Digital Commons Network^™

Categorizing Weight Growth Of Infants Born Before 32 Weeks' Gestation Using The 2023 Postnatal Growth Charts For Preterm Infants., Fu-Sheng Chou, Hung-Wen Yeh, Crystal Hsueh, Jing Zhang, Maria Fe B. Villosis, Karine Barseghyan, Ashwini Lakshmanan, Reese H. Clark

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To categorize growth and correlate growth categories with morbidities in infants born before 32 weeks of gestation.

STUDY DESIGN: This retrospective study categorized weight growth by correlating mean growth velocity (GV) with growth trajectory z-score changes (ΔGTZ ), as measured using 2023 Postnatal Growth Charts for Preterm Infants. The associations between weight categories and morbidities were assessed.

RESULTS: Weight gain of infants without morbidities was categorized into three groups based on correlating ΔGTZ with mean GV: slower ( ΔGTZ < -0.1), in-parallel ( ΔGTZ -0.1 to 0.3), and faster ( ΔGTZ > 0.3). The proportions of infants with and without morbidities in these categories were evaluated across two distinct cohorts, revealing similar …

Left And Right Ventricular Strain Mechanics In Fetal Tachyarrhythmia., Rukmini Komarlu, Janelle R. Noel-Macdonnell Phd, Neha Chellu, Geetha Haligheri

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: Assessment of myocardial function in fetuses with supraventricular tachyarrhythmia is challenging. Speckle-tracking echocardiography (STE) is a newer sensitive method to assess ventricular systolic function. We sought to assess left (LV) and right (RV) ventricular myocardial strain mechanics in fetuses with tachyarrhythmia and hypothesized that strain mechanics are impaired in this patient population even after conversion to sinus rhythm.

METHODS: This was a single-center retrospective review. LV and RV strain parameters were assessed using STE in tachyarrhythmia and after conversion to sinus rhythm and, compared to gestational age (GA), matched control fetuses in sinus rhythm.

RESULTS: Eighteen fetuses with tachyarrhythmia …

Adenovirus Types In Us Children Hospitalized Or Seen In The Emergency Department With Acute Respiratory Illness, 2016-2019., Tess Stopczynski, Varvara Probst, Adam Gailani, Justin Z. Amarin, Olla Hamdan, Haya Hayek, Laura S. Stewart, Herdi K. Rahman, Rangaraj Selvarangan, Jennifer E. Schuster, Christopher J. Harrison, Mary E. Moffatt, Marian G. Michaels, John V. Williams, Julie A. Boom, Leila C. Sahni, Vasanthi Avadhanula, Mary Allen Staat, Elizabeth P. Schlaudecker, Christina Quigley, Geoffrey A. Weinberg, Peter G. Szilagyi, Janet A. Englund, Eileen J. Klein, Aaron T. Curns, Heidi L. Moline, Ariana P. Toepfer, James D. Chappell, Andrew J. Spieker, Natasha B. Halasa

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Human adenovirus (HAdV) is a common cause of pediatric acute respiratory illness (ARI), contributing to 5-13% of cases worldwide. Clinical manifestations vary by HAdV species and type; therefore, delineating type-specific disease presentations and understanding severity of specific HAdV types' disease may help develop targeted interventions.

METHODS: We conducted a multicenter, prospective study within the New Vaccine Surveillance Network to characterize HAdV types. Children < 18 years old with ARI were enrolled in the emergency department or inpatient setting at 7 US children's hospitals from 1 December 2016 to 30 November 2019. Respiratory specimens were collected and tested for HAdV and other viruses. Subsequently, typing was conducted on HAdV specimens using single-plex real-time PCR assays targeting sequences in the hexon gene. Comparisons between HAdV types were performed to determine differences in characteristics and outcomes. Generalized linear mixed effects models were used to evaluate severity.

