Medicine and Health Sciences Commons^™

Relationship Of Early Rapid Weight Loss To Efficacy And Safety Of Tirzepatide And Semaglutide For Obesity: Surmount-5 Post Hoc Analysis, Louis J Aronne, Deborah B Horn, Alexander D Kokkinos, Beverly L Falcon, Hui Wang, Hunter T Hoffmann, Clare J Lee, Julia P Dunn

Faculty, Staff and Student Publications

Background: A knowledge gap remains in how the rate of body weight reduction impacts efficacy and safety of obesity management medications. This SURMOUNT-5 post hoc analysis aimed to define rapid responders and evaluated efficacy and safety of tirzepatide versus. semaglutide in rapid responders versus non-rapid responders.

Methods: Rapid responders and non-rapid responders were defined as participants that obtained ≥ 15% and < 15% body weight reduction by Week 24, respectively. Baseline characteristics, and proportion of participants achieving body weight reduction thresholds by Week 72 were assessed. End-of-study safety and gastrointestinal adverse events measures were summarized.

Results: Overall, 32.3% were rapid responders (tirzepatide: 44%, semaglutide: 21%). The proportions of participants achieving body weight reduction thresholds by Week 72 were higher for rapid responders versus non-rapid responders. Safety trends for tirzepatide and semaglutide were similar between …

Neuroprotective Effects Of Sorghum Polyphenol In Alzheimer’S Disease: In Vitro And In Silico Analyses, Rasheed A. Abdulraheem, Ralph N. Martins, Rajapandiyan Krishnamoorthy, Mohammad A. Alshuniaber, Prashant Bharadwaj, Zhaoyu Li, Ranil Coorey, Vijay Jayasena, Stuart K. Johnson, W. M.A.D.Binosha Fernando

Research outputs 2022 to 2026

Background/Objective: Accumulation of amyloid-beta (Aβ) senile plaques in the human brain is a major hallmark of Alzheimer’s disease (AD), which manifests as progressive decline in memory and cognitive functions and currently lacks effective disease-modifying therapies. Emerging evidence demonstrates that polyphenol-rich plant foods are potential complementary therapies for AD. Methods: In this study, we investigated crude polyphenol extracts (CPEs) and purified polyphenol extracts (PPEs) from three sorghum genotypes for their ability to inhibit Aβ42-induced toxicity in MC-65 cells. Thioflavin T fluorescence, cell viability, mitochondrial function, oxidative stress assays, and Western blotting, along with RNA sequencing and computational analyses, were used to …

A Blended Genome And Exome Sequencing Method Captures Genetic Variation In An Unbiased And Cost-Effective Manner, Toni Boltz, Benjamin Chu, Matthew Defelice, Calwing Liao, Julia Sealock, Robert Ye, Jacqueline Goldstein, Lerato Majara, Jack Fu, Lukoye Atwoli

Internal Medicine, East Africa

Here we developed and deployed the blended genome exome (BGE) method, a DNA library approach that generates low-pass whole-genome (1–4× mean depth) and deep whole-exome (30–40× mean depth) data in a single sequencing run. BGE is cost-effective, empowers most genomic discoveries possible with deep whole-genome sequencing and captures global common single-nucleotide polymorphism diversity. We applied BGE to sequence >53,000 samples from the PUMAS Project (Populations Underrepresented in Mental Illness Associations Studies), including African, African American and Latin American populations. Imputed genotypes showed high concordance with Illumina Global Screening Array calls (R2 ≥ 95% for minor allele frequency ≥1%; …

Antibiotic Administration After Previable Preterm Prelabor Rupture Of Membranes Is Associated With Prolonged Latency, Alexandra L Hammerquist, Alexander M Saucedo, Selina L Bowler, Mohan Pammi, Catherine Eppes, Ignatia Van Den Veyver, Michael D Jochum, Enrico R Barrozo

Duncan NRI Faculty and Staff Publications

Introduction: While antibiotics have been shown to increase the interval to delivery between rupture of membranes and delivery (latency) and improve neonatal outcomes after viable preterm prelabor rupture of membranes (PPROM), this has not been well investigated in the previable PPROM population. We aimed to investigate the association between antenatal antibiotics and latency following previable PPROM. Secondarily, we examined various maternal and neonatal outcomes. We hypothesized that the administration of antibiotics would prolong latency in pregnancies with previable PPROM.

