Digital Commons Network^™

Sarcomatoid Carcinoma Arising In The Gallbladder Of A 58-Year-Old Female: Case Report, Ahmed A Ahmed, Yan Gao, Rossana Kazemimood

Faculty, Staff and Student Publications

Sarcomatoid carcinoma of the gallbladder is a rare malignancy with no specific clinical manifestation. It is characterized by the presence of malignant epithelial and mesenchymal components intermingled with each other. This disease usually presents at an advanced stage, and its final diagnosis needs to be confirmed by histopathological and immunohistochemical examination. Sarcomatoid carcinoma is characterized by early metastasis through lymphatics, rapid progression, a high recurrence rate, and a worse prognosis than usual gallbladder adenocarcinoma. Herein, we report the case of a 58-year-old female patient, who underwent laparoscopic cholecystectomy, with sarcomatoid carcinoma of the gallbladder. Histologically, the epithelial component of the …

Normative Laboratory Value Ranges In Pediatric Patients Who Underwent Evaluation For Mis-C, Thomas Graf, Nathan M Money, Sindhoosha Malay, Nori Minich, Risa Bochner, Bari Winik, Ron Kaplan, Jennifer Y Colgan, Erin Aldag, Ryan O' Sullivan, Guliz Erdem, Allayne Stephans

Faculty, Staff and Student Publications

Background and objectives: Diagnosis of multisystem inflammatory syndrome in children (MIS-C) is challenging due to symptom overlap with other common conditions. The primary objective of this multicenter study was to establish normative laboratory values in MIS-C patients and compare to patients evaluated for MIS-C who had other final diagnoses.

Methods: Five hospitals reviewed records of a cohort of patients 6 months to 18 years old who were evaluated for MIS-C between March 31st 2020 and February 1st 2022. Patient demographics, clinical presentation, and laboratory values were compared in patients with a final diagnosis of MIS-C versus all other conditions. Patients' …

Association Of Cardiovascular Disease With Dementia: A Longitudinal Analysis Using National Alzheimer’S Coordinating Center Data, Diana Summanwar, Hyena Kim, Jingkai Wei, Malaz Boustani, Alvaro Alonso, Ambar Kulshreshtha

Faculty, Staff and Student Publications

We analyzed how cardiovascular disease subtypes influence the prevalence and incidence of dementia among 30,582 individuals aged 50 and older in the National Alzheimer's Coordinating Center cohort. We calculated prevalence ratios (aPR) and hazard ratios (aHR), using models adjusted for age, sex, race, years of education, hypertension, diabetes, and dyslipidemia. Stroke (aPR: 1.26; 95% CI: 1.20-1.32) and history of arrhythmias (aPR: 1.17; 95% CI: 1.09-1.24) were associated with higher dementia prevalence. In survival analysis, stroke was associated with a 55% increased risk of incident dementia (aHR: 1.55; 95% CI: 1.36-1.77).

Daily Movement Activities Are Associated With Within-Person Instability Of Cognitive Function In Older Adults: Evidence From An Ambulatory Assessment Study, Chih-Hsiang Yang, Donald Hedeker, Jongwon Lee, Halle Prine, Donna Coffman, Jingkai Wei, Jonathan George Hakun

Faculty, Staff and Student Publications

Background and objectives: Physical inactivity and excessive sedentary time (ST) are associated with poor cognitive health in older adults. However, current literature largely relies on cross-sectional designs or in-lab cognitive assessments, which do not adequately reflect cognitive function in naturalistic settings. Further, existing studies have largely overlooked the variability or the instability in daily cognitive function, which represents a critical marker of cognitive decline. This ambulatory assessment study examined the temporal associations of daily movement behaviors with the mean levels and the variability of cognition among older adults at risk of dementia.

