The University of Texas Health Science Center at Tyler

The Takini/Survivor project examined factors promoting healing and resilience among women survivors of domestic violence in primarily South Dakota, with particular attention to American Indian/Native American (Native hereinafter) and rural experiences through the resilience portfolio model. Using a phenomenological design, this study explored the narratives of 31 Native women using semistructured qualitative interviews. When appropriate, the study also delineated between narratives of Native rural (10) and nonrural women (21). Participants described "poly-strengths" sequences in which environmental strengths (such as housing and transportation) enabled them to draw on their other strengths across resilience portfolio model domains. Rural participants emphasized how geographic isolation, limited mobility, and safety concerns in small communities constrained access to additional resources such as interpersonal supportive relationships. Survivors contextualized abuse within intergenerational trauma, drew on cultural identity and spirituality as distinct meaning-making pathways, and cited children/grandchildren and helping others as central purposes. Healing occurs through reinforcing poly-strengths rather than isolated protective factors. Our findings contribute to resilience portfolio model by building on the importance of environmental strengths and how cultural identities create distinct resilience pathways. Implications include culturally responsive and supportive services, innovative service delivery in rural areas, and reforms to transportation policies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

<sec><title>OBJECTIVE</title>Poor sustained sputum culture conversion with guidelines-based therapy for Mycobacterium avium complex lung disease highlights the need for new and improved multidrug combinations.</sec><sec><title>DESIGN</title>We tested eight drugs by performing minimum inhibitory concentration (MIC) experiments with the ATCC#700898 strain and 49 clinical isolates, followed by single and multidrug combination studies.</sec><sec><title>RESULTS</title>MIC90 of rifabutin, rifampin, azithromycin, and ethambutol were 4, 16, 256, and 128 mg/L, respectively. Among other drugs, MIC90 (mg/L) in lowest to highest rank order were for bedaquiline (0.25), tedizolid (16), tebipenem (64), and minocycline (128). As monotherapy, none of the drugs had better MAC kill compared to rifampin. While minocycline alone killed 1.76 ± 0.33 log10 CFU/mL MAC, replacement of rifabutin in the standard therapy resulted in 6.27 ± 0.28 log10 CFU/mL MAC kill, showing minocycline's synergistic effect with azithromycin and ethambutol. An example of a macrolide-rifamycin-ethambutol-free oral regimen, the azithromycin-minocycline-tedizolid combination killed 4.35 ± 0.42 log10 CFU/mL MAC. The tebipenem-tedizolid-minocycline combination killed 4.82 ± 0.42 log10 CFU/mL; however, addition of bedaquiline resulted in a lower kill of 2.71 ± 0.22 log10 CFU/mL, suggesting a likely antagonism.</sec><sec><title>CONCLUSION</title>We tested eight different drugs to identify several rifamycin-, macrolide-, and ethambutol-free oral multidrug combinations. The minocycline-based regimens warrant further preclinical and clinical testing.</sec>.

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections, particularly affecting infants, young children, older adults, and immunocompromised individuals. While RSV infection often causes mild, cold-like symptoms, it can progress to severe pulmonary disease in these vulnerable populations, frequently necessitating hospitalization. Decades of research have defined the RSV fusion protein, particularly its prefusion form, as the primary target for prophylaxis and vaccine design. This has advanced transformative milestones, including the approval of long-acting monoclonal antibodies (Nirsevimab, Clesrovimab) and the vaccines for adults (Arexvy, Abrysvo, mRESVIA). This review begins with RSV molecular virology, summarizes the evolution of prophylactic antibody, and revisits lessons from past vaccine failures. It then emphasizes the current landscape of RSV vaccine development, categorizing platforms such as mRNA, protein subunit, virus-like particle/nanoparticle, live-attenuated, and viral vector approaches, highlighting both licensed vaccines and leading candidates under clinical evaluation. This review overviews current RSV vaccines and antibody prophylaxis and aims to inform the development of future prevention strategies.

