Medicine and Health Sciences Commons^™

Development And Evaluation Of A Modular 3-D Printed Adapter For Hands-Free Tissue Retraction, Fady E. Attia, Vijay A. Chhabra, Vaibhav Tadepalli,, Joseph Attia, Michael M. Hadeed

Fracture fixation procedures typically require precise retraction of soft tissues in order to provide adequate exposure of bone fragments for reduction and fixation. Such procedures require the use of multiple surgical assistants to maintain proper tissue retraction. This manual retraction using traditional instruments, such as Hohmann and Weitlaner retractors, can lead to inefficiencies and poor labor allocation within the operating room (OR). The purpose therefore is to develop and evaluate a three dimensional (3D)-printed Nylon PA12 adapter designed to dock Hohmann retractors onto Weitlaner retractors, enabling hands-free retraction during fracture fixation procedures and potentially improving labor allocation in the OR. …

Association Of Perioperative Steroid Use With Recovery Rate And Postoperative Infection Risk In Spinal Cord Injury, Nathan Zou, Athikur Rahman, Brian Lynch

Background: The purpose of this study is to compare recovery and infection outcomes between teenagers and adults who undergo surgery for traumatic spine injuries and the effect of steroid administration. Steroids are often used in traumatic spine injuries to help recovery, however there is a concern that steroid use could increase the risk of infection due to the suppression of the immune system. We examined the impact of postoperative steroid use on recovery rates and infection rates in both age groups.

Methods: A retrospective cohort study was conducted using the TriNetX Research Network, which includes data from over 100 healthcare …

Benign Painful Soft Tissue Tumors Of The Digits: A Contemporary Review, Nethmi Withanage, Athikur Rahman, Lawrence Hurst, Samantha Muhlrad

Purpose: Benign painful tumors of the digit are commonly encountered in hand surgery yet frequently pose diagnostic challenges due to overlapping clinical presentations. This review synthesizes current evidence on eight benign soft tissue tumors and cystic lesions that commonly cause digital pain: glomus tumor, giant cell tumor of the tendon sheath (GCTTS), digital mucous cyst, digital ganglion cyst, epidermoid inclusion cyst, pyogenic granuloma, nerve sheath tumors, and angioleiomyoma.

Methods: A comprehensive review of PubMed/MEDLINE was performed, supplemented by hand surgery textbooks and online educational resources. Case series, retrospective cohort studies, and review articles were included.

Results: Each tumor exhibits a …

Proceeding Of The 31st Annual Orthopaedic Symposium June 19, 2026, David Komatsu

Proceeding of the 31st Annual

Orthopaedic Symposium

June 19, 2026

Identifying And Prioritizing Essential Healthcare Services For A Private Start-Up Healthcare Hub In Laxmipasha, Bangladesh, Ferdous Ara Mostofa

Dissertations

This quantitative study identifies and prioritizes essential healthcare services for developing a private start-up healthcare hub in Laxmipasha, Bangladesh, a rural community with significant gaps in healthcare access. Using secondary data from national and international sources, the research analyzed disease burden, population characteristics, and service availability to determine the most urgent health priorities. A structured, evidence-based framework was used to evaluate services based on mortality and morbidity, service gaps, and potential health impact. The findings indicate that Maternal and Child Health (MCH), Non-Communicable Disease (NCD) management, and infectious disease control represent the most critical priorities for initial implementation. The study …

Dnp Final Report: Poverty Stigma: The Effects Of A Poverty Simulation On Undergraduate Nursing Students And Their Attitudes Toward Caring For Impoverished Patients, Jessica P. Bowen

DNP Final Reports

Background: Current evidence demonstrates that stigma toward individuals living in poverty persists among undergraduate nursing students and negatively influences patient outcomes. Evidence-based educational strategies addressing social determinants of health have been shown to improve nursing students’ perceptions of vulnerable populations.

Purpose: This quality improvement project intended to evaluate the feasibility of integrating an interactive Community Action Poverty Simulation© (CAPS) activity into an undergraduate nursing (BSN) program at an academic health system university in East Texas.

