Medicine and Health Sciences Commons^™

Eeg Features And Rotterdam Head Ct Score Predict Early Favorable Outcome In Pediatric Severe Tbi, Xuexin Lu

Presentations

INTRODUCTION Accurate prognostication after pediatric severe TBI (sTBI) remains challenging. We examined the utility of continuous EEG (cEEG) and Rotterdam head CT score in predicting short-term favorable outcome. METHODS 7-yr (01/2018-12/2024) retrospective study of children aged 1.5-18 yrs admitted to our PICU with sTBI and receiving cEEG monitoring per institutional protocol. Early favorable outcome was defined as Pediatric Cerebral Performance Category scale 1-3 at PICU discharge. cEEG features (background, sleep architecture, reactivity, and seizure) during the 1st 12-hrs of monitoring and initial Rotterdam head CT scores were recorded. Demographics, GCS score, pupillary reactivity, injury severity score (ISS), clinical seizure, cardiac …

Oral Ferrous Sulphate Supplementation Has Greater Efficacy, But Lower Tolerance Than Iron (Iii)-Hydroxide Polymaltose Complexes In Exercising Women With Low Iron Stores, Alannah Ka Mckay, Sophie Broome, Nicolin Tee, Kin Lui Yim, Marc Sim, Peter Peeling, Louise M. Burke

Research outputs 2022 to 2026

Background & Aims: Iron deficiency (ID) is a global health condition that predominately affects women. Although oral iron supplementation is an effective treatment strategy for this issue, gastrointestinal complaints are common, and if persistent, may lead to poor compliance. The efficacy of different iron formulations which claim to improve tolerance is unclear. This study assessed the efficacy and tolerability of ferrous sulphate (FS) and iron (III)-hydroxide polymaltose complex (IPC) supplementation in three different cohorts of women.. Methods: This study implemented a 12-week, single-blind, randomized controlled trial. Eligible participants had a serum ferritin concentration of <50 μg/L and met specific inclusion criteria to be enrolled to either the athlete, pre-menopausal or post-menopausal groups. Participants were randomized to receive FS (equivalent to 105 mg elemental iron) plus sodium ascorbate or IPC (equivalent to 100 mg elemental iron) daily. Venous blood samples were collected at baseline, 4-, 8- and 12-weeks of supplementation. A daily questionnaire was completed throughout the study period, documenting supplement tolerance (number and severity of symptoms), exercise load, menstrual characteristics, and supplement compliance. Results: Fifty-seven participants completed the intervention with a compliance rate of 94.9 % [range: 74.8-100 %]. A significant interaction between supplement and time was evident for ferritin (p < 0.001), where FS increased after 12 weeks (+109 %; p < 0.001) but no change was evident in IPC (+7 %; p = 0.727). No differences were detected between cohorts (p > 0.05). The IPC group had a …

Assessing Liver And Iron Markers In Steady State Pediatric Scd Patients To Ascertain The Hepatic Consequences Of Hemotransfusion: A Case-Control Study In Ghana, John Agyemang Sah, Stephen Twumasi, Allwell Adofo Ayirebi, Benedict Sackey, Enoch Odame Anto, Richard Vikpebah Duneeh, Ebenezer Senu, Veronica Barnor, David Boakye, Daniel Nii Martey Antonio, Wina Ivy Ofori Boadu

Research outputs 2022 to 2026

Background and Aims: Between 200,000 and 300,000 children with sickle cell disease (SCD) are born in Africa every year, with 75%–80% of these children living in sub-Saharan Africa. In newborns with SCD, significant iron accumulations may develop because of their increased risk of requiring multiple blood transfusions. This study aimed to assess the hepatic effects of hemotransfusion in pediatric SCD patients in steady state by measuring liver and iron markers. Methods: This case-control research enrolled 120 children with SCD and 60 children without SCD from the Asokwa Children's Hospital Sickle Cell Clinic and Child Welfare Clinic. Participants’ sociodemographic information, history …

Measuring Plantar Flexor Voluntary Activation And Maximal Voluntary Contraction In A Portable, Seated Method: A Validity And Reliability Study, Molly E. Coventry, Andrea B. Mosler, Paola T. Chivers, Brady D. Green, Ebonie K. Rio, Myles C. Murphy

