Medicine and Health Sciences Commons^™

Nuclear Export As A Therapeutic Vulnerability In Zfta-Rela Ependymoma, Siri M Ippagunta, Amir Arabzade, Srinidhi Varadharajan, Erik Emanus, Amanda Bland, Alisha Kardian, Nicholas Laboe, Hua Sun, Tuyu Zheng, Amelia Hancock, Mark Zhai, Emma Caesar, Maxwell Park, Wilda Orisme, Melissa Johnson, Brittany Rodgers, Gregory H Turner, Jeffrey Steinberg, Burgess Freeman, Martine F Roussel, Anang Shelat, Richard Kriwacki, Thomas E Merchant, Benjamin Deneen, Michael D Taylor, Sameer Agnihotri, Shondra Pruett-Miller, Jacob A Steele, Anoop Murthy Kavirayani, David W Ellison, Arzu Onar-Thomas, Giles Robinson, Stephen C Mack, Kelsey C Bertrand

Faculty, Staff and Students Publications

Background: Ependymoma (EPN) is the third most common pediatric brain tumor with no targeted therapies available to patients. In supratentorial ependymoma, the most frequent driver alteration is a gene fusion between ZFTA and RELA (denoted ZR), leads to constitutive localization of ZR in the nucleus. Because ZR is not currently druggable, we tested whether ZR expression leads to aberrant protein interactions that could represent therapeutic vulnerabilities.

Methods: Using CRISPR-Cas9 pooled screening, we identified many novel druggable ZR interacting proteins including XPO1, CARM1, SMARCA4, and CDK1. We focused on the nuclear export protein (XPO1), given the ability of most XPO1 inhibitors …

Tractor Workflow: A Scalable Nextflow Framework For Local Ancestry-Aware Genome-Wide Association Studies, Nirav N Shah, Taotao Tan, Jessica Honorato-Mauer, Yi-Sian Lin, Adam X Maihofer, Clement C Zai, Pgc-Ptsd Ancestry Working Group, Marcos Santoro, Caroline M Nievergelt, Elizabeth G Atkinson

Faculty, Staff and Students Publications

Motivation: The routine exclusion of admixed individuals from traditional genome-wide association studies (GWAS) due to concerns about spurious associations has limited multi-ancestry genetic discovery. Tractor addresses this issue by incorporating local ancestry into association testing, enabling the identification of ancestry-enriched signals and generating ancestry-specific summary statistics. However, adoption has been constrained by the complexity of prerequisite steps, including phasing and local ancestry inference, which require substantial bioinformatics expertise and introduce key analytical decision points.

Results: We developed a scalable, automated Nextflow workflow that integrates phasing, local ancestry inference, and Tractor association testing into a reproducible end-to-end pipeline. To demonstrate its …

Reimagining Occupational Therapy Fieldwork Mentorship Through A Cultural Wealth Lens: A World Café Study, Nandita A. Singh, Mph, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy (OT) fieldwork education plays a critical role in professional socialization; however, supervision models often privilege dominant sociocultural norms, disadvantaging students from non-dominant cultural and linguistic backgrounds and potentially limiting equitable workforce preparation.

Objectives: To examine how OT fieldwork partners conceptualize reciprocal mentorship within fieldwork education identify strategies grounded in Community Cultural Wealth (CCW) to support inclusive communication and strengths-based professional development.

Methods: Participatory qualitative study using a virtual World Café methodology, involving United States-based academic and clinical OT fieldwork contexts. Data were collected through audio-recorded discussions, digital whiteboards, and reflexive memos, and were analyzed using Braun …

Development Of A Unique Surgical Implant To Address The Development Of Iatrogenic Trigeminal Neuralgia Following Maxillomandibular Advancement Surgery For Osa, Erika L. Manning, Kun Yoon, Robert Diecidue, Joseph Harrington

Department of Oral and Maxillofacial Surgery Faculty Papers

A 58 y/o male with no significant past medical history presented in 2021 with obstructive sleep apnea (OSA), including trouble breathing through his nose due to hypoplastic maxilla, retrognathic mandible and chin, and microgenia. He underwent a LeFort 1 maxillary osteotomy, bilateral sagittal split osteotomy (BSSO), and genioplasty with fat graft on 2/10/2022. Postoperatively, the patient developed moderate pain and facial edema, which progressed into hypoesthesia with pain in the face with a sensation of fullness in the left ear and left masseter tightness. He also developed a positive Tinel sign in the left mandibular area and was diagnosed with …

