Digital Commons Network^™

Management Of Retropharyngeal Lymph Node Metastases In Thyroid Cancer, Isabelle Fournier, Ashwini Venkata Bandi, Sarah Hamidi, Priyanka Iyer, Naifa L Busaidy, Maria E Cabanillas, Ramona Dadu, Mimi I Hu, Steven G Waguespack, Ugur Nur Basmaci, Michelle D Williams, Mena Mansour, Maria Gule Monroe, Neil D Gross, Ryan P Goepfert, Nancy D Perrier, Victoria Banuchi, Jennifer R Wang, Anastasios Maniakas, Mark E Zafereo

Faculty, Staff and Student Publications

Background: Retropharyngeal lymph node (RPLN) metastases in thyroid cancer are rare, with optimal management underreported.

Methods: Retrospective study of consecutive thyroid cancer patients with RPLN metastases treated at MD Anderson Cancer Center between 2000 and 2024.

Results: One hundred and sixty-seven patients (75% differentiated, 21% medullary, 4% poorly differentiated thyroid cancer) were divided into three groups: active surveillance (AS) (13%), surgery (56%), and nonsurgical treatment (31%). In the AS group (median follow-up 2.3 years), RPLN metastases grew a median 3% (range: 0-56) or 0.02 cm (range: 0-0.7) per year. Surgical therapy included transcervical (73%), transoral robotic (14%), transoral (12%), and …

The Lysine Demethylase Kdm4c Is An Oncogenic Driver And Regulates Erk Activity In Kras-Mutant Pancreatic Ductal Adenocarcinoma, Menna-T-Allah Shaheen, Sarah Dhebat, Kimal I Rajapakshe, Bidyut Ghosh, Benson Chellakkan Selvanesan, Shariq S Ansari, Cara L Haymaker, Dorsay Sadeghian, Huamin Wang, Ching-Fei Li, Haoqiang Ying, Anirban Maitra

Faculty, Staff and Student Publications

Deregulation of proteins involved in chromatin regulation is common in pancreatic ductal adenocarcinoma (PDAC). Lysine demethylase 4C (KDM4C) is one of the chromatin-modifying proteins frequently overexpressed across multiple solid cancers and is linked to chromatin instability, increased cell proliferation, and enhanced stem cell–like behavior. We observed upregulation of KDM4C protein in a panel of human PDAC cell lines and patient samples compared with nonneoplastic controls. CRISPR/Cas9-mediated deletion of KDM4C in human and murine PDAC cells reduced proliferation, clonogenicity, and increased survival of orthotopically implanted murine PDAC allografts. Transcriptomic and proteomic analyses revealed that loss of KDM4C in both human and …

Initial Experience With Remote Mri Scanning Support In An Oncology Focused Practice: Opportunities For Expanded Access To Radiology Care, Christopher M Walker, Maria G Maldonado, Megan C Jacobsen, Suprateek Kundu, Michelle L Underwood, Joshua P Yung, Brandy J Reed, David Jaffray, R Jason Stafford, Marshall E Hicks, Caroline Chung, Aradhana M Venkatesan

Faculty, Staff and Student Publications

Background: As medical imaging demand grows, there is increasing stress on the currently available workforce to deliver consistent, high-quality imaging studies while ensuring rapid study turnaround times and round-the-clock radiology coverage. Advances in remote access technology facilitating remote scan assistance and control are now commercially available to address these pressing clinical needs.

Methods: This work evaluated an early clinical application of a virtual scanner operations system (syngo Virtual Cockpit (VA13A, Siemens Healthineers, Erlangen, Germany) for remote magnetic resonance imaging (MRI) monitoring and scan control at three geographically distant outpatient sites associated with our primary institution.

Results: The system facilitated execution …

Clinical Microbiology & Infectious Diseases: A Concise Guide On The Fundamentals Of Infectious Disease In Podiatric Medical Education, Paramita Basu

Open Touro Created

2026

This Open Educational Resource (OER), Clinical Microbiology & Infectious Diseases, is a student-centered textbook designed to support pre-clinical podiatric medical students enrolled in PCLP 610 Infectious Diseases at the New York College of Podiatric Medicine. The book is structured as a collection of concise “chapter briefs” or high‑yield notes that align closely with the course syllabus, lecture objectives, and student learning outcomes, while also reflecting the Microbiology learning objectives outlined in the AACPM Council of Faculties Curricular Guide.

