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Differential Impact Of Admission Type And Clinical Complexity On Diabetes Hospitalization Costs Among African American And Hispanic Patients In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf-Alddin, Michael C. Bittner, Qi Zhang Jan 2026

Differential Impact Of Admission Type And Clinical Complexity On Diabetes Hospitalization Costs Among African American And Hispanic Patients In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf-Alddin, Michael C. Bittner, Qi Zhang

Department of Obstetrics & Gynecology Faculty Publications

Background

Diabetes mellitus (DM) imposes substantial healthcare costs with documented disparities among African Americans and Hispanic patients. To inform care delivery and resource allocation, this study identified hospitalization cost predictors among African American and Hispanic patients with diabetes in Southeastern Virginia.

Methods

We analyzed 6,011 hospital discharges from the Virginia Health Information database (2016-2020) for adults aged 18-85 with diabetes. Discharges were classified by Medicare Severity Diagnosis-Related Groups: DM with complications/comorbidities (DCC, n = 3,328), DM with major complications/comorbidities (DMCC, n = 1,518), and DM without major complications/comorbidities (DWO, n = 1,165). Because cost distributions were right-skewed (skewness 3.5-8.24), we …


Contribution Of Comorbidities And Pregnancy Complications To Severe Maternal Morbidity In The United States, Tetsuya Kawakita, Sora A. Jones, Natsume Furukawa, George Saade Jan 2026

Contribution Of Comorbidities And Pregnancy Complications To Severe Maternal Morbidity In The United States, Tetsuya Kawakita, Sora A. Jones, Natsume Furukawa, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To quantify the extent to which rising rates of severe maternal morbidity (SMM) in the United States from 2016 to 2022 are attributable to increasing prevalence of maternal risk factors, including advanced maternal age, obesity, pregestational diabetes mellitus, gestational diabetes, chronic hypertension, and hypertensive disorders of pregnancy (HDP).

Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database from 2016 to 2022, representing more than 25 million weighted delivery hospitalizations. The primary outcome of SMM was identified with the Centers for Disease Control and Prevention's 21-condition algorithm; a secondary outcome excluded transfusion to improve specificity. Temporal trends …


Acute Fatty Liver Of Pregnancy And Fetal Fatty Acid Oxidation Disorders: A Systematic Review, Dante Varotsis, Sarah Araji, Rebecca Horgan, Jennifer E. Powel, Rodney Mclaren Jr., Brian Kirmse, Mona Makhamreh, Huda B. Al-Kouatly Jan 2026

Acute Fatty Liver Of Pregnancy And Fetal Fatty Acid Oxidation Disorders: A Systematic Review, Dante Varotsis, Sarah Araji, Rebecca Horgan, Jennifer E. Powel, Rodney Mclaren Jr., Brian Kirmse, Mona Makhamreh, Huda B. Al-Kouatly

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To evaluate the association between maternal acute fatty liver of pregnancy (AFLP) and fetal fatty acid oxidation (FAO) disorders and to define the clinical and genetic characteristics of mothers with AFLP and their fetuses affected by FAO disorders, we performed a systematic literature review of all reported cases of AFLP that underwent genetic testing for FAO disorders.

DATA SOURCES:

We searched PubMed, Ovid MEDLINE, Cochrane Library, CINAHL (EBSCO), Scopus, and ClinicalTrials.gov. Terms included were related to AFLP and FAO testing.

METHODS OF STUDY SELECTION:

We conducted a systematic literature review from inception through May 18, 2025, to evaluate the …


Estetrol (E4) For The Treatment Of Moderate To Severe Vasomotor Symptoms In Postmenopausal Women - Efficacy And Safety Results From The Phase 3 E4comfort I Multicenter, Placebo-Controlled Study, Tommaso Simoncini, Céline Bouchard, Marie Cloes, Mélanie Taziaux, Santiago Palacios, Sebastião Freitas De Medeiros, Valeriu Vrabii, David F. Archer, Nick Panay Jan 2026

Estetrol (E4) For The Treatment Of Moderate To Severe Vasomotor Symptoms In Postmenopausal Women - Efficacy And Safety Results From The Phase 3 E4comfort I Multicenter, Placebo-Controlled Study, Tommaso Simoncini, Céline Bouchard, Marie Cloes, Mélanie Taziaux, Santiago Palacios, Sebastião Freitas De Medeiros, Valeriu Vrabii, David F. Archer, Nick Panay

Department of Obstetrics & Gynecology Faculty Publications

Objective

To evaluate the efficacy and safety of estetrol in reducing moderate to severe vasomotor symptoms in postmenopausal women.