Methods: Single-center retrospective cohort study that included pregnancies diagnosed with previable PPROM between 140/7 and 216/7 and delivered between 2012 and …

Challenge-Based Ex Vivo Immune Profiling Reveals Stimulus-Dependent Peripheral Immune Reprogramming In Alzheimer's Disease, C. A. Naranjo-Galvis, Jovanny Zabaleta, Ney Alliey Rodriguez, Luisa Matilde Salamanca-Duque

School of Medicine Publications

Altered immune function is increasingly recognized as a contributor to Alzheimer's disease (AD); however, it remains unclear whether peripheral immune alterations reflect constitutive inflammation or stimulus-dependent changes in immune responsiveness. Addressing this distinction is critical for understanding immune dysregulation in neurodegenerative diseases. In this study, we applied a challenge-based ex vivo immune profiling approach to characterize functional immune responsiveness in patients with AD and in cognitively healthy older adults. Peripheral blood mononuclear cells were exposed to defined innate, antigenic, and mitogenic stimuli, and cytokine and β-amyloid (Aβ) responses were quantified in culture supernatants. Diagnosis-by-stimulus interaction effects were assessed using generalized …

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 …

Mechanisms Coordinating Exit From The Stem Cell State In Mammals, Emily J Park, Florencia Levin-Ferreyra, Bruno Di Stefano

Faculty, Staff and Students Publications

Differentiation requires coordinated exit from the stem cell state, during which gene regulatory networks sustaining self-renewal are dismantled, while lineage-specific programs are activated. This transition is governed by chromatin modifications, transcriptional networks, RNA processing, translational control, and metabolic rewiring that must operate with temporal precision. Despite significant progress in identifying individual regulatory components, understanding how these layers integrate to orchestrate irreversible cell fate commitment remains a fundamental challenge. This review examines common and unique regulatory principles governing stem cell exit, from totipotency during early embryogenesis to tissue-specific stem cell differentiation in adults. We synthesize recent findings on regulatory mechanisms across …

Hypovascular Aggressive Angiomyxoma In A Pregnant Adolescent: A Case Report And Review Of Its Multimodal Imaging Appearances, Kyler Shin, Kweku Agyepong, Craig Kym, Mohammad Ghasemi-Rad, David Léon

Faculty, Staff and Students Publications

Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor that primarily arises in the perineum and pelvis of young females. It is sometimes identified incidentally on pelvic examination and obstetric imaging. Although asymptomatic at small sizes, AAM is typically hypervascular and can grow large enough to complicate a patient's obstetric and gynecologic course of treatment. While AAM is a rare diagnosis reported in the literature, there are limited descriptions of its multimodal radiologic appearance, and uncommonly, it can present as a hypovascular mass. We describe a rare case of hypovascular AAM in pregnancy that did not respond favorably to targeted embolization, …

Mapping Dna Methylation Signatures To Identify Epigenetic Variation Across Subcortical Regions Of The Human Posttraumatic Stress Disorder Brain, Hongyu Li, Yujing Liu, Yiming Shi, Jiawei Wang, Tuan P Nguyen, Yuhan Xie, Wangjie Zheng, Youshu Cheng, Dianne A Cruz, Jennifer L Modliszewski, Rosemarie Terwilliger, Alexa-Nicole Sliby, José Jaime Martínez-Magaña, Janitza L Montalvo-Ortiz, John D Roache, Lynnette A Averill, Stacey Young-Mccaughan, Paulo R Shiroma, Bertrand R Huber, David A Lewis, Jill Glausier, Paul Holtzheimer, Matthew J Friedman, Jing Zhang, Alan L Peterson, Chadi G Abdallah, Amir Valizadeh, Xinyu Zhang, Ke Xu, John H Krystal, Ronald S Duman, Hongyu Zhao, David L Corcoran, Douglas E Williamson, Matthew J Girgenti

