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Full-Text Articles in Medicine and Health Sciences

Neighbourhood Social Vulnerability And Preterm Birth Risk Among Infants With Trisomy 21: A Statewide Analysis, Fatima R Sheriff, Renata H Benjamin, Qian Xiao, Jenil Patel, Charles Shumate, Alejandra Fernandez, A J Agopian Jul 2026

Neighbourhood Social Vulnerability And Preterm Birth Risk Among Infants With Trisomy 21: A Statewide Analysis, Fatima R Sheriff, Renata H Benjamin, Qian Xiao, Jenil Patel, Charles Shumate, Alejandra Fernandez, A J Agopian

Faculty, Staff and Student Publications

Background: Residing in socioeconomically vulnerable areas is known to be associated with increased preterm birth (PTB) risk in the general population. However, the relationship between social vulnerability and PTB remains unexplored among infants with trisomy 21, who experience more than twice the PTB rate of the general population.

Objectives: The primary objective was to examine the association between maternal socioeconomic vulnerability, as measured by the SVI, and PTB among infants with trisomy 21.

Methods: We conducted a retrospective cohort study among infants with trisomy 21 born in Texas (1999-2018). We examined the association between neighbourhood vulnerability, measured by Social Vulnerability …


Pangenome Analysis Of Proteus Mirabilis Reveals Lineage-Specific Antimicrobial Resistance Profiles And Discordant Genotype-Phenotype Correlations, Namrata Deka, Aimee L Brauer, Katherine Connerton, Blake M Hanson, Jennifer N Walker, Chelsie E Armbruster Jul 2026

Pangenome Analysis Of Proteus Mirabilis Reveals Lineage-Specific Antimicrobial Resistance Profiles And Discordant Genotype-Phenotype Correlations, Namrata Deka, Aimee L Brauer, Katherine Connerton, Blake M Hanson, Jennifer N Walker, Chelsie E Armbruster

Faculty, Staff and Student Publications

Urinary tract infections (UTIs) impose a large healthcare burden, with escalating antimicrobial resistance (AMR), and treatment failure. Proteus mirabilis is an undercharacterized and challenging UTI pathogen due to intrinsic resistance and biofilm formation. To understand P. mirabilis population genomics, we combined pangenome analysis, in silico AMR prediction, and phenotypic antimicrobial susceptibility testing (AST) across 1,027 P. mirabilis genomes derived from human urine specimens. This revealed a mosaic pangenome driven by extensive accessory genome plasticity. Multilocus sequence typing (MLST) identified 213 MLSTs, with only 7% having ≥10 genomes, highlighting strain diversity. AMR gene profiles were largely lineage-specific, with 25% of genomes …


Myelomalacia Severity On Preoperative Magnetic Resonance Imaging Does Not Predict Patient-Reported Outcomes After Anterior Cervical Discectomy And Fusion, Mitchell K. Ng, Joshua Mathew, Robert J. Oris, Yulia Lee, Jonathan Dalton, Gregorio Baek, Ashley Thommana, William A. Green, Yasmine Eichbaum, Morgan Hitchner, Brandon Martinazzi, Ali Farooqi, Alec Giakas, Paul Gunter, Vinay Bijoor, Andrew Vanchikorn, John J. Mangan, David I. Kaye, Mark F. Kurd, Thomas Cha, Jose A Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder Jul 2026

Myelomalacia Severity On Preoperative Magnetic Resonance Imaging Does Not Predict Patient-Reported Outcomes After Anterior Cervical Discectomy And Fusion, Mitchell K. Ng, Joshua Mathew, Robert J. Oris, Yulia Lee, Jonathan Dalton, Gregorio Baek, Ashley Thommana, William A. Green, Yasmine Eichbaum, Morgan Hitchner, Brandon Martinazzi, Ali Farooqi, Alec Giakas, Paul Gunter, Vinay Bijoor, Andrew Vanchikorn, John J. Mangan, David I. Kaye, Mark F. Kurd, Thomas Cha, Jose A Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN/SETTING: Retrospective cohort study.