Research outputs 2022 to 2026

Background: Voluntary activation testing quantifies the ability of the motor nervous system to produce maximal force. Laboratory assessment of ankle plantar flexor voluntary activation is common, but field testing in practical settings is limited by equipment portability. We aimed to compare plantar flexor voluntary activation and maximal voluntary contraction (MVC) using a portable device with a standardised laboratory method and evaluate the test–retest reliability of the portable protocol. Methods: We performed a pseudo-randomised, crossover design. Participants completed two protocols: (1) portable force plate testing and (2) a laboratory-based isokinetic dynamometer. Voluntary activation was assessed using twitch interpolation via tibial nerve …

The Relationships Between Social Network Size, Loneliness And Personality In Individuals Living With A Neurological Condition: An Exploratory Study, Isabella Branson, Kate Turner, Mitchell Turner, Manja Laws, Leah Dempsey, Simon Laws, Mandy Stanley, Johnny Lo, Travis Cruickshank

Research outputs 2022 to 2026

Background: People living with a neurological condition often report having smaller social networks and less frequent social contact, leading to greater loneliness and worse quality of life. This study explored the relationships between personality traits, social network size (SNS) and perceived loneliness in this population. Methods: Sixty-eight individuals diagnosed with a neurological condition participated in this study. Perceived loneliness was assessed using the UCLA Loneliness Scale – Version 3, SNS was evaluated by the Social Network Index and personality traits were examined using the NEO Factor Five Inventory. Path analysis was conducted to determine if loneliness was negatively associated with …

Work Challenges And Cancer-Related Cognitive Impairment: Level Of Education Accounts For Unmet Needs Beyond Cognitive Impairment Severity, Darren Haywood, Susan L. Rossell, Ashley Henneghan, Frank D. Baughman, Jennifer Haywood, Evan Dauer, Annika Hegde, Ahmed A. Moustafa, Nicolas H. Hart

Research outputs 2022 to 2026

Purpose: Cancer-related cognitive impairment (CRCI) can impact cancer survivors’ return to work and occupational functioning for many years following the completion of cancer treatment. Understanding the characteristics of CRCI-related occupational difficulties and unmet supportive care needs is critical for the development of effective interventions. Within occupational roles, a higher level of education is typically associated with greater cognitive load and different demands. The objective of this study was to examine whether the level of education accounted for CRCI-related (a) occupational difficulties and (b) occupational unmet supportive care needs, beyond the contributions of perceived cognitive functioning and employment level. Methods: A …

Essential Role Of Cd63 In Maintaining Corneal Epithelial Identity In The Human Limbus, Yuzuru Sasamoto, Kosei Suzuki, Shinri Sato, Catherine A.A. Lee, Gabrielle Martin, Bruce R. Ksander, Markus H. Frank, Natasha Y. Frank

Research outputs 2022 to 2026

Purpose: Building on the identification of ABCB5 as a marker of limbal stem cells (LSCs), this study examines CD63, a newly identified molecule co-expressed with ABCB5 in limbal epithelial cells, to define its role in maintaining corneal epithelial cell identity. Methods: RNA sequencing (RNA-seq) was performed on flow cytometry–sorted Abcb5-positive and Abcb5-negative murine corneal epithelial cells. CD63 expression in human corneal tissue was assessed by immunostaining. CD63 was silenced in cultured human limbal epithelial cells using siRNA-mediated knockdown and resulting molecular and cellular changes were analyzed by qRT-PCR, flow cytometry, RNA-seq, Western blotting, and cell proliferation assays. Results: RNA-seq analysis …

Effect Of A 6-Week Structured Exercise Intervention On Tnf-Α During The Chronic Recovery Phase Of A Burn Injury Compared To Regular Daily Activities: A Pilot Randomised Cross-Over Trial, Tyler Jerome Osborne, Grant Rowe, Dale W. Edgar, Mark Fear, Fiona M. Wood, Timothy Fairchild, Brook Galna, Pippa Kenworthy, Brad Wall

Research outputs 2022 to 2026

Background: Burn injury induces a prolonged inflammatory response that may contribute to long-term metabolic dysfunction. Exercise is known to reduce inflammation in various clinical populations; however, its effect on chronic post-burn inflammation remains unclear. This crossover trial investigated the impact of a 6-week exercise intervention on tumour necrosis factor-alpha (TNF-α) in adults with non-severe burns sustained more than one year prior. Methods: Twenty-one participants were randomised to complete either a 6-week exercise program or a control period first, separated by a 4-week washout. The exercise program comprised three supervised sessions per week of combined resistance and cardiovascular training. Primary (TNF-α) …

