Digital Commons Network^™

Leappt: Leveraging Generative Artificial Intelligence-Pediatric Pulmonology Training. Curriculum And Content Development., Alvin Singh, Erin Khan, Mary Moffatt

Manuscripts, Articles, Book Chapters and Other Papers

After redesigning the curriculum of the pediatric pulmonology fellowship program at Children's Mercy-Kansas City, leadership continued to make changes based on feedback from a faculty survey concerned about the quality and structure of didactics. These changes included leveraging generative artificial intelligence to create a detailed course content outline containing specific objectives and study points for each subject related to pediatric pulmonology. Using the content outline as a foundational reference for learners, fellowship leadership continues to enhance the curriculum by creating testing questions, flipped classroom sessions and evaluations, and hope that these specific changes will help address decreased passing rates on …

Airway Management In Thoracic Anesthesia: Eactaic Consensus Document, Manuel Granell, Caroline Vanpeteghem, Jo Mourisse, Mert Senturk, Laszlo Szegedi, Mohamed El Tahan, Chirojit Mukherjee, Izumi Kawagoe, Waheed Karzai, Marcus Lance

Anaesthesiology, East Africa

This article is the third in a series of articles prepared as part of a comprehensive, international and professional society–approved consensus project to advise on thoracic anesthesia. It represents the views and structured opinions of experts delegated to the Airway Management Task Force of the Thoracic Subcommittee of the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC). This review highlights the main concepts and expert opinion of international leaders on the task of lung isolation and separation, as well as the current recommendations on the benefits and disadvantages of different devices in both routine and difficult airway scenarios. The …

Monitoring In Thoracic Anesthesia: Eactaic Consensus Document, Mohamed El Tahan, Edda Tschernko, Tamás Végh, Jo Mourisse, Mert Sentürk, Katarina Lenartova, Maria Alberici, Thomas Wasserscheid, Nandor Marczin, Marcus Lance

Anaesthesiology, East Africa

This is the first part of a series of articles prepared for a comprehensive, international, and professional society–approved consensus project to advise on thoracic anesthesia. It represents the views and structured opinions of experts delegated to the General Management: Monitoring Task Force of the Thoracic Subcommittee of the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC). This review highlights international leaders’ main concepts and expert opinions on how monitoring is the core task of anesthesiologists involved in the care of thoracic patients, providing recommendations for assessing principal organ systems and using different devices in routine and specialized scenarios. The …

The Role Of Top-Down Appetite Self-Regulation In The Development Of Healthy Eating Behaviors Among Children: A Narrative Review And Socialization Framework, David J Bridgett, Sheryl O Hughes, Matthew Broussard, Daniela Mccourt, Christina M Croce, Jennifer O Fisher

Children’s Nutrition Research Center Staff Publications

Appetite self-regulation (ASR) among children is thought to have a fundamental role in shaping the development of healthy eating behaviors, dietary intake, and growth during childhood. Parallel to developmental frameworks for understanding "general" self-regulation among children, ASR has been described as involving children's use of "top-down" cognitive processes to moderate "bottom-up" biological drives around food approach and avoidance in the interest of achieving desired eating behaviors or outcomes. Whereas bottom-up ASR processes during early childhood are well characterized, particularly in the context of dysregulation and obesity risk, the role of top-down ASR processes in the development of healthy eating behaviors …

