Sarai Keestra

Sarai Keestra

I am a researcher focused on human biology, global health, and research ethics. My work spans three main areas:

Human Biology & Development

Investigating neurodevelopmental outcomes, thyroid function, and developmental processes across different populations and environmental contexts.

Global Health & Health Technology Access

Examining barriers to equitable access to health technologies, including vaccines and treatments, particularly in low-resource settings.

Clinical Trial Transparency & Research Ethics

Advocating for improved transparency in clinical trials and ensuring research practices prioritize public health and ethical standards.

Publications

Clinical Trial Transparency & Research Ethics

Research on clinical trial transparency and research ethics, including trial registration and reporting.

Global Health & Health Technology Access

Research on global health and access to health technologies, including vaccines, diagnostics, and treatments.

Human Biology & Development

Research on human biology and development, including health, nutrition, and disease prevention.

Nature Medicine | Vol. 31 No. 3 10.1038/s41591-024-03483-9
Argentieri, M. Austin and Amin, Najaf and Nevado-Holgado, Alejo J. and Sproviero, William and Collister, Jennifer A. and
Keestra, Sarai M.
and Kuilman, Midas M. and Ginos, Bigina N. R. and Ghanbari, Mohsen and Doherty, Aiden and Hunter, David J. and Alvergne, Alexandra and van Duijn, Cornelia M.
Integrating the environmental and genetic architectures of aging and mortality
Both environmental exposures and genetics are known to play important roles in shaping human aging. Here we aimed to quantify the relative contributions of environment (referred to as the exposome) an...
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Global Public Health | Vol. 20 No. 1 10.1080/17441692.2025.2528072
Ayolola Eni-Olotu and Rebecca Hotchkin and Rachel McCormick and Molly Pugh-Jones and
Sarai Mirjam Keestra
Achieving equitable access to health technologies during a pandemic: Lessons learned from UK universities' technology transfer practices & policies 2019–2023
The COVID-19 pandemic underlined stark inequalities in timely access to health technologies worldwide. Universities, by conducting a significant amount of early biomedical research and development, ha...
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BMJ Evidence-Based Medicine | Vol. 29 No. 2 10.1136/bmjebm-2023-112395
Gamertsfelder, Elise and Delgado Figueroa, Netzahualpilli and
Keestra, Sarai
and Silva, Alan Rossi and Borana, Ronak and Siebert, Maximilian and Bruckner, Till
Towards transparency: adoption of WHO best practices in clinical trial registration and reporting among top medical research funders in the USA
Objective To assess to what extent the clinical trial policies of the largest public and philanthropic funders of clinical research in the United States meet WHO best practices in trial registration a...
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Human Reproduction | Vol. 39 No. Supplement_1 10.1093/humrep/deae108.1075
Keestra, S
and Kooper, C and Van Welie, N and Dreyer, K and Van Eekelen, R and Roseboom, T and Oosterlaan, J and Mol, B  W and Finken, M  J J and Mijatovic, V and Königs, M
P-756 Neurodevelopmental outcomes at school-age after conception with hysterosalpingography using iodinated contrast media - follow-up of the nationwide multicentre H2Oil trial
How does conception \<6 months after hysterosalpingography (HSG) with iodinated contrast media affect the neurodevelopment of the offspring compared to naturally-conceived peers at a school-age?Chi...
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Journal of the Endocrine Society | Vol. 8 No. Supplement_1 10.1210/jendso/bvae163.1416
Keestra, S
and Kooper, C and van Welie, N and Dreyer, K and van Eekelen, R and Roseboom, T and Oosterlaan, J and Mol, B and Finken, M and Mijatovic, V and Königs, M
7912 Children's Neurodevelopmental Outcomes at School-Age After Conception with Hysterosalpingography Using Iodinated Contrast Media
Disclosure: S. Keestra: None. C. Kooper: None. N. van Welie: None. K. Dreyer: Grant Recipient; Self; research grants from Guerbet. Speaker; Self; travel and speaker fees Guerbet. R. van Eekelen: None....
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Human Reproduction | Vol. 39 No. 10 10.1093/humrep/deae183
Keestra, Sarai M
and Van Welie, Nienke and Dreyer, Kim and Van Eekelen, Rik and Roseboom, Tessa J and Oosterlaan, Jaap and Mol, Ben W and Finken, Martijn J J and Mijatovic, Velja and Königs, Marsh
Neurodevelopmental outcomes of school-age children conceived after hysterosalpingography with oil-based or water-based iodinated contrast: long-term follow-up of a nationwide randomized controlled trial
Does preconceptional exposure to oil-based iodinated contrast media during hysterosalpingography (HSG) impact children's neurodevelopment compared with exposure to water-based alternatives?Our study f...