Participatory Action Research (Par) In Designing A Supplementary Animated Teaching Resource To Support Learning Cervical Assessment, Michelle Gray, Shelley Stuart, Melanie Welfare

Research outputs 2022 to 2026

Aim: To create an education resource that assists students to understand the movement of the cervix during labour from a posterior retroverted position to a central location, cervical effacement, dilatation of the cervix and descent of the fetal skull. Background: Learning about anatomy and physiology in relation to cervical effacement and dilatation are abstract concepts that are difficult to understand from reading alone. Diagrams are of little assistance however 3D animation has the potential to improve students learning experiences. Design: Participatory Action Research (PAR) using the 7 C's Feekery Framework approach was adopted. Participants became coresearchers in conceptualising the learning …

Physical Fitness And Executive Functions In Early Childhood: A Systematic Review Of Recent Evidence, Nemanja Lakicevic, Marko Manojlovic, Elena Chichinina, Apollinaria Chursina, Kristina Tarasova, Ewan Thomas, Yuming Zhong, Antonino Bianco, Patrik Drid

Research outputs 2022 to 2026

Background Optimizing physical fitness (PF) and developing executive functions (EFs) is of great importance in preschool children. The link between PF, obtained through repetitive physical activity, and EFs is gaining increasing attention in recent years and we sought to systematically search the literature on the relationship between PF and EFs in preschool children published in the last five years. Methods Web of Science, Scopus, and PubMed were databases searched for the relevant literature. Original studies written in English and published in peer-reviewed journals including healthy children aged 3–6 years who were simultaneously tested for PF and EFs were considered eligible. …

Clinical Insights Into The Management Of Sleep Disturbances Within Cancer Care: A Qualitative Analysis, Sam Adams, Timothy D. Clay, Mitchell Turner, Christopher Kueh, Kelly Moes, Travis Cruickshank

Research outputs 2022 to 2026

Purpose: The present study aimed to gain a deeper understanding of how oncology healthcare professionals’ (HCPs) manage sleep disturbances. Methods: Semi-structured interviews were conducted with 10 oncology HCPs (medical oncologists, oncology nurse practitioners, clinical nurse consultants) working in metropolitan Perth, Western Australia. Reflexive thematic analysis was used to understand oncology HCPs’ perspectives on treating sleep disturbances, explore challenges and barriers to their management, as well as opportunities for improvement. Results: Four main themes were developed: (1) sleep disturbances are underreported and underassessed, (2) poor sleep can be difficult to manage, (3) limited capacity to address sleep issues, and (4) opportunities …

Optimizing Agility Training In Team Sport Players—The Role Of Perception-Action Coupling: A Systematic Review With Multi-Level Meta-Analysis, Zhiwei Zhao, Yuhang Liu, Kai Xu

Research outputs 2022 to 2026

Agility, characterized by rapid whole-body movement in response to external stimuli, is a key performance determinant in team sports owing to its reliance on perception-action coupling. Despite its importance, existing evidence on training effects is disproportionately focused on change-of-direction ability, overlooking the perceptual-cognitive demands of true agility. This systematic review therefore sought to quantify the effects of agility-specific training, examine moderators and establish dose-response model in team-sport players, while accounting for perception-action coupling. Following PRISMA 2020 guidelines, systematic searches were conducted in Web of Science, Scopus and PubMed for peer-reviewed English-language studies. Risk of bias was appraised using a modified …

Pleural Metastases From Acral Lentiginous Melanoma Diagnosed By Medical Thoracoscopy, Ad Rian Chong, Khai Lip Ng, Nai-Chien Huan, Nur Husna Mohd Aminudin, Fazilah Hassan, Kasuma Mohamed Nordin

Research outputs 2022 to 2026

Acral lentiginous melanoma (ALM) with pleural metastases is rare and under-recognised. We report an 86-year-old woman with progressive dyspnoea and pleuritic chest pain. 18 months ago, she was diagnosed with stage IIC ALM of the right heel, and was treated with wide local excision, but she declined adjuvant therapy. Imaging demonstrated a large left pleural effusion with diffuse pleural thickening, pulmonary mass, and hepatic metastases. Brownish pleural fluid, along with thoracoscopic identification of multiple pigmented nodules, led to a histologically confirmed diagnosis. Talc pleurodesis was performed for symptom control, and best supportive care was pursued. This case highlights the diagnostic …

