Medicine and Health Sciences Commons^™

Safety Of Spinal Anaesthesia In The East African Population: Assessment Of Spinal Cord Termination Level At And Above L2 Vertebra In Adults, David Nekyon, Sheila Waa, Samuel Gitau, David Odaba

Anaesthesiology, East Africa

Background While spinal anaesthesia is a widely used technique, failure to accurately identify the L3-L4 intervertebral space (IVS) during the procedure may expose a patient to a needlestick injury to the spinal cord.

Objectives This study aimed to determine the proportion of Conus Medullaris Terminations (CMT) at or above the L2 vertebra in a black East African population and identify any age or gender-based variations.

Methodology A prospective observational study of lumbar spine MRI was conducted on 331 patients who had no vertebral deformities or prior spine surgeries. Two radiologists assessed the CMT level by consensus, referencing the nearest vertebral …

Identifying Sex- And Gender-Specific Endocrinological, Lifestyle, Psychosocial, And Socio-Cultural Targets For Alzheimer's Disease Prevention In Africans: The Female Brain Health And Endocrine Research In Africa (Fember-Africa) Project, Chinedu Momoh, Benard Aliwa, Lukoye Atwoli, Karen Blackmon, Edna Bosire, Samuel Gitau, Harrison Kaleli, Ciru Kamanda, Linda Khakali, Rachel Maina, Peter Mativo, Sylvia Mbugua, Zul Merali, Kendi Muchungi, Anne Njogu, Douglas Nyankira, Alice Ondieki, Catherine Onyancha, Stanely Onyango, Jasmit Shah, Sheena Shah, Cynthia Smith, Dilraj Sokhi, Sheila Waa, Thomas Thesen

Brain and Mind Institute

Dementia rates are rising globally, with the burden increasing most rapidly in low- tomiddle-income countries. Despite this, research into Alzheimer’s disease and relateddementias (ADRD) among African populations remains limited, with existing modelsbased on Western cohorts that overlook sex-, gender-, and ancestry-specific factors.The Female Brain Health and Endocrine Research in Africa (FemBER-Africa) project,hosted at the Brain and Mind Institute, Aga Khan University, Kenya, will establish adeeply phenotyped cohort of 250 African individuals across the ADRD spectrum. Itwill assess sex-specific risk factors linked to ethnicity, lifestyle, and endocrinologicalvariables using fluid-based biomarkers (blood and saliva), neuroimaging (magneticresonance imaging and positron emission tomography), and …

Prevalence And Determinants Of Nomophobia Among Healthcare Workers In Nepal: A Cross-Sectional Study, Prakash Banjade, Asmita Itani, Munish Sharma, Reena Shah, Jasmit Shah, Aakansha Singh, Rahul Kashyap, Salim Surani

Brain and Mind Institute

Introduction: Nomophobia, the fear of being without a mobile phone, has become a significant concern in the current digital age. Healthcare professionals rely heavily on mobile devices for communication and information access. This cross-sectional study aimed to assess the prevalence and determinants of nomophobia among healthcare workers in Nepal.

Methods: A modified Nomophobia Questionnaire (NMP-Q) was used to determine nomophobia scores. Demographic characteristics such as age, gender, race, type of smartphone, hours spent on a smartphone, and type of medical specialty were considered to evaluate nomophobia in diverse groups of healthcare workers. Summary statistics were presented as frequencies …

Evaluating The Impact Of Alcohol On Dementia: Evidence From 13 Developing Countries, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission on Dementia Prevention identified alcoholconsumption as a risk factor contributing to a global increase in dementia cases by onepercent.

Method: We used a panel VAR model to analyze the impact of alcohol consumption ondementia prevalence in 13 developing countries with different alcohol tax systems.