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Argentieri, M. Austin and Amin, Najaf and Nevado-Holgado, Alejo J. and Sproviero, William and Collister, Jennifer A. and
Keestra, Sarai M.
and Doherty, Aiden and Hunter, David J. and Alvergne, Alexandra and van Duijn, Cornelia M.
Integrating the environmental and genetic architectures of mortality and aging
It has long been suggested that environmental exposures (i.e., the exposome) play a dominant role in shaping trajectories of human aging and premature mortality. Here we aimed to quantify the contribu...
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Journal of the Endocrine Society | Vol. 7 No. 10 10.1210/jendso/bvad108
Bar-Sadeh, Ben and Pnueli, Lilach and
Keestra, Sarai
and Bentley, Gillian R and Melamed, Philippa
Srd5a1 Differentially Regulated and Methylated During Prepubertal Development in the Ovary and Hypothalamus
5α-reductase-1 catalyzes production of various steroids, including neurosteroids. We reported previously that expression of its encoding gene, Srd5a1, drops in murine ovaries and hypothalamic preoptic...
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Gamertsfelder, Elise and Delgado Figueroa, Netzahualpilli and
Keestra, Sarai
and Silva, Alan and Borana, Ronak and Siebert, Maximilian and Bruckner, Till
Adoption of the World Health Organization's best practices in clinical trial registration and reporting among top public and philanthropic funders of medical research in the United States
Background/Aims Clinical trial funders in the United States have the opportunity to promote transparency, reduce research waste, and prevent publication bias by adopting policies that require grantees...
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The Lancet Planetary Health | Vol. 7 No. 5 10.1016/s2542-5196(23)00049-9
Pinto Jimenez, Chris E and
Keestra, Sarai
and Tandon, Pranav and Cumming, Oliver and Pickering, Amy J and Moodley, Arshnee and Chandler, Clare I R
Biosecurity and water, sanitation, and hygiene (WASH) interventions in animal agricultural settings for reducing infection burden, antibiotic use, and antibiotic resistance: a One Health systematic review
Prevention and control of infections across the One Health spectrum is essential for improving antibiotic use and addressing the emergence and spread of antibiotic resistance. Evidence for how best to...
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BMJ Global Health | Vol. 8 No. 3 10.1136/bmjgh-2022-011263
Pinto Jimenez, Chris E and
Keestra, Sarai M
and Tandon, Pranav and Pickering, Amy J and Moodley, Arshnee and Cumming, Oliver and Chandler, Clare I R
One Health WASH: an AMR-smart integrative approach to preventing and controlling infection in farming communities
Prevention is a critical, yet neglected, cornerstone for the response to antimicrobial resistance (AMR). 1 The importance of a multitude of preventative measures is recognised across the One Health sp...
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JAMA Network Open | Vol. 5 No. 8 10.1001/jamanetworkopen.2022.22378
Bruckner, Till and Rodgers, Florence and Styrmisdóttir, Lea and
Keestra, Sarai
Adoption of World Health Organization Best Practices in Clinical Trial Transparency Among European Medical Research Funder Policies
Research funders can reduce research waste and publication bias by requiring their grantees to register and report clinical trials.To determine the extent to which 21 major European research funders' ...
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Nature Human Behaviour | Vol. 6 No. 11 10.1038/s41562-022-01410-x
Hilton, Courtney B. and Moser, Cody J. and Bertolo, Mila and Lee-Rubin, Harry and Amir, Dorsa and Bainbridge, Constance M. and Simson, Jan and Knox, Dean and Glowacki, Luke and Alemu, Elias and Galbarczyk, Andrzej and Jasienska, Grazyna and Ross, Cody T. and Neff, Mary Beth and Martin, Alia and Cirelli, Laura K. and Trehub, Sandra E. and Song, Jinqi and Kim, Minju and Schachner, Adena and Vardy, Tom A. and Atkinson, Quentin D. and Salenius, Amanda and Andelin, Jannik and Antfolk, Jan and Madhivanan, Purnima and Siddaiah, Anand and Placek, Caitlyn D. and Salali, Gul Deniz and
Keestra, Sarai
and Singh, Manvir and Collins, Scott A. and Patton, John Q. and Scaff, Camila and Stieglitz, Jonathan and Cutipa, Silvia Ccari and Moya, Cristina and Sagar, Rohan R. and Anyawire, Mariamu and Mabulla, Audax and Wood, Brian M. and Krasnow, Max M. and Mehr, Samuel A.
Acoustic regularities in infant-directed speech and song across cultures
The forms of many species' vocal signals are shaped by their functions1–15. In humans, a salient context of vocal signaling is infant care, as human infants are altricial16,17. Humans often alter thei...
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Keestra, Sarai
and Miabangana, Edmond Sylvestre and Chaudhary, Nikhil and Derkx, Inez and Sikka, Gaurav and Salali, Gul Deniz
Bitter taste perception in BaYaka hunter-gatherers
Aversion towards bitter tastes evolved across vertebrate species to enable the recognition of harmful plant toxins. Most studies to date have investigated the variation in bitter taste sensitivity bet...