Reimagining Peer-Led Support In Doctoral Nursing And Midwifery Education: A Collaborative Autoethnographic Case Study, Gideon U. Johnson, Sachini Thennakoon, Mayumi Kumarage, Emy Toutountzis, Lisa Whitehead

Research outputs 2022 to 2026

Aim: To explore how peer-led initiatives can enhance connection, belonging and sustainability within higher degree by research (HDR) nursing and midwifery programmes. Background: HDR study can be an isolating experience, often characterised by fragmented support and limited opportunities for structured peer learning. While institutions provide formal mechanisms for supervision and progress, less attention has been given to student-led approaches that cultivate inclusive scholarly communities and sustained peer engagement. Design: Collaborative autoethnographic case study. Methods: HDR student representatives and academic staff at Edith Cowan University, Australia (2022–2024), reflected collaboratively on the design, implementation and impact of peer-led initiatives, including monthly hybrid …

Mainstreaming Mistrust: The Shift In Us Vaccine Policy Under The Trump Administration, Sanjin Musa, Amy Estlund, Megan A. Berman

Faculty Scholarship

Department of Health and Human Services led by Robert F. Kennedy Jr., represents a significant departure from long-standing public health norms. This commentary explores how historically marginalized anti-vaccine activism has moved into the mainstream of government oversight. Key actions driving this transition include the wholesale replacement of the Advisory Committee on Immunization Practices, the departure of senior CDC officials, and the public questioning of established childhood immunization schedules. Furthermore, the administration has ceased financial support for global health entities like the World Health Organization and Gavi, the Vaccine Alliance, while canceling funding for innovative mRNA vaccine platforms. 

These domestic policy …

Can We Refute A Role For Infections In Alzheimer's Disease Pathogenesis?, Zena K Chatila, Michael R Duggan, Esther Silberberg, Juan Fernandez, Lavinia A Auber, Elizabeth M Bradshaw, Nikki M. Schultek

PCOM Scholarly Works

While a growing body of literature suggests a role for infections in Alzheimer's disease (AD), microbial contributions to AD remains a contentious topic, in part due to challenges in reconciling the positive evidence with studies reporting null findings. Here, we examine the evidence that argues against a role for infections in AD, while offering mechanistic hypotheses that may account for both the negative and positive findings, including dysregulated host immunity and gene-environment interactions of AD-associated genes.

Mentorship Practices And Perceptions Of Nursing Faculty At The Aga Khan University In Uganda: A Qualitative Study, Mary Namuguzi, Sarah Nakaziba, Shamim Namukasa, Carolyne Namukwaya, Dinah Kassaman, Arnold Mwanzu, Jackline Estomihi Kiwelu, Duncan Osuka, Nazahed Mkiramweni, Ahmed Sarki

School of Nursing & Midwifery, East Africa

Background Mentorship of new faculty helps to reduce the challenges associated with their new roles, as some lack knowledge of teaching pedagogies. This study assessed the mentorship experiences regarding practices and perceptions of new nursing and midwifery faculty at the Aga Khan University School of Nursing and Midwifery (SONAM) in Uganda.

Methodology This study used a phenomenological design. Data were collected in semistructured interviews with 11 participants, and data saturation was reached. Data were organized with NVivo 12 Pro and analyzed using framework analysis.

Findings The main themes that emerged were mentorship practices, perceptions about mentorship, and proposed mentorship guidelines. …

Early Insights From A Multi-Centre National Stroke Surveillance Initiative In Tanzania, Sarah Shali Matuja, Azan Nyundo, Emmanuel Assey, Joel Bwelemo, Marieke Dekker, Sarah Urasa, Emanuel Makarius, Peter Kishimbo, Philip Adebayo, Paschal Ruggajo

Internal Medicine, East Africa

Background: Stroke is a leading cause of death and disability globally, with sub-Saharan Africa, bearing the greatest burden. Tanzania has only one active stroke registry, limiting evidence-based care and policy development. We aimed to expand the registry into a multi-centre study across eight major tertiary hospitals to generate baseline data for a national stroke registry.

