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Background Participation in clinical cancer research trials should diversely reflect the intersectionality characteristics of the general population for results to be representative and applicable. European migrant populations residing in the United Kingdom (UK) are a group whose participation in clinical research warrants further exploration from a community and clinical perspective. This study aimed to explore the barriers and facilitators of individuals who have migrated to the UK from an EU8 or EU2 (EU8/2) country to participating in clinical cancer research trials to update clinical and research agendas for optimising inclusive engagement strategies. Methods Perspectives of migrant individuals and of clinical research staff were explored to identify barriers and opportunities for optimising engagement. Five focus groups with clinical research staff at four hospitals across the East Midlands and three online focus groups with individuals who had migrated to the UK from Poland, Latvia and Romania were conducted. Data was analysed using template analysis. Results Twenty-two clinical research staff and 17 individuals from EU8/2 countries participated in the study. Three key themes and related subthemes were identified: (1) Ambivalence, misunderstanding and fear shape cancer research perceptions (1.1. a lack of familiarity with cancer research practices; 1.2. Cancer fear may hinder participation); (2) Structural barriers and gaps in cultural competency; and (3) Building trust through community engaged research (3.1.Co-researching with communities; 3.2. Incentivising and legitimising research). Discussion Many migrant participants were unfamiliar with UK-based research practices, and it was suggested that fatalist attitudes towards a cancer diagnosis and mistrust of research generally created apprehension and defensiveness when hearing about clinical cancer research in migrant communities. Migrant individuals and staff endorsed research design strategies which engage community champions (including clinicians); narrate positive stories of cancer research participation; and consider language accessibility and comprehension as key elements of engagement-focused research design.

Purpose Window-of-opportunity trials (WOT) are a study design that have been used to investigate drug activity in endometrial cancer (EC). Recruitment to cancer clinical trials by patients from ethnic minority groups is reported to be lower than for patients of White ethnicity. Methods A verbal questionnaire was conducted with White and Asian/Asian British ethnicity patients who had undergone treatment for EC. Strategic purposeful sampling was used to recruit patients from diverse social/educational backgrounds. Questions explored: background knowledge of clinical research, WOT study design, and views on medications that might be investigated. Thematic analysis was used to explore motivations for WOT participation and perceived barriers. Results In total, 21 patients were recruited to the study (15 White and 6 Asian/Asian British). Views on optimum time to receive trial information differed, preferences ranging from 'at the time of diagnosis' to 'a few days after diagnosis'. The choice of medication under investigation had a strong influence on potential willingness to participate, with greater interest reported in medications derived from vitamins or food supplements rather than hormone-based drugs. Potential barriers to participation included concern over potential side-effects and the emotional/physical burden of a cancer diagnosis prior to major surgery. Discussion This study provides important insights into patients’ views on WOT participation in EC and raises issues that need to be considered for future trial design and participant recruitment materials. The timing and format of study information and type of substance under investigation were factors influencing potential participation. Future studies should consider using multi-lingual visual information videos to address information needs, as this may encourage participation by ethnic minority patients.

BackgroundLimited longitudinal data exist on chronic kidney disease (CKD) in African populations undergoing epidemiological transitions. We investigated incidence, long-term predictors and progression of CKD among Ghanaians residing in Ghana and Ghanaian migrants in the Netherlands (Amsterdam).Methods and findingsWe analysed data from 2183 participants in the transcontinental population-based prospective Research on Obesity and Diabetes among African Migrants cohort, followed for approximately 7 years. CKD incidence and its progression to end-stage kidney disease (ESKD) were defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. CKD incidence was calculated using age- and sex standardisation for those without CKD at baseline. Long-term predictors of CKD incidence were identified using one-step robust Poisson regression. CKD progression to ESKD from baseline was also assessed using robust Poisson regressions. Overall age- and sex standardised CKD incidence was 11.0% (95% CI 9.3% to 12.3%) in the population, with Ghanaians residing in Amsterdam at (7.6%; 5.7% to 9.5%) and Ghanaians residing in Ghana at (12.9%; 10.9% to 14.9%). Within Ghana, rural Ghanaians had similar CKD incidence to urban Ghanaians (12.5%; 8.5% to 15.5% vs 12.3%; 8.2% to 15.8%). Residence in Amsterdam was associated with lower CKD incidence compared with Ghana after adjustments (incidence rate ratio=0.32; 0.13–0.77). CKD incidence predictors were advanced age, female sex, alcohol consumption, uric acid levels and hypertension. CKD progression to ESKD was 2.3% among Ghanaians residing in Ghana and 0.0% among Ghanaians residing in Amsterdam.ConclusionOne-tenth of Ghanaians developed CKD over 7 years, with higher incidence in Ghana compared with Europe. Age, female sex, alcohol use, uric acid levels and hypertension were predictive factors. CKD progression to ESKD was minimal. High CKD incidence among Ghanaians, especially those residing in Ghana, calls for in-depth assessment of contributing factors and targeted interventions.