Metabolic Dysfunction And Metabolic Management In Episodic Migraine, Delora E. Denney, Michael J. Marmura

Department of Jefferson Headache Center Papers and Presentations

PURPOSE OF REVIEW: Evidence suggests a significant link between migraine and metabolic syndrome,, especially in those with chronic or refractory migraine. Weight loss and exercise may effectively prevent migraine. Here, we review the evidence behind exercise and weight loss as migraine treatments.

RECENT FINDINGS: While metabolic syndrome and pain have long had a known association, only recently have strong studies demonstrated a higher risk of developing metabolic syndrome in people with migraine. Additionally, other sequelae of metabolic syndrome, obesity, hypertension, hypercoagulability, and diabetes also interplay with migraine. New medications like GLP-1 agonists may be a potential treatment for migraine as …

Antibody-Drug Conjugates Beyond Her2 In Non-Small Cell Lung Cancer (Nsclc): Mechanisms, Emerging Targets, And Future Directions., Ahmed Ismail, Aakash Desai, George R Simon, Yanis Boumber

Oncology Articles

Antibody-drug conjugates (ADCs) are a rapidly evolving class of oncology therapeutics that enable precise delivery of potent cytotoxic agents to tumor cells while minimizing systemic toxicity. While HER2-targeted ADCs such as trastuzumab deruxtecan (T-DXd) in HER2-mutant, Datopotamab deruxtecan (Dato-Dxd) in EGFR-mutant, and telisotumumab vedotin (Teliso-V) in MET IHC 3+ expressing lung cancer have already established a clinical role in non-small cell lung cancer (NSCLC), multiple ADCs targeting alternative antigens, including additional TROP2 ADCs, HER3, MET, CEACAM5, B7-H3, Nectin-4, and others, are now in advanced clinical development. This review synthesizes the current evidence for non-HER2 ADCs in NSCLC, highlighting mechanisms of …

Personalized Treatment Of Chronic Tendinopathy Using Ultrasound And Neuroimmune Markers: A Narrative Review, Rohan Phadke, Samer Salman, Kirtan Patel, Jad Wardeh, Akhil Marupudi, Rahul Kumar, Arbaz A. Momin, Alireza Tavakkoli

Department of Neurosurgery Faculty Papers

Introduction: : Chronic tendinopathy affects approximately 30% of musculoskeletal consultations, yet treatment outcomes remain inconsistent despite numerous available interventions. This variability stems from the absence of validated frameworks to match individual patients to optimal treatments based on underlying pathophysiology. To synthesize current evidence on ultrasound imaging biomarkers, neuroimmune mechanisms, and interventional therapies in chronic tendinopathy, and propose a clinically applicable framework integrating ultrasound phenotyping with neuroimmune assessment to guide personalized treatment selection. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science through December 2025. Studies examining ultrasound/elastography imaging, neuroimmune mechanisms, or treatment interventions in chronic …

Morphological Assessment Of Stage Hh38 Of The Japanese Quail (Coturnix Japonica) Heart By Micro-Sonogram, Jaden Roe, Ashlyn Benavides, Michael B. Filla, Douglas C. Bittel, Whitney Shae, Geetha Haligheri, James E. O'Brien, Nataliya Kibiryeva

Manuscripts, Articles, Book Chapters and Other Papers

A challenge of studying mammalian cardiac embryogenesis is the limited ability to perform experimental manipulations in animal models. The avian embryo is widely accepted as a model for mammalian heart developmental studies. In this study, we establish the methodology and protocols for studying the Japanese quail (Coturnix japonica) heart at embryonic day 10 (HH38) using the FUJIFILM VisualSonics Vevo 3100 ultrasound system equipped with a MX550D small animal cardiology transducer. These protocols were designed to measure right ventricular wall thickness, pulmonary artery diameter, and the outflow velocities of the right ventricular outflow tract (RVOT) and the pulmonary artery …