Research design and methods: 96 older adults from …

Polygenic Scores Contribution To Parkinson’S Disease Comorbidities, Carlos F Hernández, Camilo Villaman, Cristian Tejos, Gabriela M Repetto, Costin Leu, Dennis Lal, Ignacio F Mata, Andrés D Klein, Eduardo Pérez-Palma

Faculty, Staff and Student Publications

Comorbidities are common in Parkinson’s disease and significantly impact the disease progression and management. While polygenic scores have been widely used to assess genetic risk for complex diseases, their role in comorbidity presentation in Parkinson’s disease remains unclear. This study investigates whether genetic predisposition to comorbidities, as measured by polygenic scores, differs between individuals with Parkinson’s disease and the general population and explores how genetic risk influences disease onset and sex-related differences. We analysed data from 4144 individuals with Parkinson’s disease and 370 480 individuals from the general population in the UK Biobank, focusing on four comorbidities with high-quality genome-wide …

What Time Is It? It Is 8 And 1/2 Time: A Rare Case Of Ischemic Stroke Consistent With Eight-And-A-Half Syndrome, Jessica Daza, Marcelo Bedoya-Sommerkamp, Eunbee Cho, Celia Daza, Francisco Gomez, Fatimah Bello, Jia Lin

Faculty, Staff and Student Publications

Eight-and-a-half syndrome is a rare neuro-ophthalmic syndrome characterized by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia, and ipsilateral facial nerve palsy. It results from a lesion affecting the paramedian pontine reticular formation, the medial longitudinal fasciculus, and the abducens nucleus of the same side, at the level of the lower pons. We present a case of a 49-year-old man with 2-week diplopia and 3-day right-sided facial droop, drooling, and dysarthria. CT angiography of the head and neck revealed atherosclerotic disease, with decreased caliber of the basilar artery at the level of the pons. Brain MRI showed a subacute ischemic lesion …

Middle Meningeal Artery Embolization Does Not Confer Protection Against Symptomatic Recurrence In Patients With Early Antithrombotic Therapy Following Surgery For Chronic Subdural Hematomas, Hussein A Zeineddine, Bryden H Dawes, William W Wroe, Bronson Ciavarra, Salvatore A D'Amato, Hyun Woo Kim, Nimer Adeeb, Gabriel Galan Castro, Michael I Nahhas, Peng Roc Chen, Spiros L Blackburn, Sunil A Sheth, Ching-Jen Chen, Ryan S Kitagawa, Mark J Dannenbaum, Juan Carlos Martinez-Gutierrez

Faculty, Staff and Student Publications

Objective: Middle meningeal artery embolization (MMAE) has emerged as a promising treatment, both as an adjunct to surgery and as a primary treatment for chronic subdural hematoma (cSDH). Here, we evaluate the efficacy of MMAE following surgery in reducing the likelihood of reoperation in patients requiring early introduction of antithrombotics.

Methods: From our prospectively collected registry of patients with cSDH, we identified patients treated with surgical evacuation, either in combination with or without MMAE. Patients were included if they had a clinical indication requiring early antithrombotics within 7 days of surgery. The primary outcome was the rate of reoperation. The …

Long-Term Dynamic Profiles Of Cognitive Kinases Induced By Different Learning Protocols, Yili Zhang, Rong-Yu Liu, Paul Smolen, John H Byrne

Faculty, Staff and Student Publications

Learning is associated with activation of multiple protein kinases, but few details are known about the activation dynamics in response to different learning protocols. We addressed this issue by examining the long-term dynamics of kinases critical for long term synaptic facilitation (LTF) of the Aplysia sensorimotor synapse. Three serotonin (5-HT) protocols have been found to induce LTF with distinct effectiveness: the five-pulse regular-spaced Standard protocol; the five-pulse irregular-spaced Enhanced protocol; and the two-pulse protocol with an interval of 45 min. We previously compared long-term dynamics of the mitogen-activated protein kinase (MAPK) isoform ERK after these protocols. Here we examined the …

Quantitatively Assessing The Impact Of The Quality Of Snomed Ct Subtype Hierarchy On Cohort Queries, Xubing Hao, Xiaojin Li, Yan Huang, Jay Shi, Rashmie Abeysinghe, Cui Tao, Kirk Roberts, Guo-Qiang Zhang, Licong Cui

Faculty, Staff and Student Publications

Objective: SNOMED CT provides a standardized terminology for clinical concepts, allowing cohort queries over heterogeneous clinical data including Electronic Health Records (EHRs). While it is intuitive that missing and inaccurate subtype (or is-a) relations in SNOMED CT reduce the recall and precision of cohort queries, the extent of these impacts has not been formally assessed. This study fills this gap by developing quantitative metrics to measure these impacts and performing statistical analysis on their significance.