Abstract EP3.3, e-Poster Terminal 3, September 4, 2025, 10:05 - 10:25 Aim Liver-kidney axis plays a crucial role in overall health, yet its role in chronic kidney disease (CKD) is underexplored. We aimed to examined the associations of markers of liver cell damage (gamma-glutamyl transferase [GGT], alanine aminotransferase [ALT], aspartate aminotransferase [AST]) and fatty liver disease (fatty liver index [FLI]) with CKD incidence among Ghanaians. Methods We utilized data from prospective RODAM study (baseline 2015, follow-up 2021). Biomarkers of liver cell damage were categorized into elevated or non-elevated based on established clinical practice/literature. CKD incidence was defined by KDIGO criteria. FLI was calculated using standard Bedogni formula. Robust Poisson regressions were used to evaluate associations of baseline liver markers (2015) with CKD incidence (2021), adjusting for demographics, lifestyle, and comorbidities. Subgroup analyses were conducted by age, sex, and migration status. Results 1,832 participants were included. Elevated GGT, ALT, and AST levels were positively associated with CKD incidence six years later [incidence rate ratios (IRRs) 1.45, 95% CI 1.02–2.03; 2.17 95% CI 1.17–3.70; 1.69 95% CI 1.19–2.37, respectively]. High FLI scores were also positively associated with CKD incidence at follow-up [IRR 1.92, 95% CI 1.14–3.18]. Subgroup analyses revealed that participants aged ≥40 years, females, and urban residents had higher CKD risk from elevated GGT levels, while no subgroup differences were observed for other liver markers. Conclusion Biomarkers of liver cell damage and fatty liver disease are significant predictors of CKD risk in a West African population. Our findings highlight potential value of liver health as an indicator of future CKD risk.

Abstract PTH 1: Determinants of Health Disease and Interventions 1, B307 (FCSH), September 3, 2025, 14:30 - 15:30 Aims Chronic kidney disease (CKD) and chronic inflammation are highly prevalent in African populations, yet their relationship remains understudied. We aimed to investigated whether acute phase reactants (C-reactive protein [CRP] and ferritin) as markers of inflammation predict CKD incidence seven years later in a Ghanaian population-based cohort. Methods Data from the prospective Research on Obesity and Diabetes among African Migrants (RODAM-Pros) cohort were analyzed, including participants living in rural and urban Ghana, and Ghanaian migrants in the Netherlands. Acute phase reactants were assessed between 2012 and 2015, while CKD incidence was assessed between 2019 and 2021 using the race-free CKD-EPI 2021 equation. Robust Poisson regression models were employed to assess associations, adjusting for various confounders. Interaction analyses explored whether identified effects were modified through age, sex, education, or geographical location. We also examined CRP associations by different cut-offs (<1 mg/l, 1.0 to 3.0 mg/l, and >3 mg/l; 10 mg/l), as well as the potential contribution of ferritin as an indicator of iron storage, independent of its role as an acute phase reactant. Results 1,435 participants were included. No significant associations were found between baseline CRP and CKD incidence seven years later. Baseline ferritin levels were positively associated with CKD incidence (adjusted Incidence rate ratio 1.19, 95% CI 1.04-1.02) seven years later. Baseline ferritin was independently associated with albuminuria (aIRR 1.22. 95% CI 1.06-1.01), but not with decreased eGFR (aIRR 1.01, 95% CI, 0.95-1.06). Age, sex, education and geographical location did not mediate ferritin-CKD relationship. We did not detect a contributing role of iron overload or iron deficiency in ferritin-CKD relationship. Conclusion Elevated ferritin levels but not CRP levels may predict future risk of CKD in Ghanaians. Multi-population prospective studies with multiple ferritin measurements are needed to better understand the links between ferritin and CKD in Africans.