BACKGROUND: Signal changes within the spinal cord on magnetic resonance imaging (MRI) or myelomalacia, are frequently seen in patients with cervical myelopathy. While often assumed to predict the outcomes, their prognostic value remains uncertain. Therefore, this study aimed to: (1) describe the clinical characteristics of patients with myelomalacia undergoing Anterior cervical discectomy and fusion (ACDF); (2) evaluate whether MRI findings correlate with patient-reported outcomes (PROMs); and (3) determine whether morphology predict recovery.

METHODS: A retrospective review at a single tertiary care center was performed (2014-2021). Patients were included if they underwent a primary elective ACDF …


Nuclear Factor Of Activated T Cells As A Driver Of Tumor Progression And A Target For Precision Therapy, Hira Khan, Khushbakhat Alia, Yusra Al Dhaheri, Muhammad Naseem, Rabah Iratni, Edgar Serfling, Khalid Muhammad Jul 2026

Nuclear Factor Of Activated T Cells As A Driver Of Tumor Progression And A Target For Precision Therapy, Hira Khan, Khushbakhat Alia, Yusra Al Dhaheri, Muhammad Naseem, Rabah Iratni, Edgar Serfling, Khalid Muhammad

All Works

The Nuclear Factor of Activated T Cells (NFAT) family comprises closely related transcription factors. Numerous biological processes including angiogenesis, invasion, migration, proliferation, and cell survival are regulated by the NFAT family. NFATs are overexpressed and have increased transcriptional activity in a variety of human solid tumors and hematological cancers. Beyond tumor cell-intrinsic roles, NFAT has also emerged as an important regulator of the tumor microenvironment (TME), where it can influence immune cell behavior and contribute to mechanisms of immune evasion. The discovery of the multifaceted functions of NFATs has driven the need to further unveil their role in cancer and …


Why Pronatalism Fails The Planetary Health Test, Celine Delacroix, Marleen Temmerman, Nandita Bajaj, Ann Moore, Phoebe Barnard, William Ripple, William Rees, Michael Gerrard, Diana Coole, Robert Engelman Jul 2026

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

Centre of Excellence in Women and Child Health

No abstract provided.


Performance Of Road-Traffic-Based Exposure Proxies Against Personal Pm2.5 Measurements In Three Sub-Saharan African Countries, Handsome Nyoni, Terence Mushore, Laura Munthali, Sibusisiwe Makhanya, Laurine Chikoko, Stanley Luchters, Matthew Chersich, Fortunate Machingura, Liberty Makacha, Benjamin Barratt Jul 2026

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

Centre of Excellence in Women and Child Health

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


Neonatal Admissions And Mortality: A Statistical Adjustment Approach Using Birthweight-Specific Curves To Address Bias Due To Underreporting In 65 Hospitals In Four African Countries, Lucas Malla, Siu Wong, Samuel Ngwala, Evelyn Zimba, Msandeni Chiume, Norman Lufesi, Kondwani Kawaza, Honorati Masanja, Josephine Shabani, William Macharia Jul 2026

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

Paediatrics and Child Health, East Africa

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

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


Unlocking The Potential Of Sub-Saharan Africa In Globalized Cancer Clinical Trials: A Perspective From The 2024 Aortic-Asco Stakeholder Meeting, Abiola Ibraheem, Adedayo Joseph, Miriam Mutebi, Mansoor Saleh, Sitna Mwanzi, Olusegun Alatise Jul 2026

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

General Surgery, East Africa

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


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 Jul 2026

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 …


Not Just A Migraine: Transverse Venous Sinus Stenosis Presenting As Orthostatic Headache, Tejaswini Swamy, Aun A. Bangash, Chloe Harris, Jose E. Campo Maldonado Jul 2026

Not Just A Migraine: Transverse Venous Sinus Stenosis Presenting As Orthostatic Headache, Tejaswini Swamy, Aun A. Bangash, Chloe Harris, Jose E. Campo Maldonado

School of Medicine Publications

Transverse venous sinus stenosis (TVSS) is an underrecognized cause of intracranial hypertension that can mimic primary headache disorders. We report a woman with obesity and prior bariatric surgery who developed bifrontal headache with pulsatile tinnitus, dizziness, and visual blurring for 1 year. Orthostatic features and lack of response to therapy prompted further evaluation. Lumbar puncture revealed an opening pressure of 32 cm H2 O with immediate relief after cerebrospinal fluid removal. Magnetic resonance venography demonstrated severe TVSS, confirmed by cerebral angiography. The patient had left transverse sinus stenting with sustained improvement. This case highlights the importance of considering TVSS in …