Material and methods: We used the Optum de-identified COVID-19 Electronic Health Record dataset. We defined micro-averaged and macro-averaged recall and precision metrics to assess the …

Invasive Fungal Disease In Solid Organ And Hematopoietic Cell Transplant Recipients, United States, Jeremy A W Gold, Kaitlin Benedict, Elizabeth Sajewski, Tom Chiller, Meghan Lyman, Mitsuru Toda, Jessica S Little, Luis Ostrosky-Zeichner

Faculty, Staff and Student Publications

Background: Updated benchmark data on invasive fungal disease (IFD) in solid organ transplantation (SOT) and hematopoietic cell transplantation (HCT) recipients are necessary to increase clinical recognition and inform treatment and prevention strategies. We estimated IFD incidence and potential risk factors in transplant recipients in a large US commercial health insurance database.

Methods: We observed patients who received SOT or HCT during 2018-2022 until IFD development, disenrollment, or database end date (July 31, 2023). We calculated incidence (per 1000 person-years) and time to IFD development, comparing demographic features and underlying conditions for IFD versus non-IFD patients.

Results: Overall, 9143 patients received …

Rezafungin For Suppressive Therapy Of Candida Auris In A Patient With A Left Ventricular Assist Device (Lvad), Matthew A Stack, Luis Ostrosky-Zeichner, Rodrigo Hasbun, Sun O Park, Jessica Babic, Mona Kapadia

Faculty, Staff and Student Publications

Introduction: Invasive candidiasis is a common healthcare-associated infection with significant morbidity and mortality. Candida auris in particular has emerged as a problematic and challenging healthcare-associated infection, especially with regards to infections involving left ventricular assist devices (LVADs). There is a paucity of evidence on the best management of these particular types of infections. Rezafungin is a newly-approved echinocandin and an important new tool in the management of invasive candidiasis. We report the novel use of rezafungin for suppressive therapy in a patient with an LVAD-associated C. auris infection.

Case: The patient is a 57-year-old male with a past medical history …

National Healthcare Safety Network… We Need To Talk…., Misti Ellsworth, Luis Zeichner Ostrosky, Bela Patel, Robert Yetman, Phillip Chang

Faculty, Staff and Student Publications

No abstract provided.

Trends In Contacts Made By Immigrants To The National Domestic Violence Hotline, Before And During The Covid-19 Pandemic, Sarah Treves-Kagan, Vi D Le, Liris S Berra, Colleen M Ray, Yanet Ruvalcaba, Leila Wood, Denise V D'Angelo, Tatiana M Vera, Lianne Fuino Estefan

Faculty, Staff and Student Publications

Objectives: Immigrants in the United States are more likely than nonimmigrants to experience risk factors for intimate partner violence (IPV) and problems in getting support. The COVID-19 pandemic and recent incidents of xenophobia and anti-immigrant sentiment may have exacerbated exposure to IPV risk factors. We examined immigrant experiences of IPV before and during the COVID-19 pandemic.

Methods: This study identified changes in characteristics of abuse, services used, referrals, and barriers to services among those who contacted the National Domestic Violence Hotline (NDVH) and identified as immigrants, reported immigration status as a concern, needed immigration support, and/or identified immigration status as …

Variation Exists In Venous Thromboembolism Prophylaxis In Traumatic Brain Injury Despite National Guidelines: Insights From A Recent Aast Survey Study, Keith Walter Burczak, Jan-Michael Van Gent, Devi Bavishi, Gabrielle E Hatton, Patrick B Murphy, Asanthi Ratnasekera, Thomas W Clements, Rachel S Morris, Christopher Tignanelli, Bryan A Cotton, Thaddeus J Puzio

Faculty, Staff and Student Publications

Background: Best practice guidelines from trauma-focused organizations support early (< 72 hours) venous thromboembolism (VTE) chemoprophylaxis initiation in traumatic brain injury (TBI) patients. Recent literature suggests that an even more aggressive initiation (24 hours) is safe and efficacious. It is unknown how current practice aligns with the existing literature and best practice guidelines. We performed a national survey to characterize variation in trauma surgeons' reported practices and attitudes regarding VTE chemoprophylaxis initiation in TBI patients with the hypothesis that they will vary widely.