RESULTS: Among the 1843 HAdV-positive cases, 1402 specimens (76%) were typed. The most common types detected were HAdV-C1 (n = 439), HAdV-C2 (n = 393), and HAdV-B3 (n = 221). Children with HAdV-B7 (n = 78) …

Elevated Serum Bile Acids Predict Poor Liver Outcomes In Children With Alagille Syndrome: Results From The Gala Study Group., Carla Fiorella Murillo Perez, Shannon M. Vandriel, Emmanuel M. Gonzales, Jian-She Wang, Li-Ting Li, Huiyu She, Irena Jankowska, Piotr Czubkowski, Dorota Gliwicz-Miedzińska, Emmanuel Jacquemin, Jérôme Bouligand, Lorenzo D'Antiga, Emanuele Nicastro, Björn Fischler, Henrik Arnell, Susan M. Siew, Michael Stormon, Kathleen M. Loomes, David A. Piccoli, Elizabeth B. Rand, James E. Squires, Saul J. Karpen, Rene Romero, Mureo Kasahara, Zerrin Önal, Étienne Sokal, Tanguy Demaret, Sabina Wiecek, Florence Lacaille, Dominique Debray, Winita Hardikar, Sahana Shankar, Pamela L. Valentino, Shikha S. Sundaram, Noelle H. Ebel, Jeffrey A. Feinstein, Orith Waisbourd-Zinman, Henry C. Lin, Nathalie Rock, Henkjan J. Verkade, M Kyle Jensen, Catalina Jaramillo, Kyung Mo Kim, Seak Hee Oh, Jernej Brecemiclj, Seema Alam, Giuseppe Indolfi, Niviann Blondet, Rima Fawaz, Silvia Nastasio, Pier Luigi Calvo, Gabriella Nebbia, Cigdem Arikan, Catherine Larson-Nath, Andréanne N. Zizzo, Thomas Damgaard Sandahl, Christos Tzivinikos, Nehal M. El-Koofy, Mohamed A. Elmonem, Amal A. Aqul, Wikrom Karnsakul, Pinar Bulut, Nanda Kerkar, Victorien M. Wolters, Amin J. Roberts, Helen M. Evans, Maria Camila Sanchez, Maria Lorena Cavalieri, Deirdre A. Kelly, Jane Hartley, Way Seah Lee, Christina Hajinicolaou, Chatmanee Lertudomphonwanit, Ryan T. Fischer, Jesus Quintero Bernabeu, Ruben E. Quiros-Tejeira, Cristina Targa Ferreira, Elisa Carvalho, John Eshun, Aglaia Zellos, Antal Dezsőfi, Raquel Borges Pinto, Kathleen Schwarz, Maria Rogalidou, Jennifer Garcia, María Legarda Tamara, Marisa Beretta, Quais Mujawar, Ermelinda Santos-Silva, Cristina Molera Busoms, Eberhard Lurz, Cristina Gonçalves, Carolina Jimenez-Rivera, Jesus M. Banales, Richard J. Thompson, Bettina E. Hansen, Binita M. Kamath, Global Alagille Alliance (Gala) Study Group

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND AIM: Alagille syndrome (ALGS) is a rare disorder characterised by cholestasis and extrahepatic manifestations. Given the current era of ileal bile acid transporter (IBAT) inhibitor therapies that reduce serum bile acid (SBA) levels, we evaluated whether SBA predicts liver disease outcomes in ALGS.

METHODS: Patients were ascertained from the Global ALagille Alliance (GALA) cohort. A prognostic threshold of SBA 102 μmol/L was assessed as a time-dependent covariate in Cox regression analyses for native liver survival (NLS) and event-free survival (EFS), while adjusting for total bilirubin (TB) levels.

RESULTS: 570 GALA patients were included (348 [61%] male). There was …

Halo Gravity Traction And Temporary Internal Distraction, Nicholas D. Fletcher, Anson G. Bautista, Joshua S. Murphy, K Aaron Shaw

Manuscripts, Articles, Book Chapters and Other Papers

Severe pediatric spinal deformities may require staged correction strategies to mitigate neurologic risk and optimize cardiopulmonary outcomes. This paper reviews two adjunctive techniques—halo gravity traction (HGT) and temporary internal distraction (TID)—used in the management of rigid scoliosis. HGT enables gradual preoperative spinal elongation and coronal/sagittal realignment, improving pulmonary function and nutritional status while reducing the need for three-column osteotomies. TID offers an internal, staged distraction approach for patients contraindicated for external traction, allowing incremental correction via posterior instrumentation followed by definitive fusion. Clinical studies report Cobb angle reductions of 30–80 %, with low rates of neurologic complications when neuromonitoring and …