Methods

Multicenter, randomized, parallel group (1:1:1), placebo-controlled, double-blind, phase 3 study in hysterectomized and non-hysterectomized participants aged 40-65 years. A total of 640 participants with seven or more moderate to severe hot flashes daily or 50 weekly received estetrol 15 mg, estetrol 20 mg, or placebo for 12 weeks. Co-primary endpoints were the change in frequency and severity of moderate to severe vasomotor symptoms from baseline to weeks 4 and 12. Comparisons versus placebo were made using a mixed-effects model for …


Cervicovaginal Lavage Fluid Iron And Manganese Levels In Women With And Without Vaginitis, Barbara Kozma, David Ratonyi, Bence Kozma, Peter Takacs, Attila G. Sipos Jan 2026

Cervicovaginal Lavage Fluid Iron And Manganese Levels In Women With And Without Vaginitis, Barbara Kozma, David Ratonyi, Bence Kozma, Peter Takacs, Attila G. Sipos

Department of Obstetrics & Gynecology Faculty Publications

Transition metals such as iron and manganese are critical for cellular metabolism, redox balance, and immune function, and they also influence host–pathogen interactions. Vaginitis is characterized by mucosal inflammation that may alter local trace-element homeostasis. We hypothesize that inflammatory conditions such as vaginitis may be associated with altered cervicovaginal iron and manganese levels. We performed a prospective, single-center cohort study at the University of Debrecen (Hungary) between April 2023 and April 2024, enrolling 80 women ≥ 18 years with vulvovaginal complaints. Participants were assessed at baseline and at weeks 4, 8, and 12 with clinical evaluation and cervicovaginal lavage (CVL) …


Biomechanical Integrity Of The Female Pelvic Floor: A Comparison Of Military And Civilian Women, Vladimir Egorov, Peter Takacs, Vincent Lucente, Heather Van Raalte, Joy A. Greer, Noune Sarvazyan Jan 2026

Biomechanical Integrity Of The Female Pelvic Floor: A Comparison Of Military And Civilian Women, Vladimir Egorov, Peter Takacs, Vincent Lucente, Heather Van Raalte, Joy A. Greer, Noune Sarvazyan

Department of Obstetrics & Gynecology Faculty Publications

Introduction

The health of the pelvic floor depends on the integrity of its muscles, connective tissue, ligaments, and their innervation. The female pelvic floor may be more vulnerable to repetitive heavy loads in a military environment than the male pelvic floor because of anatomical and physiological differences. The study aim was to identify and explore possible differences in the female pelvic floor conditions between active military and civilian women with similar demographics.To identify and explore possible differences in the conditions of the female pelvic floor between active military women and civilian women with similar demographics.

Materials and Methods

Military active …


The Impact Of The 7th October War On Preterm Birth Rates And Neonatal Outcomes: A Retrospective Comparative Study From Northern Israel, Raghda Zidan Sweid, Adi Sharabi Nov, Hana Helfgot, Steven L. Warsof, Inbar Ben-Shachar Jan 2026

The Impact Of The 7th October War On Preterm Birth Rates And Neonatal Outcomes: A Retrospective Comparative Study From Northern Israel, Raghda Zidan Sweid, Adi Sharabi Nov, Hana Helfgot, Steven L. Warsof, Inbar Ben-Shachar

Department of Obstetrics & Gynecology Faculty Publications

PURPOSE: Maternal psychological stress is associated with adverse obstetric and neonatal outcomes, including preterm birth and low birthweight. Warfare represents a significant source of acute and chronic stress, yet its impact on pregnancy outcomes remains unclear. This study aimed to evaluate the association between a 6-month period of continuous wartime exposure following October 7, 2023, during the "Iron Swords" conflict and preterm birth, neonatal outcomes, and obstetric management.

METHODS: This retrospective cohort study included all deliveries at ZIV Medical Center during the 6-month conflict period, compared with a pre-war cohort from 2021 until October 6, 2023. The primary outcome was …


Consensus And Controversies Of International Guidelines For The Diagnosis, Surveillance, And Management Of Fetal Growth Restriction: An Updated Comparison, Daniele Diane Mascio, Suneet P. Chauhan, Tullio Ghi, Asma Khalil, Juliana G. Martins, Sara Sorrenti, Tamara Stampalija, Fabrizio Zullo, Francesc Figueras Jan 2026

Consensus And Controversies Of International Guidelines For The Diagnosis, Surveillance, And Management Of Fetal Growth Restriction: An Updated Comparison, Daniele Diane Mascio, Suneet P. Chauhan, Tullio Ghi, Asma Khalil, Juliana G. Martins, Sara Sorrenti, Tamara Stampalija, Fabrizio Zullo, Francesc Figueras

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE: To compare areas of consensus and disagreements across contemporary international and national guidelines on the diagnosis, surveillance, and management of fetal growth restriction (FGR).