Experiences Of Discrimination, Paternal Support, And Hypertensive Disorders Of Pregnancy (Hdp) In The Miehr Study, Houston, Texas, Tahereh Alinia, Elaine Symanski, Juan Manuel Alvarez, Kristina Walker Whitworth

Faculty, Staff and Students Publications

Background: Discrimination is a psychosocial stressor that, through activation of stress-response pathways, may influence risk of adverse perinatal health outcomes. However, few studies have evaluated the association between discrimination and hypertensive disorders of pregnancy (HDP), and none have explored effect modification by race or paternal support, which may buffer the adverse effects of discrimination.

Methods: We included 1,847 non-Hispanic Black and White participants from the Maternal and Infant Environmental Health Riskscape (MIEHR) study. Krieger's validated Experiences of Discrimination (EOD) scale was used to assess occurrence (yes/no) and frequency (once, 2-3, ≥ 4 times) of discrimination in nine situations. We created …

Securepose: Automated Face Blurring And Human Movement Kinematics Extraction From Videos Recorded In Clinical Settings, Rishabh Bajpai, Bhooma Aravamuthan

2020-Current year OA Pubs

Movement disorder diagnosis often relies on expert evaluation of patient videos, but sharing these videos poses privacy risks. Current methods for de-identifying videos, such as blurring faces, are often manual, inconsistent, or inaccurate. Furthermore, these methods can compromise automated kinematics extraction-a valuable aid to movement analysis. To address these challenges, we developed SecurePose, open-source software that provides both reliable de-identification and automated body kinematic extraction from videos recorded in clinic settings using smartphones/tablets. We validated SecurePose on gait videos recorded in outpatient clinic visits of 116 children with cerebral palsy, assessing both the accuracy of its de-identification compared to the …

How Nutrition And Physical Activity Shape Your Well-Being, Stacy Phillips

EFNEP

This publication will explore the link among nutrition, physical activity, physical health, and mental health and how it impacts whole-body well-being. Understanding how multiple aspects of a person's lifestyle can affect an individual's overall well-being is essential to providing better education on how to make better choices to improve their well-being.

Remimazolam As A Sedative For Endoscopic Procedures: A Scoping Review, Hamzha Aysheh, Megan Henderson, Megan Hinkle, Sara Holton, Spencer Turner, Dwayne Accardo Dnp, Ccrn, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Propofol is commonly used for procedural sedation during endoscopic procedures because of its rapid onset and short duration; however, its use is frequently associated with adverse effects such as hypotension, hypoxemia, respiratory depression, bradycardia, and injection site pain. As diagnostic endoscopic procedures continue to increase, particularly among older and medically complex patients, there is a growing need for sedative agents that provide effective sedation while minimizing perioperative risk. Remimazolam, a novel ultra–short-acting benzodiazepine metabolized by tissue esterases, has demonstrated favorable hemodynamic stability and a reduced adverse effect profile in recent literature. The purpose of this evidence-based quality improvement project …

Discharge Education Bundles And Evaluating The Effect On Readmission And Satisfaction Rates: A Scoping Review, Jane Campo Bsn, Rn, Charlotte Edwards Bsn, Rn, Mary Catherine Hall Bsn, Rn, Sarah Moore Bsn, Rn, Allison Walker Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Transitioning children with a chronic medical condition from hospital to home is a critical and difficult process, leaving many families feeling anxious and unprepared. Nationally, 1 in 7 pediatric patients are readmitted within thirty days, making readmission rates an important quality indicator with both clinical and financial implications. To address these challenges, multiple discharge bundles have been developed; however, their effectiveness has not been consistently evaluated. The aim of this project is to summarize the current literature and highlight its positive outcomes, with the intention of promoting further research, reducing 30-day readmission rates, and increasing parental satisfaction (Shermont et …

Impact Of Nitrous Oxide Analgesia On Labor Experience, Kierra Jones Rn, Bsn, Elyzabeth Morales Rn, Bsn, Lanitra Ray Rn, Bsn, Rhonda Johnson Dnp, Cne, Cnm, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Nitrous oxide (N₂O) has re-emerged in the United States as a labor analgesia option that supports mobility, autonomy, and patient-centered care. As nurses increasingly support low-intervention and physiologic birth approaches, understanding the effectiveness and safety of nitrous oxide for low-risk laboring individuals is essential. This scoping review examines current evidence on nitrous oxide use during labor, focusing on maternal pain management, satisfaction, and neonatal outcomes to inform evidence-based nursing and midwifery practice.