Endoscopic Retrograde Cholangiopancreatography And Primary Sclerosing Cholangitis: A Retrospective Study Of A High-Volume Program, Kristel Leung, Michael Youssef, Yasi Xiao, Catherine Streutker, Aliya Gulamhusein, Bettina Hansen, Natalia Calo, Gary May, Jeffrey Mosko, Gideon Hirschfield

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is valuable in management of primary sclerosing cholangitis (PSC). Herein, we characterize individuals with PSC who underwent ERCP on-demand at a high-volume quaternary centre, with evaluation of pathology results and short-term postprocedural outcomes.

METHODS: This retrospective cohort study evaluated patients with PSC who underwent ERCP at St Michael's Hospital between April 2011 and July 2021. Chart review was conducted to collect clinical, procedural, and pathology data, and reported post-ERCP complications within 90 days. Logistic regression analyses were conducted to evaluate factors associated with post-ERCP complications and placement of a biliary stent.

RESULTS: One hundred and …

Incidence And Management Of Adverse Events Associated With Tebentafusp Treatment In Metastatic Uveal Melanoma: Pooled Safety Analysis Of 410 Patients, Takami Sato, Marcus O. Butler, Sophie Piperno-Neumann, Jessica C. Hassel, Paul Nathan, Alexander N. Shoushtari, Piotr Rutkowski, Richard D. Carvajal, Jean-Francois Baurain, Max Schlaak, Josep M. Piulats, Ryan J. Sullivan, Sebastian Ochsenreither, Reinhard Dummer, John M. Kirkwood, Alexandra Ikeguchi, Anthony M. Joshua, Mark R. Middleton, Ramakrishna Edukulla, Constance Pfeiffer, Joseph J. Sacco

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

PURPOSE: We conducted an integrated safety analysis from three clinical studies of tebentafusp, a first-in-class ImmTAC bispecific T-cell engager, which can redirect T cells to target glycoprotein 100-positive cells, in metastatic uveal melanoma.

EXPERIMENTAL DESIGN: HLA-A*02:01-positive patients with unresectable or metastatic uveal melanoma enrolled in three clinical trials (IMCgp100-01, IMCgp100-102, and IMCgp100-202) who received ≥1 dose of tebentafusp were included. Safety data were pooled to evaluate the profile, onset, and management of treatment-related adverse events (TRAE). Adverse events of special interest included cytokine release syndrome (CRS), acute skin reactions (ASR), and liver function test elevations. Primary prophylaxis with medications was …

Factors Associated With Stillbirth In Four Selected Hospital Maternity Units: An Unmatched Case-Control Study In Eswatini, Phetsile Thwala, Abednego Ongeso, Rose Maina, Benard Mutwiri

School of Nursing & Midwifery, East Africa

Background: Stillbirth is a substantially under-recognized adverse pregnancy outcome that predominantly occurs in low-middle-income countries. In 2019, Eswatini’s stillbirth rate was 13.2 per 1,000 births, higher than global targets. However, there is limited research on stillbirths in Eswatini. This study analyzed factors associated with stillbirths among women giving birth in four selected hospitals.

Methods: A multi-center unmatched case-control study was conducted using secondary data sources from July 1 to December 31, 2021. Birth records of 268 stillbirths (cases) and 1,151 live births (controls) were selected using consecutive and systematic random sampling, respectively. A piloted data extraction tool was used to …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed

Doctoral Projects

Postoperative delirium (POD) is a significant and preventable complication in geriatric patients undergoing non-cardiac surgery. Such complication is associated with foreseeable consequences, such as prolonged hospitalization, long-term cognitive decline, increased morbidity and mortality, and increased costs. Despite the emerging awareness of evidence-based nonpharmacologic and pharmacologic interventional strategies, POD still represents a clinical challenge for anesthesia providers.