Result: In countries with progressive alcohol tax systems, an increase in taxes onbeer and spirits leads to a 10 percent reduction in per capita alcohol consumption.This decline corresponds to a 4 percent reduction in dementia prevalence within fouryears. In countries with hybrid alcohol tax systems, a combination of alcohol bansand tax …

Assessing The Tumor Suppressive Impact And Regulatory Mechanisms Of Spdef Expression In Breast Cancer, Maansi Solanky, Maninder Khosla, Suresh K. Alahari

School of Graduate Studies Faculty Publications

Background/Objectives: Breast cancer is a heterogeneous disease, and the role of the transcription factor SPDEF remains controversial. We aimed to clarify the prognostic value of SPDEF, explore demographic and molecular correlates of its expression, and investigate potential regulatory mechanisms underlying its dysregulation. Methods: Genomic and clinical data for 1218 breast cancer tumors were obtained from The Cancer Genome Atlas (TCGA). SPDEF mRNA expression was compared across intrinsic subtypes, age, and race, and prognostic significance was evaluated by Kaplan–Meier analysis. Promoter methylation patterns and DNA methyltransferase (DNMT) expression were examined as potential regulatory drivers. Co-expression analysis was performed using gene panels …

Small For Gestational Age Subgroups Have Differential Morbidity, Growth, And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Ménde, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, Zulfiqar Ahmed Bhutta

Department of Obstetrics & Gynaecology

Background: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.
Objective: To refine the classification of small for gestational age by identifying subgroups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.
Study design: Prospective …

Plasma Biomarkers In Neuropsychiatric Syndromes: A Narrative Review, Zahinoor Ismail, Dylan X Guan, Ganesh Babulal, James Bateman, Marc Cantillon, Byron Creese, Fabrizia D'Antonio, Corinne Fischer, Jennifer Gatchel, Chinedu Momoh

Brain and Mind Institute

Neuropsychiatric symptoms (NPS) are common features of neurodegenerative disease (NDD) but are relatively understudied compared to cognition, especially regarding biomarkers. Further, emerging evidence describes the utility of systematic assessment of NPS across the cognitive continuum, even in advance of dementia. In this narrative review, we discuss the role of plasma biomarkers in relation to NPS across the cognitive continuum of unimpaired, subjective cognitive decline, mild cognitive impairment, and dementia. While Alzheimer's disease is the primary focus, vascular, Lewy body, and frontotemporal dementia etiologies are also discussed. Literature searches included NPS and dementia-related search terms with additional literature identified based on …

Prevalence Of Local Ige Elevation And Its Effect On Intranasal Capsaicin Therapy In The Nonallergic Rhinitis Population, Kunal R Shetty, Salman Hasan, Christopher Bankston, Dylan Vance, Elaijah Islam, Gabriella Cruz, Faramarz Ashoori, David Z Allen, William C Yao, Martin J Citardi, Amber U Luong

The Brown Foundation: Institute of Molecular Medicine

No abstract provided.

Exploring Perception Of Coarticulatory Cues In Childhood Apraxia Of Speech And Residual Speech Sound Disorders: A Pilot Study, Molly Beiting, Navin Viswanathan, Nicole Caballero, Elaine Hitchcock, Tara Mcallister, Jonathan L. Preston

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Introduction: Children with childhood apraxia of speech (CAS) exhibit speech production deficits beyond segmental errors, including atypical coarticulation. Broadly, children with speech sound disorders (SSD) also exhibit weaknesses in speech perception, which may directly relate to specific production difficulties. This study examined differences in categorical perception among children with CAS, residual SSD affecting /ɹ/ (rSSD), and typical speech (TD). We hypothesized that children with CAS would demonstrate weaker performance on a task requiring perception of coarticulatory cues—a defining weakness in their speech production—but perform similarly to rSSD peers on a segmental task. Methods: This study was designed as an exploratory …

Enhancing Surgical Understanding Of Diabetic Foot Ulcer Classification Through Anatomage Integration: A Digital Approach To Wagner Grading, Nidhin John, Hooman Mir

School of Podiatric Medicine - Student Research

Background: Diabetic foot ulcers often lead to amputation, and accurate Wagner classification requires strong spatial understanding. Anatomage, a 3D digital anatomy tool, may improve this learning.

