Medicine and Health Sciences Commons^™

Prediction Of First And Multiple Antiretroviral Therapy Interruptions In People Living With Hiv: Comparative Survival Analysis Using Cox And Explainable Machine Learning Models, Donald Salami, Emily Koech, Janet Turan, Kristen Stafford, Lilly Nyagah, Stephen Ohakanu, Anthony Ngugi, Manhattan Charurat

Institute for Human Development, East Africa

Background: The Cox proportional hazards (CPH) model is a common choice for analyzing time-to-treatment interruptions in patients on antiretroviral therapy (ART), valued for its straightforward interpretability and flexibility in handling time-dependent covariates. Machine learning (ML) models have increasingly been adapted for handling temporal data, with added advantages of handling complex, nonlinear relationships and large datasets, and providing clear practical interpretations.

Objective: This study aims to compare the predictive performance of the traditional CPH model and ML models in predicting treatment interruptions among patients on ART, while also providing both global and individual-level explanations to support personalized, data-driven interventions …

Wellness Connection Newsletter February 2026, Roger Williams University School Of Law

Life of the Law School (1993- )

No abstract provided.

Himmelfarb Liaison Letter - February 2026, The George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Catatonia And Elevated Mortality: A Population-Wide Cohort Study With Healthy, Sibling, And Schizophrenia Spectrum Controls, Chih-Wei Hsu, Yang-Chieh Brian Chen, Marco Solmi, Chih-Sung Liang, Mu-Hong Chen, Yao-Hsu Yang, Liang-Jen Wang, Edward Chia-Cheng Lai

Children’s Nutrition Research Center Staff Publications

Aim: To determine whether catatonia is associated with increased long-term all-cause and cause-specific mortality.

Methods: Using Taiwan's National Health Insurance Database (2000-2022), we assembled a population-based cohort of all adults (≥18 years) with catatonia and matched each to four controls without catatonia on sex and birthdate. Mortality was compared between (1) individuals with catatonia and their unaffected siblings and (2) individuals with schizophrenia spectrum disorders with catatonia and those with schizophrenia spectrum disorders without catatonia. The primary outcome was all-cause mortality; secondary outcomes were natural- and unnatural-cause deaths. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated with …

Uncovering Predictors Of Bipolar Ii Conversion To Bipolar I: A Machine Learning Analysis Of National Health Records In Taiwan, Chih-Wei Hsu, Yang-Chieh Brian Chen, Liang-Jen Wang, Kuo-Chuan Hung, Mu-Hong Chen, Eduard Vieta, Chien-Yuan Chen, Chih-Sung Liang, Andre F Carvalho

Children’s Nutrition Research Center Staff Publications

Background: Bipolar II disorder (BD-II) can progress to bipolar I disorder (BD-I), carrying profound psychosocial consequences. However, limited research has investigated the transition from BD-II to BD-I. Our study uses machine learning to predict the conversion using real-world data.

Methods: We conducted a retrospective cohort study using the Taiwan National Health Insurance Research Database (2000-2013) to identify adults diagnosed with BD-II. A predictive model for BD-I conversion was developed using extreme gradient boosting (XGBoost), incorporating demographic factors, healthcare utilization, comorbidities, and psychotropic medication use. The dataset was randomly divided into development (80 %) and test (20 %) sets. Model performance …

Quality Improvement Project: Improving Transitional Care Management (Tcm) Follow-Up Through Medical Assistant Education, Oben Assick

Doctor of Nursing Practice Projects

The underutilization of Transitional Care Management (TCM) services in primary care significantly contributes to preventable hospital readmissions and revenue loss. Despite established Centers for Medicare & Medicaid Services (CMS) guidelines, execution often fails due to knowledge gaps among frontline staff. This quality improvement project addressed low TCM task completion rates by implementing a structured educational intervention for medical assistants (MAs). The purpose was to evaluate whether targeted training improves timely patient follow-up, visit scheduling, and billing accuracy. The project utilized Kotter’s 8-Step Change Model to guide organizational change and the Health Belief Model to address behavioral barriers. A quantitative, quasi-experimental …