Healthcare workers are at the forefront of the global battle against COVID-19. Their vaccination perspectives, particularly in regions like Sierra Leone that have faced health crises such as the Ebola outbreak, are essential for shaping public health strategies in low-income countries that routinely face infectious disease outbreaks. This research sought to understand the perceptions and experiences of Sierra Leone's healthcare workers concerning COVID-19 vaccination and booster doses, set against the backdrop of global health resource disparities and regional vaccine distribution challenges. Utilizing a mixed-methods approach, the study analyzed data from an online survey, which saw 1001 complete responses from 2060 participants across six Ebola-impacted districts (October-November 2022), and in-depth interviews with 24 health workers from three of these districts (February-July 2022). Approximately 80% of respondents reported having received a COVID-19 vaccine, predominantly Sinopharm and AstraZeneca, yet only 34% of vaccinated participants had received a booster dose. In multivariable analyses, personally knowing someone who experienced serious COVID-19 illness or death was associated with higher odds of both initial vaccination and booster uptake (p < 0.05). By contrast, prior Ebola-related experiences were not consistently associated with vaccination outcomes. Qualitative findings contextualized these patterns, highlighting the roles of professional exposure, limited booster-related information, and inequities in vaccine availability and distribution. These findings indicate that vaccination strategies must move beyond initial rollout to address barriers to sustained engagement, particularly for booster uptake among healthcare workers. They also emphasize the need for equitable vaccine access and transparent, locally tailored communication to mitigate structural and informational constraints in low-income settings.

Abstract Background Obefazimod (Obe) is an oral, once-daily (QD), small molecule which enhances expression of microRNA-124 and has been studied in two Phase 2 induction trials and subsequent open-label maintenance studies [1-3] in patients (pts) with moderately to severely active ulcerative colitis (UC). In Phase 3 ABTECT-1 [NCT05507203] and ABTECT-2 [NCT05507216] 8-week induction trials, Obe achieved clinically meaningful improvements in clinical, endoscopic and histologic endpoints. Here, we present a pooled analysis of the efficacy and safety of Obe in the North American (NA) subgroup of pts enrolled in the ABTECT induction trials. Methods The multicenter, randomized, double-blind, placebo-controlled ABTECT trials enrolled pts with moderate-to-severe UC (MMS≥ 5, with rectal bleeding sub-score (RBS) ≥ 1 and centrally read Mayo endoscopic score ≥2) who had inadequate response, loss of response, or intolerance to at least one prior systemic therapy (corticosteroids, immunosuppressants, biologics, S1P receptor modulators and/or JAK inhibitors), with no limit on the number of prior advanced therapy inadequate responders (ATIR). Pts were randomized 2:1:1 to Obe 50 mg QD (Obe-50), Obe 25 mg QD (Obe-25) or placebo (PBO) for 8 weeks. This post-hoc analysis focuses on the subgroup of pts recruited from study defined NA centers. Efficacy endpoints included clinical remission (per MMS), clinical response, endoscopic improvement, symptomatic remission, and histo-endoscopic mucosal improvement. All p-values are nominal. Treatment emergent adverse events (TEAEs), serious TEAEs and dropout rates were evaluated. Results Among the 1272 pts randomized in the ABTECT trials, 122 were NA pts (116 pts from USA and 6 pts from Canada). Baseline demographics and disease characteristics were well balanced between treatment groups and generally comparable between NA pts and the overall study population. In the pooled analysis, a higher proportion of NA pts receiving Obe-25 or Obe-50 vs. PBO achieved clinical remission (Obe-25-PBO difference: 13.6%, p = 0.0218; Obe-50-PBO difference: 13.2%, p = 0.0235), clinical response, and symptomatic remission with nominal significance (Table). Headache was the most common TEAE (Obe-25: 29.2%; Obe-50: 24.2%; PBO: 5.6%). Among NA pts, no serious TEAEs occurred with Obe-25, and the rate with Obe-50 was similar to PBO (3.2% vs 8.3%, respectively). TEAE leading to study discontinuations were less frequent with Obe-25 (4.2%) and Obe-50 (6.5%) vs PBO (13.9%). No opportunistic infections or malignancies were reported. Conclusion In the ABTECT induction trials, clinically meaningful improvements in efficacy measures were observed, and Obe treatment demonstrated a favorable safety profile in NA pts, consistent with the overall study population.