Methods: All 1700 American Association for the Surgery of Trauma members were surveyed online. Members who routinely cared for patients with TBI were asked to proceed with the survey. Descriptive data were reported. The questions characterized institutional guidelines, and if none existed, individual practice patterns regarding goal timeline of VTE chemoprophylaxis in TBI patients.

Results: 374 members (22%) completed the survey. Most respondents worked at academic institutions (40%) and represented a level one trauma center (44%). Enoxaparin was the most common VTE chemoprophylactic (73%) with most using weight-based dosing (76%) …

Risk Factors For Progression Of Intracranial Hemorrhage After Initiation Of Vte Chemoprophylaxis: An Evaluation Of 1390 Tbi Patients, Keith Walter Burczak, Jan-Michael Van Gent, Devi Bavishi, Joel James, Thomas W Clements, Thaddeus J Puzio, Bryan A Cotton

Faculty, Staff and Student Publications

Objectives: Patients with traumatic intracranial hemorrhage (ICH) often undergo early stability CT scans to evaluate for progression of bleeding. The factors associated with progression after initiating venous thromboembolism (VTE) chemoprophylaxis (CP) remain poorly described. This study aimed to determine the rate of and factors associated with ICH progression following CP initiation.

Methods: This retrospective observational study included adult (≥16 years) polytrauma patients with blunt or penetrating traumatic brain injury (TBI) admitted between September 2016 and December 2021. Progression was defined as a radiographic increase in ICH following VTE CP initiation, determined by neurosurgery or radiology faculty. Postprophylaxis CT scans were …

Home-Based Transcranial Direct Current Stimulation Treatment For Major Depressive Disorder: A Fully Remote Phase 2 Randomized Sham-Controlled Trial, Rachel D Woodham, Sudhakar Selvaraj, Nahed Lajmi, Harriet Hobday, Gabrielle Sheehan, Ali-Reza Ghazi-Noori, Peter J Lagerberg, Maheen Rizvi, Sarah S Kwon, Paulette Orhii, David Maislin, Lucia Hernandez, Rodrigo Machado-Vieira, Jair C Soares, Allan H Young, Cynthia H Y Fu

Faculty, Staff and Student Publications

Transcranial direct current stimulation (tDCS) has been proposed as a new treatment in major depressive disorder (MDD). This is a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of 10-week home-based tDCS in MDD. Participants were 18 years or older, with MDD in current depressive episode of at least moderate severity as measured using the Hamilton Depression Rating Scale (mean = 19.07 ± 2.73). A total of 174 participants (120 women, 54 men) were randomized to active (n = 87, mean age = 37.09 ± 11.14 years) or sham (n = 87, mean age = 38.32 ± 10.92 …

Limitations Of The Radiotheranostic Concept In Neuroendocrine Tumors Due To Lineage-Dependent Somatostatin Receptor Expression On Hematopoietic Stem And Progenitor Cells, Nghia Nguyen, Yu Min, Jennifer Rivière, Mark Van Der Garde, Sukhen Ghosh, Laura M Bartos, Matthias Brendel, Florian Bassermann, Ali Azhdarinia, Wolfgang A Weber, Katharina S Götze, Susanne Kossatz

Faculty, Staff and Student Publications

Rationale: Radiopharmaceutical therapy (RPT) has become an effective treatment option for neuroendocrine tumors (NETs) and castration-resistant prostate cancer and is in clinical development for many indications. One of the major advantages of theranostic RPT is that the distribution of radiopharmaceuticals in the human body can be imaged, and radiation doses to the patient's organs can be calculated. However, accurate dosimetry may be fundamentally limited by microscopic heterogeneity of radiopharmaceutical distribution.