Methods

A scoping review was conducted using PubMed, CINAHL Complete, and the Cochrane Library between September and October 2023. Inclusion criteria consisted of English-language studies published within …

Comparative Effectiveness Of Immunotherapy Alone Or With Chemotherapy As First-Line Treatment For Marginal Zone Lymphoma, Adam Olszewski, Thomas Ollila, Dai Chihara, Geoffrey Shouse, Natalie Grover, Reem Karmali, Pallawi Torka, Colin Thomas, Praveen Ramakrishnan Geethakumari, Stefan Barta, Nancy Bartlett, Narendranath Epperla

Cardeza Foundation for Hematologic Research

No abstract provided.

A Hidden Giant: Tee Superiority In Mrsa Endocarditis With A Massive Supravalvular Aortic Mass, Mohammad Abed Alhaleem, Nebras Abu Abed, Salman Muslem, Fatma Bisher, Nadeen Sukhon, Wehbi Hanayni

Conference Presentation Abstracts

Background: A 66-year-old male with MRSA bacteremia developed septic pulmonary emboli, sternoclavicular joint infection, and prosthetic knee infection. While initial TTE was negative, subsequent TEE identified a large supravalvular aortic vegetation necessitating surgical excision and valve repair, underscoring the diagnostic superiority of TEE and the need for early surgical consideration in complicated MRSA endocarditis. Case Presentation: A 66-year-old male with diabetes, hypertension, and prior knee arthroplasty presented with MRSA bacteremia complicated by septic pulmonary emboli, sternoclavicular joint infection, and prosthetic knee infection. He underwent debridement of the chest wall and knee prosthesis with cultures confirming MRSA. Initial transthoracic echocardiography (TTE) …

Avoiding Anchoring Bias In Lymphadenopathy: Metastatic Thyroid Cancer Mimicking Tuberculous Lymphadenitis, Giuliano Romano, Mitchell Schwocho, Jacob Morton

Conference Presentation Abstracts

Introduction The differential diagnosis for a new neck mass is broad and includes malignant, infectious, and autoimmune etiologies. A systematic approach incorporating history, physical examination, and diagnostic testing is essential when developing and narrowing down a differential. Case Presentation A 52-year-old man with a history of diabetes, asthma, ankylosing spondylitis on weekly etanercept, and GERD presented with a 2-day history of painless right-sided neck swelling. He denied fever, chills, weight loss, night sweats, dysphagia, dyspnea, cough, recent illness, or constitutional symptoms aside from mild fatigue. He had recently returned from a 1.5- month trip to Bangladesh and had self-discontinued etanercept …

Household Air Pollution Is Associated With Disease Severity In Ugandan Children Hospitalized With Hypoxemic Pneumonia, Ayla Ahmed, Sehaj Sandhu, Sophie Namasopo, Juliet Nabwire, Qaasim Mian, Andrea Conroy, Jackson Amone, Charles Olaro, Robert Opoka, Michael Hawkes

Paediatrics and Child Health, East Africa

Background Household air pollution (HAP) due to biomass fuel use is a risk factor for childhood pneumonia, a leading cause of under-five mortality globally. This study examined the relationship between HAP and disease severity in Ugandan children hospitalized with hypoxemic pneumonia.

Methods We conducted a retrospective case-control study across 20 Ugandan hospitals. PM2.5 exposure was estimated using caregiver-reported fuel use, cooking duration, kitchen structure, and ventilation. Pneumonia severity was assessed clinically, and associations were analyzed using non-parametric tests.