Methods: Thirty-six surgical trainees completed a pretest, explored digitally reconstructed Wagner grade 0–5 ulcers on Anatomage, and completed a posttest. Paired-sample analysis measured changes in accuracy, comprehension, and confidence.

Results: Classification accuracy improved from 61% to 89% (p < 0.05), with the greatest gains in higher Wagner grades. Participants reported clearer visualization of wound depth, bone involvement, and infection spread.

Conclusion: Anatomage enhances understanding and diagnostic precision of Wagner ulcer classification, supporting more effective limb-preservation education

Predictors Of Caregiver Satisfaction With A Hybrid Care Model For Autism Diagnostic Evaluations, Michele Kilmer, Emily Shah, Danielle Randolph, Lauren Quetsch

The Eleanor Mann School of Nursing Faculty Publications and Presentations

Background: Decreased access to diagnostic services is a known barrier in autism care management. Utilizing a hybrid care model incorporating telehealth and face-to-face appointments may be one option to increase access to care. The current study examined caregivers' satisfaction with a hybrid model used to administer pediatric autism diagnostic evaluations. Methods: We used a quantitative research design with convenience sampling to administer a telehealth satisfaction survey to caregivers of children living in medically underserved areas who were referred for an autism diagnostic evaluation. Timeliness and accuracy of diagnostic evaluations via the hybrid model were also assessed. Findings: Most caregivers did …

Design And Implementation Of Data Quality Controls In The Eq-Daphnie Study: Insights From The Pilot Phase And 15-Country Analysis, Fatima Al Sayah, Hilary Short, Juan M. Ramos-Goñi, Rosalie Viney, Erica I. Lubetkin, Mathieu F. Janssen, Jeffrey A. Johnson

Publications and Research

Objective

The EQ-DAPHNIE (EuroQol Data for Assessment of Population Health Needs and Instrument Evaluation) project is a large, multi-country survey initiative designed to generate population norms and enable comparative research using self-reported health measures. This paper describes the quality control processes and summarizes data quality metrics from the United Kingdom (UK) pilot and full implementation across 15 countries.

Methods

Representative samples were recruited via Dynata, an online survey panel provider, using quota sampling by age, sex, income, community setting, and language (where applicable). The UK pilot (n = 3012) informed survey refinements ahead of full rollout (n = 68,411). Quality …

Effects Of Neurocognitive Multitask Activities On A Novel Lower Extremity Functional Performance Test, Sidney M. Stoddard, Logan Hill, Bryan L. Riemann, George J. Davies

Physical Therapy Faculty Publications

Objective: To examine the effects of incorporating (1) a neurocognitive reactive component and (2) a neurocognitive multitask component on performance degradation of a single-limb hop functional performance test.

Design: Randomized within-subject design of 32 healthy young adults.

Methods: Participants performed 3 randomly assigned variations of the single-limb T-Drill Hop Test (TDHT). The time to complete each test was recorded. The reactive TDHT (R-TDHT) consisted of the TDHT with a flashing light, indicating the "T" intersection hop direction. The neurocognitive reactive-recall TDHT (RR-TDHT) incorporated the R-TDHT and required participants to observe 5 flashing light colors. Participants then recalled the colors in …

Hand Swelling And Other Non-Raynaud Phenomenon Symptoms As The Initial Presentation Of Systemic Sclerosis: Prevalence And Clinical Associations In Two Us Cohorts, Iqtidar Hanif, Shervin Assassi, Maureen D Mayes, Zsuzsanna H Mcmahan, Meng Zhang, Julio Charles, John M Vanburen, Jessica S Alvey, Kimia Ghaffari, Elana J Bernstein, Flavia V Castelino, Lorinda Chung, Luke Evnin, Tracy M Frech, Jessica K Gordon, Faye N Hant, Laura K Hummers, Dinesh Khanna, Kimberly S Lakin, Dorota Lebiedz-Odrobina, Yiming Luo, Ashima Makol, Jerry A Molitor, Duncan F Moore, Carrie Richardson, Nora Sandorfi, Ami A Shah, Ankoor Shah, Victoria K Shanmugam, Virginia D Steen, Elizabeth R Volkmann, Carleigh Zahn, Brian Skaug