Methods: We developed fluorescent analogs of somatostatin-receptor-subtype 2 (SSTR2) targeting Lutetium-177 labeled radiopharmaceuticals that are clinically used in patients with NETs and studied their uptake by hematopoietic stem and progenitor …

New Insights Into Liver Injury And Regeneration From Single-Cell Transcriptomics, Yankai Wen, Cynthia Ju

Faculty, Staff and Student Publications

Recent advancements in single-cell transcriptomics have significantly enhanced our understanding of acute liver injury (ALI) and regeneration. These technologies enable high-resolution profiling of individual cells, uncovering the diverse and dynamic responses of liver cells to injury. By integrating single-cell RNA sequencing (scRNA-seq) with spatial transcriptomics, researchers have elucidated the complex cellular and molecular mechanisms driving ALI and regeneration processes. This review summarises the platforms and analytical methods of single-cell transcriptomics in liver research and discusses liver sample processing considerations for scRNA-seq, including the comparison between in vivo enzymatic perfusion and ex vivo digestion. It highlights the transformative impact of single-cell …

American Society For Gastrointestinal Endoscopy Guideline On Gastrostomy Feeding Tubes: Methodology And Review Of Evidence, Divyanshoo Rai Kohli, Natalie Cosgrove, Wasif M Abidi, Jorge D Machicado, Madhav Desai, Nauzer Forbes, Neil B Marya, Nikhil R Thiruvengadam, Nirav C Thosani, Omeed Alipour, Saowanee Ngamruengphong, Sherif E Elhanafi, Sunil G Sheth, Wenly Ruan, John C Fang, Stephen A Mcclave, Rodrick C Zvavanjanja, Dhruvil K Radadiya, Amir Y Kamel, Bashar J Qumseya

Faculty, Staff and Student Publications

This article from the American Society for Gastrointestinal Endoscopy (ASGE) provides a full description of the methodology used to inform the final guidance outlined in the accompanying summary and recommendations article for strategies to manage endoscopically placed gastrostomy tubes. This article was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and specifically addresses the utility of PEG versus interventional radiology-guided gastrostomy (IR-G), the need for withholding antiplatelet and anticoagulant medications, appropriate timing to initiate tube feedings, and appropriate selection of the gastrostomy technique in patients with malignant dysphagia. In patients needing enteral access, the ASGE suggests …

Comparative Efficacy Of Fluoroscopically Guided Vs Landmark-Based Injections In The Management Of Ischial Bursitis: A Pilot Study, Jamal Hasoon, Giustino Varrassi, Omar Viswanath

Faculty, Staff and Student Publications

Introduction: Ischial bursitis is a challenging chronic pain condition often resistant to conservative treatments. Ischial bursa injections, including fluoroscopically guided and landmark-based approaches, are commonly used when first-line interventions fail. This study aims to compare the efficacy of these two techniques in providing pain relief and improving function in patients with refractory ischial bursitis.

Methods: A retrospective analysis was conducted using electronic medical records of nine patients with refractory ischial bursitis treated between April 1, 2023, and November 30, 2024. Patients were categorized based on the injection technique: fluoroscopically guided (n=4) or landmark-based (n=5). Pain relief was assessed at follow-up …

Advanced Method For The In Vivo Measurements Of Lysophospholipid Translocation Across The Inner (Cytoplasmic) Membrane Of Escherichia Coli, Yibin Lin, Lei Zheng, Mikhail Bogdanov

Faculty, Staff and Student Publications

Phospholipid translocation occurs ubiquitously in biological membranes and primarily is protein catalyzed. Lipid flippases mediate the net translocation of specific phospholipids from one leaflet of a membrane to the other. In the inner (cytoplasmic) membrane (IM) of Gram-negative bacteria, lysophospholipid translocase (LplT) and cytosolic bifunctional acyl-acyl carrier protein (ACP) synthetase/2-acylglycerolphosphoethanolamine acyltransferase (Aas) form a glycerophospholipid regeneration system, which is capable of facilitating rapid retrograde translocation of lyso forms of phosphatidylethanolamine (PE), phosphatidylglycerol (PG), and cardiolipin (CL) but not exogenous (host-derived) phosphatidylcholine (PC) across the IM of Gram-negative diderm (two-membraned) bacteria in consequential order lyso-PE = lyso-PG > > lysophosphatidic acid (lyso-PA) >> lyso-PC. …

Semi-Automated Virtual Endoscopy Of The Frontal Recess, Ali Jafar, William Yao, Martin Citardi

Faculty, Staff and Student Publications

Introduction: Virtual endoscopy (VE) is the computer-based reprocessing of diagnostic imaging to simulate endoscopy of an anatomic region of interest. VE of the Frontal Sinus Outflow Tract (FSOT) may assist surgical planning and education.