DATA SOURCES: Electronic searches of MEDLINE from database inception up to March 2026 using MeSH terms and keywords related to FGR and guidelines. STUDY ELIGIBILITY CRITERIA: Critical, structured comparison of national or international guidelines on FGR published since 2010. Final inclusion required unanimous agreement from all authors.

STUDY APPRAISAL AND SYNTHESIS METHODS: Pre-specified extraction across domains: definition; prediction/prevention; surveillance tools and frequency; delivery timing and mode; and labor induction methods. Dual data …


Factors Influencing Obstetric Ultrasound Examination Duration In A Tertiary Fetal Center, Juliana Gevaerd Martins, Diana Aboukhater, Tetsuya Kawakita, Maya Vishna, Salimah Navaz Gangji, Alfred Abuhamad Jan 2026

Factors Influencing Obstetric Ultrasound Examination Duration In A Tertiary Fetal Center, Juliana Gevaerd Martins, Diana Aboukhater, Tetsuya Kawakita, Maya Vishna, Salimah Navaz Gangji, Alfred Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

To quantify scan duration across commonly performed obstetric ultrasound examinations in a tertiary fetal imaging center and to evaluate whether exam type, maternal body mass index (BMI), and sonographer experience independently influence scan time.

Methods

We conducted a retrospective cohort study of singleton pregnancies undergoing diagnostic obstetric ultrasound between January 2023 and May 2024 at a high-volume tertiary care center. Ultrasounds were categorized into five exam types: dating/viability (6-10 weeks), detailed first-trimester (11-14 weeks), detailed second-trimester anatomic survey (18-22 weeks), fetal echocardiography (22-24 weeks), and second/third-trimester growth/Doppler (24-38 weeks) scans. Scan duration was defined using ultrasound image timestamps from …


Longitudinal Patterns Of Urinary Biomarkers Of Placental And Renal Function In Pregnancy And Associations With Early Pregnancy Exposure To Phthalates And Replacements, Erin E. Mcnell, Danielle R. Stevens, Barrett M. Welch, Suzanne Fenton, Antonia M. Calafat, Julianne Cook Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson Jan 2026

Longitudinal Patterns Of Urinary Biomarkers Of Placental And Renal Function In Pregnancy And Associations With Early Pregnancy Exposure To Phthalates And Replacements, Erin E. Mcnell, Danielle R. Stevens, Barrett M. Welch, Suzanne Fenton, Antonia M. Calafat, Julianne Cook Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Phthalates and replacements are endocrine-disrupting chemicals that may interfere with early pregnancy processes such as placentation and renal adaptation. Placental and renal biomarkers may help examine these toxicologic mechanisms. This study aims to characterize longitudinal changes in urinary protein biomarkers of placental angiogenesis (sFlt-1, PlGF, sEng) and renal function (KIM-1, NGAL, nephrin), and investigate associations with early pregnancy exposure to phthalates and replacements. Among 291 participants from the Human Placenta and Phthalates prospective cohort, urinary metabolites of eight phthalates and two replacements were quantified at up to 2 time points from 12 to 15 weeks gestation. Repeated measures were averaged …


Hungarian Validation Of The Pelvic Floor Distress Inventory - 20 (Pfdi-20) Questionnaire And The Pelvic Floor Impact Questionnaire - 7 (Pfiq - 7), Barbara Kozma, Bence Kozma, Peter Takacs, Dávid Rátonyi, Nelli Farkas, Attila G. Sipos, Balint Farkas Jan 2026

Hungarian Validation Of The Pelvic Floor Distress Inventory - 20 (Pfdi-20) Questionnaire And The Pelvic Floor Impact Questionnaire - 7 (Pfiq - 7), Barbara Kozma, Bence Kozma, Peter Takacs, Dávid Rátonyi, Nelli Farkas, Attila G. Sipos, Balint Farkas

Department of Obstetrics & Gynecology Faculty Publications

Introduction and Hypotheses

Pelvic floor disorders (PFDs) affect women's quality of life through physical, psychological, and social domains. The Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) are validated tools for assessing symptom severity and quality of life impact. The current study aim to investigate the reliability and validity of the Hungarian versions of these questionnaires in women with PFD symptoms.