Methods: Guided by the Plan Do Study Act (PDSA) quality improvement framework and The Johns Hopkins Evidence-Based Practice (JHEBP) Model, Missouri's Community Action Poverty Simulation …

Dnp Final Report: Reducing 30-Day Readmissions Through Follow-Up Appointments In An Acute Care Setting, Sukhnandan Kaur

DNP Final Reports

Thirty-day hospital readmissions remain a persistent quality and financial concern for acute care organizations. Poorly coordinated discharge processes, inconsistent follow-up appointment scheduling, and gaps in care transitions may increase the risk of avoidable readmissions among adult medical-surgical patients. The purpose of this quality improvement project was to implement a standardized follow-up appointment scheduling workflow prior to hospital discharge and evaluate its effect on follow-up scheduling compliance and 30-day readmission trends in a 93-bed acute care hospital. The intervention was implemented over 12 weeks on an adult medical-surgical unit from September through December 2025. The standardized workflow included electronic health record …

Nanoparticle Carriers Enhance The Prophylactic Antiviral Effects Of Dsrna In Vitro And Ex Vivo, Shayne Oberhoffner, Stephanie Dewitte-Orr, Starla Richardson, Leah Haile, Dominique Daniels, Erin Cooper, Aizah Ijaz, Janet Velasquez Perez, Mathilde Peruzzi, Bertrand Collet, Paul Craig, Kristof Jenik

Theses and Dissertations (Comprehensive)

Aquaculture now outpaces traditional capture fisheries as the world population and demand for sustainable protein sources increases. Wild and farmed species are increasingly susceptible to pathogen spread as global temperatures rise and stocking densities increase. Despite the devastating losses experienced by aquaculture due to viral infections, there remain few effective prophylactic antiviral therapeutics. Long double-stranded (ds)RNA is a uniquely viral molecule produced by nearly all viruses during their replication cycle, and its detection by salmonids like rainbow trout (Oncorhynchus mykiss) and chinook salmon (Oncorhynchus tshawytsha) leads to the establishment of a defensive antiviral state. Previous in vitro studies demonstrated a …

Neural Correlates Of Cognitive Fatigue In Regular Cannabis Users And Non-Users: A Pilot Fnirs Study, Mariia Vistyzenko

Theses and Dissertations (Comprehensive)

Background: Cognitive fatigue impairs performance across multiple domains, yet how regular cannabis use affects fatigue responses remains unclear. This pilot study investigated neural and behavioural correlates of cognitive fatigue in abstinent cannabis users versus non-users.

Methods: Twenty-six participants (18 non-users, 8 regular cannabis users after 24-hour abstinence) completed cognitive tasks before and after a 60-minute Sustained Attention to Response Task (SART) designed to induce fatigue. Tasks assessed working memory (N-Back), cognitive flexibility (Wisconsin Card Sorting), psychomotor speed (Digit Symbol Substitution), sustained attention (Continuous Performance Task), inhibition (Stroop, Stop Signal), and motion perception. Functional near-infrared spectroscopy (fNIRS) continuously monitored prefrontal cortex …

The Disruption Of Gastrointestinal Hormonal Control Of Digestion In Nile Tilapia By Omeprazole, Rema Abutaha

Theses and Dissertations (Comprehensive)

Stomach acidity is a critical feature of the digestive system, facilitating the breakdown of protein through the activation of the protease pepsin. Gastric acid is secreted by H⁺/K⁺ ATPase, the gastric proton pump. A previous study on Nile tilapia (Oreochromis niloticus) showed that inhibiting the production of stomach acid using the proton pump inhibitor omeprazole (omz), reduced growth that correlated with an acceleration of the rate of gastric emptying. This contrasts with omz exposure studies in mammals in which there is a delay in gastric emptying and no impact on growth. To understand the mechanism …

Identifying The Physical Activity Promotion Practices Of Obstetricians And Gynecologists: Patients With Endometriosis And Polycystic Ovary Syndrome, Allison P. Herman

Theses and Dissertations (Comprehensive)

Despite efforts to promote physical activity, many females in Canada do not meet recommended physical activity guidelines. For individuals with gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS), physical activity may aid in symptom management and improve daily functioning. Healthcare settings, including obstetrics and gynecology, represent an area of opportunity to promote physical activity among this population. This thesis aims to understand the physical activity promotion practices of Ontario-based Obstetricians and Gynecologists (OBGYNs) to patients with endometriosis and/or PCOS. A cross-sectional online survey was conducted to explore OBGYNs promotional practices and perceived factors influencing their engagement in physical …