Pre- And Postnatal Exposure To Pm2.5 And No2 And Blood Pressure In Children: Results From The Echo Cohort, Yu Ni, Andrew Law, Xingyu Gao, Adam A Szpiro, Christine T Loftus, Miranda Jones, Logan C Dearborn, Marnie F Hazlehurst, Allison R Sherris, Sindana Ilango, Kaja Z Lewinn, Nicole R Bush, Qi Zhao, Leonardo Trasande, Joseph T Flynn, Daniel A Enquobahrie, Ruby H N Nguyen, Tom O'Connor, Arpita K Vyas, Mingyu Zhang, Hooman Mirzakhani, Alison Hipwell, Anne Starling, Alicia K Peterson, Akhgar Ghassabian, Assiamira Ferrara, Judy Aschner, Scott Collingwood, Margaret R Karagas, Michelle Katzow, Annemarie Stroustrup, Mehtap Haktnair, Tina V Hartert, Brittney M Snyder, Sophia Jan, Anne Marie Singh, Dana Dabelea, Angela M Malek, Jennifer K Straughen, Carlos A Camargo, Miatta A Buxton, Rosalind Wright, Kecia Carroll, Keia Sanderson, Daphne Koinis Mitchell, Viren D'Sa, Christine Hockett, Anne L Dunlop, Shohreh F Farzen, Sunni L Mumford, Akram N Alshawabkeh, Hudson P Santos, Xueying Zhang, Zhongzheng Niu, Nan Ji, Carrie Breton, Donghai Liang, Catherine J Karr, Echo Cohort Consortium

Children’s Nutrition Research Center Staff Publications

Background: There is growing interest in understanding the link between early life exposures to ambient air pollution and childhood blood pressure; however, existing findings, largely from single site/cohort studies, are inconclusive.

Methods: We examined the association between exposures to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) and blood pressure measured at age 5-12 years in 4863 U.S. children from 20 pregnancy cohorts of the NIH ECHO cohort. Point-based residential exposures were derived from spatiotemporal models with a biweekly resolution and averaged over each trimester, the whole pregnancy, and child age 0-2 years. We converted systolic (SBP) and diastolic blood …

Effect Of Dental Treatments On Reduction Of Preterm Birth: A Systematic Review And Meta-Analysis, Camille Thomas, Shakil Ahmed, Vincenzo Berghella, Romina Brignardello-Petersen, Mohamed El-Rabbany, Catherine Devion, Stefania Ronzoni

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: Periodontal disease is associated with increased risk of preterm birth. Effective management during pregnancy may reduce preterm birth, though clinical trial evidence has been inconsistent. This study aimed to assess whether treating dental disease during pregnancy reduces preterm birth.

DATA SOURCES: A systematic search was performed of EMBASE, MEDLINE, PubMed, Cochrane Library, and trial registries up to December 2023 and re-run in January 2025.

STUDY ELIGIBILITY CRITERIA: Randomized controlled trials (RCTs) enrolling pregnant persons with any dental disease randomized to receive dental treatment vs no treatment were included. No language restriction was applied.

STUDY APPRAISAL AND SYNTHESIS METHODS: Data …

Exploring Adolescent Hearing Aid Usage And Appearance Of Psychiatric Symptoms In Adolescents Using Hearql-28 Surveys, Courtney J. Austin, Dylan Chan

MEDI 9331 Scholarly Activities Clinical Years

Approximately 2% of DHH people in need of mental health services actually receive these services. Among pediatric hearing loss populations, co-occurring cognitive and physical impairments are risk factors for poor mental health status. Due to language barriers and isolation, more children with hearing loss do not have access to mental health services. Cochlear implants have been shown to improve mental health status among the DHH population. Current literature focuses on the mental health status of children with cochlear implants, with little focus on hearing aid users. Using HEAR28 data and surveys, we can quantify the incidence of psychiatric symptoms among …

Screening Ptsd In Clinical Populations Within East Africa: Results From The First Follow-Up Study Of Neurogap-Psychosis, Shaili Jha, Rocky Stroud, Ana Lucia Dice, Joseph Kyebuzibwa, Stella Gichuru, Fredrick Ochieng, Manasi Sharma, Hayden Mountcastle, Lydia Marshall, Lukoye Atwoli

Brain and Mind Institute

Background: Given the high burden of trauma in Sub-Saharan Africa, there is a critical need for scalable tools to screen for trauma and posttraumatic stress disorder (PTSD) symptoms, especially in low-resource settings.

Objective: This study aimed to evaluate the utility, reliability, and validity of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) administered over the telephone to individuals previously enrolled in the Neuropsychiatric Genetics of African Populations-Psychosis study (NeuroGAP-Psychosis) study in Uganda (N = 4,921) and Kenya (N = 3,149).