Staff and Researcher Publications

Background: Posttraumatic stress disorder (PTSD) is a mental disorder that may occur in the aftermath of severe psychological trauma. Epigenetic changes in the brain may play a critical role in understanding the neurobiology of PTSD by linking environmental traumatic stress exposure to lasting alterations in gene expression that shape neuronal function.

Methods: We examined 1,065,750 DNA methylation (DNAm) sites from 171 donors including neurotypical controls and PTSD and major depressive disorder (MDD) cases across 6 regions implicated in the fear circuitry of the brain. We performed RNA sequencing (RNA-seq) to examine changes in gene expression and linked these changes to …

Intimate Partner Violence And Adverse Pregnancy Outcomes Among Women Accessing Postnatal Care In A Tertiary Hospital In North-Central Nigeria: A Cross-Sectional Study, Paul E. Agbo, Lucky L. Changkat, Mary C. Momoh, Salihu O. Mohammed, Dogara B. Bawa, Adeola Olabamiji, Rashida Musa, Steve C. Okoro, Ene F. Agbo, Lawal A. Abdulmumuni

Preventia: The Indonesian Journal of Public Health

Intimate partner violence (IPV) during pregnancy is a major public health concern associated with adverse maternal and neonatal outcomes, particularly in low- and middle-income countries. Despite increasing recognition, evidence linking specific forms of IPV to pregnancy outcomes in Nigeria remains limited. This study was conducted to determine the prevalence of intimate partner violence and examine its association with adverse pregnancy outcomes among women attending postnatal care in a tertiary hospital in North-Central Nigeria. A hospital-based cross-sectional analytic study was conducted among 381 women attending postnatal care. Data were collected using a structured, interviewer-administered questionnaire that incorporated the Abuse Assessment Screen. …

Kmt2d As An Epigenetic Target In Cervical Cancer: A Literature Review On Polyclonal Antibody Therapeutics And Translational Prospects, Farsya Hidayah Septiananda, Taurisma Aulia Nanda Wibisono, Rajendra Aulya Gilardino, Andreas Budi Wijaya

Preventia: The Indonesian Journal of Public Health

Cervical cancer remains a significant global health burden, particularly in regions with limited access to advanced therapeutics. Beyond viral oncogenesis, accumulating evidence highlights the crucial role of epigenetic dysregulation, particularly KMT2D, in tumor initiation and progression. This literature review aimed to critically synthesize current evidence regarding the biological role of KMT2D in cervical cancer and to explore the opportunities and limitations of antibody-based approaches for future epigenetic intervention. A structured narrative literature review was conducted using PubMed, Scopus, and Web of Science to identify relevant studies published between January 2020 and May 2025. Literature selection was guided by a modified …

Endophytic Actinobacteria: Deciphering Therapeutic And Industrial Potential, And Prospects Of Genome Mining In Novel Products Discovery, Yusra Waheed, Rabia Shahdin, Imran Sajid

Journal of Bioresource Management

Endophytic actinobacteria are a diverse group of Gram-positive bacteria with high G+C content, which inhabit plants’ internal tissues, and represent a significant yet underexplored reservoir of bioactive secondary metabolites. In host plants, a remarkable repertoire of metabolites, including broad-spectrum antibiotics, anticancer, antiviral, antifungal, antioxidant, and immunomodulatory compounds, is synthesized by these microbial allies, carrying significant medicinal and agricultural potential. These endophytes, in contrast to their soil relatives, have developed unique biosynthetic gene clusters (BGCs) strongly influenced by plant-associated factors, leading to the production of structurally novel metabolites. In recent years, the advances in genome mining, metagenomics, and metabolomics have accelerated …