Methods: From January to August 2024, we analysed de-identified data from adults (≥18 years) admitted with a World Health Organisation defined stroke. Data collected included demographics, risk factors, imaging, and in-hospital mortality. Logistic regression identified predictors of mortality.

Results: A total of 1000 patients were …

Bayesian Machine Learning Enables Discovery Of Risk Factors For Hepatosplenic Multimorbidity Related To Schistosomiasis, Yin-Cong Zhi, Victor Anguajibi, John Oryema, Betty Nabatte, Christopher Opio, Narcis Kabatereine, Goylette Chami

Internal Medicine, East Africa

One in 25 deaths worldwide is related to liver disease, and often with multiple hepatosplenic conditions. Yet, little is understood of the risk factors for hepatosplenic multimorbidity, especially in the context of chronic infections. We present a novel Bayesian multitask learning framework to jointly model 45 hepatosplenic conditions assessed using point-of-care B-mode ultrasound for 3155 individuals aged 5-91 years within the SchistoTrack cohort across rural Uganda, where chronic intestinal schistosomiasis is endemic. We identify distinct and shared biomedical, socioeconomic, and spatial risk factors for individual conditions and hepatosplenic multimorbidity, and introduce methods for measuring condition dependencies as risk factors. Notably, …

Disseminated Iatrogenic Upper Gastrointestinal Kaposi Sarcoma Following Prolonged Steroid Use In A Patients With Crohn's Disease: A Case Report, Glory Makupa, Furaha Serventi, Leila Mwakipunda, Godwin Nnko, Edwin Liwa, Salum Lidenge, Ayesiga Herman, Lilian Gasper, Amos Mwasamwaja, Beatrice Kombole

Internal Medicine, East Africa

Background Kaposi sarcoma is a malignant vascular neoplasm caused by human herpesvirus-8. It is mostly seen in immunocompromised individuals, particularly those with human immunodeficiency virus/acquired immunodeficiency syndrome or organ transplants. Cutaneous and mucosal Kaposi sarcoma manifestation is common; however, Kaposi sarcoma may involve the visceral organs. Iatrogenic or drug-induced Kaposi sarcoma may develop in immunocompromised patients undergoing immunosuppressive medication. It is quite uncommon for patients with inflammatory bowel diseases on immunosuppressive medication to develop intestinal Kaposi sarcoma. This case report describes the clinical presentation of steroid-induced disseminated upper gastrointestinal Kaposi sarcoma in a patient with underlying Crohn’s disease and examines …

Barriers To Implementing Simulation-Based Surgical Training For Improving Quality And Safety In Developing Countries: A Short Communication, Abdullah Saeed Khan, Selina Hasan, Faisal Wasim Ismail, Nadeem Ahmed Siddiqui

Centre for Innovation in Medical Education

Simulation-based surgical training has the potential to significantly improve surgical outcomes in developing countries. However, its implementation faces numerous challenges, including financial constraints, infrastructural limitations, cultural barriers, and a lack of trained personnel. High costs, limited access to technology, and resistance to innovative teaching methods hinder the adoption of simulation-based surgical training. To overcome these obstacles, strategic approaches are needed, such as leveraging low-fidelity simulators, building strong partnerships, and investing in faculty development. By addressing these challenges, developing countries can harness the power of simulation-based surgical training to enhance surgical education and improve patient care.

Measurement Of Mucocutaneous Domain Activity In A Novel Treatment Response Measure For Systemic Lupus Erythematosus Clinical Trials, Kathryn Connelly, Eric Morand, Rachel Koelmeyer, Lavanya Rajagopala, Ambika Wakhlu, Yanjie Hao, Katie Liao, Darshini Ayton, Amita Aggarwal, Angela Migowa

Paediatrics and Child Health, East Africa

Objectives Previous work by an international taskforce delivered consensus to include rash, mucosal ulcers and alopecia in the mucocutaneous domain of a novel multi-domain clinical outcome measure for systemic lupus erythematosus (SLE) clinical trials, the Treatment Response Measure for SLE (TRM-SLE). (1) Here we report results of a consensus process to define a fit for purpose clinical outcome assessment and entry and response thresholds for assessment of mucocutaneous activity.