Global Prevalence Of Internet Gaming Disorder: An Umbrella Review Of Meta-Analytic Evidence And Implications For Child And Adolescent Psychiatry, Elisabeth C. S. Poon, Xun Ci Soh, Trina J. H. Poh, Andre C. S. Tan, Andree Hartanto Jul 2026

Global Prevalence Of Internet Gaming Disorder: An Umbrella Review Of Meta-Analytic Evidence And Implications For Child And Adolescent Psychiatry, Elisabeth C. S. Poon, Xun Ci Soh, Trina J. H. Poh, Andre C. S. Tan, Andree Hartanto

Research Collection School of Social Sciences

Background/Objectives: Internet gaming has become a widespread global activity, raising concerns about the prevalence of Internet Gaming Disorder (IGD). However, existing meta-analyses report highly variable prevalence estimates. This umbrella review aims to clarify the prevalence and variability of IGD by synthesizing evidence from meta-analyses to provide a comprehensive overview of IGD prevalence across populations, age groups, and regions. Methods: Following PRISMA guidelines, systematic searches were carried out across five published literature databases and two supplementary search sources. Title and abstract screening, followed by full-text eligibility assessment, were conducted independently by three authors. The same three authors then performed data extraction …


Cyberbullying Perpetration: A Systematic Review Of Global Prevalence, Profiles, Antecedents, Consequences, And Interventions, Ysabel A. Guevarra, K. T. A. Sandeeshwara Kasturiratna, Charlotte K. Y. Lee, Andree Hartanto Jul 2026

Cyberbullying Perpetration: A Systematic Review Of Global Prevalence, Profiles, Antecedents, Consequences, And Interventions, Ysabel A. Guevarra, K. T. A. Sandeeshwara Kasturiratna, Charlotte K. Y. Lee, Andree Hartanto

Research Collection School of Social Sciences

The anonymity afforded by cyberspace enables individuals to engage in harmful online behaviours, most notably cyberbullying perpetration, which has become a pressing social and psychological concern worldwide. Despite extensive research on its antecedents, outcomes and interventions, insights into cyberbullying perpetration remain scattered, highlighting the value of a comprehensive synthesis to capture its multifaceted nature. This systematic review synthesised findings from 54 meta-analyses, comprising 314 effect sizes (Sample size: Range = 3273–1,479,614, Mdn = 46,604) across diverse populations worldwide. Results indicate that approximately one in ten individuals engage in peer cyberbullying, with even higher prevalence in partner-directed forms such as cyber …


Transforaminal Endoscopic Lumbar Decompression: Defining Its Scope And Limitations, Kai-Uwe Lewandrowski, Álvaro Dowling, Jun Ho Lee, Benedikt W Burkhardt, Óscar L. Alves, Avelino Parajón, Jorge Felippe Ramirez, Nicola Montemurro, Alex R. Vaccaro, Morgan P. Lorio Jul 2026

Transforaminal Endoscopic Lumbar Decompression: Defining Its Scope And Limitations, Kai-Uwe Lewandrowski, Álvaro Dowling, Jun Ho Lee, Benedikt W Burkhardt, Óscar L. Alves, Avelino Parajón, Jorge Felippe Ramirez, Nicola Montemurro, Alex R. Vaccaro, Morgan P. Lorio

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Transforaminal endoscopic lumbar decompression (TELD) has emerged as a minimally invasive alternative for managing lumbar stenosis and disc herniations. While the literature consistently reports favorable outcomes, real-world adoption remains variable, with discrepancies often linked to surgeon experience and case complexity.

OBJECTIVE: To evaluate surgeon perspectives on the clinical applicability of TELD across different pathologies and compare these findings with published evidence.