Tumor–Immune Dynamics With Memory And Time Delay: A Fractional-Order Model With Ctla-4 Regulation, Mutaz Mohammad, Mohyeedden Sweidan, Alexander Trounev, Fathalla Rihan

Mathematical Modelling and Numerical Simulation with Applications

This study develops a fractional-order tumor-immune interaction model incorporating Caputo memory effects, delayed immune activation, and CTLA-4 checkpoint regulation. The model describes the coupled dynamics of tumor cells, CD4$^{+}$ T cells, IFN-$\gamma$, and CTLA-4, and extends classical integer-order tumor-immune models by accounting for hereditary immune responses and biologically motivated latency effects. Theoretical properties, including positivity, boundedness, equilibrium structure, and fractional-order stability, are examined to establish the biological and mathematical consistency of the model. The delayed fractional system is then investigated computationally by comparing several numerical methods, including finite difference discretization, Daubechies wavelet collocation, Euler wavelet collocation, and a predictor-corrector scheme. …

Leading Healthcare Improvement: An Implementation Strategy, Kelley Arredondo, Anthony Ecker, Lindsay Vaclavik, Jacquelene Shahin, Ashley Thompson, Molly Horstman, David Ramsey, Kyler M Godwin

Faculty, Staff and Students Publications

Introduction: Healthcare professionals often implement quality improvement (QI) initiatives but lack training to implement and sustain QI initiatives. Leading Healthcare Improvement (LHI) is a course that combines principles from change management, team science, and leadership effectiveness into an implementation strategy to enable clinicians to lead sustainable change.

Methods: LHI is a 6-session, 4-month interactive training. Learners work on an active QI project throughout the course. A Wilcoxon signed-rank test was conducted to evaluate pre- and post-course changes in learners' self-reported confidence across five QI competencies.

Results: Veterans Healthcare Administration clinicians and fellows completed the LHI pre- (n = 111) and …

Extended-Phase Anticoagulation For Pediatric Venous Thromboembolism After Einstein Jr, Nathan Wilken, Jun Teruya

Faculty, Staff and Students Publications

No abstract provided.

Oncocytic Intraductal Carcinoma Of The Parotid Gland With Strn::Alk Fusion, Reham H Soliman, Chris Shi, Kevin E Fisher, Hong Yu, Fouad El-Dana, Xu Cao, Li Liang, Pei Ying, Songlin Zhang

Faculty, Staff and Students Publications

Intraductal carcinoma (IDC) of the salivary gland is an uncommon epithelial neoplasm characterized by a predominantly intraductal or intracystic proliferation rimmed by a myoepithelial cell layer. Advances in molecular profiling have revealed recurrent gene fusions in IDC, most frequently involving RET, although fusions implicating other kinase genes have also been described. Among these, ALK rearrangements are rare and remain poorly characterized. Herein, we report a case of oncocytic IDC of the parotid gland harboring a STRN::ALK fusion, further expanding the molecular landscape of this tumor. Although this fusion has been previously reported in intercalated duct IDC, to our knowledge, this …

Effect Of Androgen Receptor Polymorphism On Hypogonadism Severity And Efficacy Of Testosterone Replacement Therapy, Nelson W Mills, Beatriz S Hernandez, Peyton J Coady, Arnaav Walia, Gal Saffati, Daniela Orozco Rendon, Dalia Khera, Nadia Khera, Weitao Song, Mohit Khera

Faculty, Staff and Students Publications

Background: The preferred treatment for hypogonadism, testosterone replacement therapy (TRT), has a varying efficacy that is currently not fully understood. This observation may be explained by polymorphism of the androgen receptor (AR), a ligand-binding transcription factor whose polyglutamine tract length affects various health conditions and androgen sensitivity. It has been theorized that this polymorphism may also affect the severity of hypogonadism. This study sought to determine a correlation between hypogonadism severity, TRT efficacy, and number of CAG trinucleotide repeats in the AR gene.