Background A surge in pro-inflammatory markers, Il-6 and TNF-α, has been associated with type 2 diabetes mellitus (T2DM). However, there is no data on the dynamics of these markers in T2DM Ghanaian populations. The aim of this study was to determine variations in the levels of IL-6 and TNF-α in T2DM patients. This study also examined the associations of IL-6 and TNF-α with anthropometric measurement and the effect of co-morbidity with hypertension using rural and urban dwellers in the Ashanti region, Ghana. Methods A nested case–control design using participants aged 25–70 years consisting of 77 T2DM ± hypertension patients and 112 controls were selected from a larger study on Research on Obesity and Diabetes among African Migrants (RODAM). Anthropometric measurements, blood pressure and body fat percentage were measured. Fasting blood samples were analyzed for glucose, IL-6 and TNF-α levels. Results The median level of IL-6 was significantly higher ( p  < 0.0001) among rural dwellers compared to urban dwellers. Inversely, urban dwellers had significantly higher ( p  = 0.0424) median level of TNF-α compared to rural cases. No significant differences were observed in IL-6 ( p  = 0.3571) and TNF-α ( p  = 0.2581) among T2DM patients compared with T2DM ± hypertension patients. A weak negative correlation was found between IL-6 and BMI in urban T2DM. Discussion The average level of IL-6 was higher in rural T2DM participants compared with those in urban setting. However, higher levels of TNF-α was observed among the study participants with T2DM in urban settings compared to those of rural. In this study, we observed that co-morbidity of hypertension had no significant effect on the levels of IL-6 and TNF-α. We are of the opinion that higher physical activity levels among rural particpants and high obesity levels in urabn participants explain the observation but needs more numbers to validate. Conclusion This study revealed that IL-6 levels were higher among rural dwellers than urban while TNF-α levels were higher in urban dwellers than rural in patients with T2DM. There was no association of body fat percentage and body mass index with IL-6 and TNF-α levels. Co-morbidity of hypertension with T2DM had no effect on IL-6 and TNF-α levels.

A surge in pro-inflammatory markers, Il-6 and TNF-[alpha], has been associated with type 2 diabetes mellitus (T2DM). However, there is no data on the dynamics of these markers in T2DM Ghanaian populations. The aim of this study was to determine variations in the levels of IL-6 and TNF-[alpha] in T2DM patients. This study also examined the associations of IL-6 and TNF-[alpha] with anthropometric measurement and the effect of co-morbidity with hypertension using rural and urban dwellers in the Ashanti region, Ghana. A nested case-control design using participants aged 25-70 years consisting of 77 T2DM [+ or -] hypertension patients and 112 controls were selected from a larger study on Research on Obesity and Diabetes among African Migrants (RODAM). Anthropometric measurements, blood pressure and body fat percentage were measured. Fasting blood samples were analyzed for glucose, IL-6 and TNF-[alpha] levels. The median level of IL-6 was significantly higher (p < 0.0001) among rural dwellers compared to urban dwellers. Inversely, urban dwellers had significantly higher (p = 0.0424) median level of TNF-[alpha] compared to rural cases. No significant differences were observed in IL-6 (p = 0.3571) and TNF-[alpha] (p = 0.2581) among T2DM patients compared with T2DM [+ or -] hypertension patients. A weak negative correlation was found between IL-6 and BMI in urban T2DM. The average level of IL-6 was higher in rural T2DM participants compared with those in urban setting. However, higher levels of TNF-[alpha] was observed among the study participants with T2DM in urban settings compared to those of rural. In this study, we observed that co-morbidity of hypertension had no significant effect on the levels of IL-6 and TNF-[alpha]. We are of the opinion that higher physical activity levels among rural particpants and high obesity levels in urabn participants explain the observation but needs more numbers to validate. This study revealed that IL-6 levels were higher among rural dwellers than urban while TNF-[alpha] levels were higher in urban dwellers than rural in patients with T2DM. There was no association of body fat percentage and body mass index with IL-6 and TNF-[alpha] levels. Co-morbidity of hypertension with T2DM had no effect on IL-6 and TNF-[alpha] levels.