Currently, there is a lack of clinical guidelines to guide formalized education and evidence-based interventions on POD prevention across anesthesia practice settings. Consequently, there is a critical need to raise awareness that the lack of clinical guidelines and the high incidence of POD may …

Advancing Anesthesia Provider Proficiency In Airway Assessment Using Point-Of-Care Ultrasound: An Osce-Based Educational Initiative, Austin Fike, Trevor Jordan, Sam Sherrill Iii

Doctoral Projects

Airway management is one of the fundamental pillars of anesthesia. Traditionally, tools such as the Mallampati classification and the thyromental distance are used for airway assessment in the perioperative area. However, often, these methods fail to reliably predict difficult intubations. The use of point-of-care ultrasound (POCUS) has emerged as a valuable adjunct in airway assessment. However, a knowledge deficit exists among anesthesia providers regarding its application in airway assessments for perioperative adult patients. This doctoral project addressed the knowledge deficit in POCUS airway assessment among Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs) through the development and …

Impact Of Intravenous Drug Use On Neck Abscess Outcomes: 30-Day Readmission & 5-Year Survival Rates, Elliott Sina, Bryce Hambach, Eric Mastrolonardo, Sruti Tekumalla, Meghan Crippen, Richard A. Goldman

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: Injection drug use (IDU) is a known risk factor for neck abscesses, often requiring urgent surgical intervention by acute-care Otolaryngologists. However, data on the prevalence and long-term outcomes of IDU-related neck abscesses are limited. This study investigates differences in 30-day readmission rates and 5-year all-cause mortality between patients with and without a history of IDU hospitalized for neck abscesses.

METHODS: This is a retrospective cohort study utilizing the TriNetX national clinical database. Patients hospitalized for neck abscesses (ICD-10: L02.11) were categorized into two cohorts: IDU (current/previous) and non-IDU. Demographics, 30-day readmission rates, and 5-year survival were analyzed. 1:1 Propensity …

Enhancing Crna's Knowledge Of Radiation Safety Through Online Education, Angela Iledan, Madeline Pousson

Doctoral Projects

Although ionizing radiation is frequently used in anesthesia-related procedures, many CRNAs receive minimal training in radiation safety principles and protective measures. This knowledge gap increases the risk of cumulative radiation exposure for providers and patients. To address the issue, this doctoral project developed and implemented an online educational intervention designed to enhance CRNAs’ understanding of radiation safety, ultimately promoting safer practices in radiation-prone environments.

The doctoral project follows a QI and EBP approach that incorporated diverse adult learning styles to enhance engagement and knowledge retention of CRNAs. The online educational module was designed and delivered to CRNAs that currently practice …

Asymptomatic Cryptococcal Antigenemia: A Multi-Clinic Cross-Sectional Study On The Prevalence, Associated Factors And Predictors Of Three-Month Outcomes Among Antiretroviralnaïve And Antiretroviral-Experienced Hiv Patients In Dar Es Salaam, Tanzania, Mandela Makakala, Mukasa Mohammed, Mabula Mabelele, Kamran Hameed, Philip Adebayo

Internal Medicine, East Africa

Background: Cryptococcal meningitis remains a leading cause of HIV/AIDS-related mortality, predominantly in Sub-Saharan Africa. Current screening and prevention efforts primarily target antiretroviral therapy (ART)-naïve patients, whereas strategies for ART-experienced individuals are less well defined.

Objectives: This study primarily aimed at determining the prevalence of asymptomatic cryptococcal antigenemia (ACA) among ART-naïve and ART-experienced patients, along with associated factors and predictors of three-month outcomes among HIV patients in three HIV clinics in Dar es Salaam, Tanzania. Secondarily, factors associated with serum cryptococcal antigen positivity in the overall study population were also assessed.

Methods: This cross-sectional clinic-based study recruited 273 HIV-positive participants (ART-naïve …

A Feasibility Study Of Sexual Organ-Dose Sparing Volumetric Modulated Arc Therapy In Female Low Rectal Cancer Patients Treated With Three-Dimensional Conformal Radiation Therapy, Margaret Downes, Victoria Olsen, Andre Williams, Rendi Sheu, Maria Thor, Lucy Greenwald, Vishruta Dumane, Kristin Hsieh, Ayesha Ali, Orly Morgan, Michael Buckstein, Deborah Marshall

Department of Radiation Oncology Faculty Papers

BACKGROUND: Sexual dysfunction is a significant toxicity of pelvic radiation therapy (RT) for female rectal cancer patients and may be more common with intensity-modulated techniques compared to three-dimensional conformal radiation therapy (3D-CRT). However, limited research has evaluated dose sparing of female sexual organs at risk (OARs), particularly erectile tissues that are critical for sexual function.