Methods: One hundred sixty-two males presenting to a single institution with symptoms of hypogonadism were recruited for …

Comprehensive Prediction Analysis Of Novel Noncoding Regulatory Variants Identified In The Microrna Binding Regions In Complement System Genes, Anthony Shadid, Haydn E Rich, Kathryn D Hok, Marie-Francoise Doursout, Marcos I Restrepo, Nirmal K Banda, Lavanya Gunamalai, Pooja Shivshankar

The Brown Foundation: Institute of Molecular Medicine

The complement system is a central component of innate immunity that coordinates host defense, immune surveillance, and inflammatory responses through tightly regulated proteolytic cascades. Genetic variation within complement genes contributes substantially to interindividual differences in complement activity and disease susceptibility. While coding variants directly alter complement protein structure and function, the microRNA (miRNA)-mediated control and post-transcriptional regulation is not fully understood in shaping complement gene expression across immune and inflammatory mechanisms. Complement pathway genes exhibit extensive and heterogeneous 3'-untranslated regions (3'UTRs), which serve as primary platforms for miRNA binding and RNA-binding protein interactions. Both common and rare single-nucleotide polymorphisms within …

Fgfr3::Tacc3 Fusion And Notch1 Loss-Of-Function In A Case Of Hpv-Associated Sinonasal Squamous Cell Carcinoma: Diagnostic Challenge And Implications For Targeted Therapy, Xu Cao, Hong Yu, Reham Hamdy Abdulazim Soliman, Pei Ying, Songlin Zhang, Li Liang

Faculty, Staff and Students Publications

Sinonasal squamous cell carcinoma (SNSCC) comprises a heterogeneous group of tumors with emerging molecular subtypes. Human papillomavirus (HPV)-associated SNSCC is a distinct entity, although actionable genomic alterations beyond HPV-driven pathways remain underexplored. Distinguishing HPV-associated SNSCC from carcinoma ex inverted papilloma can be particularly challenging in limited biopsy specimens, as these lesions may appear morphologically similar. We report a case of HPV-associated SNSCC with concurrent FGFR3::TACC3 fusion and NOTCH1 p.C1416 stop-gain mutation.

Analysis Of Priority Vaccine-Preventable Diseases Using The Paho-Adapted Hanlon Method In Bogor City In 2024, Sonia Annisa Br Ketaren, Tri Yunis Miko Wahyono, Bai Kusnadi

Jurnal Epidemiologi Kesehatan Indonesia

Vaccine-preventable diseases (VPDs) remain a major public health challenge despite substantial progress in immunization programs. In Indonesia, routine immunization coverage has shown a post-pandemic recovery trend; however, disparities in access to health services and surveillance quality persist across regions. This study aimed to determine priority VPD problems in Bogor City and identify factors contributing to the highest-ranked disease. A mixed-methods study was conducted in Bogor City from October 2024 to January 2025. Quantitative prioritization was performed using the Pan American Health Organization (PAHO)-adapted Hanlon method across eight VPDs. Qualitative data were collected through in-depth interviews with key informants and analyzed …

Tusc3 Serves As A Rate-Limiting Gatekeeper Of A Glycan-Mediated Er Triage Checkpoint For Bmp4/Dpp, Antonio Galeone, Emilio Solazzo, Francesco Lavezzari, Seung Yeop Han, Gaia Consonni, Bruna My, Riccardo Rizzo, Giuseppe Gigli, Hamed Jafar-Nejad, Thomas Vaccari

Faculty, Staff and Students Publications

Trimming of the three glucose residues decorating nascent N-glycoproteins is a critical step for their entry into the endoplasmic reticulum quality control (ERQC) and recognition by ER chaperones. However, the functional relevance of the second glucose (G2) and the regulatory step upstream of its removal by glucosidase II (GCS2) remain poorly understood. Here, we report that TUSC3, a component of the oligosaccharyltransferase (OST) complex, regulates G2 to G1 trimming on N-glycosylated bone morphogenetic protein 4 (BMP4) and its Drosophila homolog Dpp to promote their ERQC entry. Loss- and gain-of-function genetic experiments and biochemical assays in mammalian cells and flies indicate …