Methods

This validation study was carried out at the University of Debrecen among women with clinically confirmed pelvic floor disorders. The PFDI-20 and PFIQ-7 questionnaires were translated into Hungarian using independent native English speaker in …


The Taper Sign: Sonographic Representation Of Uterine Dehiscence In Severe Cases Of Placenta Accreta Spectrum, Uma Deshmukh, Anna M. Modest, Alfred Abuhamad, Alireza A. Shamshirsaz, Jonathan L. Hecht, Scott A. Shainker Jan 2026

The Taper Sign: Sonographic Representation Of Uterine Dehiscence In Severe Cases Of Placenta Accreta Spectrum, Uma Deshmukh, Anna M. Modest, Alfred Abuhamad, Alireza A. Shamshirsaz, Jonathan L. Hecht, Scott A. Shainker

Department of Obstetrics & Gynecology Faculty Publications

Introduction: Prenatal diagnosis of placenta accreta spectrum (PAS) depends on reliable ultrasound markers and skilled image interpretation. Existing PAS markers emphasize placental features suggestive of abnormal adherence and require advanced image optimization. However, emerging hypotheses suggest that uterine dehiscence—not placental invasion—is the central mechanism underlying PAS, particularly in severe (Grade 3) disease. Despite this, few established ultrasound markers address this uterine dehiscence. We describe a novel ultrasound marker, the taper sign, which uniquely represents the uterine dehiscence in severe PAS with anterior placenta previa, and outline a standardized technique for image acquisition and interpretation.

Methods: This descriptive report details the …


Racial Differences In Adverse Pregnancy Outcomes And Incident Hypertension: A Mediation Analysis, Lucia C. Petito, Xiaoning Huang, C. Noel Bairey, Natalie Bello, Janet Catov, Ernesto Licon, Abbi Lane, David M. Haas, Lisa D. Levine, Rebecca B. Mcneil, Eliza Miller, Uma M. Reddy, Bethany Barone Gibbs, George Saade, Lauren Theilen, Laura E. Wiener, Brian M. Mercer, Hyagriv N. Simhan, Lynn M. Yee, Philip Greenland, William A. Grobman, Sadiya S. Khan Jan 2026

Racial Differences In Adverse Pregnancy Outcomes And Incident Hypertension: A Mediation Analysis, Lucia C. Petito, Xiaoning Huang, C. Noel Bairey, Natalie Bello, Janet Catov, Ernesto Licon, Abbi Lane, David M. Haas, Lisa D. Levine, Rebecca B. Mcneil, Eliza Miller, Uma M. Reddy, Bethany Barone Gibbs, George Saade, Lauren Theilen, Laura E. Wiener, Brian M. Mercer, Hyagriv N. Simhan, Lynn M. Yee, Philip Greenland, William A. Grobman, Sadiya S. Khan

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) are associated with increased hypertension risk. Black women experience higher rates of APOs and hypertension compared with White women, but whether APOs contribute to Black-White hypertension disparities remains unknown.

Methods

The nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be-Heart Health Study) prospectively recruited nulliparous pregnant people at 8 US centers (2010-2013) with follow-up 2 to 7 years postpartum (2014-2017). Race, which represents a social construct, was self-identified. The primary outcome was incident hypertension at follow-up. APOs included hypertensive disorders of pregnancy, preterm birth, and small-for-gestational age birth. Potential confounders (psychological health, social factors, and health behaviors) …


Osmotic Dilators Vs. Foley Balloons: Bayesian Secondary Analyses Of The Dilafol Trial, Antonio F. Saad, Elenir B. C. Avritscher, Claudia Pedroza, Xiao Han, George R. Saade Jan 2026

Osmotic Dilators Vs. Foley Balloons: Bayesian Secondary Analyses Of The Dilafol Trial, Antonio F. Saad, Elenir B. C. Avritscher, Claudia Pedroza, Xiao Han, George R. Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: Dilapan-S, a synthetic osmotic dilator used for pre-induction cervical ripening, has proven to be as effective as the Foley balloon in terms of vaginal versus cesarean delivery and has been associated with increased patient satisfaction. Nevertheless, its ability to lower cesarean rates and its cost-effectiveness remain poorly studied.

Objectives: To estimate the likelihood that synthetic osmotic dilators reduce cesarean deliveries and to evaluate their health system costs (2026 US$) and incremental cost-effectiveness compared to the Foley balloon during cervical ripening.