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Keestra, Sarai
and Rodgers, Florence and Osborne, Rhiannon and Wimmer, Sabrina
University patenting and licensing practices in the United Kingdom during the COVID-19 pandemic
Universities play a vital role in biomedical innovation during the COVID-19 pandemic, and decisions made during technology transfer may affect affordability, accessibility, and availability of health ...
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Frontiers in Endocrinology | Vol. 13 10.3389/fendo.2022.836245
Keestra, Sarai M.
and Motoc, Irina and Ravelli, Anita C.J. and Roseboom, Tessa J. and Finken, Martijn J.J.
Thyroid Function at Age Fifty After Prenatal Famine Exposure in the Dutch Famine Birth Cohort
Universities' decisions during technology transfer may affect affordability, accessibility, and availability of COVID-19 health technologies downstream. We investigated measures taken by the top 35 pu...
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Clinical Trials | Vol. 19 No. 2 10.1177/17407745211071015
Mirjam Keestra, Sarai
and Rodgers, Florence and Gepp, Sophie and Grabitz, Peter and Bruckner, Till
Improving clinical trial transparency at UK universities: Evaluating 3 years of policies and reporting performance on the European Clinical Trial Register
Background: January 2019, the House of Commons' Science and Technology Committee sent letters to UK universities admonishing them to achieve compliance with results reporting requirements for Clinical...
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Frontiers in Public Health | Vol. 10 10.3389/fpubh.2022.821117
Pilkington, Victoria and
Keestra, Sarai Mirjam
and Hill, Andrew
Global COVID-19 Vaccine Inequity: Failures in the First Year of Distribution and Potential Solutions for the Future
Within the first year of distribution of vaccines against COVID-19, high-income countries (HICs) have achieved vaccination rates of 75-80%, whilst low-income countries (LICs) vaccinated <10%. This ...
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Cross, Samuel and Rho, Yeanuk and Reddy, Henna and Pepperrell, Toby and Rodgers, Florence and Osborne, Rhiannon and Eni-Olotu, Ayolola and Banerjee, Rishi and Wimmer, Sabrina and
Keestra, Sarai
Who funded the research behind the Oxford-AstraZeneca COVID-19 vaccine? Approximating the funding to the University of Oxford for the research and development of the ChAdOx vaccine technology
Objectives The Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1 nCoV-19 or Vaxzevira) builds on nearly two decades of research and development (R\&D) into Chimpanzee adenovirus-vectored vaccine (ChAdO...
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Women's Health Reports | Vol. 2 No. 1 10.1089/whr.2021.0010
Högqvist Tabor, Vedrana and Högqvist Tabor, Mikael and
Keestra, Sarai
and Parrot, Jean-Etienne and Alvergne, Alexandra
Improving the Quality of Life of Patients with an Underactive Thyroid Through mHealth: A Patient-Centered Approach
Three hundred fifty million people worldwide suffer from underactive thyroid conditions, which can lead to infertility, obesity, heart disease, and impaired mental health when poorly managed. Although...
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American Journal of Human Biology | Vol. 33 No. 2 10.1002/ajhb.23465
Keestra, Sarai M.
and Bentley, Gillian R. and Núñez-de la Mora, Alejandra and Houghton, Lauren C. and Wilson, Hannah and Vázquez-Vázquez, Adriana and Cooper, Gillian D. and Dickinson, Federico and Griffiths, Paula and Bogin, Barry A. and Varela-Silva, Maria Inês
The timing of adrenarche in Maya girls, Merida, Mexico
Abstract Background Adrenarche involves maturation of the hypothalamic-pituitary-adrenal axis and increased production of dehydroepiandrosterone and its sulfate ester, dehydroepiandrosterone-sulfate (...
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Trials | Vol. 22 No. 1 10.1186/s13063-021-05330-5
Keestra, Sarai Mirjam
and Rodgers, Florence and Lenz, Daphne and Osborne, Rhiannon and Bruckner, Till and Lee, Sean
Clinical trial reporting performance of thirty UK universities on ClinicalTrials.gov--evaluation of a new tracking tool for the US clinical trial registry
Clinical trial transparency forms the foundation of evidence-based medicine, and trial sponsors, especially publicly funded institutions such as universities, have an ethical and scientific responsibi...
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Plos One | Vol. 16 No. 10 10.1371/journal.pone.0258384
Knight, Jessica K. and Salali, Gul Deniz and Sikka, Gaurav and Derkx, Inez and
Keestra, Sarai M.
and Chaudhary, Nikhil
Quantifying patterns of alcohol consumption and its effects on health and wellbeing among BaYaka hunter-gatherers: A mixed-methods cross-sectional study
Ethnographers frequently allude to alcoholism and related harms in Indigenous hunter-gatherer communities, but very few studies have quantified patterns of alcohol consumption or its health and social...