Results We included 735 children (median age 9 months, 42% female) hospitalized with hypoxemic pneumonia. Most households used firewood (84%) or charcoal …

Minimal Change Disease Following B-Cell Maturation Antigen-Directed Chimeric Antigen Receptor T-Cell Therapy, Kiran Shivaraj, Omar Mamlouk, Amanda Tchakarov, Krina Patel, Ala Abudayyeh

Faculty, Staff and Student Publications

Acute kidney injury (AKI) is a well-recognized complication of chimeric antigen receptor (CAR) T-cell therapy, typically attributed to cytokine release syndrome and acute tubular injury. However, glomerular disease post CAR-T cell is rare. We report a case of minimal change disease presenting with AKI and nephrotic-range proteinuria 3 weeks after B-cell maturation antigen-directed CAR-T cell therapy, ciltacabtagene autoleucel, in a patient with relapsed refractory multiple myeloma. The kidney biopsy revealed diffuse podocyte foot process effacement and a predominance of CD4+ T cells with potential on-target, off-tumor effect of B-cell maturation antigen-directed CAR-T cell therapy, leading to podocyte injury. The patient …

Transcranial Doppler Ultrasound Velocity Measurements In Children With Sickle Cell Disease In Kenya, Catherine Mwalimu, Oscar Odhiambo, Elaine Mashisia, Teresa Mwanja, Allan Ade, Maria De Vita, Katherine Oyieke, Pauline Samia, Fenella Kirkham, Samson Gwer

Paediatrics and Child Health, East Africa

Background Sickle cell disease (SCD) is the most common inherited haemoglobinopathy and poses a high public health burden in Sub-Saharan Africa. Children with sickle cell anaemia are at a highrisk of ischemic stroke, and transcranial Doppler (TCD) ultrasonography helps identify those at highest risk for primary stroke prevention.

Objective To determine the prevalence of abnormal cerebral blood flow velocity (CBFV) in children with SCD and describe CBFV in children without SCD.

Methods We conducted a two-component study comprising a retrospective review and a cross-sectional assessment. TCD measurements from 143 children with confirmed SCD aged 2–16 years were reviewed. In a …

Impact Of Intracranial Pressure Monitoring On 30-Day Mortality In Severe Traumatic Brain Injury: A Retrospective Cohort Study In Kenya, George Ongas, Idris Chikophe, Jacqueline Mavuti, David Olunya, Mubashir Qureshi, Beverly Cheserem, Edwin Mogere

General Surgery, East Africa

OBJECTIVE The objective of this study was to evaluate 15-year trends in epidemiology, baseline severity, management, and outcomes of severe traumatic brain injury (sTBI) at a Kenyan tertiary center, and to determine the impact of invasive intracranial pressure (ICP) monitoring on 30-day mortality in a low- and middle-income country (LMIC) context.

METHODS A retrospective quasi-experimental cohort analysis of consecutive sTBI admissions (postresuscitation Glasgow Coma Scale [GCS] score ≤ 8, age ≥ 13 years) from January 1, 2010, to December 31, 2024, was conducted. This time period was divided into two eras: era 1 (2010–2014), premonitoring, and era 2 (2015–2024), routine …

The Intersection Between Adolescent Pregnancy, Mental Health Concerns, Stigma, And Sex Education, Madelon Cox

Honors Program: Senior Projects (Public)

This thesis discusses research from the past two decades focused on factors contributing to an increased risk of adolescent pregnancy and the lasting impact of that pregnancy. The consequences of being a pregnant adolescent can be compounded by race, gender, socioeconomic class, and access to education. Adolescent pregnancy also carries significant physical and mental health risk for the adolescent and the child. Awareness and various interventions can help pregnant adolescents or those who may be at risk for adolescent pregnancy to support them, prevent isolation, and reduce further negative mental health conditions, such as depression and anxiety.

Cost Of Health Systems Strengthening For Small And Sick Newborn Care In Four Sub-Saharan African Countries Implemented With Nest360: Incremental Cost Analyses, Alice Tarus, Meghan Kumar, Rebecca Penzias, Rosemary Kamuyu, James Cross, Mbozu Sipalo, Edith Gicheha, Christine Bohne, George Okello, William Macharia

Paediatrics and Child Health, East Africa

Background

Methods

Improving Dimensional Stability Of Irreversible Hydrocolloid By Condensation Silicone Incorporation, Jefferson David Melo De Matos, João Pedro Oliveira De Batista, Jozely Francisca Mello Lima, Mário Alexandre Coelho Sinhoreti, Umberto Demoner Ramos, Daher Antonio Queiroz, Daniel Sartorelli Marques De Castro

Faculty, Staff and Student Publications

Background: Irreversible hydrocolloid (alginate) is widely used for dental impressions, but its poor dimensional stability over time limits accuracy when delays in pouring occur. Enhancing its stability through material modification, such as incorporating condensation silicone, may improve clinical outcomes.