The content covers core principles of medical microbiology and infectious diseases, including bacteria, viruses, fungi, parasites, host–pathogen interactions, antimicrobial therapy, resistance …

The Nurse's Role In Curative-To-Palliative Transitions In Advanced Cancer: A Theory Synthesis Using Turner's Method, Geya George, Deborah Kirk, Davina Porock

Research outputs 2022 to 2026

Aim: This paper aims to explain the process of formulating a robust theory that comprehensively explains the nurse's role during the transition from curative to the palliative phase in advanced cancer care. Design: A qualitative theory synthesis approach was applied, utilising Turner's 9-step theory synthesis method to integrate five grounded theories and 10 qualitative studies. The Walker and Avant method of concept development and analysis further ensured rigour. Methods: Turner's theory synthesis was used to formulate a more comprehensive, testable theory from five existing grounded theories and 10 other qualitative studies that explain the nurse's role in supporting and facilitating …

It Was Part Of The Plan, So I Showed Up: An Exploration Of Patient Experiences With An Embedded Exercise Referral Process During Cancer Treatment, Mary A. Kennedy, Jack Dalla Via, Kim Edmunds, Pam Eldridge, Yvonne Zissiadis, Lauren Fortington

Research outputs 2022 to 2026

Introduction: Exercise is a key part of cancer care, yet its integration into routine practice remains limited. This study explored the experiences of people living with and beyond cancer, with an updated, opt-out referral model embedded within a supportive oncology setting, focusing on initial engagement with exercise physiology appointments. Through this model, patients were automatically scheduled for a consultation with an in-house exercise professional during their cancer treatment. Methods: A qualitative descriptive design comprised of two focus groups with 13 participants was employed to explore views across pre-defined elements of the model: referral to exercise, appointments, counselling, and tailoring. Results: …

A Collaborative Communities-Of-Practice Methodology For Environmental Design Research: A Case Study Application In Palliative Care, Emil E. Jonescu, Benjamin Farrell, Chamil Erik Ramanayaka, Lori Delaney, Edward Litton, Talia J. Uylaki, Gareth Watts, Bella Brigham, Frances Bellemore, Davinia Seah

Research outputs 2022 to 2026

Environmental design in palliative care settings receives increasing attention, yet methodologies for studying such environments often lack interdisciplinary integration. Traditional research designs may overlook the lived expertise of clinicians and designers. Objectives: This article describes a collaborative, cross-disciplinary communities-of-practice model developed as a methodological framework to enable effective environmental evaluation and design processes in healthcare settings. Its application is illustrated through a case study in a palliative care unit. Methods: A co-designed, multi-methods approach was developed by a team of clinicians, facility managers, and academic researchers. The methodology included a scoping review, site-specific environmental data logging (sound, temperature, lighting), and …

Navigating Prediabetes In A Foreign Country: A Qualitative Study Of Self-Management Experiences Among Chinese-Speaking Immigrants In Australia, Min Zhang, Kirsten J. Coppell, Johnny Lo, Lisa Whitehead

Research outputs 2022 to 2026

Aim: Chinese-speaking immigrants in Australia have a higher risk of type 2 diabetes and face more barriers to accessing quality healthcare compared to non-culturally and linguistically diverse populations. This study aimed to explore the self-management experiences of Chinese-speaking Australians with self-reported lived experience of prediabetes following immigration. Design: Qualitative study. Methods: Semi-structured interviews were conducted with 10 purposively selected Australian Chinese-speaking immigrants aged over 40 years. Data collection was undertaken in Perth, Western Australia between April and August 2024. Data were analysed using reflexive thematic analysis. Results: Three themes are presented in this paper: (1) An acculturation journey: Reshaping cultural …

Fill The Void - An Introductory Guide For Learning Medical Imaging, Reid Faith, Peter Gahan, Adam Trusty, Aleksandr Zyskin, Chukwuka Ukekwe, Denise Nchinda, Amanda K. Burbage, Alberto E. Musto

EVMS School of Health Professions Faculty Publications

No standardized, comprehensive approach for radiological image interpretation exists among medical schools in the United States of America. In order to rectify this, we outline a model aimed to help improve how medical imaging can be taught in medical schools. The VOID (Visualization, Orientation/Observation, Identification, Description) guide is a proposed universal, stepwise approach to medical image identification, interpretation, and communication. This structured guideline is aimed at building a foundation for students in early medical education. The VOID was applied to CT (Computed Tomography), MRI (Magnetic Resonance Imaging), and x-ray modalities as integrated sessions for medical students during human anatomy laboratory. …