Method: Cases with psychosis and controls without psychosis (patients, caretakers, or employees) were recontacted from the NeuroGAP-Psychosis …

N Y State Dent J March 2026

The New York State Dental Journal

In the March 2026 issue, the reader will find the following feature articles:

• Pebbly Gingival Nodule in an Older Male
• Extraction of Teeth or Root Tips from Underneath Fixed Partial Denture Abutments or Pontics
• Successful Regenerative Endodontic Therapy of an Immature Dens Evaginatus Mandibular Second Premolar with Apical Periodontitis

This issue includes regular columns with regional news impacting the New York membership including editorial and perspectives columns, legal, association activities, component news, continuing education opportunities, and classifieds.

Morphea With Seronegative Inflammatory Arthritis And Normal Acute Phase Reactants: A Case Report, Balakrishnan Navaneethakrishnan, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Localised scleroderma, also known as morphea, is an immune-mediated fibrosing disorder that primarily affects the skin and subcutaneous tissues. While traditionally considered purely a cutaneous disease, extracutaneous manifestations (especially inflammatory arthritis) are increasingly being appreciated. The combined presence of morphea and inflammatory arthritis is rare and can be difficult to diagnose, particularly when inflammatory markers and serological testing are non-contributory.

Case Summary : We describe a 41-year-old woman with long-standing biopsy-proven morphea who over 2 years developed chronic, asymmetric inflammatory arthritis of the left wrist and hand small joints. On examination, she had active synovitis with restricted movements of her …

Pseudo-Hallucinations: A Diagnostic Conundrum, Dr Sankram Nayak, Manju Aswath, Vathsalya S. Gowda

Digital Journal of Clinical Medicine

Background:

Pseudohallucinations are vivid, hallucination-like experiences that are internal, recognized as unreal. Distinguishing from true hallucinations remains a diagnostic challenge.

Case-report

33-year-old female with family history of psychosis presented with 10-year duration of delusion of infidelity and auditory experiences, with normal Biopsychosocial functioning. She had multiple psychiatric consultations, diagnosed as paranoid schizophrenia, treated with  various antipsychotics, ECT, current prescription of clozapine(350mg) with clozapine induced seizure.  Reported that her husband was emotionally unavailable. She described the voices in her head which were non-threatening, praising her for having qualities of an ideal-wife.  They were constant companions giving her solace and hence refrained …

Severe Bilateral Retinal Degeneration Following A Twenty-Six-Year Pentosan Polysulfate Sodium Exposure: A Case Report., Aaron T. Zhao, Turner D. Wibbelsman, Martin Calotti, Collin J Richards, Tamara R. Vrabec

Wills Eye Hospital Papers

PURPOSE: To describe an advanced case of pentosan polysulfate sodium (PPS)-associated retinopathy with extensive macular and peripheral retinal involvement following prolonged high-dose exposure.

OBSERVATIONS: An 86-year-old male presented with bilateral hand motion visual acuity and a 26-year history of PPS use (400mg daily, ∼3769g cumulative dose) for treatment of interstitial cystitis. Fundus examination revealed widespread retinal degeneration characterized by confluent nummular patches of retinal atrophy in a radial distribution from the optic nerves. Ocular coherence tomography (OCT) demonstrated severe outer retinal disorganization, and fundus autofluorescence (FAF) showed extensive RPE loss and absence of the Robson Holder ring. Genetic testing excluded …

Undergraduate Health And Wellbeing Course And Study Away Program To Alaska, Lorraine S. Wallace, Steven J. Mousetes, Jennifer Bickley

Journal of Global Education and Research

High-impact practices, such as diversity/global education, have been shown to positively contribute to student development, engagement, and success. As the US is both culturally and linguistically diverse, domestic study away programs can offer students impactful multicultural educational experiences without leaving the country. The purpose of this study was to describe the design of a health and well-being academic course and accompanying study away program to Alaska for undergraduates at The Ohio State University (OSU). The authors (1) describe the application of the backward design process in guiding ELOs development, (2) provide a sample of course assignments and student responses, and …

An Adp Getaway Service, Not An Atp Tank: Insights Into The Phosphagen System In Neurons, Madeline P Marques, Kartik Venkatachalam

Faculty, Staff and Student Publications

No abstract provided.