Materials and methods: Three groups (n = 10) were evaluated: Group I (conventional alginate, Avagel), Group II (extended-pour alginate, Hydrogum 5), and Group III (alginate modified with condensation silicone). Specimens were fabricated using standardized molds and stored under controlled humidity. Dimensional stability was assessed at five time points (immediate, 24, 48, 72, and 120 h) by measuring mass and linear dimensions. …

Interventional Approach To Intermediate-High-Risk Pe: Catheter-Directed Mechanical Thrombectomy, Shreya Agarwal, Kirill Ruban, Ishan Kirti, Karina Ruban, Fadi Saab, Sujata Kambhatla, Pranay Gupta

Conference Presentation Abstracts

Acute pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. The clinical outcomes are largely determined by thrombus burden and its hemodynamic impact on the right ventricle (RV). Over the past decade, catheter-directed mechanical thrombectomy has emerged as a promising alternative for systemic thrombolysis for PE management, particularly in patients at high risk for major bleeding. This approach provides rapid mechanical debulking of thrombus without exposure to thrombolytics and has been associated with significant improvements in RV function and pulmonary artery pressures. We present a case of extensive bilateral PE successfully treated with mechanical thrombectomy, highlighting the …

Right Ventricular Involvement In Stress Cardiomyopathy: A Case Of Biventricular Takotsubo With Cardiogenic Shock, Ahmad Muhammad, Yazan Alkehef, Theodore Schreiber

Conference Presentation Abstracts

Introduction Takotsubo cardiomyopathy (TC) is characterized by transient left ventricular (LV) dysfunction following a stressor in the absence of obstructive coronary artery disease. We present a case of a less common variant with right ventricular involvement. Hospital course A 45-year-old woman with sickle cell disease and asthma presented with nausea, vomiting, abdominal pain, and fevers, one week after the death of her father. Examination revealed an irregular tachycardia. Labs demonstrated leukocytosis, elevated lactate, and markedly increased troponin. Chest imaging showed bilateral basilar opacities. ECG demonstrated atrial flutter with rapid ventricular response. She developed progressive respiratory failure requiring intubation. Repeat ECG …

How Employment-Based Clinical Experience During Undergraduate Education Influences Transition To Practice: A Qualitative Systematic Review, Seung A. Park, Marion Eckert, Rebecca Sharp, Belinda Clark, Micah D.J. Peters

Research outputs 2022 to 2026

Aim: To synthesize qualitative evidence on the experiences of undergraduate nursing students and new graduate nurses engaged in formal paid employment models or health-related work during their undergraduate studies, to examine how these employment-based clinical experiences influence their transition to nursing practice, and to identify elements that facilitate or hinder this transition. Design: Qualitative systematic review. Methods: Searches were conducted in MEDLINE, Embase, Emcare (Ovid), CINAHL Complete (EBSCOhost), ERIC (ProQuest), and gray literature sources, including ProQuest Dissertations and Theses and Google Scholar. No date or country limits were applied, although only English-language studies were included. The review followed JBI methodology …

Operative Versus Non-Operative Management Of Infant Perianal Abscesses: A Pediatric Surgery Research Collaborative Prospective Quality Improvement Study, Leigh Selesner, Chakshu Soni, Romeo C. Ignacio, Rimla Khan, Robert Wright, Alicia Mcintire, Bethany J. Slater, Nathan M. Novotny, Ryan T. Davis, Artem F. Dadamyan