Faculty, Staff and Student Publications

Objective: Raynaud phenomenon (RP) is often the initial clinical manifestation of systemic sclerosis (SSc), but some patients develop other manifestations first. To help elucidate the diversity of SSc presentation in its early stages, we describe the initial clinical manifestations and antinuclear antibody (ANA) profiles of patients in two early SSc cohorts.

Methods: All patient data in the Genetics vs Environment in Scleroderma Outcomes Study (GENISOS) and Collaborative National Quality and Efficacy Registry (CONQUER) cohorts were reviewed. Both studies enrolled patients within five years of the first non-RP symptom.

Results: In GENISOS and CONQUER, respectively, 194 (44.2%) of 439 and 292 …

Exploring Nursing Students’ Experiences Of Factors Influencing Reflective Practice In Clinical Setting, Wafaa El Zaatari, Imad Maalouf

All Works

Purpose – Reflective practice is crucial in clinical nursing education at a nursing college in Al Ain. This study aims to explore nursing students’ perspectives on reflective practice in a clinical setting. Design/methodology/approach – The study employed an exploratory case study design, using semi-structured interviews to collect data from eight nursing students studying at a nursing college in the UAE. The recorded interviews were transcribed verbatim and manually analysed using thematic analysis. Findings – Three main themes have been extracted, and these are the significance of reflection, facilitating factors and hindering factors. Four sub-themes emerged from the facilitating factors: moral …

State Of Menstrual Health Education In 2024: Content Analysis Of Us K-12 Public School Education Standards, Emily Richardson, Sarah Bemis, Page Dobbs, Hope Ballentine, Shristi Bhochhibhoya, Victor Kwaku Akakpo, Kylie Lovett

The Eleanor Mann School of Nursing Faculty Publications and Presentations

Background: Exploratory study aiming to assess the prevalence and time of initiation of menstrual health curriculum in US public school education standards by state. Methods: US public school Kindergarten-12th grade education standards from each state's Department of Education website, including D.C. (n = 51), were searched for menstruation, menstrual, menses, menopause, period, menarche, reproduction, puberty, and growth and development. Results25.5% (n = 13) of US education standards include menstruation. Of these, constructs of comprehensive menstrual health were recorded including abnormal menstruation (n = 6), menstrual hygiene (n = 6), menopause (n = 1), and stigma (n = 7). Education is …

A House Divided: A Mixed Method Investigation Of Primary Care Interprofessional Teams Using The Core Principles And Values Of Teamwork Framework, Erin L. Kelly, Catherine Guariglia, Jeanne Felter, Dhruvi Shah, Brooke Mauriello, Amy Cunningham, Chris Arenson, Randa Sifri

Department of Family & Community Medicine Faculty Papers

Context

Primary care teams are facing increased demands, turnover, and escalating rates of burnout. A primary care team aligned in its core values and organized according to common teamwork principles is essential for delivering patient-centered, coordinated, and effective healthcare.

Methods

As part of a series of studies on workplace factors and burnout among primary care practice team members, we selected an urban practice with high rates of burnout to assess their teamwork via a practice-wide survey and six focus groups divided by role. The interview guide focused on identifying areas for potential intervention around teamwork. Transcripts were open-coded using a …

A Novel Method For Examining Autistic Children’S Comprehension Of Individual Words Produced Within Delayed Echolalia: A Proof-Of-Concept Pilot Study, Janine Mathee-Scott, Grace Corrigan, Emily Lorang, Zachary Hesse, Jennifer Johnson, Courtney E. Venker