Foot And Ankle Biomaterials: A Comprehensive Review Of Current Applications, Challenges, And Future Directions, Peter Elvin, Amayrani Sanchez, Anthony Allen Reyes, Hagner L. Andrade, Meelad Karami, Hooman Mir, Javier La Fontaine, Danieli Rodrigues, Claudia Biguetti

School of Podiatric Medicine Publications

Metallic biomaterials enable successful reconstruction and fixation of skeletal tissues by supporting repair, load-bearing function, and anatomical alignment in foot and ankle surgery. However, the unique anatomic and biomechanical demands of this region, combined with challenging pathologies such as flatfoot and Charcot neuroarthropathy, present distinct challenges, with effective intervention requiring targeted biomaterial solutions and precise indications. Furthermore, metallic biomaterials currently represent the most predominant and clinically validated fixation systems in foot and ankle surgical reconstructions, while also generating the largest body of outcome-based evidence. This review summarizes and discusses their contemporary applications, outcomes, limitations, unmeet needs, and future directions based …

Neutrophil-To-Lymphocyte Ratio As A Prognostic Factor Of Survival Outcomes In Head And Neck Squamous Cell Carcinoma Receiving Neoadjuvant Immunotherapy, Pablo Llerena, Praneet C. Kaki, Kathryn Nunes, Eric Mastrolonardo, Kelly Bridgham, Annie Moroco, Hani Samarah, Mouadh Barbirou, David Baek, Chun Wang, Voichita Bar-Ad, David Cognetti, Joseph Curry, Jennifer M. Johnson, Hushan Yang, Larry A. Harshyne, Adam J. Luginbuhl

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

PURPOSE: The neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker in cancers treated with immune checkpoint inhibitors (ICI), reflecting the link between inflammation and cancer immune response. This study examines NLR's prognostic value in head and neck squamous cell carcinoma (HNSCC) patients receiving neoadjuvant ICI therapy, focusing on its potential as an independent predictor of overall survival (OS) and disease-free survival (DFS).

METHODS: We conducted a retrospective cohort study including three neoadjuvant trials: durvalumab ± metformin, nivolumab ± tadalafil, or nivolumab ± BMS-986205 from 2017 to 2022. Pre-treatment NLR was calculated using absolute neutrophil and absolute lymphocyte counts obtained before neoadjuvant …

Testing And Evaluation Of Generative Large Language Models In Electronic Health Record Applications: A Systematic Review, Ya-Wen Chuang, Yiming Li, Richard Yang, Wenyu Zhang, Xinyi Wang, Xinyu Chen, Hao Guan, John Lian, Pengyu Hong, David W Bates, Li Zhou

Faculty, Staff and Students Publications

           Background: The use of generative large language models (LLMs) with electronic health record (EHR) data is rapidly expanding to support clinical and research tasks. This systematic review characterizes the clinical fields and use cases that have been studied and evaluated to date.

Methods: We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to conduct a systematic review of articles from PubMed and Web of Science published between January 1, 2023, and November 9, 2024. Studies were included if they used generative LLMs to analyze real-world EHR data and reported quantitative performance evaluations. Through data extraction, we identified …

Relationship Between Heart Rate Variability And Sleep Among Girls And Boys With Abdominal Pain-Related Disorders Of Gut-Brain Interaction, Emily Simonds, Tasha Murphy, Margaret M Heitkemper, Rona L Levy, Robert J Shulman, Miranda A L Van Tilburg

Faculty, Staff and Students Publications

Background: Children with abdominal pain-related disorders of gut-brain interaction (AP-DGBI) often experience sleep disturbances which may be linked to the autonomic nervous system. Heart rate variability (HRV) is a non-invasive measure of autonomic nervous system activity. Our aim was to examine if HRV was associated with characteristics of disturbed sleep in children with AP-DGBI in order to elucidate the underlying physiological mechanisms of disturbed sleep.

