Digital Commons Network^™

Ultrasound Applications In The Treatment Of Major Depressive Disorder: A Systematic Review Of Techniques And Therapeutic Potentials In Clinical Trials And Animal Model Studies, Gansheng Tan, Hong Chen, Eric C Leuthardt

2020-Current year OA Pubs

OBJECTIVE: Major depressive disorder (MDD) is a debilitating condition that inflicts significant personal and economic burdens and affects approximately 8% of the US population. Approximately 30% of patients with MDD do not respond to conventional antidepressant and psychotherapeutic treatments. Current treatment options for refractory MDD include transcranial magnetic stimulation (TMS) and invasive surgical procedures such as surgical ablation, vagus nerve stimulation, and deep brain stimulation. In this context, therapeutic ultrasound emerges as a promising alternative for treating refractory MDD, which has the unique advantage of combining noninvasiveness with selective targeting. Over the past ten years, there has been growth in …

How To Measure, Analyze, And Interpret Age-Related Changes In Caenorhabditis Elegans: Lessons For Mechanistic And Evolutionary Theories Of Aging, Zuzana Kocsisova, Brian M Egan, Andrea Scharf, Xavier Anderson, Franziska Pohl, Aaron Anderson, Kerry Kornfeld

2020-Current year OA Pubs

Aging is characterized by progressive degenerative changes in tissue organization and function, some of which increase the probability of mortality. Major goals of aging research are to elucidate the series of events that cause degenerative changes, and to identify environmental, pharmacological, and genetic factors that influence these changes; this information might lead to new strategies to extend health span and lifespan. Mechanistic studies of aging depend on accurate and precise descriptions of age-related changes, since these descriptions define the aging phenotype. Here, we review studies that describe age-related changes in C. elegans, including measurements of integrated functions such as behavior …

Evaluating The Effectiveness Of Escalating To Weekly Adalimumab Dosing For The Treatment Of Noninfectious Uveitis: A Multicenter Study, Shani Pillar, Akshay Thomas, Lynn M Hassman, Howard Chen, Sapna Gangaputra, Laura J Kopplin, Kelly Boyd, Kareem Moussa, Derek C Pham, Keren Chen, Nicholas J Jackson, Edmund Tsui

2020-Current year OA Pubs

PURPOSE: To evaluate the effectiveness of adalimumab dosage escalation in patients with noninfectious uveitis that is controlled inadequately with standard dosing.

DESIGN: Multicenter retrospective interventional case series.

PARTICIPANTS: Patients with noninfectious uveitis receiving active standard biweekly adalimumab dosing who underwent treatment escalation to weekly adalimumab dosing at 6 tertiary referral centers.

METHODS: Demographic data and clinical findings were assessed at the time of adalimumab dosage escalation and 6 months later. Mixed-model analysis was performed to analyze clinical outcomes and to assess predictive factors of success.

MAIN OUTCOME MEASURES: Treatment success composite criteria included: (1) disease quiescence (≤ 0.5+ anterior chamber …

Computational Single-Neuron Mechanisms Of Visual Object Coding In The Human Temporal Lobe, Runnan Cao, Jie Zhang, Jie Zheng, Yue Wang, Peter Brunner, Jon T Willie, Shuo Wang

2020-Current year OA Pubs

Understanding how the human brain encodes visual objects involves deciphering the neural computations and circuits in the temporal lobe. Here, we recorded intracranial EEG from the human ventral temporal cortex (VTC) and medial temporal lobe (MTL), as well as single-neuron activity in the MTL, to investigate the computational mechanisms of neural object coding. The VTC exhibited axis-based feature coding, and a neural feature space could be constructed using VTC neural axes, within which visual objects clustered according to high-level categorical relationships. Importantly, MTL neurons encoded receptive fields within this VTC neural feature space, exhibiting selective responses to objects that shared …

Supporting Emergency Department Patients Experiencing Homelessness, Antony Hsu, Michael A Light, Callan Fockele, Samantha Hay, Stephen Y Liang, Wendy Macias-Konstantopoulos, Carla B Brim, William Weber

2020-Current year OA Pubs

Homelessness is a growing public health crisis across the United States. Emergency physicians are uniquely positioned to address immediate medical concerns and the underlying social drivers of health for patients experiencing homelessness. Initiating coordination of care in the emergency department addresses their hierarchy of needs and can help support patient movement through the department. Practice adaptations described include early engagement; trauma-informed care approach; addressing unmet nonmedical needs; establishing safe dispositions; documenting homelessness, substance use disorder, and linkages to care; clinical practice adaptations; and palliative care approaches. Programs and initiatives outside of the emergency department described include street medicine and government …

A Female With Missing Anatomical Landmarks During Emergency Endotracheal Intubation, Matthew P Olocco, Rawan Safa, Philip A Mudd, Aaron J Lacy

2020-Current year OA Pubs

No abstract provided.