Study Design: Secondary Bayesian analyses were conducted using data from the single-center DILAFOL randomized controlled trial, which enrolled 419 …


Vaginal Pra1 Identifies Clinically Relevant Candida Albicans Vaginitis And Excludes Asymptomatic Colonization: An Exploratory Study, Elena Roselletti, Barbara Kozma, David Ratonyi, Alexandra Kunkli, Bence Kozma, Peter Takacs, Duncan Wilson Jan 2026

Vaginal Pra1 Identifies Clinically Relevant Candida Albicans Vaginitis And Excludes Asymptomatic Colonization: An Exploratory Study, Elena Roselletti, Barbara Kozma, David Ratonyi, Alexandra Kunkli, Bence Kozma, Peter Takacs, Duncan Wilson

Department of Obstetrics & Gynecology Faculty Publications

Background

Accurate interpretation of Candida detection in women with vulvovaginal symptoms remains difficult, because organism recovery may reflect either clinically relevant infection or nonpathogenic colonization. We have recently demonstrated that the secreted fungal zinc-binding protein, Pra1 is responsible for driving the inflammatory immunopathology of VVC. We therefore reasoned that PRA1 expression by Candida albicans in the vagina may act as a diagnostic tool to discriminate between commensal colonisation and active disease.

Methods

We conducted a 12-week prospective, single-center exploratory biomarker analysis nested within a registered parent clinical trial. Nine women with vulvovaginal symptoms provided cervicovaginal lavage samples and clinical data …


Risk Of Gestational Diabetes By Aerobic And Resistance Exercise During The First And Second Trimesters, Takaki Tanamoto, George Saade, Leryn J. Reynolds, Tetsuya Kawakita Jan 2026

Risk Of Gestational Diabetes By Aerobic And Resistance Exercise During The First And Second Trimesters, Takaki Tanamoto, George Saade, Leryn J. Reynolds, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

While some studies have shown that exercise reduces the incidence of gestational diabetes mellitus (GDM), there is limited evidence on whether aerobic or resistance exercise is more beneficial. This study aimed to examine the rate of GDM according to the type of exercise during early pregnancy.

Study design

We analyzed data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), a prospective cohort of individuals enrolled during the first and second trimesters. We excluded participants with pregestational diabetes or delivery < 20 weeks. The primary exposure was either aerobic or resistance exercises in the first or second trimester. For each trimester, the metabolic equivalent of task hours per week (MET-h/week) was calculated for each exercise. Participants were grouped as follows: "Aerobic exercise" (≥7.5 MET-h/week from aerobic exercises), "Resistance exercise" (≥2 times/week from resistance exercises), "Both types of exercise" (≥7.5 MET-h/week from aerobic exercise and ≥2 times/week from resistance exercises), and "Insufficient exercise" (≤7.5 MET-h/week from aerobic exercise and ≤2 times/week from resistance exercises). Our primary outcome was GDM. Adjusted relative risks (aRRs) with 95% confidence intervals (95% CIs) were calculated using modified Poisson regression, adjusting for potential confounders.

Results

In both the first and second trimesters, analyses included 9049 individuals. In the first trimester, individuals who performed …


The Association Between The Degree Of Social Vulnerability And Maternal Anemia And Other Adverse Perinatal Outcomes, Rubymel J. Knupp, Christina T. Blanchard, Ariann Nassel, Ashley Shea, Lindsay S. Robbins, Jeff M. Szychowski, Ashley N. Battarbee, Akila Subramaniam Jan 2026

The Association Between The Degree Of Social Vulnerability And Maternal Anemia And Other Adverse Perinatal Outcomes, Rubymel J. Knupp, Christina T. Blanchard, Ariann Nassel, Ashley Shea, Lindsay S. Robbins, Jeff M. Szychowski, Ashley N. Battarbee, Akila Subramaniam

Department of Obstetrics & Gynecology Faculty Publications

Objective

Maternal anemia in pregnancy is associated with many adverse maternal, fetal, and neonatal outcomes. The role of social determinants of health (SDOH) in the development of maternal anemia and other adverse outcomes is continually evolving. One such newer tool, the Social Vulnerability Index (SVI), measures an individual's community-level SDOH, with higher SVI denoting higher vulnerability. Our objective was to evaluate the association between SVI, maternal anemia, and other adverse perinatal outcomes.

Methods

Retrospective cohort study of pregnant individuals delivering singletons at a gestational age ≥23 weeks at a single center from 2014 to 2018. Patients with sickle cell disease, …


The Association Between Social Vulnerability And Racial Disparities In Preterm Birth, Anita Pershad, Gabby Adams, Lindsay Robbins, George Saade, Tetsuya Kawakita Jan 2026

The Association Between Social Vulnerability And Racial Disparities In Preterm Birth, Anita Pershad, Gabby Adams, Lindsay Robbins, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

To evaluate the association between county-level social vulnerability and preterm birth and assess whether racial disparities vary across levels of vulnerability.