Reply To: A Lethal Progressive Neuroinflammation Disguised As Mogad Revealing A Final Diagnosis Of Griscelli Syndrome: Regarding: Mogad Is The Most Common Cause Of Isolated Optic Neuritis In Children, Chaitanya Aduru, Akansha Chandrasekar, Kyla Blasingame, Jonathan Rosen, Jesse M Levine, Karla Salazar, Madhuri Chilakapati, Rod Foroozan, Victoria Adeseye, Jonathan M Yarimi, Nikita Shukla, Timothy E Lotze, Kristen S Fisher, Alexander J Sandweiss

Faculty, Staff and Students Publications

No abstract provided.

Chemotherapeutic Induction Of Cytosolic Single-Stranded Dna Accumulation Sensitizes Triple-Negative Breast Cancer To Immunotherapy, Yong Du, Li Yang, Hui Dai, Jianli Zhou, Zhicheng Zhou, Ruoxi Yuan, Rui Ye, Anh Thai Quynh Nguyen, Kishor Bhatia, Shiaw-Yih Lin

Faculty, Staff and Students Publications

Background: Despite the widespread adoption of chemoimmunotherapy in triple-negative breast cancer (TNBC), the mechanisms by which cytotoxic chemotherapy engages antitumor immunity remain poorly defined. Identifying tumor-intrinsic immunogenic programs that predict and enhance responsiveness to immune checkpoint blockade (ICB) is therefore of critical clinical importance.

Methods: Transcriptomic signatures of TREX1 deficiency were generated from CRISPR-engineered TNBC models and applied to multiple independent TNBC cohorts treated with chemoimmunotherapy. Cytosolic single-stranded DNA (ssDNA) accumulation was quantified using a flow cytometry-based assay to functionally screen chemotherapeutic agents. Immune activation and therapeutic efficacy were evaluated using in vitro assays, syngeneic mouse tumor models, flow cytometry, …

Letter To The Editor: Hemodynamic Role In Hepatic Encephalopathy Pathogenesis Following Transjugular Intrahepatic Portosystemic Shunt Placement, John Halphen, Yash S Dayal, Cameron Laurie, Mohadese Ahmadzade, David Wynne, Mohammad Ghasemi-Rad

Faculty, Staff and Students Publications

Hepatic encephalopathy (HE) is a common complication following transjugular intrahepatic portosystemic shunt (TIPS) placement and is thought to result from reduced hepatic detoxification of neurotoxins. However, Zhuang et al in the World Journal of Radiology demonstrate that this understanding may be incomplete through exploration of the pathophysiology from a hemodynamic perspective. They found significant changes in cerebral blood flow (CBF) and spontaneous brain activity following TIPS. Initially, CBF increased in specific areas within the first month, followed by a return to baseline at three months. These CBF changes coincided with increased spontaneous brain activity that persisted in some areas, suggesting …

Long-Term Functional Synaptic Integration Of Genome-Edited Retinal Organoids In A Primate Model Of Macular Degeneration, Atsuta Ozaki, Akihiro Kawai, Ryutaro Akiba, Satoko Okayama, Nobuhiko Ohno, Keisuke Kajita, Tomohiro Masuda, Satoshi Yokota, Shin-Ichiro Ito, Du Peiyan, Kenta Onoue, Shigenobu Yonemura, Mineo Kondo, Yasuo Kurimoto, Yingbin Fu, Michiko Mandai