Age And Sex Impact The Role Of Thrombospondin-2 And Thrombospondin-5 In Response To Hindlimb Ischemia, Irene Helenowski, Ashley Peters, Melissa Rangel, Corinne Bunn Md, Xuerong Wang, Kristopher Maier, Vivian Gahtan

Biostatistics Collaborative Core: Faculty Publications and Other Works

Peripheral arterial disease progression to critical limb ischemia remains a significant burden in the aged, necessitating revascularization. Therapies to enhance neovascularization, such as angiogenesis or arteriogenesis, may provide an option for patients not suitable for surgery. The thrombospondins (TSPs) are secreted matricellular glycoproteins, with TSP-1, TSP-2, and TSP-5 implicated in neovascularization. Currently, there is little data regarding the effects of TSP-2, TSP-5, sex, and aging on angiogenesis and arteriogenesis. In vitro, the effect of TSP-2 or TSP-5 on early or late passage endothelial cell (EC) tubule formation or disruption was assessed. In vivo, angiogenesis, and arteriogenesis in male and female, …

Does Hormone Replacement Therapy Reduce Bone Resorption In Postmenopausal Women With An Intact Uterus?, Ashley Harding

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not hormone replacement therapy reduces bone resorption in postmenopausal women with an intact uterus.

STUDY DESIGN: A systematic review of three double blind randomized control trials (RCTs) published from 2016 to 2022.

DATA SOURCES: All RCTs were published in peer reviewed journals in English and were found on PubMed and Google Scholar. Articles were chosen based on relevance to the clinical question.

OUTCOME MEASURED: Level of bone resorption was measured via assessment of bone turnover markers at baseline and after use of hormone replacement therapy in all …

In Adults With Elevated Or Borderline-High Ldl Cholesterol Levels, Does Daily Consumption Of Oat-Derived Products Providing Approximately 3 G Of Β-Glucan Reduce Ldl Cholesterol?, Marilyn K. Enderson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence-based medicine review is to determine whether daily consumption of approximately 3 g of oat-derived β-glucan reduces low-density lipoprotein cholesterol (LDL-C) in adults with elevated or borderline-high LDL-C when compared with a β-glucan–free control.

STUDY DESIGN: Review of three double-blind randomized controlled trials (RCTs) published from 2020 to 2021.

DATA SOURCES: All RCTs were published in English in peer-reviewed journals and identified using PubMed. Articles were selected based on relevance to the clinical question, inclusion of adult populations with elevated LDL-C, and evaluation of oat-derived β-glucan as an intervention.

OUTCOMES MEASURED: The primary outcome …

Are Berberine-Based Treatments Effective In Reducing Hemoglobin A1c (Hba1c%) In Adults With Type Ii Diabetes?, Queenie Douangpraseuth

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Are berberine-based treatments effective in reducing Hemoglobin A1c (HbA1c%) in adults with type 2 diabetes?”

STUDY DESIGN: A review of 3 randomized control trials (RCTs) published between 2015 to 2020 DATA SOURCES: Articles were found on PubMed and Google scholar. Selected articles were published in peer-reviewed journals in English and were chosen based on applicability to clinical questions posed in the objective and meeting inclusion criteria.

OUTCOMES MEASURED: All three RCTs measured the mean HbA1c% over time. A blood sample is taken and laboratory tests are …

Does A Single Dose Of Intravenous Ketamine Reduce Suicidal Ideation In Adults With Major Depressive Disorder?, Rylee Schieman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a “single dose of intravenous (IV) ketamine can decrease suicidal ideation in adults with major depressive disorder (MDD)?”

STUDY DESIGN: A systematic review of 3 double-blind, randomized controlled trials (RCTs) published from 2018 to 2024.

DATA SOURCES: All RCTs were found using PubMed and Google Scholar. The articles were published in peer-reviewed journals and in English. The articles were selected based on their relevance to the clinical question posed in the objective.