Implementation And Clinical Utility Of Ultra-Low-Field Portable Magnetic Resonance Imaging For Postprocedural Neurological Evaluation In Ambulatory Neurosurgery: Illustrative Cases, Devan Patel, Vinay Jaikumar, Taysia P. T. Morioka, Laz Rifkin, Kenneth S. Jacoby, Jaims Lim, Anais Andrade, Aimee C. Degaetano, Pui Man Rosalind Lai, Elad I. Levy

EVMS School of Health Professions Faculty Publications

BACKGROUND

Elective endovascular neurosurgical procedures are increasingly performed in ambulatory neurosurgery centers, enabled by advances in catheter technology, safety of conscious sedation, and refined patient selection. Although complication rates are low, rapid evaluation of postprocedural neurological deficits remains critical. Conventional MRI is often impractical in outpatient or procedural settings, whereas ultra-low-field portable MRI (ULF-pMRI) systems (such as Swoop) allow bedside imaging with favorable diagnostic performance.

OBSERVATIONS

Two women in their 60s developed acute neurological deficits at an ambulatory neurosurgery center (ANSC) after diagnostic cerebral angiography in one case and elective internal carotid artery flow diversion in the other. In both …

Neuron-Enriched Extracellular Vesicle Micrornas Reflect Hormonal Suppression Associated With Oral Contraceptive Use In Young Women, Amulya Chowdhory, Rebekah Frye, Roxann Roberson-Nay

UROP Posters

Hormonal contraceptives alter hypothalamic–pituitary–ovarian (HPO) feedback, but their impact on brain-associated molecular communication remains poorly understood. Neuron- enriched extracellular vesicle (nEV) microRNAs (miRNAs), isolated from plasma, provide a minimally invasive window into brain molecular activity. This pilot study examined nEV miRNA expression in young women (ages 18–22) who were either naturally cycling or using a combined monophasic oral contraceptive (OC) pill. To identify hormonally responsive miRNAs, we calculated effect sizes (Cohen’s d) between the two groups and selected those showing large between-group differences (|d| ≥ 0.8). These miRNAs were entered into a principal component analysis (PCA) to reduce dimensionality, and …

Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

The Effects Of Music Therapy On Anxiety And Sedation Requirements For Total Knee Arthroplasty Patients Undergoing Regional Anesthesia: An Evidence-Based Practice Pilot Initiative, Kyra Marie Savrese

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Excessive noise in the operating room negatively impacts patient comfort and outcomes, particularly in patients undergoing spinal anesthesia who have the potential for awareness.

Background: Research demonstrates that music therapy is a low-cost, low-risk intervention that reduces perioperative anxiety and sedative requirements. Literature supports the use of music as an adjunct to anesthesia care, especially in orthopedic populations.

Purpose: At J.W. Ruby Memorial Hospital, orthopedic procedures with regional anesthesia expose patients to high noise levels, often leading to increased anxiety, sedation use, and longer recovery times. Addressing this problem aligns with institution goals for safe, patient-centered care.

Methods: Using …

Seasonal And Geographic Trends In Photodynamic Therapy And Cryosurgery Use In The United States: A Cross-Sectional Study From 2015-2022., Dawn Merritt, Jon Lyons, Mouna Mikati, Christian Geils, Todd Schlesinger

Ambulatory and Primary Care Articles

BACKGROUND: Photodynamic therapy (PDT) is an effective field treatment for actinic keratoses (AKs). It is an ideal option for patients who prefer a minimally invasive procedure conveniently administered in their physician's office. Anecdotal clinician insights suggest that it may not be used at the same rate year-round.

OBJECTIVE: This study investigates whether PDT and cryosurgery usage is affected by season and geographic location in the United States.

METHODS: The data source is an aggregate of closed and open United States medical procedural claims (

RESULTS: PDT utilization is affected by season and geographic location. Procedural claims peak during cooler months …

The Association Between Maternal-Fetal Medicine Physician Density And Pregnancy Outcomes, Tetsuya Kawakita, Rula Atwani, Misa Hayasaka, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective

We sought to examine the association between maternal-fetal medicine (MFM) physician density and adverse pregnancy outcomes at the state level.