PURPOSE: This feasibility study aimed to demonstrate the practicality of contouring and sparing female sexual OARs in rectal cancer RT by generating sexual organ-sparing volumetric modulated arc therapy (SO-VMAT) plans from a small 3D-CRT cohort and comparing dose distributions to guide future planning.

METHODS: Nine …

Living With Dementia In Kenya: Pathways To Care, Diagnosis And Management, Edna Bosire

Institute for Human Development, East Africa

Background: Sub-Saharan Africa (SSA) is experiencing a sharp rise in the size of theolder population; consequently, the incidence and prevalence of Alzheimer’s DiseaseRelated Dementias (AD/ADRD) is also expected to rise. There is limited research onAD/ADRD lived experiences have been conducted in SSA including Kenya. Our projectaimed to explore patient’s and caregivers lived experiences with Alzheimer’s disease inKenya.

Methods: This ethnographic study was conducted at the Aga Khan University hospital(AKUH), involving in-depth interviews with 21 health care providers, 26 patientswith mild cognitive impairment and 36 caregivers. We also conducted 10 homevisits and observations. Data were transcribed verbatim and thematically analysed.In what …

Blood-Based Clinical Markers For Early Dementia Detection: Insights From Ad-Detect-Cohort, Benard Aliwa, Jasmit Shah, Olivera Nesic Taylor,, Samuel Nguku, Juzar Hooker, Dilraj Sokhi, Sylvia Mbugua, Litha Musili, Rachel Maina, Harrison Kaleli, Levi Muyela, Anne Njoki Gitere, Anne Nyambura, Zul Merali, Karen Blackmon, Chinedu Momoh

Brain and Mind Institute

Background: Over 55 million people worldwide live with dementia, with more than60% residing in low- and middle-income countries. Alzheimer’s disease, the mostcommon form of dementia, accounts for 60–70% of cases. Early and accurate diagnosisremains a global challenge, necessitating novel approaches to mitigate the diseaseburden. Biomarkers hold significant promise in improving diagnostic accuracy andpredicting disease progression. Validated biomarkers for the preclinical stages ofdementia are crucial for advancing diagnosis and therapeutic strategies. We aimedto identify potential clinical markers for early dementia detection and assess theirpredictive accuracy in identifying high-risk individuals.

Method: We analyzed blood samples from dementia cases (n = 30) and …

Understanding And Willingness To Participate In Dementia Clinical Trials In Kenya: An Ethnographic Study, Edna Bosire, Lucy Kamau, Chinedu Momoh, Jasmit Shah, Karen Blackmon, Caroline Kiio, Irene Meier, Vaibhav Narayan, Olivera Nesic Taylor,, Zul Merali

Brain and Mind Institute

Background: Advancements in dementia research are in part contingent on participation in clinical research. Clinical trials can help researchers determine if new drugs, devices, or diagnostic procedures for dementia are safe and effective. However, little is known about clinical trials for dementia in resource constrained settings such as Kenya. The aim of our research was to explore people’s understanding of dementia clinical trials, their attitudes and perceptions towards dementia clinical trials and what can be done to enhance enrollments on such clinical trials.

Method: This was an ethnographic study involving 8 focused group discussions (FGDs; age and gender stratified; n=81) …

Disruption Of The Placenta–Brain Axis In Transgenic Mice Lacking Serotonin Transporter (Sert) In Trophoblast Cells, David T. Ellenberger, Zhen Lyu, Rosalind T. B. Herrington, Jessica A. Kinkade, Gustavo W. Leone, Ji Ying Sze, Nathan J. Bivens, R. Frank Baker, R. Michael Roberts, Trupti Joshi, Cheryl S. Rosenfeld