Speech Pathology and Audiology Faculty Research and Publications

Delayed echolalia, or the repetition of previously heard speech, is often observed in the expressive language of autistic children. Relatively little is known about how the production of delayed echolalia fits within the overall picture of autistic children’s language ability, including receptive language. To date, no empirical studies have tested autistic children’s comprehension of individual words within their delayed echoes. The present study aimed to establish proof-of-concept for a novel method of examining children’s comprehension of individual words that they produce in their own delayed echoes. Using natural language sampling combined with parent report, we identified instances of delayed echolalia …

Too Loud To Ignore: Knowledge, Attitudes, And Practices Regarding Hearing Protection In Student Musicians And Ensemble Directors, Lucile Donald, Ashley G. Flagge

Ashley Flagge Publications

Musicians are at an elevated risk for noise-induced hearing loss (NIHL) due to repeated exposure to sound levels exceeding occupational safety guidelines. Although many strides have been made in educating music students on the potential dangers of noise exposure and the mitigating effects of hearing protection devices, the current attitudes on this topic among high school and college-level student musicians remain largely unknown. An electronic survey was administered to high school (n = 195) and university (n = 161)-level band students and ensemble directors (n = 15) regarding knowledge of noise/music-induced hearing loss (MIHL), personal practices with HPDs, and types …

Vestibular Migraine And Ssri Withdrawal: A Case Report, Grace Fairchild, Sarah Redding, Ashley G. Flagge

Ashley Flagge Publications

Vestibular migraine (VM) has been described as a diagnosis of exclusion, with no one singular definitive assessment for diagnosis. It has been suggested that possible pharmaceutical intervention for VM can include antidepressant drugs, but this is potentially complicated by the fact that dizziness is a common side effect of both use and withdrawal for certain types of antidepressant medications. This article describes the case of a 56-year old with probable VM, who was previously diagnosed with depression and treated with the selective serotonin reuptake inhibitor (SSRI) Citalopram. Following discontinuation with no taper, the patient experienced a series of withdrawal side …

Use Of An Electronic Medical Record Tool To Ensure Tertiary Survey Compliance In Pediatric Trauma Patients, Ryan T. Davis, Erica Surman, Begum Akay, Nathan Novotny, Anthony Stallion, Pavan Brahmamdam

Conference Presentation Abstracts

Introduction:
The purpose of the tertiary survey is to ensure that traumatic injuries that may be missed during the primary and secondary survey are identified and treated accordingly. After a review, our trauma program identified a quality gap where tertiary surveys were not being documented. The purpose of this study is to evaluate whether the use of an electronic medical record tool, in conjunction with a reporting process, improved documentation of the tertiary survey in pediatric trauma patients.

Methods:
A review of the pediatric trauma database was performed. Patients < 16 years old who were admitted after level 1 or 2 activations or trauma evaluations were included. The study period was between January 2023 and January 2024. An Epicâ„¢ SmartPhrase was developed with input from the pediatric surgery team, pediatric trauma nurse manager, and the general surgery residents. The residents and pediatric surgery attendings were educated and the smartphrase was implanted July 2023. Reviews were made on a month-to-month basis and if a patient did not have a tertiary survey documented, emails to the trauma attending and residents of record were sent, notifying them of missed documentation of a tertiary survey.

Results:
Tertiary survey documentation compliance in the six months prior to …

Lymphoma Imaging In Hiv And Non-Hiv Patients: A Retrospective Cross-Sectional Study With Clinical And Pathological Correlation, Poonamjeet Loyal, Edward Chege, Jasmit Shah, Anne Mwirigi, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Background: Patients with Human Immunodeficiency Virus (HIV)have an atypical imaging pattern of lymphoma. There is paucity of literature on differences in tumor volume or burden of disease amongst HIV positive patients compared with HIV negative patients and how this correlates with clinicopathological parameters of aggressiveness and prognosis.