Study Design

This was a cross-sectional analysis of publicly available, state-level data from 2018 to 2021, including Natality, Multiple Cause-of-Death, and Fetal Death databases. The number of active MFM physicians per year was obtained for each state from the American Medical Association Masterfile. The primary exposure was the density of MFM per state, categorized into three groups: (1) low density (< 30 MFM physicians per 100,000 live births), (2) moderate density (30-59 MFM physicians per 100,000 live births), and (3) high density (≥60 MFM physicians per 100,000 live births). Our primary outcome was maternal mortality during pregnancy and up to 42 days postdelivery. Our secondary outcomes were pregnancy-related mortality up to 365 days postdelivery and stillbirth. We calculated adjusted incident rate ratios (aIRR) and average marginal effect (AME) with 95% confidence intervals (95% CI) using multivariable negative binomial mixed effects regression models.

Results

Overall, there were 14,792,743 live births, 3,440 maternal mortalities, 4,980 pregnancy-related mortalities, and 90,848 stillbirths included. The …

Applications And Challenges Of Utilizing Digital Pathology And Ai-Enabled Workflows In Clinical Trials, Manu Sebastian, Harsh Batra, Monika Lamba Saini, Staci Kearney, Lorcan Sherry, Serge Alexanian, Michael Cohen, William Weber, Joe Lennerz, Anil V Parwani

Faculty, Staff and Student Publications

This is a comprehensive review on current utilization and challenges of digital pathology adoption in clinical trials and aims to provide a broad view on its impact on pathology review processes in clinical trials. It provides an overview of current pathology review practices in clinical trials and unique advantages digital pathology adoption can offer. The key areas including existing workflows, use case scenarios in different disease areas in clinical trials, including but not limited to patient identification and pre-screening, and regulatory aspects have been described with relevance. In addition, the review delves into the integration of genomics, AI, image analysis, …

Directional Association Between Irritable Bowel Syndrome And Dermatological Disease: A Large-Scale Retrospective Study, Alex Y. Liu, Naomi T. Matsuno, Houston Nelson, David Johnson, David Pariser

Department of Medicine Faculty Publications

Background/Objectives: Microbial dysbiosis is implicated with a pathogenic role in both irritable bowel syndrome (IBS) and several dermatological conditions. Yet, few studies have assessed a potential overlapping epidemiologic association. We aimed to assess the 1-year prevalence of common dermatologic conditions following an initial IBS diagnosis and to evaluate the reverse association using reciprocal analyses. Methods: We conducted a retrospective study using TriNetX. Patients aged 18–50 with no history of inflammatory bowel disease, celiac disease, or infectious intestinal disease were matched 1:1 to healthy controls by demographics and comorbidities. The primary outcome was the prevalence of acne vulgaris, psoriasis, …

Selenium And Liver Steatosis And Fibrosis: Opposing Direct And Steatosis-Mediated Associations In A Large Cohort, Neda Rehan, Jubilee Benedict, Rehan Qayyum

Department of Medicine Faculty Publications

Background and Aims

Epidemiologic studies have reported conflicting associations between selenium exposure and liver disease. Whether selenium exerts opposing direct and steatosis-mediated effects on liver fibrosis is unknown. To evaluate the associations of blood selenium with elastography-defined hepatic steatosis and fibrosis and to determine whether hepatic steatosis mediates the relationship between selenium and fibrosis.

Methods

We conducted a cross-sectional analysis of adults aged >= 18 years in NHANES 2017-2023. Hepatic steatosis was assessed using the controlled attenuation parameter (CAP) and fibrosis using liver stiffness measurement (LSM). Blood selenium was categorized into quartiles. Survey-weighted multivariable linear regression and structural equation modeling …

Platypnea-Orthodeoxia Syndrome Caused By A Patent Foramen Ovale And Interatrial Septal Aneurysm: A Case Report, Abes A. Bautista Neughebauer, Raymond L. Benza, Deepak Talreja

Department of Medicine Faculty Publications

Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by positional hypoxemia, often due to right-to-left shunting across a patent foramen ovale (PFO) despite normal right-sided pressures. Early recognition is essential as symptoms may be subtle and imaging is often unrevealing. A 78-year-old female patient with a known PFO presented with one week of lower abdominal pain and mild exertional dyspnea without chest pain. She was profoundly hypoxic to 76% on room air, with improvement when supine and worsening when upright. Initial labs were unremarkable, and arterial blood gas revealed primary respiratory alkalosis with severe hypoxemia. Despite unremarkable chest radiography, CT …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