Methods: This analysis used baseline data from a randomized control trial of 156 children ages 7-12 years with AP-DGBI. HRV was measured after dinner using a Polar monitor. Sleep disturbances were evaluated using the Children's …

Biomimetic And Bioinspired Materials: Design Strategies, Mechanical Properties, And Engineering Applications-A Review, Vijaya Prakash Balasubramanian, Manivannan Jayamani, Subramanian Lakshmi Sankar, Karthikayan Sundararajan, Gokulkumar Sivanantham, Syed Kashif Ali, Murugesan Palaniappan, Mezigebu Belay, Mohamed Abbas

Faculty, Staff and Students Publications

The field of biomimetic and bioinspired materials has progressed rapidly by drawing inspiration from nature's intricate structures and multifunctional systems in order to address pressing challenges in modern engineering. This review critically examines the mechanical performance of these materials, focusing on their hierarchical design principles, synthesis strategies, and versatility of application. Natural exemplars such as nacre, spider silk, and bone are emphasized, as their structural efficiency and functional adaptability have informed the development of synthetic analogues with superior strength, toughness, flexibility, and lightweight characteristics. The review also highlights advanced fabrication methods, such as additive manufacturing and precision chemical synthesis, which …

Mri Suspicious Lesions In Patients Under Active Surveillance Do Systematic Biopsies Still Add Value?, Natasha Oppenheim, Ron Marom, Yotam Veredgorn, Haim Herzberg, Snir Dekalo, Gal Keren-Paz, Roy Mano, Ofer Yossepowitch

Faculty, Staff and Students Publications

Introduction: Active surveillance (AS) requires regular monitoring to detect disease progression. Multiparametric magnetic resonance imaging (mpMRI) and targeted biopsies are commonly used to identify clinically significant prostate cancer (csPC) in AS patients, yet their diagnostic value remains unclear among this population.

Methods: We conducted a retrospective study of patients who underwent mpMRI followed by combined prostate biopsies between 2017 and 2022. Patients were categorized into AS and non-AS groups. We compared the diagnostic yield of mpMRI suspicious Prostate Imaging-Reporting & Data System (PI-RADS) 3-5 lesions using comparisons of PI-RADS score distribution and detection rates of csPC from targeted biopsies between …

Simulation-Free Spine Palliative Radiotherapy Enabled By Ai-Adapted Diagnostic Ct, Vincent Ugarte, Boran Zhou, Abdallah S R Mohamed, Piyush Pathak, Daniel Allen Hamstra, Baozhou Sun

Faculty, Staff and Students Publications

Background: Radiotherapy planning traditionally requires a dedicated simulation CT (sCT), which can introduce delays in initiating treatment. This is particularly impactful in spinal palliative care, where timely treatment is often important for symptom control and prevention of neurological deterioration. Although diagnostic CT (dCT) is frequently available earlier in the workflow, it can lead to geometric and dosimetric inaccuracies when used directly for treatment planning due to discrepancies in patient positioning, vertebral alignment, and table curvature.

Purpose: To develop and evaluate an AI-based method that transforms dCT into a simulation-equivalent planning CT (AI-pCT), enabling a clinically feasible simulation-free workflow for spinal …

Cardiac Catheterization In American Indian/Alaska Native Populations: Empowering Communities, Providers, And Systems Toward Equity, Lindsay F Eilers, Athar M Qureshi, Christine J Chung, Jason F Deen

Faculty, Staff and Students Publications

American Indian/Alaska Native (AI/AN) people face numerous health disparities, including alarming rates of cardiovascular morbidity and mortality. These inequities are closely tied to unique social, political, and economic circumstances due to the ongoing consequences of systemic racism. Although poorly described, these cardiovascular inequities extend to adult and pediatric interventional cardiology. AI/AN adults are less likely to undergo cardiac catheterization and are more likely to experience complications. There are no published studies on pediatric interventional cardiology outcomes in AI/AN children. The scarcity of available data underscores the need for novel studies to investigate the epidemiology, sociodemographic associations, and outcomes of AI/AN …