Conference Presentation Abstracts

Abstract: Purpose Treatment of infant perianal abscesses (IPA) remains controversial, with ongoing debate between operative and non-operative management. Recurrence is common and prospective data to guide care are lacking. We performed the first multi-institutional prospective quality improvement (QI) study comparing non-operative to operative IPA management. Methods The primary endpoint was time to complete abscess resolution. Secondary endpoints included surgical intervention (incision and drainage ± fistulotomy) and abscess recurrence. Institutions were recruited through a national research collaborative. IRB approval was obtained individually. Between 2022 and 2025, we prospectively enrolled patients < 1 year of age with an abscess ≤2 cm from the anal verge. Patients with predisposing conditions (e.g. inflammatory bowel disease) were excluded. Management was determined by the treating provider, with either upfront surgical intervention (control group) or non-operative care per our QI protocol (protocol group, Figure 1). Data were collected on management prior to surgical evaluation, presentation, subsequent treatment and outcomes. Statistical analyses were performed using STATA, with p < 0.05 considered significant. Endpoints were compared between groups by non-parametric methods, with denominators based on available data. Results Fourteen institutions participated across the U.S., with a total of 288 patients (108 control, 180 protocol) enrolled. Median follow-up was 0.99 (interquartile range 0.23-3.93) and 1 (0.16-4.56) months for control and protocol groups. Abscess resolution occurred in 155 patients during follow-up (36/71 (51%) control, 119/134 (89%) protocol, p < 0.01). Median time to abscess resolution was 1.21 (0.33-4) and 1.13 (0.57-3.83) months for control and protocol groups (p=0.64). Recurrences were frequent in both cohorts (34/93 (37%) control, 62/153 (41%) protocol). Surgical intervention was significantly more common in the control group: incision and drainage were performed in 61/107 (57%) versus 19/166 (11%) and exam under anesthesia with fistulotomy in 31/106 (29%) versus 20/166 (12%) (both p< 0.01). Conclusions Time to abscess resolution was similar between patients treated with upfront surgical intervention and non-operative management according to our QI protocol. Significantly more patients underwent surgical intervention in the control group, without an impact on time to resolution. Our data support initial non-operative management of infant perianal abscesses, emphasizing antibiotics at initial presentation, sitz baths and family reassurance. Abbreviations: IPA - infant perianal abscess; QI - quality improvement; IRB - institutional review board

Fetal Vascular Malperfusion And Other Placental Lesions In Relation To Maternal Sars-Cov-2 Exposure: A Case–Control Study, Irene Mwandoto, Marleen Temmerman, Ingrid Gichere, Patricia Okiro

Pathology, East Africa

Background:

The morphologic characteristics of placentas associated with coronavirus disease-19 (COVID-19) have been described but with varying findings. Studies conducted at the onset of the pandemic reported frequency of Fetal Vascular Malperfusion (FVM), an umbrella term that describes occlusive vasculopathies that affect fetal circulation and their associated sequelae. Morphologic manifestations include thrombosis, avascular villi and vascular stromal karyorrhexis. Associated outcomes include fetal growth restriction, thromboembolic events such as neonatal stroke and fetal demise. Placental lesions associated with a severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection present a unique picture in histology, especially in the attempt to decipher the …

Breastfeeding Support For Mothers Of Low Birthweight Infants In Hospitals In Rural Western Kenya: An Exploratory Study, Fiona Dickinson, Florence Were, Alloys K’Oloo, Iwaret Otiti, Linda Tindi, Mwanamvua Boga, Mary Kimani, Laura Kiige, Kathy Mellor, Helen Nabwera

Centre of Excellence in Women and Child Health

Background One in ten newborns in sub-Saharan Africa weigh < 2500 g (i.e. low birthweight [LBW]). Breastfeeding difficulties from birth are common among LBW infants. This study explored the use of trained peer mothers to deliver breastfeeding support to mothers of LBW infants in healthcare facilities in rural Kenya.

Methods Five trained peer mothers provided breastfeeding support to 23 mothers of LBW infants across eight healthcare facilities in Homa Bay County. Qualitative, semi-structured interviews were conducted with 11 mothers, 10 healthcare providers and 5 peer mothers prior to and during the breastfeeding support intervention. Inductive thematic analysis was used.

Results Three key themes were discovered: mothers valued the confidence the peer mothers gave them to breastfeed their LBW infants, peer mothers found that the training and their previous experience caring for LBW infants enabled them to work collaboratively with mothers …