Seeg-Guided Responsive Neurostimulation To Treat Neocortical Epilepsy: A Multicenter Retrospective Study Of The Efficacy And Safety Of Depth Electrode-Mediated Neuromodulation, Sina Sadeghzadeh, Jon T Willie, Et Al.

2020-Current year OA Pubs

OBJECTIVES: Pivotal trials have established the effectiveness of the Responsive Neurostimulation System (RNS® System) in treating focal epilepsy. In clinical trials, depth leads were primarily used to treat mesial temporal seizure onsets while cortical strip leads were used to treat neocortical seizure onsets. Here, we systematically analyze the safety and efficacy of stereoelectroencephalography (sEEG)-guided depth leads to provide responsive stimulation to neocortical gray matter.

METHODS: Patients were stratified as strong responders (>median cohort seizure reduction %), weak responders (>0% and ≤median cohort seizure reduction %), and anti-responders (≤0%) based on percent seizure reduction at 1 year post-implant (1-Y). …

Association Of Sleep Disturbance With Survival After Colorectal Cancer Diagnosis: Results From The Colocare Study, Anita R Peoples, Adetunji T Toriola, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Sleep problems are common among cancer patients. The relationship between sleep disruption and clinical outcomes after colorectal cancer (CRC) diagnosis remains poorly understood. We investigated associations of sleep disruption with survival and recurrence in patients with CRC.

METHODS: CRC patients with stages I-IV (N = 895) were included in this study. Self-reported sleep disturbance was assessed presurgery using the sleep item from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core-30 and classified into "no/mild" or "moderate/severe" sleep disturbance. Cox-proportional hazard models were computed (HRs and 95% confidence intervals) to investigate associations of sleep disturbance …

In-Silico Trial Of Same-Day Simulation-Free Spatially Fractionated Adaptive Radiotherapy (Sf2-Art), Dennis N Stanley, Alyssa R Birchmeier, Carlos E Cardenas, Richard A Popple, Natalie Viscariello, Joel A Pogue, Courtney B Stanley, Mehran Yusuf, Michael Soike, Samuel R Marcrom, Joseph Harms

2020-Current year OA Pubs

PURPOSE: Here we present an in-silico trial of the feasibility and deliverability of a same-day, simulation-free workflow for spatially fractionated adaptive radiotherapy (SF

METHODS AND MATERIALS: Ten patients (five thoracic and five extremity), previously treated with spatially fractionated radiotherapy (SFRT), were selected for this in silico trial. A two-phase regimen was simulated: Phase 1 delivered 12 Gy SBRT to a uniform, predefined high-dose lattice and 4 Gy to the gross tumor volume (GTV); Phase 2 consisted of 4 additional fractions of 4 Gy to the GTV. The planning workflow was performed entirely in silico, without the need for CT simulation. …

Accelerated Diffusion Basis Spectrum Imaging With Tensor Computations, Kainen L Utt, Jacob S Blum, Donsub Rim, Sheng-Kwei Song

2020-Current year OA Pubs

This paper introduces an advanced framework for accelerated processing of diffusion-weighted imaging (DWI) data that utilizes an entire-image modeling approach to optimize the estimation of diffusion parameters from DWIs by mapping input diffusion data to predicted signals and estimating parameter values via a stochastic gradient descent optimizer (Adam). To validate this approach, we applied this framework to diffusion basis spectrum imaging (DBSI) and analyzed in vivo human brain and ex vivo mouse brain DWIs. Results demonstrate significant improvements to computational speed and signal-to-noise ratio (SNR) in estimated parameter maps compared to standard DBSI. Our approach is applicable to any diffusion …

Management Of Mechanical Ventilation In Emergency Medicine: A Scoping Review, Robert J Klemisch, Mitchell S Hymowitz, Ryan J Alcantara, Brendan F Mullan, Margaret L Davis, Rachel Blume, Nicholas J Johnson, Brian M Fuller

2020-Current year OA Pubs

OBJECTIVES: Invasive mechanical ventilation is used for approximately 250,000 emergency medicine (EM) patients annually and continues to increase. Despite rising volumes, EM clinicians receive limited training in ventilation management. Much of the existing evidence is derived from other environments, which may not fully apply to the unique conditions of EM. This scoping review broadly categorizes literature on invasive ventilation specific to EM patients and clinicians and identifies knowledge gaps to direct future research.