Predictive Validity Of The Obsessive-Compulsive Inventory-4 And Florida Obsessive-Compulsive Inventory-Ii Severity Scale, Mahnoor Ahmad, Vanessa Zavala Cruz, Dayan Berrones, Josselyn S Muñoz, Diana Obando, Servando Rodriguez Barajas, Renee M Frederick, Jacey L Anderberg, Hannah C Moore, Marcos E Ochoa-Panaifo, Mayra C Martinez Mallen, Ogechi C Onyeka, Andrew D Wiese, Melisa N Sagarnaga, Joseph F Mcguire, Ygor Arzeno Ferrão, Latin American Trans-Ancestry Initiative For Ocd Genomics (Latino), Wayne K Goodman, James J Crowley, Brazilian Obsessive-Compulsive Spectrum Disorder Working Group (Gttoc)

Faculty, Staff and Students Publications

Efficient and accurate screening tools are crucial for improving early identification and treatment outcomes among individuals with obsessive-compulsive disorder (OCD). This study evaluated the sensitivity and specificity of two OCD screening measures: the Obsessive-Compulsive Inventory-4 (OCI-4) and the Florida Obsessive-Compulsive Inventory-II (FOCI-II) severity scale. The measures were administered in a large transnational sample of Spanish speaking Latin American adults (N = 1696) with elevated obsessive-compulsive symptomatology. Participants completed diagnostic interviews (MINI and Y-BOCS) and self-report assessments across 23 sites in 11 countries. Both measures significantly distinguished OCD from non-OCD cases, with the FOCI-II demonstrating somewhat better predictive performance (AUC = …

Incidence Of Cancers Among Children Living With Hiv In Malawi After Widespread Availability Of Antiretroviral Therapy: A Population-Based Study, Jimmy Villiera, Mark Zobeck, Joseph Mhango, Allison Silverstein, Samuel Maloya, Apatsa Matatiyo, Eluness Simwela, Honour Mhango, Desire Hellings, Brigid O'Brien, Claudia Wallrauch, Tom Heller, Matthew Painschab, Kate Westmoreland, Atupele Mpasa, Rizine Mzikamanda, Nmazuo Ozuah, Joseph Lubega, Nader Kim El-Mallawany, Carl E Allen, Michael E Scheurer

Faculty, Staff and Students Publications

Purpose: Few data describe the modern epidemiology of pediatric HIV-associated cancers in sub-Saharan Africa, home to over 80% of the world's children living with HIV. This study evaluated the incidence of cancers among these children over 15 years after widespread antiretroviral therapy (ART) adoption in Malawi.

Methods: We conducted a retrospective population-based cohort study leveraging multiple independent data sources comprehensive of all cancer diagnoses among children living with HIV in Northern and Central Malawi between 2010 and 2024. HIV-associated cancers were defined as those cancers with well-established epidemiologic associations with HIV. Cumulative incidence and average annual percent change were estimated …

Communicating Across Languages: Experiences Of Spanish-Speaking People With Dementia And Care Partners In The Emergency Department, Annika R Bhananker, Edgar Ordoñez, Michelle I Suh, Manish N Shah

Faculty, Staff and Students Publications

No abstract provided.

Predicting Mortality And Costs After Emergency Department Visits By People With Dementia: Timing And Location Matter, Kyler M Godwin, James A Tulsky, Joan M Teno

Faculty, Staff and Students Publications

Background: People with dementia have high rates of emergency department (ED) and hospital utilization, high mortality and costs, and other poor outcomes. To successfully impact the care trajectories of these patients, health care systems must pragmatically identify the correct target population. This study described patterns of ED utilization by people with dementia and explored the accuracy of administrative data models to predict mortality and costs.