Methods

This cross-sectional study utilized restricted Centers for Disease Control and Prevention natality data from 2023. We included Black or White births with singleton pregnancies across 3123 US counties from 50 US states and the District of Columbia. Participants were grouped into quartiles based on the county-level Social Vulnerability Index (SVI), with quartile 4 representing the most socially vulnerable populations. The primary outcome was preterm birth, defined as delivery before 37 weeks. Secondary outcomes included small for gestational …


Evaluating The Mediating Role Of Gestational Phthalate And Replacement Biomarkers In The Associations Between Race/Ethnicity And Birthweight, Amir J. Lueth, Danielle R. Stevens, Sarahna A. Moyd, Elena Sinkovskaya, Ann Przybylska, Antonia M. Calafat, Julianne C. Botelho, George Saade, Alfred Abuhamad, Kelly K. Ferguson Jan 2026

Evaluating The Mediating Role Of Gestational Phthalate And Replacement Biomarkers In The Associations Between Race/Ethnicity And Birthweight, Amir J. Lueth, Danielle R. Stevens, Sarahna A. Moyd, Elena Sinkovskaya, Ann Przybylska, Antonia M. Calafat, Julianne C. Botelho, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background

Gestational exposure to phthalates is higher among non-Hispanic black (NHB) women than non-Hispanic white (NHW) women and may contribute to racial/ethnic differences in birthweight z-scores.

Objective

We aimed to investigate whether gestational phthalate and replacement biomarkers mediate the association between race/ethnicity and birthweight z-scores.

Methods

We analyzed data from 271 pregnancies in the Human Placenta and Phthalates study, a prospective cohort recruited from 2017 to 2020. Urinary phthalate metabolite concentrations were measured at up to eight time points during pregnancy and averaged to represent gestational exposure. Metabolites were grouped by parent compound. Linear regression models estimated associations in phthalate …


Femtosecond-Laser-Inscribed Cladding Fiber Bragg Gratings: Architectures, Design Trade-Offs And Future Sensing Opportunities, Koustav Dey, Rex E. Gerald, Chen Zhu, Jie Huang Jan 2026

Femtosecond-Laser-Inscribed Cladding Fiber Bragg Gratings: Architectures, Design Trade-Offs And Future Sensing Opportunities, Koustav Dey, Rex E. Gerald, Chen Zhu, Jie Huang

Electrical and Computer Engineering Faculty Research & Creative Works

Femtosecond (fs) laser inscription enables fiber Bragg gratings (FBGs) to be positioned beyond the fiber core, including within the cladding, thereby expanding control over modal interactions and directional sensing. These cladding fiber Bragg gratings (CLFBGs) extend FBG functionality through interactions with core, cladding, and evanescent fields. Their operation does not involve fundamentally different grating physics; rather, core-mode, cladding-mode, and coupled-mode responses depend on power distribution, modal overlap with the laser-inscribed refractive-index modulation (RIM), grating position, fiber geometry, modal excitation, and interrogation configuration. This Perspective reviews advances in CLFBG fabrication, optical characteristics, sensing mechanisms, and applications. Cladding-waveguide-assisted, evanescent-field-coupled, and direct cladding-mode-excitation …


Temperature Compensation In Loop And Patch Fss Strain Sensors: Analysis And Experimental Validation, Swathi Muthyala Ramesh, Kristen M. Donnell Jan 2026

Temperature Compensation In Loop And Patch Fss Strain Sensors: Analysis And Experimental Validation, Swathi Muthyala Ramesh, Kristen M. Donnell

Electrical and Computer Engineering Faculty Research & Creative Works

Frequency selective surfaces (FSSs) are arrays of conductive elements or apertures that exhibit frequency-dependent reflection and transmission properties. Their electromagnetic response is influenced by geometry and environmental conditions, making them attractive for wireless strain-sensing applications. However, temperature variations can produce frequency shifts similar to those caused by strain, reducing measurement accuracy. This work investigates the effects of intrinsic temperature compensation on two common FSS unit cell geometries—loop and patch—through comprehensive simulation analysis. The results show that loop-based cells offer superior thermal stability, while patch-based cells provide greater strain sensitivity, illustrating the trade-off between thermal robustness and mechanical responsiveness. A patch-type …


