating acute ischemic stroke from active multiple sclerosis (MS) plaques using conventional MRI can be challenging due to overlapping radiological features. The Apparent Diffusion Coefficient (ADC) provides a quantitative measure of water diffusion, potentially offering a solution to this diagnostic dilemma. This study aims to evaluate the role of ADC value measurements in distinguishing between acute ischemic stroke and acute demyelinating MS lesions. This cross-sectional study was conducted at a tertiary care center in Iraq from November 2024 to July 2025. All participants underwent a standardized brain MRI protocol on a 1.5-T scanner. ADC values were measured by manually placing …

Precise-Dyad: A Prospective Cohort Study Linking Maternal And Infant Health Trajectories In Sub-Saharan Africa, Marie-Laure Volvert, Robin Owino, Angela Koech, Onesmus Wanje, Isaac Mwaniki, Joseph Mutunga, Emily Mwadime, Geoffrey Omuse, Moses Mukhanya, Marvin Ochieng, Grace Mwashigadi, Agnes Mutua, Marleen Temmerman, Melissa Gladstone, Amina Abubakar, Helen Nabwera

Centre of Excellence in Women and Child Health

Purpose The PREgnancy Care Integrating Translational Science, Everywhere (PRECISE)-DYAD Study is a prospective observational cohort designed to investigate health outcomes among mother-child pairs (dyads) over the first 3 years of life in two contexts from sub-Saharan Africa. The primary objective of the study was to explore the effects of selected placenta-related complications, such as pregnancy hypertension, fetal growth restriction and preterm birth, on (1) Child health and development, and (2) Women’s health and well-being, including outcomes after stillbirth.

Participants The PRECISE-DYAD Study enrolled women (and their children) originally recruited into the PRECISE pregnancy cohort study in The Gambia and Kenya …

Why Pronatalism Fails The Planetary Health Test, Celine Delacroix, Marleen Temmerman, Nandita Bajaj, Ann Moore, Phoebe Barnard, William Ripple, William Rees, Michael Gerrard, Diana Coole, Robert Engelman

Centre of Excellence in Women and Child Health

No abstract provided.

Hpv Vaccination Status And Associated Factors Among Postpartum Patients, Morgan L. Malonson, Sandhya B. Avula, Mary B. Rysavy

Summer Research Program Abstracts

No abstract provided.

Long-Term Quality Of Life For Patients With Merkel Cell Carcinoma Receiving Standard-Of-Care Adjuvant Radiation Therapy, Christian Paul D. Denolan, Kelsey N. Nordlund, Aya F. Salem, Devarati Mitra

Summer Research Program Abstracts

No abstract provided.