Method: VE was performed on 16 normal sinus computed tomography (CT) scans for a total of 32 sides using the "path-to-target" tool on the TruDi surgical navigation system (ver. 2.3; Acclarent, Irving, CA, USA). To aid orientation during VE, planning points were placed on the middle turbinate, ethmoidal bulla, and skull base. The VE representation of anatomy and FSOT accuracy was manually confirmed by reviewing the …

Three-Year Outcomes After Temperature-Controlled Radiofrequency Treatment Of Nasal Airway Obstruction, William C Yao, Randall Ow, Michael J Sillers, Nathan E Nachlas, Curtis D Johnson, Dale Ehmer, Jordan Pritikin, Henry P Barham

Faculty, Staff and Student Publications

Objective: To evaluate the long-term safety and effectiveness of temperature-controlled radiofrequency (TCRF) treatment of nasal valve collapse (NVC) in patients with nasal airway obstruction (NAO).

Study design: This is an extended follow-up from a prospective, multicenter, single-arm study. The initial study included participants from 12 sites across the United States who were followed for 24 months and additionally agreed to participate in the extended 36-month follow-up.

Setting: Procedure was performed in-office with an in-person follow-up at 3 months and subsequent follow-up assessment remotely.

Methods: Participants received TCRF treatment of only the nasal valve and participated in the extended 36-month follow-up. …

Semi-Quantitative Assessment Of Surgical Navigation Accuracy During Endoscopic Sinus Surgery In A Real-World Environment, David Z Allen, Jason Talmadge, Martin J Citardi

Faculty, Staff and Student Publications

Introduction: Although surgical navigation is commonly used in rhinologic surgery, data on real world performance are sparse because of difficulties in collecting measurements for target registration error (TRE). Despite publications showing submillimeter TRE, surgeons do report TRE of >3 mm. We describe a novel method for assessing TRE during surgery and report findings with this technique.

Methods: The TruDi navigation system (Acclarent, Irving, CA) was registered using a contour-based protocol. The surgeon estimated target registration error (e-TRE) at up to 8 points (anatomic regions of interest [ROI]) during endoscopic sinus surgery (ESS). System logs were used to simulate the localization …

Synthetic Versus Biologic Mesh For Complex Open Ventral Hernia Repair: 3-Year Follow-Up Of A Pilot Randomized Controlled Trial, Naila H Dhanani, Nicole B Lyons, Kyung Hyun Lee, Oscar A Olavarria, Aris R Arakelians, Julie L Holihan, Lillian S Kao, Ali Siddiqui, Connor Hogan, Tunmi Anwoju, Zuhair Ali, Mike K Liang

Faculty, Staff and Student Publications

Background: Biologic mesh is often used in complex hernia repair, but there has been limited clinical evidence to date to support this practice. The aim of this study was to compare clinical and patient-reported outcomes of biologic versus synthetic mesh for complex open ventral hernia repair (OVHR) at 3 years.

Methods: Patients from a single center, randomized, controlled, pilot trial comparing biologic versus synthetic mesh in complex OVHR were followed for 3 years. The primary outcome focused on major complications, namely mesh infections, hernia recurrences, reoperations, and deaths. Secondary outcomes included surgical site infections, surgical site occurrences, and patient-reported outcomes. …

Poor Oral Health Is Associated With Social Vulnerability In Critically Ill Trauma Patients, Mokunfayo O Fajemisin, Stephanie Martinez Ugarte, Chelsea J Guy-Frank, Gabrielle E Hatton, Kayli A Quinton, Sophia Syed, Erin E Fox, Charles E Wade, Kimberly A Mankiewicz, Lillian S Kao

Faculty, Staff and Student Publications

Background: Social factors affect oral health status, and poor oral health has been associated with worse health outcomes. Using the Oral Health Risk Assessment Value Index (OHRAVI), a bedside tool for non-dentists to assess oral health, we investigated the interplay of oral health with social drivers of health and social vulnerability, as measured by the Social Vulnerability Index (SVI), in severely injured patients.