METHODS: Following Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews Checklist guidelines, this review comprehensively mapped the literature on optimizing invasive mechanical ventilation …

Blood Dna Methylation-Predicted Plasma Protein Levels And Colorectal Cancer Survival, Alicia R Richards, Maria F Gomez, Bianca I Dowling, Esther Jean-Baptiste, Biljana Gigic, Jane C Figueiredo, Christopher I Li, David Shibata, Adetunji T Toriola, Doratha A Byrd, Cornelia M Ulrich, Paul A Stewart, Erin M Siegel, Jacob K Kresovich

2020-Current year OA Pubs

BACKGROUND: Protein EpiScores are a novel class of DNA methylation (DNAm)-based metrics proposed to measure peripheral immune system characteristics. Although Protein EpiScores have been associated with chronic disease risk, their relationship with colorectal cancer (CRC) survival has not been investigated.

METHODS: We generated new genome-wide DNAm data on pre-treatment whole blood samples from a case-control sample of 136 newly diagnosed CRC patients nested in the ColoCare Study and calculated 107 Protein EpiScores using the developer's algorithm. Over a median follow-up of 7.3 years (range: 0.3-13.8 years), 35 (26%) patients experienced disease recurrence, and 47 (35%) died. Protein EpiScore associations with …

Lightweight Open-Source Large Language Models Versus Ctakes For Information Extraction From Discharge Summaries: Tobacco Smoking Status Test Case, David M Dávila-García, Matthew J Schuelke, Adam B Wilcox

2020-Current year OA Pubs

OBJECTIVES: To compare lightweight open-source large language models (LLMs) with cTAKES, a state-of-the-art natural language processing (NLP) system, in an information extraction task from hospitalization discharge summaries.

MATERIALS AND METHODS: Two readers annotated 250 randomly sampled adult discharge summaries (BJC HealthCare, 2018-2023) for tobacco smoking status as "Smoker," "Never smoker," "Unknown." Six LLMs (Llama-3 [1B-70B], gpt-oss-20B, MedGemma-27B) and cTAKES extracted smoking status from summaries. Performance was benchmarked against consensus annotations using weighted F1-score, macro F1-score, and per-class F1-scores and a noninferiority test.

RESULTS: Inter-reader agreement was excellent (κ = 0.91). LLM size (2.3-47.3 GB) and inference time (2.5-14.5 s/note) varied. …

Effects Of Dual-Eligible Integrated Care Plans On Medicaid Enrollment And Retention: Evidence From The Implementation Of Medicare-Medicaid Plans, Eric T Roberts, Eliza Macneal, Kenton J Johnston, José F Figueroa

2020-Current year OA Pubs

Medicare and Medicaid are separate programs that together cover 13 million low-income older adults and people with disabilities, known as dual-eligible individuals. Concern about a lack of coordination across Medicare and Medicaid has prompted the development of Integrated Care Programs (ICPs). Although the primary goal of ICPs is to coordinate financing and care across Medicare and Medicaid, ICPs may also influence whether low-income individuals obtain or keep Medicaid. We evaluated whether the rollout of Medicare-Medicaid Plans (MMPs)-one of the largest ICPs-was associated with changes in Medicaid take-up and retention among Medicare beneficiaries residing in high-poverty zip codes. Using a stacked …

Association Of Self-Rated Health And Risk Of Incident Atrial Fibrillation: Findings From Three Cohorts, Parveen K Garg, Aniqa Alam, Harpreet S Bhatia, Jens Horn, Vegard Malmo, Jan Pal Loennechen, Scott Mu, Randi Foraker, Elizabeth Selvin, Imre Janszky, Susan R Heckbert, Alvaro Alonso

2020-Current year OA Pubs

BACKGROUND: Self-rated health (SRH) is easy to obtain and is known to be a good predictor for mortality and several comorbidities, including cardiovascular disease, but its relation to atrial fibrillation (AF) is largely unknown. We determined the association of SRH with risk of developing AF.