Biomedical Sciences

Serotonin reuptake inhibitors (SSRIs) are commonly prescribed to pregnant women experiencing depression. Such drugs, however, might adversely affect placenta and fetal brain development. Parietal trophoblast giant cells (pTGCs) in the mouse placenta are postulated to internalize maternal serotonin (5-HT) via transport through SERT, encoded by Slc6a4, and to provide the initial source of 5-HT to the emerging brain via the placental–brain axis. Genetic deletion of Slc6a4 in pTGCs has been hypothesized to impact placental and fetal brain development. A transgenic mouse line with high-affinity SERT, encoded by Slc6a4, was selectively deleted by pairing mice with Cre recombinase linked …

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Objective Structured Clinical Examination (Osce) For Interscalene Brachial Plexus Block Utilizing Ultrasound Guidance And Landmark Technique, Madison Mize, Mckayla Moore, Peyton Shell

Doctoral Projects

The purpose of this doctoral project was to create learning and evaluation tools for interscalene brachial plexus blocks (ISBPB) to be used by certified registered nurse anesthetists (CRNAs) and students in the Nurse Anesthesia Program (NAP) at The University of Southern Mississippi (USM). ISBPB is a regional anesthesia technique used to provide anesthesia for procedures of the shoulder and upper arm. CRNAs and students can use these tools to refresh their current knowledge and enhance their regional anesthesia skills.

The objective structured clinical examination (OSCE) and cognitive aid for ISBPB utilizing landmark and ultrasound-guided techniques were evaluated by the USM …

Listening Beyond The Stethoscope, Lia M. Smerina, Priya Darbhanga

be Still

No abstract provided.

What The Stethoscope Can’T Hear: A Book Review Of Every Patient Tells A Story, Faith Abraham

be Still

My love for reading has always shaped the way I see people and stories. Through books, I’ve learned to listen deeply to characters, voices, and emotions. That same curiosity drives how I approach medicine and the humanities. Reading reminds me that every person carries a story worth understanding, and that healing often begins with paying attention.

A Retrospective Analysis Of Relapse Rates And Medication Compliance In Bipolar I And Bipolar Ii Disorders: A Comparative Study, Nasir Mehmood, Qudsia Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective:

Bipolar disorder is a chronic, serious mental health condition characterized by mood episodes, and medication non-compliance is a significant predictor of relapse. The objective of this study was to investigate the relapse rates and medication compliance in patients with bipolar I and II disorders.

Methods:

This retrospective observational study was conducted at Karwan-e-Hayat Institute for Mental Health Care, Karachi, Pakistan. Medical records of 377 patients diagnosed with bipolar I or bipolar II disorder between July 2019 and June 2022 were retrieved from the Hospital Management System (HMS). Diagnosis was confirmed using DSM-IV criteria. Medication compliance was assessed …

Dual-Level Pattern Tree For Visual Field Improves Glaucoma Progression And Polygenic Risk Prediction, Luo Song, Lucy Q. Shen, Louis R. Pasquale, Michael V. Boland, Sarah R. Wellik, Carlos Gustavo De Moraes, Ayellet Segre, Janey L. Wiggs, Constance Turman, Jonathan S. Myers, Tobias Elze, Nazlee Zebardast, David S. Friedman, Jae H. Kang, Mengyu Wang

Wills Eye Hospital Papers

PURPOSE: To develop a dual-level pattern tree to characterize visual field (VF) loss subtypes that can be used to better predict glaucoma progression and glaucoma polygenic risk scores (PRSs).

METHODS: This study included 113,030 patients from three datasets, each used for a specific purpose: (1) model training, (2) progression forecasting, and (3) PRS correlations. We applied archetypal analysis to cluster 24-2 VFs into trunk patterns and their branch patterns. The Cox regression model was used to forecast VF progression using mean deviation (MD) slope, MD-fast slope, total deviation (TD) pointwise slope, and visual field index (VFI) slope. Multivariable regression analyses …

Net Effects Of Correlated Determinants Of Health Among U.S. Older Adults, Haomiao Jia, E I. Lubetkin

Publications and Research

Background

The health effect produced by a contributing factor alone may be different from the effect when other interacting factors are present. The effects of a set of contributors, estimated by regression coefficients, may be invalid or inappropriate if some of the predictors are correlated or the model has interaction and nonlinear terms. The net effect (NE) of a given contributing factor is the effect produced by the factor alone, not by other factors due to their correlations with the factor of interest. This study estimated NE of selected determinants of health for U.S. older adults.