Large Language Models For Neurology: A Mini Review, Donald C. Wunsch, Daniel B. Hier Jan 2026

Large Language Models For Neurology: A Mini Review, Donald C. Wunsch, Daniel B. Hier

Electrical and Computer Engineering Faculty Research & Creative Works

Large language models have the potential to transform neurology by augmenting diagnostic reasoning, streamlining documentation, and improving workflow efficiency. This Mini Review surveys emerging applications of large language models in Alzheimer's disease, Parkinson's disease, multiple sclerosis, and epilepsy, with emphasis on ambient documentation, multimodal data integration, and clinical decision support. Key barriers to adoption include bias, privacy, reliability, and regulatory alignment. Looking ahead, neurology-focused language models may develop greater fluency in biomedical ontologies and FHIR standards, improving data interoperability and supporting more seamless collaboration between clinicians and AI systems. Two future developments have the potential to be particularly impactful: (1) …


Safety Aware Continual Reinforcement Learning-Based Output Tracking Control Of Nonlinear Continuous-Time Systems, Irfan Ganie, Sarangapani Jagannathan Jan 2026

Safety Aware Continual Reinforcement Learning-Based Output Tracking Control Of Nonlinear Continuous-Time Systems, Irfan Ganie, Sarangapani Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

An output feedback (OF)-based control scheme utilizing both a scalable multilayer neural network (MNN) observer and actor–critic MNN via integral reinforcement learning (IRL)/adaptive dynamics programming (ADP) approach for a class of nonlinear systems with output constraints is introduced. The proposed observer, critic, and actor MNN weight updates are derived using a singular value decomposition (SVD) of MNN activation function gradient along with output error, Bellman and control input errors, respectively. Next, the approach incorporates continual learning (CL), utilizing a penalty function in the weight update laws for both actor–critic MNNs to consolidate knowledge from previous tasks and enhance learning in …


High-Resolution, Fast-Response Optical Fiber Temperature Sensor With A Large Measurement Range Based On Fiber-Tip Alumina Fabry-Pérot Interferometer, Ruimin Jie, Chen Zhu, Robert Abbott, Michael Davis, Xiong Zhang, Jie Huang Jan 2026

High-Resolution, Fast-Response Optical Fiber Temperature Sensor With A Large Measurement Range Based On Fiber-Tip Alumina Fabry-Pérot Interferometer, Ruimin Jie, Chen Zhu, Robert Abbott, Michael Davis, Xiong Zhang, Jie Huang

Electrical and Computer Engineering Faculty Research & Creative Works

We present an alumina-tip optical fiber Fabry-Pérot interferometric temperature sensor exhibiting high-temperature performance, rapid response, and high resolution. Fabricated by fusion splicing an alumina micro disk directly to a single-mode fiber, the sensor achieves robust, stable operation without complex fabrication processes or adhesives. Experimental evaluation confirms a measurement range extending to 1000°C, with sensitivity of 28.66 pm/°C, a resolution of 0.042°C, and a rapid response time of approximately 13 ms. Compared to state-of-the-art optical fiber FPI sensors, our alumina-tip sensor offers superior overall performance, effectively addressing critical demands for high-resolution, fast-response temperature measurement in extreme environments including aerospace, structural monitoring, …


Safe Optimal Control Framework For Cooperative Manipulation Of Objects In Human–Robot Teams, Irfan Ganie, Sarangapani Jagannathan Jan 2026

Safe Optimal Control Framework For Cooperative Manipulation Of Objects In Human–Robot Teams, Irfan Ganie, Sarangapani Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This article introduces a distributed deep neural network (NN)-based adaptive control framework for cooperative object manipulation in human–robot teams with unknown agent dynamics by using three distinct multilayer NN observers (MNNOs). The first observer, termed the reference point estimator, enables each robotic agent to estimate the object's reference center using consensus-based learning, even without direct access to global reference trajectories. The second observer, referred to as the human force-to-trajectory estimator, uses human-applied forces to infer the intended position, velocity, and acceleration of the object, enabling real-time estimation of human intent. Together, these two observers allow distributed estimation of human-intended motion. …


Distributed Temperature Sensing In The Spray-Cooled Shell Of A 150-Ton Dc Electric Arc Furnace Using Brillouin Optical Fiber Technology, Farhan Mumtaz, Yeshwanth Reddy Mekala, Koustav Dey, Rony Kumer Saha, Ogbole Collins Inalegwu, Manoj Kumar Pullagura, Bohong Zhang, Muhammad Roman, Nicholas Dionise, Zane Voss, Jeffrey D. Smith, Ronald J. O'Malley, Rex E. Gerald, Jie Huang Jan 2026