Cognitive Load Classification Using Functional Near-Infrared Spectroscopy, Pratham Shah

Theses and Dissertations (Comprehensive)

This thesis investigates the classification of cognitive load using functional near-infrared spectroscopy (fNIRS) signals recorded during an N-back working memory task. The study introduces a novel short-channel correction layer designed to suppress superficial physiological noise adaptively, addressing limitations of traditional General Linear Model (GLM) based regression. A single participant dataset comprising 69 validated sessions was analyzed using both conventional machine learning and deep learning approaches. Traditional classifiers: Linear Discriminant Analysis (LDA), Support Vector Machines (SVM), Random Forests, and Gradient Boosting were first evaluated using statistical features (mean, variance, peak, and slope). Among these, Gradient Boosting achieved the highest accuracy (55.6%), …

Error-Driven Density Control For Compact Gaussian Splatting Under Sparse Supervision, Abdelrhman Elrawy

Theses and Dissertations (Comprehensive)

This thesis studies efficiency and stability challenges in Gaussian-splatting-based reconstruction under sparse supervision. In few-shot novel view synthesis, standard 3D Gaussian Splatting (3DGS) can overfit the limited training views and grow an unnecessarily large number of primitives due to limitations in its Adaptive Density Control (ADC) mechanism. This thesis introduces an error-driven reformulation of ADC that triggers densification using opacity gradients as a lightweight proxy for rendering error, and shows that such aggressive densification must be paired with delayed and conservative pruning to prevent destructive create--destroy cycles. When combined with depth-based geometric regularization, the resulting framework produces substantially more compact …

Robust And Interpretable Medical Image Segmentation Via Retrieval And Mechanistic Analysis, Salma Ahmed

Theses and Dissertations (Comprehensive)

Medical image segmentation is a critical component of clinical decision-making, yet deep learning based segmentation models face persistent challenges. These models typically require large volumes of densely annotated data, exhibit strong sensitivity to domain shifts across scanners and patient populations, and lack explicit anatomical priors. Furthermore, despite continual architectural advances beyond fully convolutional networks, most segmentation models remain opaque, where they lack the granularity required for component-level analysis. As a result, when segmentation models fail, it is difficult to identify which internal representations are responsible, limiting developers’ ability to diagnose errors, improve robustness, or establish trust in clinical settings. Existing …

Taylorkan-Vit: Parameter-Efficient Vision Transformers For Medical Image Classification, Kaniz Fatema, Dr. Emad Mohammed, Dr. Sukhjit Singh Sehra

Theses and Dissertations (Comprehensive)

Effective and interpretable classification of medical images remains a critical challenge in computer-aided diagnosis, particularly in data-scarce and resource-constrained clinical settings where traditional deep learning models prove impractical. This study addresses the fundamental barrier to Vision Transformer adoption in medical imaging—massive parameter counts and data requirements—through a systematic two-phase methodology. Phase 1 evaluates three spline-based Kolmogorov–Arnold Network (KAN) variants to identify the optimal nonlinear approximation function for parameter-efficient medical image classification: SBTAYLOR-KAN (B-splines with Taylor series), SBRBF-KAN (B-splines with Radial Basis Functions), and SBWAVELET-KAN (B-splines with Morlet wavelets). Comprehensive experiments across brain MRI, chest X-rays, and tuberculosis datasets—without any image …

Investigating The Immunostimulatory Potential Of Dsrna-Silk Nanoparticle Complexes In Melanoma, Samuel J. Peters

Theses and Dissertations (Comprehensive)

The rate of resistance to immune checkpoint inhibitor treatment in metastatic melanoma is quite high, with an overall rate of 70%. Melanoma achieves these high rates of resistance by suppressing the immune response in the tumour microenvironment (TME), making them immunologically “cold”. The type 1 interferon response could be leveraged to initiate immune responses in melanoma, making their “cold” TMEs “warm” again. Double-stranded ribonucleic acids (dsRNAs) are potent activators of an innate immune response; however, they are susceptible to degradation by nucleases present in the body and need a carrier. Silk nanoparticles (SNPs) are an ideal drug-delivery platform as they …