METHODS: We conducted a pooled cohort analysis of participants in the Atherosclerosis Risk in Communities Study (ARIC) (

RESULTS: Over a mean of 16±6, 9 ± 2, and 10±4 years of follow-up, 2340 (22.8 %), 1525 (3.5 %), and 879 (17.4 %) incident AF events occurred in ARIC, HUNT-3, and MESA respectively. Lower SRH categories …

Risk Factors For Anticoagulant-Related Bleeding In Cancer: Traditional And Cancer-Specific Factors, Alexa Loncharich, Brian F Gage, Suhong Luo, Martin Schoen, Amber Afzal, Amir Mahmoud, Kenneth Carson, Su-Hsin Chang, Yan Yan, Kristen M Sanfilippo

2020-Current year OA Pubs

Managing anticoagulant therapy in cancer-associated venous thromboembolism (VTE) is challenging due to risks of recurrent VTE and anticoagulant-related bleeding. Existing clinical risk models for bleeding are limited by discriminatory ability in patients with cancer, perhaps due to the omission of cancer-specific risk factors for bleeding. This study estimated the associations of traditional and cancer-specific risk factors with bleeding requiring hospitalization in patients with cancer-associated VTE prescribed anticoagulant therapy. We conducted a retrospective cohort study using the Veterans Health Administration database to identify patients with cancer-associated VTE between 2012 and 2020. Cancer-associated VTE was defined by diagnostic International Classification of Diseases …

Skida1 Sustains Mll::Enl-Expressing Hematopoietic Progenitors During Neonatal Stages And Promotes B-Lineage Priming, Jonny Mendoza-Castrejon, Wei Yang, Elisabeth Denby, Rohini Muthukumar, Emily B Casey, Riddhi M Patel, Sarah K Tasian, Jeffrey A Magee

2020-Current year OA Pubs

Infant leukemias arise as B-cell acute lymphoblastic or acute myeloid leukemia. Most are driven by chromosomal rearrangements of the

Plasma Ceramides Levels In Severe Covid-19 Disease: Correlations With Survival, Tri Pham, Andrea M Heredia Castillo, Andrew Atkinson, Linda R Peterson, M Cristina Vazquez Guillamet

2020-Current year OA Pubs

BACKGROUND: Dysregulated inflammatory processes have been associated with severe COVID-19 disease. Ceramides, bioactive lipids involved in inflammatory signaling, have been utilized to predict outcomes in chronic cardiometabolic diseases and pancreatic cancer, but their role in COVID-19 remains unknown.

METHODS: This observational study prospectively enrolled patients with COVID-19 disease who required intubation and mechanical ventilation at a Midwestern academic hospital between August 2020 and March 2021. Plasma ceramides 16:0 (C16), 22:0 (C22), and 24:0 (C24) and inflammatory markers (CRP, ESR, D-Dimer, and ferritin) were collected and organized weekly from symptom onset for up to 6 weeks. Patients were grouped by in-hospital …

The Sport Publication Observational Research Tool (Sport): An Objective Tool To Score The Methodological Quality Of Observational Clinical Sports Medicine Research, Andrew W Kuhn, Paul M Inclan, Ameer A Haider, Michele N Christy, Robert Brophy, Matthew Smith, Matthew J Matava, Et Al.

2020-Current year OA Pubs

BACKGROUND: A critical component of conducting systematic reviews or meta-analyses is assessing the methodological quality and bias of included studies. Several methodological quality assessment tools have been developed; however, these tools may not be relevant to observational sports medicine research, which carries numerous unique nuances and biases.

PURPOSE: To develop the Sport Publication Observational Research Tool (SPORT), which evaluates and scores the methodological quality of observational sports medicine research.

STUDY DESIGN: Consensus statement.