Methods: This was a retrospective cross-sectional study of patients with non-Hodgkin lymphoma which were categorized into HIV positive and HIV negative. The tumor burden, disease sites, international prognostic score and Ki-67 index were recorded. Continuous variables were analyzed using the Kruskal Wallis test and categorical variables with Fisher’s Exact test.

Results …

Not All That Hurts Is Malignant: A Painful Case Of Focal Nodular Hyperplasia, Zamanali Khakhar, Abdullahi Abdigafar Yunis, Dayib Buthul, Khadija Warfa, Soraiya Manji, Rajiv Patel, Sayed Ali Raza Bukhari

Imaging & Diagnostic Radiology, East Africa

Focal nodular hyperplasia (FNH) is a benign hepatic lesion most often detected incidentally during imaging studies. While typically asymptomatic, a small subset of patients may present with abdominal pain or discomfort. Clinically and radiologically, FNH can mimic malignant liver tumors, occasionally resulting in unnecessary invasive procedures. This case report describes a 45-year-old woman with symptomatic FNH who was placed on routine imaging surveillance and managed conservatively. This case underscores the importance of accurately distinguishing this benign condition from hepatic malignancies. It further highlights the diagnostic challenges associated with achieving a definitive diagnosis.

Challenges And Opportunities With Providing Genetic Testing And Counseling For Mucopolysaccharidosis Type Ii In Kenya, Lucy Mungai, Charles Njeru, Allan Njoroge, Michuki Maina, Syokau Ilovi, Dalton Wamalwa, Ruth Nduati, Beatrice Odongkara, Danny Miller

Pathology, East Africa

Background Limited or absent genetic counseling and testing resources in low- and medium-income countries lead to missed or late diagnoses for treatable metabolic conditions with irreversible complications. In some communities, misunderstanding about the etiology of a genetic condition may lead women whose children are affected to be viewed as a bad omen and become stigmatized or ostracized from their community. Mucopolysaccharidosis type II (MPS II), or Hunter syndrome, is a lysosomal storage disorder in which deficiency or inactivity of the enzyme iduronate-2-sulfatase leads to accumulation of glycosaminoglycans throughout the body. The diagnosis can be made through clinical assessment, enzyme activity …

Development And Evaluation Of The Phenotypic 2g Test To Detect Drug-Resistant Tb, J. I. Garcia, E. T. Mambuque, Amberlee Hicks, Alyssa Schami, S. Munguambe, N. Gomez, G. Tembe, B. Saavedra, S.-H. Wang, Blanca I. Restrepo

School of Medicine Publications

Background: Early diagnosis of TB with drug susceptibility testing (DST) is critical to achieve successful treatment outcomes. We aimed to develop and test a novel colorimetric, 12-well, thin-layer agar-based test to assess its accuracy for TB diagnosis and DST in a clinical setting in Southern Mozambique.

Methods: Development of the first prototype of the second generation (2G) test in the laboratory setting followed by a cross-sectional diagnostic accuracy study with consecutive recruitment of subjects with microbiologically confirmed TB using GeneXpert MTB/RIF Ultra.

Results: In the laboratory setting, the 2G test showed 100% accuracy in detecting resistance of genotypically characterised drug-resistant …

Cultural Humility In Patient Education: Development Of A Nutrition-Related Simulation For Nursing Students, Theresa G. Schnable, Sylvia Peña, Juanita T. Garcia, Marilyn Frenn

College of Nursing Faculty Research and Publications

Introduction:

The Latinx community is disproportionately impacted by social and structural inequities such as food insecurity and culturally and linguistically appropriate resources. To address a gap in culturally appropriate nutrition education with Latinx individuals among baccalaureate nursing students, a simulation learning experience (SLE) was developed.

Methodology:

The SLE was designed using best practice standards by faculty experts and reviewed by consultants. After the SLE, students and faculty provided feedback regarding simulation design and implementation.

Results:

Participants reported improved knowledge and confidence when providing culturally appropriate nutrition education and valued working with an interpreter.