Characteristics Of Women Who Fast During Pregnancy: Findings From The Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Reem Al Sabah, Ahmed N. Albatineh, James Blando, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical …

Rapid Decentralized Prostate Cancer Risk Stratification By Portable Liquid Biopsy Analysis Within A Clinical Biosensor Validation Framework, Kevin M. Koo, Grant Phillips, Sriganesh Srihari, Áine Farrell, Binny Jaradi, Kira J. Fitzpatrick, John W. Yaxley, Hemamali Samaratunga, Paul N. Mainwaring, Ke-Lin Ru, Darren J. Korbie, Scott A. Tomlins, Matthew J. Roberts, Robert A. Gardiner, Matt Trau

Research outputs 2022 to 2026

Clinical liquid biopsy (e.g., blood or urine) specimens, as a minimally invasive source of crucial molecular information, continue to grow in importance for efficacious targeted cancer treatment. Yet, current molecular profiling technologies are still confined to centralized laboratory testing, which escalates testing costs, result turnaround time, and patient anxiety. Crucially, there is also a scarcity of purposeful clinical validation studies to rigorously evaluate emerging liquid biopsy technologies from research settings to facilitate clinical translation. Here, we report liquid biopsy biosensor advancements in achieving rapid, accurate, and decentralized molecular profiling of a clinically accredited prostate cancer (PCa) urinary circulating RNA biomarker …

Development And Application Of A Frailty Index Derived From Patient-Reported Outcome Measures And Comorbidities In Oncology Patients, Divya Mathew, Heather Lane, David Ward, Rosemary Saunders, Lesley Millar, Christopher Etherton-Beer

Research outputs 2022 to 2026

Background: Emerging evidence supports the use of a frailty index as an objective measure of frailty. We constructed a frailty index from patient-derived outcome measures, as well as self-reported comorbidity data, and tested its correlation with survival.

Method: Data from 464 patients with lung, breast and colorectal cancer were obtained from the Continuous Improvement in Care – Cancer Project database, and a 42-variable frailty index was generated by dividing the total number of deficits present by the total number assessed and expressed as a ratio between 0 and 1. Frailty was defined as a frailty index of >0.2. Its association …

It Will Only Work If Everyone Is On Board: A Needs And Context Assessment To Inform Exercise Oncology Implementation Within A Public Healthcare Organisation, Georgia L. White, Mary A. Kennedy, Bryan A. Chan, Hattie Wright, Grace L. Rose

Research outputs 2022 to 2026

Introduction: Exercise has well-established benefits across the cancer continuum for people living with and beyond cancer, yet the exercise oncology field faces a research-to-practice gap. Understanding the factors that influence implementation in any given context is essential to ensure implementation strategies have the greatest likelihood of success. The study mapped onsite exercise oncology services, staff-reported implementation barriers and facilitators, organisational readiness, and experiences reported by people living with or beyond cancer, across a large public healthcare organisation.

Methods: Staff and people living with and beyond cancer across cancer care centres within the public healthcare organisation completed an online survey. Data …

Healthcare Provider Perspectives On A Clinical Decision Tool To Support Individualized Exercise Prescriptions And Discussions For Breast Cancer Survivors, Jinani Jayasekera, Oliver W. A. Wilson, Kaitlyn M. Wojcik, Eleanor M. Kerr, Rachelle Brick, David Berrigan, Jennifer Yeong-Shin Sheng, Takeo Fujii, Kathleen Thomas, Henri K. Parson, Padma Sheila Rajagopal, Richard L. Street Jr.

Department of Medicine Faculty Publications

Purpose: We evaluated healthcare providers' current knowledge, practices, and perspectives on a novel clinical decision tool (beta-version) to facilitate individualized exercise prescriptions and discussions in clinical settings.

Methods: We recruited healthcare providers who had treated or provided care to breast cancer survivors aged >= 35-years in the past 12 months. The participants were presented with a tool to provide individualized exercise recommendations considering women's individual, clinical, and contextual characteristics. Validated and reliable pre-existing instruments were used to survey providers' current knowledge, practices regarding exercise discussions, and perspectives on the beta-version (paper-draft) of the novel tool.