Prolonged Qt Interval In Hiv-1 Infected Humanized Mice Treated Chronically With Dolutegravir/Tenofovir Disoproxil Fumarate/Emtricitabine, Ali Namvaran, Julian V. Garcia, Mahendran Ramasamy, Kayla Nguyen, Farzaneh Tavakkoli Ghazani, Bryan T. Hackfort, Prasanta Dash, Reagan E. Fisher, Benson J. Edagwa, Santhi Gorantla, Keshoer R. Bidasee

Journal Articles: Cellular & Integrative Physiology

The REPRIEVE Trial recently reported high rates of sudden cardiac death (SCD) middle-aged people living with HIV-1 infection (PWH) using the WHO/NIH-recommended two nucleoside reverse transcriptase inhibitors (NRTIs)/one integrase strand inhibitor (INSTI) regimen to manage HIV-1 viremia. To date, clinically relevant animal models to delineate underlying causes for this remain limited. Here, we assessed if HIV-1-infected NOD.Cg-Prkdc^scidIl2rg^tm1Wjl/SzJ humanized mice (Hu-mice) treated with the WHO/NIH-recommended antiretroviral regimen, dolutegravir (DTG, INSTI)/tenofovir disoproxil fumarate (TDF, NRTIs)/emtricitabine (FTC, NRTIs), can recapitulate abnormalities in the ECG and subclinical structural heart disease that serve as harbingers of SCD in middle-aged PWH. …

Attenuation Of Cardiac Dysfunction In The Collagen-Induced Arthritis Mouse Model Mediated By A Reactive Aldehyde Species Inhibitor, Wenxian Zhou, Hannah J. Johnson, Michael J. Duryee, Ali Namvaran, Aradhana Thapa, Cole Blasing, Amy J. Nelson, Engle E. Sharp, Carlos D. Hunter, Bryan T. Hackfort, Bryant England, Tate M. Johnson, Daniel R. Anderson, Adam Lazorchak, Robert G. Bennett, Jill A. Poole, Keshoer R. Bidasee, Geoffrey M. Thiele, Ted R. Mikuls

Journal Articles: Cellular & Integrative Physiology

Individuals with rheumatoid arthritis (RA) experience increased risk of heart failure. Malondialdehyde-acetaldehyde (MAA) adducts are overexpressed and co-localize with citrullinated (CIT) proteins in RA myocardium. This study investigated whether reactive aldehyde species (RASP) inhibitors prevent MAA formation in vitro and attenuate cardiac dysfunction in a collagen-induced arthritis (CIA) mouse model. Among eight RASP inhibitors screened, ADX-246 demonstrated the greatest inhibition of MAA formation in vitro. Mice with early CIA (week 5) exhibited elevated levels of myocardial MAA adducts, myocardial inflammation, and reduced ejection fraction, but normal cardiac collagen deposition and diastolic function vs. control. By weeks 10-12, mice with chronic …

Lumbosacral Orthosis Can Improve Postural Control In Older Adults With Chronic Low Back Pain, Régis M.-L. D'Assomption, Christian Lariviere, Hakim Mecheri, Suzy Ngomo, Rubens A. Da Silva

Études primaires

Background

Older adults with chronic low back pain may report poor postural control and increased fall risks. Possible key mechanisms are altered lumbar spine proprioception, stiffness and mobility, which could be enhanced through lumbar stabilization approaches. The purpose of this study was thus to evaluate the immediate effects of two lumbar stabilization approaches on postural control measures, namely a lumbosacral orthosis and the abdominal drawing-in maneuver.

Methods

57 older adults (> 65 yrs): 22 with chronic low back pain and 35 healthy controls performed two trials (30 s) of a semi-tandem balance task on a force platform, while three experimental …

Advances In Survival Analyses: Machine Learning Methods And Model Comparison, Ryan Gately, Dharshana Sabanayagam, Wai H. Lim, Lin Zhu, Farzaneh Boroumand, Shuvo Bakar, Armando Teixeira-Pinto, Germaine Wong

Research outputs 2022 to 2026

This is the second article in a 2-part series on survival analysis. In part 1, we discussed the core concepts and traditional methods used in survival analysis. Part 2 explores the novel approaches to predict survival outcomes and evaluate model performance. To facilitate hands-on learning and practical implementation, the R code used in these analyses is provided in the supplementary materials, along with instructions to help readers apply these methods to their data.