This study was to extrapolate potential roles of augmented reality goggles as a clinical support tool assisting in the reduction of preventable causes of death on the battlefield. Our pilot study was designed to improve medic performance in accurately placing a large bore catheter to release tension pneumothorax (prehospital setting) while using augmented reality goggles. Thirty-four preclinical medical students recruited from Morehouse School of Medicine performed needle decompressions on human cadaver models after hearing a brief training lecture on tension pneumothorax management. Clinical vignettes identifying cadavers as having life-threatening tension pneumothoraces as a consequence of improvised explosive device attacks were used. Study group (n = 13) performed needle decompression using augmented reality goggles whereas the control group (n = 21) relied solely on memory from the lecture. The two groups were compared according to their ability to accurately complete the steps required to decompress a tension pneumothorax. The medical students using augmented reality goggle support were able to treat the tension pneumothorax on the human cadaver models more accurately than the students relying on their memory (p < 0.008). Although the augmented reality group required more time to complete the needle decompression intervention (p = 0.0684), this did not reach statistical significance.

Uvod:Tip 2 dijabetes predstavlja veliki zdravstveni problem za ljudsko društvo. Ovoj bolesti često prethodi kliničko stanje koje se naziva metabolički sindrom. C57BL/6J miševi na režimu ishrane sa visokim sadržajem masti (HFD) su dugo korišćen životinjski model za tip 2 dijabetes i metabolički sindrom. Nova saznanja o patogenezi insulinske rezistencije, koja je karakteristična za tip 2 dijabetes i metabolički sindrom, ukazala su na veliki značaj poremećaja u mitohondrijama. Ćelije regulišu sadržaj i oblik mitohondrija mitohondrijalnom biogenezom, fisijom i fuzijom mitohondrija i uklanjanjem oštećenih mitohondrija mitofagijom, koja predstavlja jedan od oblika selektivne autofagije. Autofagija je ćelijski katabolički proces pomoću koga ćelije uklanjaju oštećene i/ili nepotrebne delove citoplazme, među njima i organele, uz pomoć lizozomalnih enzima. Mitofagija ima pretežno zaštitnu ulogu jer se ovim procesom mogu ukloniti oštećene i/ili nefunkcionalne mitohondrije koje bi mogle dovesti do povećane produkcije kiseoničkih slobodnih radikala i oštećenja ćelije. Metformin i statini su često korišćeni lekovi u dijabetesu tipa 2 i metaboličkom sindromu i za oba ova leka se zna da ispoljavaju direktan uticaj na mitohondrije. Jetra je organ u kome se odigrava najveći deo metabolizma, a obilje mitohondrija je čini očiglednim izborom za proučavanje ovih organela i efekata lekova na njihovo uklanjanje procesom mitofagije.Cilj:Cilj ovog istraživanja bio je da se ispita uticaj ishrane sa visokim sadržajem masti na ultrastrukturne karakteristike subcelularnih struktura, mitofagiju i ekspresiju regulatora autofagije u jetri, aorti i ishijadičnom nervu C57BL/6J miševa, kao i da se ispita uticaj metformina i simvastatina na ultrastrukturne karakteristike subcelularnih struktura, mitofagiju i ekspresiju regulatora autofagije u jetri, aorti i ishijadičnom nervu C57BL/6J miševa na režimu ishrane sa visokim sadržajem masti.Materijal i metode:Miševi soja C57BL/6J muškog pola bili su podeljeni u četiri grupe: grupa miševa na režimu ishrane HFD-om, metforminom tretirana grupa na režimu ishrane HFD-om, simvastatinom tretirana grupa na režimu ishrane HFD-om i kontrolna grupa miševa iste starosti.Rezultati:Miševi iz svih grupa na režimu ishrane sa visokim sadržajem masti su na kraju eksperimenta imali veću telesnu masu od miševa na standardnom režimu ishrane. Miševi tretirani metforminom su imali manju telesnu masu od druge dve grupe HFD miševa na kraju eksperimenta. Rezultati oralnog testa tolerancije na glukozu su pokazali lošiju regulaciju nivoa glukoze kod netretiranih HFD miševa u poređenju sa kontrolnom grupom, i poboljšanje regulacije kod tretiranih HFD miševa koje je bilo izraženije kod tretmana metforminom.