Methods A multi-step consensus process was completed by a 18-person working group comprising rheumatologists, dermatologists, and patients with lived experience of mucocutaneous SLE. The domain scope for rash, mucosal ulcers and …

An Odd Protocol For An Agent-Based Model Of Hepatitis C Virus Transmission In A Two-Group Structural Heterogeneous Syringe-Sharing Network (M2), Seun Ale, Que Nguyen Dr., John D. Kelleher Prof., Elizabeth Hunter Dr.

Reports

The model described in this ODD is an agent-based model of hepatitis C virus (HCV) transmission among people who inject drugs (PWID). The model extended a baseline homogeneous model by incorporating structural heterogeneity via a two-group interaction framework. The syringe-sharing population in the model is divided into inner and outer circle groups representing individuals with differing levels of syringe-sharing interaction intensity. While all agents share the same syringe-sharing probability and epidemiological processes remain identical across agents, the number of daily interaction opportunities differs between the two groups. Interactions in the model are generated dynamically using proximity-based sampling at each timestep …

An Odd Protocol For An Agent-Based Model Of Hepatitis C Virus Transmission In A Three-Group Structural Heterogeneous Syringe-Sharing Network (M3), Seun Ale, Que Nguyen Dr., John D. Kelleher Prof., Elizabeth Hunter Dr.

Reports

The model described in this ODD is an agent-based model of hepatitis C virus (HCV) transmission among people who inject drugs (PWID). The model incorporates structural heterogeneity through a three-group interaction framework. The syringe-sharing population in the model is divided into core, inner, and outer circle groups representing individuals with high, moderate, and low levels of syringe-sharing interaction intensity, respectively. While the syringe-sharing rate and all epidemiological processes remain identical across agents, the number of daily interaction opportunities differs by agent grouping, capturing variation in structural position within the syringe-sharing network. Interactions are generated dynamically using proximity-based sampling at each …

Consolidation Enfortumab Vedotin And Pembrolizumab After Cisplatin Induction In Metastatic Urothelial Cancer: Outcomes Of Complete Response And Bladder Preservation, Kok Hoe Chan, Putao Cen, Tung Shu, Steven Canfield, Hui Zhao, Anneliese Gonzalez, Julie Rowe, Varaha Tammisetti, Hajar Ayoub, Angel Blanco, Mark Amsbaugh, Nizar Tannir

Faculty, Staff and Student Publications

Bladder preservation remains a highly desirable therapeutic goal in urothelial carcinoma, particularly when durable survival can be achieved. Radical cystectomy is the standard treatment for muscle-invasive disease; however, it results in irreversible bladder loss and significant morbidity. Among patients with locally advanced or metastatic urothelial carcinoma, recurrence rates after standard therapy remain high. Consolidation therapy with enfortumab vedotin and pembrolizumab following cisplatin-based induction chemotherapy has demonstrated promising efficacy, with substantial complete response rates and improved bladder preservation. This single-center retrospective analysis evaluated the efficacy and safety of enfortumab vedotin plus pembrolizumab as consolidation therapy in 11 patients with metastatic urothelial …

Did A.T. Still, Do, Have An Md Degree?, David B. Fuller

PCOM Scholarly Works

A.T. Still, DO (1828–1917), founder of osteopathic medicine, was a licensed physician practicing in late 19th- and early 20th-century America. Although many assume he held an MD degree, the reality is more complex. Examining whether Dr. Still earned an MD degree provides important insight into the origins of osteopathic medicine and the profession that followed.

Feasibility And Outcomes Of Perirectal Spacer Implantation In Previously Treated Prostate Cancer Patients Undergoing Salvage Proton Therapy Radiation., Irini Yacoub, Keyur Mehta, Daniel Gorovets, Shaakir Hasan, J Isabelle Choi, Arpit M Chhabra, Stanislav Lazarev, Madhur Garg, Charles B Simone

Oncology Articles

PURPOSE: Treatment of recurrent prostate cancer following prior therapy is challenging due to the risk of toxicities to previously irradiated normal tissues, particularly the rectum. Proton therapy offers a conformal approach that may reduce this risk. Perirectal spacers have been shown to further minimize rectal dose in primary treatment, but the ability to be placed and their value in the retreatment setting have not been thoroughly evaluated to date. The purpose of this study was to evaluate feasibility of rectal spacer placement after prior pelvic radiation or other local treatments for prostate cancer.