Abstract Introduction Erectile dysfunction (ED) secondary to prostate cancer treatment or aging-related vascular decline often results in structural changes to the penile shaft. In patients treated with inflatable penile prosthesis (IPP), complaints such as diminished urethral engorgement, visible urethral indentation, and loss of spongiosal bulk have emerged as a common cause of dissatisfaction. These issues persist despite restoration of functional rigidity, and traditional medical therapies fail to reconstitute urethral volume. The UroFill® technique, originally developed for penile girth enhancement using cross-linked hyaluronic acid (HA), has recently been applied to address this aesthetic and structural deficiency by recreating a “neo-urethra.” Objective To evaluate the feasibility, safety, and patient-reported outcomes of a novel HA injection protocol using the UroFill® technique to reconstruct a neo-urethral contour in IPP patients with post-treatment loss of urethral prominence or spongiosal atrophy. Methods This is a retrospective, single-center study of patients presenting between October 2021 and May 2025 with complaints of urethral flatness or indentation following IPP placement. All subjects had a history of prostate cancer therapy and/or long-standing ED, and expressed a desire to restore the appearance and tactile bulk of the ventral shaft. Following failure of pharmacological and mechanical interventions, patients underwent UroFill® HA injection targeting the ventral midline using a controlled, distal-to-proximal hydrodissection technique. The number of sessions, volume injected, adverse events, and subjective satisfaction were tracked. Aesthetic and functional outcomes were assessed through pre- and post-procedural imaging and validated satisfaction questionnaires Results Among 74 IPP patients treated with the neo-urethral UroFill® protocol, the average injected HA volume was 4.2 mL (range 3.0–6.0 mL) localized along the ventral shaft in a midline column to simulate the corpus spongiosum. Of this cohort, 51 (69%), had previous history of RP. No adverse events were reported, including no infections, prosthesis compromise, or vascular injury. At 3-month follow-up, 94% of patients reported improved aesthetic satisfaction and 89% reported improved partner feedback related to phallic symmetry and decreased cylinder palpability. Notably, 86% of patients perceived a more natural transition between the glans and shaft in the inflated state. HA retention was rated as “excellent” in 91% of patients. No patients requested reversal or expressed regret about the procedure. Conclusions The UroFill® technique can be safely and effectively adapted to restore ventral shaft contour and simulate a neo-urethra in post-IPP patients experiencing spongiosal atrophy or urethral indentation issues commonly observed following prostate cancer treatment or longstanding erectile dysfunction. This novel aesthetic application addresses a significant gap in post-implant satisfaction, offering patients not just restored function but a more natural and symmetric appearance. Given the strong patient-reported outcomes and excellent safety profile, consideration should be given to offering neo-urethral reconstruction proactively to all post-RP patients undergoing IPP. Larger prospective studies are warranted to further validate these findings and establish standardized treatment protocols. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: UroFill, Coloplast, Boston Scientific, Rigicon

Metabolic and bariatric surgery (MBS) is an established treatment for severe obesity and its related comorbidities. While long-term outcomes are often emphasized, early postoperative complications remain a critical metric of safety and resource utilization. Large database studies have reported national trends in MBS outcomes but are limited by lack of granularity, inconsistent definitions, and inclusion of heterogeneous surgical experience. This study aimed to provide a detailed analysis of 30-day postoperative complications following sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) over a 17-year period at a single high-volume quaternary academic center. A retrospective cohort study of adult patients who underwent primary laparoscopic SG, RYGB, or DS between 2008 and 2024. All procedures were performed by fellowship-trained, minimally invasive bariatric surgeons. Complications occurring within 30 days postoperatively were identified through comprehensive chart review and classified using the Clavien-Dindo grading system. Primary outcomes included incidence, severity, and type of complications, as well as rates of readmission, reoperation, and reintervention. Multivariable logistic regression was used to identify predictors of overall and major complications. Of 2190 patients included, 413 (18.9%) experienced at least 1 early complication, totaling 467 discrete events. DS had the highest complication rate (29.3%), followed by RYGB (18.4%) and SG (17.5%). RYGB was associated with a high burden of major complications, including anastomotic strictures, GI bleeding, and reoperations for obstruction or leak. The 30-day rates of readmission (2.0%) and reoperation (1.3%) were low across all groups. Independent predictors of major complications included venous stasis (aOR=3.22), renal insufficiency (aOR=2.65), and type 2 diabetes (aOR=1.96); both RYGB (aOR=2.25) and DS (aOR=2.77) carried higher risk than SG. This study provides a granular, procedure-specific profile of early complications after SG, RYGB, and DS. While all 3 procedures demonstrated acceptable safety profiles, DS had the highest overall complication rate, and RYGB carried the greatest burden of major complications. These findings underscore the variability in early postoperative outcomes by procedure type and reflect the value of institutional experience in characterizing complication profiles.