OUTCOMES MEASURED: All 3 studies focused on reducing suicidal ideation. The outcome was measured …

Associations Between County-Level Vape-Free Air Law Coverage And E-Cigarette Use Behaviors Among U.S. Adolescents In Monitoring The Future, James H. Buszkiewicz, Yanmei Xie, Catherine A. Vander Woude, Steven Cook, Bukola Usidame, Megan E. Patrick, Michael R. Elliott, James F. Thrasher, Nancy L. Fleischer

Department of Health and Kinesiology Faculty Publications

Purpose

We examined whether workplace and hospitality vape-free air law (VAL) population coverage was associated with adolescent e-cigarette use and related disparities in the United States.

Methods

We analyzed associations between county-level workplace and hospitality VAL coverage (100% vs. < 100%) and current e-cigarette use (2014–2022) and first e-cigarette initiation (2015–2022) among US 8th, 10th, and 12th graders using nationally representative, cross-sectional Monitoring the Future data. We implemented weighted, grade-stratified, modified Poisson regression models, adjusted for individual-, county-, and state-level confounding factors, examining disparities by sex, race and ethnicity, parental education, and college educational expectations through two-way interactions.

Results

Workplace and hospitality VAL coverage was not associated with adolescent e-cigarette use or initiation overall. However, we did find that VAL coverage was associated with lower current e-cigarette use in some sociodemographic subgroups. Full (100%) hospitality VAL coverage was linked to lower e-cigarette use among male 8th and 12th graders, 12th graders with parents without a bachelor's degree, Hispanic 8th …

Effectiveness Of Dialectical-Behavioral Intervention On Emotional Regulation Difficulties, Distress Tolerance, And Social Functioning Among Patients With Bipolar Disorder: Randomized Controlled Trial, Nashwa Ibrahim

Nursing

Aim

To determine the effect of implementing dialectical behavior therapy (DBT) skills training groups on emotional regulation difficulties, distress tolerance, and social functioning among patients with bipolar disorder (BD).

Methods

A randomized controlled trial was conducted with 120 patients diagnosed with BD who were attending follow-up at the outpatient clinic. Participants were randomly assigned to either the experimental group, which received 16 group psychoeducation sessions held twice weekly, or the control group, which received standard outpatient care. Analysis of variance (ANOVA) with repeated measures was applied to compare normally distributed quantitative variables across more than two time points or stages, …

Perioperative Anaphylaxis In A Healthy Adolescent After First Lifetime Surgery, Shayan Sazdar, Salman Aljubran

Posters

Introduction: Perioperative anaphylaxis is a rare life-threatening event. Its evaluation poses complex considerations inherent to the use of multiple medications. Patient presentation: A healthy 11-year-old boy developed anaphylaxis shortly after discharge home from first lifetime surgery for orchiopexy. Perioperative medications included rocuronium, propofol, fentanyl, bupivacaine, sugammadex, ondansetron, dexamethasone, dexmedetomidine, and ketorolac. No antibiotics. After surgery, he consumed fast food dinner and ice cream. Within 2 hours after discharge home, he returned to our Emergency Department (ED) with facial and tongue angioedema, hives, and respiratory distress. He received multiple doses of intramuscular epinephrine and briefly required epinephrine drip in the ED. …

Asthma Phenotypes And Control In 22q11.2 Deletion Syndrome: A Single-Center Retrospective Study, Cody Shopper, Katey Campbell, Nikita S. Raje

Posters

Background: Patients with 22q11.2 deletion syndrome have increased rates of atopy and immune dysregulation and may experience a higher burden of asthma; however, real-world data describing asthma control, severity, and treatment patterns in this population are limited. We hypothesized that asthma control and severity patterns in patients with 22q11.2 deletion syndrome differ from those observed in the general asthma population. Objectives/Goal: To characterize asthma control, severity, and treatment patterns among patients with 22q11.2 deletion syndrome and to compare observed patterns with those typically reported in the general asthma population. Methods/Design: We conducted a retrospective observational cohort study of patients with …

A Case Report Of Milk-Alkali Syndrome Secondary To Excessive Antacid Use, Samir Beso, Layla Abubshait

Einstein Health Papers

INTRODUCTION: Milk-alkali syndrome is characterized by the triad of hypercalcemia, metabolic alkalosis, and acute kidney injury resulting from excessive intake of calcium and absorbable alkali. Despite falling out of prominence with the advent of modern ulcer treatments, milk-alkali syndrome has experienced a resurgence with the widespread availability of over-the-counter calcium preparations, which now account for up to 10% of hypercalcemia cases.