Distributed Temperature Sensing In The Spray-Cooled Shell Of A 150-Ton Dc Electric Arc Furnace Using Brillouin Optical Fiber Technology, Farhan Mumtaz, Yeshwanth Reddy Mekala, Koustav Dey, Rony Kumer Saha, Ogbole Collins Inalegwu, Manoj Kumar Pullagura, Bohong Zhang, Muhammad Roman, Nicholas Dionise, Zane Voss, Jeffrey D. Smith, Ronald J. O'Malley, Rex E. Gerald, Jie Huang

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents the deployment and validation of a Brillouin - distributed temperature sensing (DTS) system for real-time thermal monitoring of the spray-cooled upper shell of a 150-ton direct current Electric Arc Furnace (DC EAF) at Big River Steel Plant, Osceola, AR, USA. A four-channel Brillouin DTS system from OZ Optics was employed, with one active channel instrumented using an in-house-fabricated Brillouin scattering-depressed single-mode optical fiber (SMF28e+). The 60 m optical fiber sensor was fabricated, with 20 m allocated for thermal measurement and 40 m used as lead-in fiber to isolate the interrogator from the furnace environment. The fiber was …


Self-Calibrating Uav Navigation: Reinforcement Learning Approaches For Horizontal Trajectory Estimation, Shirin Nasr-Esfahani, S. Jagannathan Jan 2026

Self-Calibrating Uav Navigation: Reinforcement Learning Approaches For Horizontal Trajectory Estimation, Shirin Nasr-Esfahani, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

Accurate unmanned aerial vehicle (UAV) trajectory estimation is essential for autonomous navigation, particularly in GPS-denied environments. Visualodometry and simultaneous localization and mapping (SLAM) approaches require precise camera intrinsic parameters, which are typically obtained through predefined or offline calibration. Instead, in this work, we propose a reinforcement learning (RL)-based self-calibration framework that estimates camera intrinsic parameters directly from monocular video sequences, without requiring prior knowledge of the camera, environment, or calibration targets. This intrinsic parameter estimation is then leveraged to achieve robust UAV trajectory estimation using only video data. We formulate the problem as a sequential decision-making task, where an RL …


Sapphire Optical Fiber Bragg Grating Sensors Based On Dispersive Microwave-Photonic Frequency-Time Domain Analysis, Ruimin Jie, Chen Zhu, Farhan Mumtaz, Koustav Dey, Bohong Zhang, Jie Huang Jan 2026

Sapphire Optical Fiber Bragg Grating Sensors Based On Dispersive Microwave-Photonic Frequency-Time Domain Analysis, Ruimin Jie, Chen Zhu, Farhan Mumtaz, Koustav Dey, Bohong Zhang, Jie Huang

Electrical and Computer Engineering Faculty Research & Creative Works

Sapphire fiber Bragg gratings (SFBGs) have attracted growing interest for high temperature sensing in harsh environments, yet their interrogation typically relies on optical spectrum measurements, demanding a high-resolution optical spectrum analyzer (OSA) that is bulky, expensive, and constrained in acquisition speed. Moreover, the inherently multimode nature of sapphire fiber further complicates spectrum-based demodulation, thereby limiting the achievable sensing resolution. In this paper, we propose and experimentally demonstrate a microwave-photonic interrogation approach for SFBG sensors. Instead of measuring the optical reflection spectrum, the complex frequency response in the microwave domain of an SFBG is acquired using a vector network analyzer (VNA) …


Annual Fire Safety Report, 2025, Illinois State University, Environmental Health And Safety Jan 2026

Annual Fire Safety Report, 2025, Illinois State University, Environmental Health And Safety

Fire Safety Annual Reports

The Higher Education Opportunity Act (HEOA) requires all institutions of higher education that provide residential housing facilities for students to develop an annual fire safety report. Elements of Illinois State University’s campus fire safety program consists of: fire prevention policies and practices, fire safety educational and training initiatives, description of fire protection equipment in the residence halls, emergency evacuation procedures, fire safety statistics, and plans for future improvements to the residence hall campus fire safety program. The annual fire safety report summarizes the elements of the campus fire safety program, which is administered and maintained by Environmental Health and Safety …


Annual Security Report For Calendar Year 2025, Illinois State University Police Department Jan 2026

Annual Security Report For Calendar Year 2025, Illinois State University Police Department

Clery Act Annual Security Report

Illinois State University Police Department Annual Security Report