The Effects Of Cigarette Smoke And Heated-Tobacco Aerosol On Streptococcus Mutans Adhesion And Surface Topography Of Dental Hard Tissues In Vitro, Mahmoud Bakr, Mohamed Shamel, Mahmoud Al Ankily

Dentistry

No abstract provided.

Bone Dimensional Stability With Versus Without A Stent Following Apically Repositioned Flap And Single-Stage Implant Placement: A Randomized Clinical Trial, Dalia Ghalwash, Ahmed Hamdy, Jazia Alblowi

Dentistry

Abstract Maintaining peri-implant bone and tissue health is essential for long-term implant success. The effectiveness of adjunctive stent stabilization is still unclear, though the apically repositioned flap (ARF) improves soft tissue conditions. Therefore, this study assessed whether the use of stents during single-stage placement improves peri-implant bone changes and clinical outcomes following ARF. This randomized clinical trial included twenty partially edentulous patients who were divided into two groups: ARF with stent stabilization (n = 10) and ARF using conventional suturing (n = 10). At baseline, three months, and six months, radiographic bone dimensions measured by cone-beam computed tomography (CBCT) were …

Reproductive Hormones And Semen Quality Among Fertile Adults With And Without Periodontitis: A Crosssectional Study, Dalia Ghalwash, Rim Ghanem, Mazen Ghanem, Manal Safan, Ahmed Ghanem

Dentistry

No abstract provided.

Importance Of Placental Evaluation In Pregnancies At High Risk For Placenta Accreta Spectrum: Expert Clinical Perspective, Rebecca H. Jessel, Alesha White, Hope Y. Yu, Amie L. Hollard, Meena Khandelwal, Carolyn M. Zelop, Jennifer Philips, Alireza A. Shamshirsaz, John C. Kingdom, Alfred Abuhamad, Christina L. Herrera, Pan American Society For Placenta Accreta Spectrum (Pas2)

Department of Obstetrics & Gynecology Faculty Publications

Background

Placenta accreta spectrum (PAS) is a leading cause of obstetric morbidity and peripartum hysterectomy. Rising cesarean delivery rates, advanced maternal age, and assisted reproductive technologies have increased its incidence. Early, standardized diagnosis is essential for multidisciplinary planning and improved outcomes, yet formal screening guidelines are lacking.

Objective

To raise awareness of the importance of antenatal screening for PAS, summarize key clinical and imaging risk factors, and propose a standardized mid-trimester ultrasound protocol for high-risk patients.

Methods

An expert panel convened under the Pan-American Society for the Placenta Accreta Spectrum (PAS2) reviewed available evidence, risk stratification models, and prior consensus …

Acute Fatty Liver Of Pregnancy And Fetal Fatty Acid Oxidation Disorders: A Systematic Review, Dante Varotsis, Sarah Araji, Rebecca Horgan, Jennifer E. Powel, Rodney Mclaren Jr., Brian Kirmse, Mona Makhamreh, Huda B. Al-Kouatly

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To evaluate the association between maternal acute fatty liver of pregnancy (AFLP) and fetal fatty acid oxidation (FAO) disorders and to define the clinical and genetic characteristics of mothers with AFLP and their fetuses affected by FAO disorders, we performed a systematic literature review of all reported cases of AFLP that underwent genetic testing for FAO disorders.

DATA SOURCES:

We searched PubMed, Ovid MEDLINE, Cochrane Library, CINAHL (EBSCO), Scopus, and ClinicalTrials.gov. Terms included were related to AFLP and FAO testing.

METHODS OF STUDY SELECTION:

We conducted a systematic literature review from inception through May 18, 2025, to evaluate the …

Cervicovaginal Lavage Fluid Iron And Manganese Levels In Women With And Without Vaginitis, Barbara Kozma, David Ratonyi, Bence Kozma, Peter Takacs, Attila G. Sipos

Department of Obstetrics & Gynecology Faculty Publications

Transition metals such as iron and manganese are critical for cellular metabolism, redox balance, and immune function, and they also influence host–pathogen interactions. Vaginitis is characterized by mucosal inflammation that may alter local trace-element homeostasis. We hypothesize that inflammatory conditions such as vaginitis may be associated with altered cervicovaginal iron and manganese levels. We performed a prospective, single-center cohort study at the University of Debrecen (Hungary) between April 2023 and April 2024, enrolling 80 women ≥ 18 years with vulvovaginal complaints. Participants were assessed at baseline and at weeks 4, 8, and 12 with clinical evaluation and cervicovaginal lavage (CVL) …