Methods

Participants, aged ≥ …

Monte Carlo Simulations Of Geometric Deformation Of Harrison-Anderson-Mick Applicators Used In Intraoperative Radiation Therapy, Benjamin Insley, Brett Bocian, Sam Beddar, Reza Reiazi, Patrick James Jensen, Rachael M Martin-Paulpeter, Joshua Scott Niedzielski, David Flint, Gabriel Oliveira Sawakuchi, Luis Augusto Perles

Faculty, Staff and Student Publications

Background: The Harrison-Anderson-Mick (HAM) applicator is a high-dose-rate intraoperative radiotherapy (HDR-IORT) applicator used to position Ir-192 brachytherapy sources over surgically-accessed tumor volumes or post-resection tumor beds. Because of the lack of a 3D imaging system, dwell times are optimized pre-surgery by a TG-43-based treatment planning system (TPS) that assumes a perfectly flat applicator surface surrounded by an infinite water phantom. These assumed conditions are disparate from typical treatment conditions, especially in the pelvic regions, which often involve uneven patient surfaces and superficial irradiations with little to no backscatter material.

Purpose: Develop and validate a Monte Carlo (MC) model of HDR-IORT …

The Association Between Gestational Body Mass Index Change, Cesarean Section, And Other Pregnancy Outcomes: Research Protocol: Retrospective Cohort Analysis, Kirsten I. Black, Owen Streeter, Arianne Sweeting, Pejman Adily, Mark Lauer, Adrienne Gordon, Vincenzo Berghella, Belinda R. Bruce, Lauren Ferris, Bradley De Vries

Department of Obstetrics and Gynecology Faculty Papers

Increasingly the value of gestational weight gain (GWG) as a useful measure to predict obstetric outcomes including cesarean section is being questioned. We will undertake a retrospective cohort study of recorded births in 2023 from 24 to 42 weeks' gestation for women aged from 16 to 49 years in the United States. Using multivariable Robust Poisson Regression, maternal body mass index (BMI) and BMI gain will be modelled on the primary outcome of cesarean delivery. The primary analysis will be restricted to nulliparous women if there is interaction between parity and BMI or BMI gain. A sample of 716,392 births …

Trends In Hospital Resource Use For Children With Complex Chronic Conditions., Nathaniel D. Bayer, Matthew Hall, Maria Osipovich, John M. Morrison, Christian D. Pulcini, Jana C. Leary, Joanna E. Thomson, Tamara D. Simon, Dennis Z. Kuo, Jeffrey D. Colvin, Eyal Cohen, Jay G. Berry

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Despite a small prevalence, children with complex chronic conditions (CCCs) use substantial inpatient resources.

OBJECTIVE: To assess national trends in hospital discharges, bed days, and hospital charges for children with and without CCCs in the US from 2000 to 2022.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, repeated cross-sectional study used hospital discharge data from the Kids' Inpatient Database (KID) from the years 2000, 2003, 2006, 2009, 2012, 2016, 2019, and 2022 for US children aged 0 to 18 years, excluding uncomplicated newborn discharges.

EXPOSURE: Presence of 0, 1, 2, or 3 or more CCCs.

MAIN OUTCOMES AND MEASURES: Trends …

Definition Of The 3d Position And Motion Status Of The Moving Heart Based On 2d Projections, Lawrence D. Orijuela

Electronic Theses, Projects, and Dissertations

This thesis presents a novel application of deep learning to the estimation of pulmonary vein coordinates using X-ray image pairs from a FORBILD Thorax phantom derived motion dataset. A Siamese neural network was developed to predict the 3D coordinates of one pulmonary vein at a time, specifically the Right Superior Pulmonary Vein (RSPV), Left Superior Pulmonary Vein (LSPV), Left Inferior Pulmonary Vein (LIPV), or Right Inferior Pulmonary Vein (RIPV), based on two-dimensional projection images.

The input data consisted of over 1.6 million grayscale X-ray image pairs across 1331 virtual patients, each annotated with ground truth 3D coordinates. To manage memory …