Methods: Retrospective cohort study of a 20% random sample of Traditional Medicare (TM) beneficiaries with dementia, age ≥ 66 years, and an index ED visit in 2018. One-year mortality and high costs were described, and …

Testing And Evaluation Of Generative Large Language Models In Electronic Health Record Applications: A Systematic Review, Ya-Wen Chuang, Yiming Li, Richard Yang, Wenyu Zhang, Xinyi Wang, Xinyu Chen, Hao Guan, John Lian, Pengyu Hong, David W Bates, Li Zhou

Faculty, Staff and Students Publications

Background: The use of generative large language models (LLMs) with electronic health record (EHR) data is rapidly expanding to support clinical and research tasks. This systematic review characterizes the clinical fields and use cases that have been studied and evaluated to date.

Methods: We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to conduct a systematic review of articles from PubMed and Web of Science published between January 1, 2023, and November 9, 2024. Studies were included if they used generative LLMs to analyze real-world EHR data and reported quantitative performance evaluations. Through data extraction, we identified …

Defining The Society Of Pediatric Liver Transplantation (Split) Research Agenda: A Delphi Consensus Project, Katryn N Furuya, Kayla Hartjes, Chaowapong Jarasvaraparn, Beau Kelly, Stacee M Lerret, Krupa Mysore, Arti Pawaria, Philip Rosenthal, Amy Shui, Voytek Slowik, Sarah Taylor, Jennifer Vittorio, Pamela L Valentino

Faculty, Staff and Students Publications

Background: Despite major advances in surgical and medical management, only one-third of pediatric liver transplant (LT) recipients remain morbidity-free at 10 years. The Society of Pediatric Liver Transplantation (SPLIT) published a research agenda over 10 years ago, and much progress has been made since then. An updated consensus-driven SPLIT research agenda could guide future research and funding priorities. We aimed to identify and prioritize key research needs across the continuum of pediatric LT care using a modified Delphi consensus approach.

Methods: We conducted a three-round modified Delphi process among SPLIT members. In round 1, participants submitted open-ended research priorities. In …

Validation And Longitudinal Trajectory Analysis Of An Ai-Based Ecg Model For Aortic Stenosis: From Community Screening To Pre-Ta\Vr Risk Stratification, Stephanie Coulter, Jasen Gilge, Naveed Razvi, Mohammad Saeed, Robert D Paisley, Ambarish Pandey, Mehdi Razavi

Faculty, Staff and Students Publications

Aims: Early aortic stenosis (AS) detection remains challenging, with many patients presenting late when left ventricular dysfunction may be irreversible. We evaluated whether longitudinal AI-enhanced ECG patterns can predict outcomes years before intervention and assessed the community screening potential of the AK-AVS model.

Methods and results: We conducted two complementary analyses: (1) community validation of the AK-AVS model in 3632 cardiovascular disease-free ARIC participants, and (2) longitudinal trajectory analysis of 7860 ECGs from 2040 TAVR recipients collected up to 10 years pre-procedure. Unsupervised clustering identified distinct AK-AVS trajectories, with mortality associations assessed using Cox regression and net reclassification improvement. In …

Development Of Retrieval-Augmented Generation-Based Large Language Model For Drug-Induced Liver Injury Using Livertox Data, Gagan Sood, Terrence E White, Fasiha Kanwal, Hashem B El-Serag

Faculty, Staff and Students Publications

Background: Idiosyncratic DILI is a complex clinical challenge requiring timely and accurate decision support. LiverTox, curated by the National Institute of Health (NIH), offers a comprehensive DILI evidence base, but its encyclopedia-like format hinders point-of-care use. Health care providers increasingly use general large language models (LLMs) for clinical care, raising safety concerns due to LLM hallucinations or misinformation. We hypothesize that retrieval-augmented generation (RAG) integration-grounding LLM responses in LiverTox content-would enable accurate DILI decision support.

Methods: We processed 1343 LiverTox drug monographs into 8759 indexed segments using BioBERT embeddings. We developed a RAG pipeline that employs drug-specific prioritization, section-aware weighting, …