METHODS AND MATERIALS: We conducted a retrospective …

Automated Abdominal Aortic Calcification Scores And Atherosclerotic Cardiovascular Disease In The Uk Biobank Imaging Study, Marc Sim, James Webster, Cassandra Smith, Afsah Saleem, Syed Zulqarnain Gilani, Carlos J. Toro-Huamanchumo, David Suter, Gemma Figtree, Anne Karine Lagendijk, Emma L. Duncan, Carl Schultz, Pawel Szulc, Joseph Hung, Wai H. Lim, Parminder Raina, Nicola P. Bondonno, Richard Woodman, Jonathan M. Hodgson, Douglas P. Kiel, Richard L. Prince, William D. Leslie, John P. Kemp, Nicholas C. Harvey, John T. Schousboe, Joshua R. Lewis

Research outputs 2022 to 2026

Background: Abdominal aortic calcification (AAC) is a subclinical measure of atherosclerotic cardiovascular disease (ASCVD). AAC can be captured on lateral spine images obtained from bone density machines during routine osteoporosis screening. Identifying individuals with AAC provides a new opportunity to prevent disease progression. Objectives: The aim of the study was to externally validate a machine learning-derived AAC 24-point algorithm (ML-AAC24) with incident ASCVD. Methods: Middle-aged individuals from the UK Biobank Imaging Study with lateral spine images, obtained via dual-energy x-ray absorptiometry, were included. ML-AAC24 scores were grouped as low (<2), moderate (2 to <6), and high (≥6). Linked health records were used to identify ASCVD-associated events, including hospitalizations and death. Results: Among 53,611 participants (52% female; mean age 65 years), 78.2% had low, 16.4% had moderate, and 5.4% had high ML-AAC24. After excluding people with prevalent ASCVD or missing data, 1,163 (2.3%) of 50,923 people had an incident ASCVD event over a median follow-up of 4.1 [3.0-5.5] years. In age- and sex-adjusted analysis, compared to those with low ML-AAC24, those with moderate (HR: 1.80 [95% CI: 1.57-2.08]) and high ML-AAC24 (HR: 2.87 [95% CI: 2.39-3.44]) had a higher HR for incident ASCVD. Results remained comparable after adjustment for established ASCVD risk factors. Consistent patterns were observed when considering incident coronary artery disease, myocardial infarction, and stroke. Conclusions: Assessing ML-AAC24 on lateral spine images offers a new and promising screening method to identify people with higher risk of incident ASVD events.

Hospital-Presenting Self-Harm And Suicide Among Justice-Involved Adolescents On Community-Based Orders: A Population-Based Cohort Study, Emaediong I. Akpanekpo, George Karystianis, Jocelyn Jones, Tony Butler

Research outputs 2022 to 2026

Objective To estimate the incidence and identify risk factors for hospital-presenting self-harm and suicide among justice-involved adolescents serving community-based orders in New South Wales, Australia. Method We conducted a population-based retrospective cohort study of 44,887 adolescents aged 10–17 years at first proven offence who received community-based orders between 1994 and 2020. Hospital and emergency department records were linked with mortality, child protection, and justice data. Cox regression estimated hazard ratios (HRs) for self-harm, and Fine-Gray models estimated subdistribution HRs for suicide, accounting for competing risks. Results Over 163,676 person-years, 1901 adolescents had a first self-harm episode (11.6 per 1000 person-years), …

Preserving Residual Kidney Function In Haemodialysis: Current Practices, Challenges, And Perspectives From Renal Clinicians, Lijun Zhong, Ulrich Steinwandel, Hugh Davies, Sara Bayes, Jagadish Jamboti, Hemant Kulkarni, Doris Chan

Research outputs 2022 to 2026

Background: Residual kidney function in patients receiving haemodialysis is associated with improved survival, reduced cardiovascular risk and better quality of life. Yet, clinical guidelines on its preservation are limited, and local practices remain unclear. Objectives: To explore current practices, perceptions and challenges related to residual kidney function preservation among renal clinicians. Design: Descriptive cross-sectional survey. Participants: Renal physicians and nurses working in hospital-based haemodialysis units across Western Australia. Measurements: Role-specific questionnaires were administered to renal physicians and nurses. Results: Eighty-four completed responses were received (physicians n = 25; nurses n = 59). Over half of physicians (56%, n = 14) …