Rad ima za cilj da na osnovu dosadašnjih saznanja o dinamici požara, korišćenjemprogramskog paketa Fire Dynamics Simulator (FDS), i CST Studio Suiteizvrši prikaz i analizuosnovnih parametara požara, temperature, brzine sagorevanja, količine oslobađanja toplote, iposebno toplotnog fluksa zračenja, kao jednog od najvažnijih veličina prenosa toplote urazvijenoj fazi požara. Na osnovu ovako dobijenih saznanja formiran je anatomski model čovekai posebno model kože čoveka, sa ciljem utvrđivanja bezbednog rastojanja od požara. U tu svrhukreiran je nov algoritamski postupak za određivanje bezbednog rastojanja ljudi od požara kaoizvora toplotnog zračenja, koji se sastoji od više koraka: određivanje vrednosti radijativnogtoplotnog fluksa koji dospeva na kožu čoveka i temperature na površini tela; izračunavanjeenergetskih doprinosa za sve opsege toplotnog zračenja; izračunavanje intenziteta jačineelektričnog polja za odabrani opseg toplotnog zračenja; formiranje anatomskog modela kože;proračunavanje prodrlih komponenti elektromagnetnog polja u tkivo kože i analiza dubineprodiranja ovih komponenti; formiranje novog toplotnog izvora dimenzija dubine penetracijepovršinskog sloja kože i izračunavanje snage ovog izvora; formiranje novog anatomskog modelakože dodavanjem još jednog sloja prethodnom sloju uz definisanje sekundarnog toplotnog izvorai proračunavanje komponenata elektromagnetnog polja, apsorbovane gustine energije i raspodelatemperature u modelu; analiza dobijenih rezultata i odlučivanje da li je u bilo kojoj tački modelakože došlo do prekoračenja temperature bola i naj tačin određivanje bezbednog rastojanja.Materija je u radu izložena u okviru sledećih poglavlja:• Uvod;• Prenos toplotnog zračenja i dejstvo na materiju;• Maxwellova teorija prostiranja elektromagnetnih talasa;• Efekti toplotnog zračenja požara i biološki materijali;• Numeričke metode proračuna toplotnog zračenja;• Novi metod za određivanje bezbednog rastojanja ljudi od požara;• Zaključak.U uvodu je dat je predstavljen problem i inicijalna ideja za njegovo rešavanja.U prvom poglavlju je dat prikaz osnovnih zakona prenosa toplote zračenjem požara injegovog dejstva na materiju. Posebna pažnja je posvećena sadržaju i cilju rada, radi lakšegpraćenja materije koja sledi.U drugom poglavlju detaljno je izložena Maxwell-ova teorija prostiranjaelektromagnetnih talasa, osnovne veličine električnog i magnetnog polja, teorija prostiranjaelektromagnetnih talasa kao i prodiranje i apsorpcija toplotnog zračenja.Treće poglavlje sadrži podatke o koži kao biološkom materijalu, građi, funkciji, kao iteoretska razmatranja i eksperimentalna saznanja o vezi između toplotnog zračenja i oštećenjatkiva. Podaci za komparativnu analizu korišćeni su iz literature, a rezultat su raznih eksperimenta.Četvrto poglavlje daje opis numeričkih metoda koje koriste programski paketi zasimulaciju (FDS, PiroSym i CST Studio Suite) veličina toplotnog zračenja.Peto poglavlje daje prikaz koraka novog metoda za određivanje bezbednog rastojanjaljudi od požara, rezultate simulacije i njihovu uporednu analizu sa podacima iz trećeg poglavlja.U zaključku rada ukazano je na dobru usaglašenost između dobijenih rezultata simulacijei u literaturi objavljenih eksperimentalnih rezultata. Prikazan je značaj dobijenih rezultata koji seogleda u činjenici što dobijeni rezultati i predložen model mogu naći široku primenu upreventivnoj zaštiti od požara.