Methods: Our retrospective study included dentulous critically ill trauma patients who were previously assigned an OHRAVI score (range 0-3; unhealthy score >1). Patient demographics, comorbidities, and self-reported social drivers were obtained from health records. SVI was calculated …

The Interplay Between Pulse Width And Activation Depth In Tens: A Computational Study, Alexander Guillen, Dennis Q Truong, Yusuf O Cakmak, Sheng Li, Abhishek Datta

Faculty, Staff and Student Publications

Background: Transcutaneous electrical nerve stimulation (TENS) has been a commonly used modality to relieve aches and pain for over 40 years. Commercially available devices provide multiple therapy modes involving a different combination of frequency and pulse width with intensity. While frequency sets sensation, intensity helps determine tolerability, longer pulse width is reported to induce a feeling of deeper stimulation. In fact, longer pulse width has been empirically shown to deliver current into deeper tissues, but in context of other electrical stimulation modalities. The goal of this study was to unpack the relationship between pulse width and activation depth in TENS. …

Suicide Phenotyping From Clinical Notes In Safety-Net Psychiatric Hospital Using Multi-Label Classification With Pre-Trained Language Models, Zehan Li, Yan Hu, Scott Lane, Salih Selek, Lokesh Shahani, Rodrigo Machado-Vieira, Jair Soares, Hua Xu, Hongfang Liu, Ming Huang

Faculty, Staff and Student Publications

Accurate identification and categorization of suicidal events can yield better suicide precautions, reducing operational burden, and improving care quality in high-acuity psychiatric settings. Pre-trained language models offer promise for identifying suicidality from unstructured clinical narratives. We evaluated the performance of four BERT-based models using two fine-tuning strategies (multiple single-label and single multi-label) for detecting coexisting suicidal events from 500 annotated psychiatric evaluation notes. The notes were labeled for suicidal ideation (SI), suicide attempts (SA), exposure to suicide (ES), and non-suicidal self-injury (NSSI). RoBERTa outperformed other models using binary relevance (acc=0.86, F1=0.78). MentalBERT (F1=0.74) also exceeded BioClinicalBERT (F1=0.72). RoBERTa fine-tuned with …

Evaluating The Emotional Accuracy Of Ai-Generated Facial Expressions In Neurotypical Individuals, Antonio Pagán, Katherine A Loveland, Ronald Acierno

Faculty, Staff and Student Publications

This study examines the ability of generative artificial intelligence to produce facial expressions representing basic emotions in a neutral context using black-and-white cartoon imagery. Mentalization, the capacity to recognize and interpret one’s own and others’ mental states, is critical for social interaction and emotional regulation. We explored the emotional validation of artificial intelligence (AI)-generated images by assessing the agreement between human interpretations of emotions and those generated by an AI model. Thirty-four participants evaluated images depicting six basic emotions: sadness, anger, happiness, surprise, fear, and disgust. Our findings revealed significant variability in human agreement, with higher concordance for sadness, anger, …

Efficacy And Safety Of Once-Daily Roflumilast Cream 005% In Pediatric Patients Aged 2-5 Years With Mild-To-Moderate Atopic Dermatitis (Integument-Ped): A Phase 3 Randomized Controlled Trial, Lawrence F Eichenfield, Rocco Serrao, Vimal H Prajapati, John C Browning, Lisa Swanson, Tracy Funk, Mercedes E Gonzalez, Adelaide A Hebert, Mark Lee, Mark Boguniewicz, Eric L Simpson, Melissa S Seal, David Krupa, Diane Hanna, Scott Snyder, Patrick Burnett, David H Chu, Erin Almaraz, Robert C Higham, David R Berk

Faculty, Staff and Student Publications

Background/objectives: Efficacy and safety of roflumilast cream 0.15% were demonstrated in patients aged ≥ 6 years with atopic dermatitis (AD) in two Phase 3 trials. This Phase 3 parallel-group, double-blind trial (INTEGUMENT-PED; NCT04845620) compared the efficacy and safety of roflumilast cream 0.05% and a vehicle in patients aged 2-5 years with AD.

Methods: Patients aged 2-5 years with mild-to-moderate AD were treated with once-daily roflumilast cream 0.05% or vehicle for 4 weeks. The primary efficacy endpoint was Validated Investigator Global Assessment for AD (vIGA-AD) Success (0 [Clear] or 1 [Almost Clear] plus ≥ 2-grade improvement from baseline) at Week …