METHODS: SPORT was developed through a modified Delphi approach involving members from the Herodicus Society and The FORUM. All active members were invited to participate in the …

A Comparative Study Of Word Embedding Techniques For Classification Of Star Ratings, Craig Mcneile, Malgorzata Wojtys, Hesham Abdelmotaleb

School of Engineering, Computing and Mathematics

Telecom services are at the core of today’s societies’ everyday needs. The availability of numerous online forums and discussion platforms enables telecom providers to improve their services by exploring the views of their customers to learn about common problems that customers face. Natural Language Processing (NLP) tools can be used to process the free text collected.One way of working with such data is to represent text as numerical vectors using one of many word embedding models based on neural networks. This research uses a novel dataset of telecom customers’ reviews to perform an extensive comparative study showing how different word …

Priority Without Progress: The Fda's Neglected Tropical Disease Voucher Program After 18 Years, Maple Goh, Kevin Outterson, Aaron Kesselheim

Faculty Scholarship

Introduction: To incentivize drug and vaccine development for neglected tropical diseases (NTDs), US Congress created the Priority Review Voucher (PRV) program in 2007. Sponsors that obtain Food and Drug Administration (FDA) approval for an eligible product receive a voucher redeemable to accelerate review of another product.

Methods: We reviewed the program’s public health impact by examining all 14 vouchers awarded for NTD products between 2007 and 2024, including the timing of FDA approval relative to World Health Organization (WHO) Prequalification, Essential Medicines List inclusion, first use in endemic countries, and voucher disposition.

Results: Eight (57%) achieved WHO …

Anxiety Gets All The Likes, Saniye Nur Ergan

Journal of Humanistic Mathematics

This internet meme (created by me:)) emerges from a simple yet persistent question that underlies much of my work: Why do we continue to treat certain emotions in mathematics as visible, nameable, and research-worthy, while others linger in the background as faint, unarticulated traces?

Being Different Doesn’T Make You Odd, Raffaella Mulas

Journal of Humanistic Mathematics

The number 2 is beautiful and it has many unique properties. It is the only even prime number, and being different from the other prime numbers doesn't make it odd. This is true also for people: being different doesn't make you odd. It makes you beautiful and unique.

Logical Conclusion, Robert Dawson

Journal of Humanistic Mathematics

There is a well-known anecdote about Kurt Gödel, just before his citizenship hearing, telling Einstein that the Constitution was logically flawed. This alternate-history story explored the possible ramifications.

Nightmare In The Library, Charles A. Coppin

Journal of Humanistic Mathematics

Students of real analysis and calculus find that the completeness property of the real numbers is difficult to understand, especially, its importance. The word numbers denote real numbers throughout this piece. After all, the real numbers are not any less imaginary than the so-called imaginary numbers. Although, sometimes, it does gain some mention in calculus courses, its presence as a topic is a mere will-o’-the-wisp of bygone days when teachers would often reach deep into the big ideas of calculus as a mainstay of their courses. For the sake of cultural literacy and the development of mathematical maturity, we believe …

To Those Who Ask "What's The Name Of Your Book, Again?", Marion D. Cohen

Journal of Humanistic Mathematics

No abstract provided.

Yet No Ramanujan, Db Jonas

Journal of Humanistic Mathematics

The poem Yet No Ramanujan conveys the musings of a layman in his garden, obsessed by the way that mundane things, the small experiences of everyday life, suggest the ways in which, as Baudelaire says, "everything is number." This meditation ends with the recognition that the putative stability of a self, a thinking subject, is after all, however complex and unique, like all matter, a kind of oscillation, a complex product of number.

Missing, James S. Huntley

Journal of Humanistic Mathematics

Fifty-five word stories have achieved a certain currency as a reflective format, perhaps especially in medicine. Many of them turn out to be poems. Here is one such story inviting the reader to consider the nature of the absent, of the 'missing', of zero, and the philosophical underpinnings of mathematics.

To The Mysterious Gamma: Euler- Mascheroni Constant, Md Sadikur Rahman

Journal of Humanistic Mathematics

No abstract provided.

Poems For A Calculus Class (After Reading Midlife Calculus And At The Dimensional Border), Kevin Farey

Journal of Humanistic Mathematics

This poetry folder is made up of two short trios. The first begins with “Methods,” a thirteen-line poem by Britt Kaufmann, and continues with two thirteen-line responses to it. The folder’s second half consists of three (non-thirteen-line) responses to a collection of thirteen-line-almost-sonnets by Philip Fried, who had in turn been inspired, during the pandemic, by Edwin Abbot’s Flatland.

Both Kaufmann and Fried are authors of previous JHM poetry folders. Poems from Kaufmann’s book Midlife Calculus appeared in the January 2025 issue and poems from Fried’s series At the Dimensional Border appeared in the July 2024 issue. In addition, …