METHODS: An international cross-sectional survey was conducted among spine surgeons. Responses were analyzed using Rasch modeling to assess consensus levels, with agreement categorized as strong, moderate, weak, or disagreement. Differential Item Functioning (DIF) and correlation analyses were applied …


Health Systems Interventions For Prevention Of Maternal Peripartum Infection In Low And Middle-Income Countries: A Systematic Review, Roseline Abwao, Job Mapesa, Wanja Tenambergen, David Odada, Nasra Gathoni, Felix Riunga Jul 2026

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

Internal Medicine, East Africa

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

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

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


Antibody-Oligonucleotide Conjugates: An Emerging Modality For Precision Rna Therapeutics, Chen-Hsu Yu, Summer Y Y Ha, Zhiqiang An, Kyoji Tsuchikama, Wenbo Li Jul 2026

Antibody-Oligonucleotide Conjugates: An Emerging Modality For Precision Rna Therapeutics, Chen-Hsu Yu, Summer Y Y Ha, Zhiqiang An, Kyoji Tsuchikama, Wenbo Li

The Brown Foundation: Institute of Molecular Medicine

RNA-targeting therapeutics have enormous potential to precisely target disease-causing RNAs, extending beyond the traditional limits of "druggability" for small molecules, antibodies, and protein-targeting cell therapies. However, one crucial limitation is that RNA-targeting drug modalities (such as oligonucleotides) cannot effectively reach diseased tissue or cell types. Antibody-oligonucleotide conjugates (AOCs) emerge as a promising frontier in aiding RNA therapeutics by harnessing antibodies to deliver drug modalities to target specific RNAs in desired tissues or cells. In this Review, we summarize the critical components of AOCs, key considerations for their design and manufacturing, ongoing AOCs in preclinical/clinical development, and disease indications. We discuss …


Nano-Bio Interfacial Effects Modulating Protein Adsorption In Dialdehyde Lentinan-Crosslinked Polysaccharide Sponges Reinforced With Zein Nanoflowers, Dorota Chelminiak-Dudkiewicz, Miloslav Machacek, Hana Janová, Klara Konecna, Ondrej Jandourek, Jana Kejmarová, Kinga Mylkie, Aleksander Smolarkiewicz-Wyczachowski, Marta Ziegler-Borowska Jul 2026

Nano-Bio Interfacial Effects Modulating Protein Adsorption In Dialdehyde Lentinan-Crosslinked Polysaccharide Sponges Reinforced With Zein Nanoflowers, Dorota Chelminiak-Dudkiewicz, Miloslav Machacek, Hana Janová, Klara Konecna, Ondrej Jandourek, Jana Kejmarová, Kinga Mylkie, Aleksander Smolarkiewicz-Wyczachowski, Marta Ziegler-Borowska

The Brown Foundation: Institute of Molecular Medicine

The interfacial organization of porous biomaterials critically influences protein adsorption and subsequent cell-material interactions at hydrated biointerfaces relevant to wound-contacting environments. Herein, hybrid sponges were developed by rationally assembling chitosan, lentinan, levan, and fucoidan into a covalently defined macromolecular network featuring nano-bio interfacial effects. The materials were designed to modulate interfacial biological performance via engineered pore-wall structures, with protein-layer formation at sponge interfaces associated with downstream cell-material responses. A dialdehyde lentinan was deliberately employed to establish a chemically defined pore-wall interface via dense Schiff-base junctions with chitosan. The incorporation of zein nanoflowers introduced additional nanoscale structure features, providing additional anchoring …


Cost Utility Analysis Of Fluticasone Exhalation Delivery System Versus Budesonide Nasal Irrigation For Chronic Rhinosinusitis With Nasal Polyps, Daniel Xiao, Martin J Citardi, William C Yao, Amber U Luong Jul 2026

Cost Utility Analysis Of Fluticasone Exhalation Delivery System Versus Budesonide Nasal Irrigation For Chronic Rhinosinusitis With Nasal Polyps, Daniel Xiao, Martin J Citardi, William C Yao, Amber U Luong

The Brown Foundation: Institute of Molecular Medicine

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is managed after sinus surgery with topical corticosteroids. Given limited distribution of nasal steroid sprays, patients have the option of either steroid nasal irrigation (SNI) or exhalation delivery system with fluticasone (EDS-FLU). This study evaluates the cost-effectiveness of EDS-FLU compared to SNI for CRSwNP.