Results: The sample consisted of …

Ex Vivo Assessment Of Keratinocytic Carcinomas Using A Fast Mid-Infrared Probe., Maria G Vazquez De Vasquez, Rebecca C Bradley, Charles L Hitchcock, Angela S Casey, Austin Cusick, James V Coe, Ronald Siegle

Ambulatory and Primary Care Articles

A fast mid-infrared spectral probe was used to record infrared (IR) spectra of fresh skin tissue removed from patients with biopsy-proven keratinocytic cancer (KC) during Mohs surgery. A 150-patient library of IR spectral data was obtained to see if KC on the epidermal side (outside) of tissue samples can be differentiated from adjacent nonmalignant tissue and normal skin. A linear support vector machine model minimized overtraining predicting the contributions to decisions at each step in the spectrum. Training with an equal cost for KC and nontumor cases samples demonstrated a KC sensitivity of 93% ± 5% and specificity 82% ± …

Effectiveness, Reach, Uptake, And Feasibility Of Digital Health Interventions For Culturally And Linguistically Diverse Populations Living With Prediabetes Across The Lifespan: Systematic Review And Meta-Analysis, Lisa Whitehead, Min Zhang, Wai Hang Kwok, Diana Arabiat, Amanda Towell Barnard

Research outputs 2022 to 2026

Background: Culturally and linguistically diverse (CaLD) populations are at a higher risk of developing prediabetes; however, the effectiveness and implementation of digital health interventions for prediabetes management in this population are not well understood. Objective: This review aims to evaluate the effectiveness and implementation of digital health interventions (DHIs) versus usual care for glycemic control in CaLD populations living with prediabetes. Methods: This review aimed to include people of any age living with prediabetes who are from a CaLD background. Experimental and quasi-experimental studies that compare digital health interventions to usual care, waitlist, or active control were eligible. The primary …

Dose–Response Association Between Systemic And Dermatologic Glucocorticoid Use And Type 2 Diabetes Mellitus: A Nationwide Case–Control Study, David Vadsholt, Annika V. Kvist, Chano Sandiramoorthy, Joshua R. Lewis, Peter Vestergaard, Johan Røikjer, Nicklas H. Rasmussen

Research outputs 2022 to 2026

Aims: To investigate the association and dose–response between systemic and topical glucocorticoids and odds of Type 2 diabetes mellitus. Materials and Methods: We conducted a nationwide case–control study using Danish registry data from 2013 to 2021. People aged 40 years or older with incident type 2 diabetes mellitus (n = 149 113) were matched 1:3 with controls (n = 447 339) by age, sex and weighted Charlson Comorbidity Index. Glucocorticoid exposure was defined as ≥ 1 prescription within 1 year before the date of diagnosis and ≥ 2 within 3 years and classified as systemic or topical. Conditional logistic regression …

Tuberculosis Presenting As Multiple Pulmonary Nodules Mimicking Malignancy, Abdel Martinez Borrego, Fatimah Bello, Brandon Cantazaro, Luisa Montoya, Frank Mediola

School of Medicine Publications

Multiple pulmonary nodules often raise concern for metastatic malignancy; however, the differential diagnosis is broad and includes infectious, inflammatory, granulomatous, vascular, and benign etiologies. Tuberculosis (TB), although uncommon, can present with multiple nodules that closely mimic metastatic disease on advanced imaging, requiring careful clinicoradiologic and microbiologic correlation. We describe a woman in her 50s who presented with dyspnea and new-onset heart failure, in whom imaging revealed mediastinal lymphadenopathy and bilateral pulmonary nodules concerning for malignancy. Evaluation was limited by concurrent COVID-19 infection, and CT-guided biopsy demonstrated necrotizing granulomas without evidence of malignancy or infection. She later re-presented with fever and …

Preoperative Patient Sentiment Is Associated With Postoperative Outcomes In Adult Spinal Deformity Surgery, Ross J. Gore, David Mazur-Hart, Mohan K. Sunkara, Aaqib Ali, Qizar Ali, Christopher J. Lynch, Christopher Ames

Center for Secure and Intelligent Critical Systems (CSICS) Publications

Study Design: Prospective observational pilot study of adult spinal deformity surgery patients.

Objective: To determine whether preoperative patient sentiment, quantified using a 21-class valence scale extending the CARP paradigm implemented through an offline Large Language Model, predicts postoperative outcomes.

Summary of Background Data: Predicting adult spinal deformity surgery outcomes remains challenging with traditional clinical and radiographic parameters alone. Although patient psychological factors and expectations significantly influence postoperative satisfaction and quality of life, systematic approaches to capture these factors are underdeveloped. Offline Large Language Models offer scalable, privacy-preserving psychological risk stratification.

Materials and Methods: We prospectively enrolled 18 patients undergoing adult …