Faculty, Staff and Students Publications

Retinal organoids represent a promising regenerative strategy for restoring vision in retinal degenerative diseases, but the capacity of host cone bipolar cells in the primate macula to rewire with transplanted photoreceptors has not been established. In this study, we transplanted genome-edited ISL1-/- human retinal organoids lacking ON-bipolar cells into an acute laser-induced macular photoreceptor ablation non-human primate model. Using immunohistochemistry, ultrastructural imaging, and focal macular electroretinography, we demonstrate that host rod and cone bipolar cells actively extend dendrites toward grafted photoreceptors and form synaptic contacts, with evidence of functional signal transmission in a subset of transplanted eyes. Longitudinal, per-eye analyses …

Surviving Sepsis 2026: Key Updates, Amanda Rawa, Katherine Ghattas

Transformative Medicine

The 2026 update to the Surviving Sepsis Campaign guidelines introduces several important changes in the management of sepsis and septic shock, with a greater focus on tailoring treatment to individual patients. Notable updates include lower blood pressure targets for older adults with septic shock, continued support for early fluid resuscitation, the selective use of rapid diagnostic testing to guide antibiotic therapy, and increased flexibility in vasopressor selection for patients with cardiac dysfunction. These recommendations are based on emerging evidence aimed at improving patient outcomes while reducing unnecessary interventions and treatment-related complications. Overall, the updated guidelines reinforce a more personalized approach …

Patient Activation Measures Among Individuals With Epilepsy: A Cross-Sectional Study Of An Arabic-Speaking Population, Ghada M. Abbas, Abeer A. Khoja, Haythum O. Tayeb, Nagham S. Alsolaimani, Ibrahim M. Aldurayhim, Saher F. Alqarni

Neurosciences

Objectives: To examine patient activation levels among Arabic-speaking adults with epilepsy and to explore their associations with selected clinical and sociodemographic variables.

Methods: We conducted a cross-sectional study of 109 adult patients with confirmed epilepsy between December 2023 and October 2025. Data were collected during outpatient clinic visits, with additional information obtained through telephone contact when necessary. A sample size estimate indicated that at least 96 participants were required to achieve 80% statistical power. Patient activation was assessed using the validated Arabic version of the 13-item Patient Activation Measure (PAM-13). The variables examined included seizure type, medication regimen (monotherapy versus …

Antiseizure Drug Adherence In Pediatric Patients With Epilepsy And The Associated Factors In Saudi Arabia, Ola A Shawky, Shaima A Althoubaiti, Reham M Alkahtani, Amirah S Alharthi

Neurosciences

Objectives: To assess the prevalence of adherence to antiseizure medications and related factors in Saudi Arabia. Pediatric epilepsy presents significant challenges to the well-being and quality of life of children. Adherence to antiseizure medication is associated with better outcomes.

Methods: This study was carried out using a cross-sectional methodology to determine the prevalence of antiseizure medication adherence among children with epilepsy aged ≤ 17 years in Saudi Arabia. Data were collected between July and September 2024 via an online self-administered questionnaire, using convenience sampling through social platforms (Telegram and WhatsApp). Medication adherence was assessed using the MMAS-8 and categorized as …

Cerebrovascular And Bleeding Outcomes Of Warfarin Versus Direct Oral Anticoagulants Therapy For Atrial Fibrillation: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Abeer A. Alomairi, Rana Alduhaysh, Alaa Samandar, Abeer Alshehri, Ghada Alabdullah, Saud Almutairi, Faisal Althekair

Neurosciences

Objectives: To compare the effects on cerebral health in atrial fibrillation patients receiving either warfarin or direct oral anticoagulants (DOACs). Atrial fibrillation is linked to a higher likelihood of both stroke and cognitive impairment. While warfarin has historically served as the leading anticoagulant treatment, DOACs are now more frequently viewed as alternatives with an improved safety profile.

Methods: The methodology involved an extensive search of multiple databases, completed up to June 2024. This search yielded randomized controlled trials, which together enrolled over 60,000 participants between the ages of 70 and 84. The DOACs studied were dabigatran, rivaroxaban, apixaban, and edoxaban, …