Methods: A cohort-style Markov decision-tree economic model with a 33-year time horizon was developed in TreeAgePro. Because EDS-FLU is not currently covered by Medicare, costs of medications were estimated using retail pricing. A willingness-to-pay threshold of $50,000/quality adjusted life year (QALY) was used to determine cost-effectiveness. One-way and probabilistic …


Functional Characterization Of Uhrf1 Variants In Facilitating Dna Methylation, Bigang Liu, Kaila Nayvelt, Swanand Hardikar, Kimie Kondo, Marcos R Estecio, Xiaodong Cheng, Taiping Chen Jul 2026

Functional Characterization Of Uhrf1 Variants In Facilitating Dna Methylation, Bigang Liu, Kaila Nayvelt, Swanand Hardikar, Kimie Kondo, Marcos R Estecio, Xiaodong Cheng, Taiping Chen

The Brown Foundation: Institute of Molecular Medicine

Ubiquitin-like with plant homeodomain (PHD) and really interesting new gene (RING) finger domains 1 (UHRF1) is essential for DNA methylation inheritance. However, the functional impacts of several natural and engineered UHRF1 variants are either insufficiently characterized or obscured by conflicting results, with some discrepancies likely stemming from cellular toxicity and adaptive responses induced by DNA methylation changes. In this study, we utilized mouse embryonic stem cells (mESCs)-which uniquely tolerate the complete loss of DNA methylation-to evaluate the functional consequences of clinical mutations, isoform variation, and epitope tagging. Using rescue experiments in Uhrf1-deficient mESCs, we characterized two UHRF1 mutations identified in …


Da Mosang Tarsier Series: Developing Digital Bullying Prevention Materials For Filipino Parents Of Grade School Students, Rudy M. Danganan Jr., Ann Christine V. Braga, Maria Kristina S. Alfonso, Romelito Manuel D.S. Clorina, Ma. Regina Hechanova Jul 2026

Da Mosang Tarsier Series: Developing Digital Bullying Prevention Materials For Filipino Parents Of Grade School Students, Rudy M. Danganan Jr., Ann Christine V. Braga, Maria Kristina S. Alfonso, Romelito Manuel D.S. Clorina, Ma. Regina Hechanova

Children and Families

Bullying remains a significant public health and educational concern worldwide and is particularly prevalent in Philippine public schools, with Grade 7 students identified as a vulnerable group. Although the Anti-Bullying Act of 2013 (Republic Act No. 10627) mandates school-based policies and procedures, persistent implementation gaps underscore the need to strengthen home–school partnerships and equip parents with practical, culturally grounded response strategies. This paper describes the development of the Da Mosang Tarsier Series, a set of digital psychoeducational comic strips designed for Filipino parents of Grade 7 students. Guided by a user-centered design (UCD) framework, the project began with a Generative …


Medical, Socioeconomic, And Geographic Disparities In Primary Health Care Access And Utilization: A Population-Based Study Of 8038 Individuals Aged One Year And Older In Rural Uganda, Saadiyah Mayet, Christin Puthur, Betty Nabatte, Benjamin Tinkitina, Christopher Opio, Yin-Cong Zhi, Narcis Kabatereine, Goylette Chami Jul 2026

Medical, Socioeconomic, And Geographic Disparities In Primary Health Care Access And Utilization: A Population-Based Study Of 8038 Individuals Aged One Year And Older In Rural Uganda, Saadiyah Mayet, Christin Puthur, Betty Nabatte, Benjamin Tinkitina, Christopher Opio, Yin-Cong Zhi, Narcis Kabatereine, Goylette Chami

Internal Medicine, East Africa

Background There is limited data on trends in primary health care (PHC) access and utilisation in rural sub-Saharan Africa, with a particular lack of knowledge on disparities beyond geographic barriers.