Considerations For The Analysis Of Urinary Environmental Chemical Concentrations During Pregnancy, Danielle R. Stevens, Kaleigh Hinton, Katie M. O'Brien, Jessie P. Buckley, Barrett M. Welch, Jason A. Watts, Antonia M. Calafat, Julianne C. Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background:

Pregnancy physiology may impact indicators of hydration, affecting exposure assessment in gestational studies with urinary chemical biomarkers.

Methods:

We aimed to characterize hydration and demonstrate the impact of different methods for standardizing urinary chemical biomarker concentrations on exposure descriptives in the Human Placenta and Phthalates Study (n = 303, 2017-2020), a prospective pregnancy cohort with eight study visits between 12 and 38 weeks of gestation. We assessed trajectories and predictors of hydration using urine flow rate (UFR) and specific gravity (SG). Likewise, we examined trajectories and predictors of mono-n-butyl phthalate (MBP), for which concentrations were unstandardized or standardized via …

Severe Maternal Morbidity According To Sickle Cell Disease Genotype, Tetsuya Kawakita, Natsume Furukawa, Sora A. Jones, Salimah Navaz Gangji

Department of Obstetrics & Gynecology Faculty Publications

Background

Sickle cell disease (SCD) is a genetic hemoglobinopathy that disproportionately affects individuals of African descent and is associated with elevated risks of maternal complications. However, the contribution of specific SCD genotypes to severe maternal morbidity (SMM) and postpartum readmission remains poorly characterized at the population level.

Objective

We sought to examine the association between SCD genotypes-hemoglobin SS (HbSS) disease, hemoglobin SC (HbSC) disease, sickle thalassemia, and sickle cell trait-and SMM, hospital readmission, and related adverse maternal outcomes.

Study design

This was a retrospective cohort study using the Nationwide Readmissions Database from 2016 through 2022, representing over 20 million weighted …

Racial Differences In Adverse Pregnancy Outcomes And Incident Hypertension: A Mediation Analysis, Lucia C. Petito, Xiaoning Huang, C. Noel Bairey, Natalie Bello, Janet Catov, Ernesto Licon, Abbi Lane, David M. Haas, Lisa D. Levine, Rebecca B. Mcneil, Eliza Miller, Uma M. Reddy, Bethany Barone Gibbs, George Saade, Lauren Theilen, Laura E. Wiener, Brian M. Mercer, Hyagriv N. Simhan, Lynn M. Yee, Philip Greenland, William A. Grobman, Sadiya S. Khan

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) are associated with increased hypertension risk. Black women experience higher rates of APOs and hypertension compared with White women, but whether APOs contribute to Black-White hypertension disparities remains unknown.

Methods

The nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be-Heart Health Study) prospectively recruited nulliparous pregnant people at 8 US centers (2010-2013) with follow-up 2 to 7 years postpartum (2014-2017). Race, which represents a social construct, was self-identified. The primary outcome was incident hypertension at follow-up. APOs included hypertensive disorders of pregnancy, preterm birth, and small-for-gestational age birth. Potential confounders (psychological health, social factors, and health behaviors) …

Osmotic Dilators Vs. Foley Balloons: Bayesian Secondary Analyses Of The Dilafol Trial, Antonio F. Saad, Elenir B. C. Avritscher, Claudia Pedroza, Xiao Han, George R. Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: Dilapan-S, a synthetic osmotic dilator used for pre-induction cervical ripening, has proven to be as effective as the Foley balloon in terms of vaginal versus cesarean delivery and has been associated with increased patient satisfaction. Nevertheless, its ability to lower cesarean rates and its cost-effectiveness remain poorly studied.

Objectives: To estimate the likelihood that synthetic osmotic dilators reduce cesarean deliveries and to evaluate their health system costs (2026 US$) and incremental cost-effectiveness compared to the Foley balloon during cervical ripening.

Study Design: Secondary Bayesian analyses were conducted using data from the single-center DILAFOL randomized controlled trial, which enrolled 419 …