Discussion:

This innovative strategy using simulation offers …

Enhancement Of Antimicrobial Activity Of Truncated Cecropin B Peptides With The Substitution Of Tryptophan Residues, Sarah Smith, Christopher Feudale, Josephina R. Vermillion, Joseph Feudale, Joshua Do, Sabrina Arroyo, Juan Barrera, Madeleine Whitsitt, Marion Duval, Colby Grames, Bret Hatzinger, Makenzie Hilling, Tia Kean, Jasayle Rivera, Mia Shum, Hannah Zyra, David Rovnyak, Moria C. Chambers

Faculty Journal Articles

Cecropins are a class of antimicrobial peptides (AMPs) expressed by insects that have broad-spectrum antimicrobial activity and low cytotoxicity. However, cecropins are also long (40–45 amino acids) peptides, making their adaptation for therapeutic use challenging. Here, we present a series of 16 amino acid-long peptides derived from cecropin B from Drosophila melanogaster. The native truncated peptide is cationic and expected to form an amphipathic α-helix, but does not have antimicrobial activity. The incorporation of two Trp residues, depending on the position in the peptide backbone, results in antibacterial activity compa-rable to that of full-length cecropin B against the gram-negative bacteria …

Mortality Among Transgender Persons: A Taiwan Matched-Population And Sibling-Comparison Cohort Study, Chih-Wei Hsu, Yang-Chieh Brian Chen, Liang-Jen Wang, Mu-Hong Chen, Yao-Hsu Yang, Chih-Sung Liang, Po-Yen Chen, Edward Chia-Cheng Lai

Children’s Nutrition Research Center Staff Publications

Background: Transgender persons have been reported to experience excess mortality, but evidence is dominated by Western cohorts and seldom addresses familial confounding.

Methods: We conducted a nationwide, retrospective cohort study using two prespecified comparison designs: matched population controls (1:4, matched on legal sex and birth date) and within-family cisgender sibling comparisons. Transgender persons were identified by ≥2 psychiatrist-recorded gender identity disorder diagnoses during 2001-2021; cohort entry required age ≥6 years. Participants were followed until death or December 31, 2022. We compared all-cause, external-cause (suicide and accidents), and internal-cause mortality using Cox regression adjusted for sociodemographics and medical comorbidity.

Findings: Among …

Concerns Regarding The Standard Deviation Of Individual Responses For Assessing Treatment Response Heterogeneity, Aaron R Caldwell, David B Allison, Andrew W Brown, Gary L Gadbury, Thirupathi Reddy Mokalla, R Drew Sayer, Andrew D Vigotsky

Children’s Nutrition Research Center Staff Publications

The estimation of treatment response heterogeneity (TRH) is increasingly important as medicine moves toward personalized approaches. While various statistical methods have been proposed to quantify TRH in parallel-group trials, the standard deviation of individual responses (SDIR) has gained prominence within physiological research. This method is intended to quantify individual response variation by comparing standard deviations of change scores between intervention and control groups. We acknowledge that SDIR represents an improvement over many other flawed approaches that often involve responder counting. However, SDIR has critical limitations: 1) it cannot overcome the fundamental problem of causal inference because the correlation between potential …

Female Genital Mutilation And Its Effects Among Women Of Reproductive Age In Kenya: Insights From Kenya Demographic And Health Survey 2022, Jovinary Adam, Joyce Jebet

School of Nursing & Midwifery, East Africa

Introduction Female genital mutilation (FGM) is a significant public health issue rooted in cultural traditions, affecting millions of women and girls. In Kenya, the practice is prevalent in various ethnic groups and is often associated with social and economic pressures.

Objective To determine the prevalence of FGM, the factors associated with FGM, and its effects among women of reproductive age in Kenya.

Methods This study used secondary data of a total 16,716 weighted women of reproductive age drawn from the 2022 Kenya Demographic and Health Survey. The study used the “svy” command in Stata to assign the sample weight. Multivariable …