Methods A cross-sectional study was conducted within the community-based cohort, SchistoTrack. 2191 households were randomly sampled from 52 rural villages in Pakwach, Buliisa, and Mayuge Districts in Uganda. All household members aged one year and older were surveyed between 2022–2024, resulting in 8038 individuals with baseline health access information. Key outcomes included any care sought within the month preceding the study, type of care sought, and usual source of care. …


Just Opt For Caesarean Section And Pick The Birthdate': A Qualitative Study Exploring Women's Delivery Preferences After Caesarean Section In Urban Tanzania, Daudi Gidion, Columba Mbekenga, Miriam Mgonja, Marleen Temmerman, Muzdalfat Abeid Jul 2026

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

Obstetrics and Gynaecology, East Africa

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

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

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

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

Results Thematic analysis identified four key …


Health Beliefs And Lung Cancer Screening Uptake Among Eligible Asian Americans In Philadelphia, Pennsylvania, United States, Julia G. Katcher, Kuang-Yi Wen, Christine S. Shusted, Jessica Liang, Kyunghee Koh, Hee-Soon Juon, Julie Barta Jul 2026

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

Department of Medical Oncology Faculty Papers

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

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

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


Mosaic Loss Of Y Chromosome Associates With Lung Function, Emphysema, And Epigenetic Aging, Woei-Yuh Saw, Kangjin Kim, Yichen Huang, Jeong H Yun, Xiaolong Ma, Jason Bacon, Yash Pershad, Daniel Levy, George T O'Connor, Eric Boerwinkle, R Graham Barr, Stephen S Rich, Jerome I Rotter, April P Carson, Laura M Raffield, Sina A Gharib, Traci M Bartz, Bruce M Psaty, Tamar Sofer, Kari E North, Robert C Kaplan, Elizabeth C Oelsner, Ani Manichaikul, Alexander G Bick, Paul Scheet, Alexander P Reiner, Nhlbi Trans-Omics For Precision Medicine Consortium, Yasminka A Jakubek, Paul L Auer, Michael H Cho, Dawn L Demeo Jul 2026

Mosaic Loss Of Y Chromosome Associates With Lung Function, Emphysema, And Epigenetic Aging, Woei-Yuh Saw, Kangjin Kim, Yichen Huang, Jeong H Yun, Xiaolong Ma, Jason Bacon, Yash Pershad, Daniel Levy, George T O'Connor, Eric Boerwinkle, R Graham Barr, Stephen S Rich, Jerome I Rotter, April P Carson, Laura M Raffield, Sina A Gharib, Traci M Bartz, Bruce M Psaty, Tamar Sofer, Kari E North, Robert C Kaplan, Elizabeth C Oelsner, Ani Manichaikul, Alexander G Bick, Paul Scheet, Alexander P Reiner, Nhlbi Trans-Omics For Precision Medicine Consortium, Yasminka A Jakubek, Paul L Auer, Michael H Cho, Dawn L Demeo

Faculty, Staff and Student Publications

Rationale: As the global population ages, identifying risk factors for age-related diseases, such as COPD, is crucial for public health. Mosaic loss of Y chromosome (mLOY) in blood cells is an age-related somatic mosaicism event, but its relationship with pulmonary health remains undercharacterized.

Objectives: To examine the association between mLOY and pulmonary outcomes in men.

Methods: Leveraging mLOY assessment (cell fraction ≥ 5%) in over 12 000 men, including 5097 from the COPDGene Study and 7235 from six additional cohorts in the Trans-Omics for Precision Medicine program, we investigated mLOY associations with respiratory outcomes and epigenetic aging using multivariable cross-sectional, …


Current Adoption Of The Prosthodontic Diagnostic Index For Clinical Care-A Cross-Sectional Survey Study, Esther O Kuyinu, Joseph B Breitman, Arthur Nimmo, Jay S Patel Jul 2026

Current Adoption Of The Prosthodontic Diagnostic Index For Clinical Care-A Cross-Sectional Survey Study, Esther O Kuyinu, Joseph B Breitman, Arthur Nimmo, Jay S Patel

Faculty, Staff and Student Publications

Purpose: To assess current utilization of the Prosthodontic Diagnostic Index (PDI), identify perceived benefits and limitations, and evaluate support for future updates.