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Global Health Action | Vol. 14 No. 1 10.1080/16549716.2021.1892309
Pepperrell, Toby and Rodgers, Florence and Tandon, Pranav and Sarsfield, Kelly and Pugh-Jones, Molly and Rashid, Theo and
Keestra, Sarai
Making a COVID-19 vaccine that works for everyone: ensuring equity and inclusivity in clinical trials
Coronavirus disease 2019 (COVID-19) mortality and morbidity have been shown to increase with deprivation and impact non-White ethnicities more severely. Despite the extra risk Black, Asian and Minorit...
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Global Health: Annual Review | Vol. 1 No. 6
Keestra, Sarai
Sofosbuvir: The Creation of an [In]Valuable Medicine for Hepatitis C
BMJ Global Health | Vol. 6 No. 5 10.1136/bmjgh-2020-004916
Keestra, Sarai
Structural violence and the biomedical innovation system: what responsibility do universities have in ensuring access to health technologies?
Universities intend to create knowledge that serves the needs of the public, yet this does not always happen in practice. By engaging in inequitable technology transfer practices, such as the exclusiv...
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Medical Hypotheses | Vol. 151 10.1016/j.mehy.2021.110558
Sarai M. Keestra
and Victoria Male and Gul Deniz Salali
Out of balance: the role of evolutionary mismatches in the sex disparity in autoimmune disease
Over the past century autoimmune disease incidence has increased rapidly in (post-) industrialised, affluent societies, suggesting that changes in ecology and lifestyle are driving this development. E...
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Forced Migration Review | Vol. 67
Stevenson, Edward and Buffavand, Lucie and
Keestra, Sarai
Thinking upstream: a critical examination of a cholera outbreak in Ethiopia - Forced Migration Review
A case-study from the Lower Omo Valley explores some of the challenges to water security for people who have been displaced within their own homelands
Rodgers, Florence and Pepperrell, Toby and
Keestra, Sarai
and Pilkington, Victoria
Missing clinical trial data: the evidence gap in the safety of potential COVID-19 drugs
Background Several drugs are being repurposed for the treatment of the coronavirus disease 2019 (COVID-19) pandemic based on in vitro or early clinical findings. As these drugs are being used in varie...
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Evolutionary Human Sciences | Vol. 2 10.1017/ehs.2020.26
Salali, Gul Deniz and Dyble, Mark and Chaudhary, Nikhil and Sikka, Gaurav and Derkx, Inez and
Keestra, Sarai M.
and Smith, Daniel and Thompson, James and Vinicius, Lucio and Migliano, Andrea Bamberg
Global WEIRDing: transitions in wild plant knowledge and treatment preferences in Congo hunter-gatherers
Cultures around the world are converging as populations become more connected. On the one hand this increased connectedness can promote the recombination of existing cultural practices to generate new...
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Evolution, Medicine, and Public Health | Vol. 9 No. 1 10.1093/emph/eoaa043
Keestra, Sarai
and Högqvist Tabor, Vedrana and Alvergne, Alexandra
Reinterpreting patterns of variation in human thyroid function
Two hundred million people worldwide experience some form of thyroid disorder, with women being especially at risk. However, why human thyroid function varies between populations, individuals, and acr...
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Pinto J, C and
Keestra, S
and Tandon, P and Chandler, CIR
WASH and biosecurity interventions for reducing burdens of infection, antibiotic use and antimicrobial resistance in animal agricultural settings: a One Health mixed methods systematic review
Background: Infection prevention and control (IPC) is recognised as essential to addressing the emergence and spread of antimicrobial resistance (AMR) in human health, food production and the environm...
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International Journal of Health Policy and Management 10.34172/ijhpm.2020.166
Wimmer, Sabrina and
Keestra, Sarai M.
Public Risk-Taking and Rewards During the COVID-19 Pandemic - A Case Study of Remdesivir in the Context of Global Health Equity
Public investment, through both research grants and university funding, plays a crucial role in the research and development (R&D) of novel health technologies, including diagnostics, therapies, and v...
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3 Minute Quick Fire 10.1136/bmjebm-2019-ebmlive.59
Keestra, Sarai
and Gepp, Sophie and Grabitz, Peter and Lee, Yi Nian and Bruckner, Till
51 Enhancing clinical trial transparency at UK's top research universities - from generating evidence to improving practice
Objectives In February 2019, the Chair of the House of Commons' Science and Technology Committee sent a letter to forty universities warning them to upload their backlog of missing summary results fro...
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