Materials and methods: A survey regarding the use of the PDI was made available through email invitations to 68 US dental school prosthodontic/restorative department chairs (PD), 48 graduate prosthodontic program directors (GP), and 1834 private practice prosthodontists (PP) from the American College of Prosthodontists (ACP) member database. The results of this initial survey were inconclusive due to low response rates. The survey was also administered during the 2024 ACP Annual Session with an improved response rate for educators. …


Kras G12c And Kras G12d Respond To Lipid Metabolism In An Allele-Specific Manner, Neha Arora, Hong Liang, Walaa Kattan, Wantong Yao, Haoqiang Ying, Junchen Liu, Yong Zhou Jul 2026

Kras G12c And Kras G12d Respond To Lipid Metabolism In An Allele-Specific Manner, Neha Arora, Hong Liang, Walaa Kattan, Wantong Yao, Haoqiang Ying, Junchen Liu, Yong Zhou

Faculty, Staff and Student Publications

KRAS mutated at hotspots G12, G13, and Q61 possess profound allele-specific oncogenesis. Signaling of KRAS mutants is mostly compartmentalized to the proteolipid nanoclusters on the plasma membrane (PM), illustrating critical roles of spatiotemporal organization in KRAS cancer signaling. The activated GTP-bound KRAS molecules, including the wild type and mutants, have been traditionally thought to favor similar lipids. We recently reported distinct lipid sensing capabilities of different KRAS mutants, especially with KRASG12D favoring unsaturated lipids and KRASG12C gaining additional enrichment of saturated lipids. As such, KRAS mutants may respond to lipid acyl chain remodeling in an allele-specific manner. Lysophosphatidylcholine acyltransferase 1 …


Quantitative Analysis Of Peri-Implant Collagen Fiber Orientation Around External Hexagon And Morse Taper Implant Connections: A Dog Model Study, Daniel Sartorelli Marques De Castro, Jefferson David Melo De Matos, Jozely Francisca Mello Lima, Maria Angelica Rehder De Araujo, Mário Alexandre Coelho Sinhoreti, Daher Antonio Queiroz, Adriano Piattelli, Carlos Dos Reis Pereira De Araújo Jul 2026

Quantitative Analysis Of Peri-Implant Collagen Fiber Orientation Around External Hexagon And Morse Taper Implant Connections: A Dog Model Study, Daniel Sartorelli Marques De Castro, Jefferson David Melo De Matos, Jozely Francisca Mello Lima, Maria Angelica Rehder De Araujo, Mário Alexandre Coelho Sinhoreti, Daher Antonio Queiroz, Adriano Piattelli, Carlos Dos Reis Pereira De Araújo

Faculty, Staff and Student Publications

Background: Peri-implant soft tissue stability depends on the implant-abutment interface and collagen fiber organization. Unlike natural teeth, peri-implant fibers exhibit a less favorable orientation, potentially weakening the biological seal. Implant connection design may influence this collagen arrangement and tissue integrity.

Materials and methods: Eighteen immediately loaded implants (n = 9 per group) were placed in nine mongrel dogs. Group I received external hexagon implants, while Group II received Morse taper implants. After a 4-month healing period, animals were euthanized and specimens were processed for histological evaluation. Collagen fiber orientation was analyzed using polarized light microscopy and quantified with ImageJ software. …


Erk-Mediated Phosphorylation Of Yap Defines A Noncanonical Fgf Signaling Mechanism In Stem Cells, Xiaolei Zhao, Shannon Erhardt, Li Tang, Xiaotong Chen, Stephen M Farmer, Zixiu Cheng, Wen Chen, Ella Ziyuan Lu, Kihan Sung, Chang-Ru Tsai, Mingjie Zheng, Sheng Zhang, Yang Liu, Jianxin Wang, Min Li, James F Martin, Jun Wang Jul 2026

Erk-Mediated Phosphorylation Of Yap Defines A Noncanonical Fgf Signaling Mechanism In Stem Cells, Xiaolei Zhao, Shannon Erhardt, Li Tang, Xiaotong Chen, Stephen M Farmer, Zixiu Cheng, Wen Chen, Ella Ziyuan Lu, Kihan Sung, Chang-Ru Tsai, Mingjie Zheng, Sheng Zhang, Yang Liu, Jianxin Wang, Min Li, James F Martin, Jun Wang

Faculty, Staff and Student Publications

While Fgf and Hippo-Yap signaling are fundamental for proper development, homeostasis, and disease, their crosstalk remains largely unknown. Here, we identified that Yap and Taz, canonical Hippo effectors, function as noncanonical effectors of Fgf signaling to maintain the proper function of neural crest (NC) lineages. NC cells are a multipotent stem cell population during vertebrate embryogenesis that contribute to numerous structures and diverse cell lineages, including craniofacial and cardiac tissues, neurons, and suture mesenchymal cells (SMCs), a specified cell population required for cranial bone growth and repair. We observed that activation of Fgf signaling in NC cells and NC-derived SMCs …


Precise-Dyad: A Prospective Cohort Study Linking Maternal And Infant Health Trajectories In Sub-Saharan Africa, Marie-Laure Volvert, Robin Owino, Angela Koech, Onesmus Wanje, Isaac Mwaniki, Joseph Mutunga, Emily Mwadime, Geoffrey Omuse, Moses Mukhanya, Marvin Ochieng, Grace Mwashigadi, Agnes Mutua, Marleen Temmerman, Melissa Gladstone, Amina Abubakar, Helen Nabwera Jul 2026

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

Centre of Excellence in Women and Child Health

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

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


Cefepime Pharmacokinetics In Critically Ill Children With Multiple Organ Dysfunction Syndrome Using Volumetric Absorptive Microsampling, Victor Amajor, Amanda Bwint, Steven Shein, Janet Hume, Courtney Rowan, Leeanne Flygt, Matthew Malone, Erin Stenson, Scott Weiss, Matt Zinter, Sujatha Kannan, Mary Dahmer, Ryan Nofziger, Manjunath Pai, Athena Zuppa, Nathaniel Rhodes, Mark Hall, Marc Scheetz, Kevin Downes Jul 2026

Cefepime Pharmacokinetics In Critically Ill Children With Multiple Organ Dysfunction Syndrome Using Volumetric Absorptive Microsampling, Victor Amajor, Amanda Bwint, Steven Shein, Janet Hume, Courtney Rowan, Leeanne Flygt, Matthew Malone, Erin Stenson, Scott Weiss, Matt Zinter, Sujatha Kannan, Mary Dahmer, Ryan Nofziger, Manjunath Pai, Athena Zuppa, Nathaniel Rhodes, Mark Hall, Marc Scheetz, Kevin Downes

Department of Pediatrics Faculty Papers

Up to half of critically ill children experience multiple organ dysfunction syndrome (MODS), which worsens outcomes and increases mortality risk. Cefepime is a broad-spectrum antibiotic commonly used in pediatric sepsis, but its pharmacokinetics during MODS has not been evaluated. We performed a prospective, observational study of critically ill children with MODS who were administered cefepime and collected up to 15 whole blood samples over 3 days using volumetric absorptive microsampling (VAMS). We performed nonlinear mixed-effects modeling to develop a population PK model for cefepime in children with MODS. We then reran our final population PK model using estimated plasma concentrations …


Persistent Gaps In Management And Risk Factor Control Among Patients With Atherosclerotic Cardiovascular Disease: All Of Us Research Program, Yakubu Bene-Alhasan, Soad Al Osta, Yussif Issaka, Isaac Acquah, Ahmad Alkhatib, Leen Othman, Samuel Mensah, Ato Howard, Christie Ballantyne, Salim S. Virani Jul 2026

Persistent Gaps In Management And Risk Factor Control Among Patients With Atherosclerotic Cardiovascular Disease: All Of Us Research Program, Yakubu Bene-Alhasan, Soad Al Osta, Yussif Issaka, Isaac Acquah, Ahmad Alkhatib, Leen Othman, Samuel Mensah, Ato Howard, Christie Ballantyne, Salim S. Virani

Population Health, East Africa

Background

Contemporary guidelines recommend aggressive low-density lipoprotein cholesterol (LDL-C) lowering in patients with atherosclerotic cardiovascular disease (ASCVD), yet significant treatment gaps persist in clinical practice. We evaluated lipid-lowering therapy (LLT) use, LDL-C control, and prevelance of cardiovascular risk factors among patients with coronary artery disease (CAD), peripheral artery disease (PAD), cerebral atherosclerosis (CAS) and those with all three (polyvascular disease) using real-world data from the NIH-run All of Us Research Program.

Methods

We analyzed electronic health records from 26,935 patients with ASCVD (CAD 21,573; PAD 4752; CAS 6864; and polyvascular 902) enrolled between 2018 and 2023. We assessed baseline LLT …