CASE REPORT: A 60-year-old man with multiple comorbidities presented to the emergency department with altered mental status after his scheduled kyphoplasty was canceled due to concerning neurological findings. Laboratory evaluation revealed severe hypercalcemia, marked metabolic alkalosis, and acute kidney …

Pericardial Effusion, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Total Hip Replacement Eras, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

How The Dental Workforce Personifies Servant Leadership, William Chase Dds, Maom

The Journal of the Michigan Dental Association

This feature article explores various leadership styles, identifying servant leadership as the most relevant model for dental professionals. The author connects servant leadership to emotional intelligence (EI), detailing how traits like empathy, self-awareness, and active listening empower clinicians to build trusting patient relationships. By dedicating themselves to high standards of care and maintaining respect for patients, dental teams personify trusted providers. The feature encourages dentists to view themselves as leaders and oral health counselors.

The Scope And Impact Of Walking The Talk For Dementia 2024, Sherril B. Gelmon, Kate Irving, Walter Dawson, Jonathan Adrián Zegarra-Valdivia, Lingani Mbakile-Mahlanza, Fernando Aguzzoli-Peres

Institute on Aging Publications

Walking the Talk for Dementia (WTD) is a global educational initiative integrating a walk along the Camino de Santiago with a symposium to combat dementia stigma, raise awareness, and foster inclusion.

Adapt Vr In Dental Education: Boosting Preclinical Skill And Self-Confidence, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Introduction: Preclinical dental training requires extensive feedback and repetition, which traditional manikin exercises often lack. Adapt VR is a cost-effective, immersive system that delivers interactive, adaptive training with real-time feedback. Methods: This comparative study aimed to evaluate the effectiveness of the Adapt VR system in preclinical training. A total of 126 third-year dental students were randomly assigned to an Adapt VR Group 1 (n = 63), acquiring VR learning experience before practicing on laboratory simulators, or a control group (n = 63) who started their training on simulators directly. After practising Class I and II cavity preparations, laboratory performance was …

Essays On Public Policy And Health Outcomes: Unintended Consequences And The Cost Of Influence, Wenhan Yan

Dissertations and Theses Collection (Open Access)

This dissertation investigates the complex behavioral responses to public policy shifts and institutional cues, quantifying their intended and unintended societal impacts. Across two distinct empirical contexts, this research examines how individuals adapt their risk profiles when signals from political or legal authorities change and how these adaptations generate measurable externalities.

The first chapter, "From Punishment to Treatment: Unintended Social Impacts of Changing Drug Policies," shifts the focus to the intersection of health policy and criminal justice. This chapter evaluates the sudden transition from punitive drug enforcement to health-oriented decriminalization, utilizing the 2021 State v. Blake decision in Washington as a …

The 2025 Accra Declaration On Upskilling And Cost-Effective Cardiac Surgery In Africa, Charles Yankah, Jonathan Nwiloh, Carlos Mestres, Abdelmalek Bouzid, Tom Mwambu, Andrew Duncan, Mohamed Debieche, Samuel Omokhodion, Uvie Onakpoya, Matthias Angres

General Surgery, East Africa

The Pan-African Society for Cardiothoracic Surgery (PASCaTS) organized the 1st Pan-African Cardiothoracic Surgery Summit on 21 to 24 February 2025 in Accra, Ghana. The summit brought together leading specialists from across Africa, China, Europe, South America and the USA to address the growing burden of cardiovascular disease, to share their vision for the fight against cardiovascular disease, to raise standards in the diagnosis, treatment, and recovery of patients thereby improving procedural safety and clinical outcomes in Africa. The experts agreed on the need for cost effectiveness in cardiac surgery, simulation skills training, an African regional cardiothoracic surgery database, African heart …

The Global Cancer Crisis: A Review Of Growing Burden, Deepening Inequality And Initiatives For Prevention And Early Detection, Charles Yankah, Jonathan Nwiloh, Carlos Mestres, Abdelmalek Bouzid, Tom Mwambu, Andrew Duncan, Mohamed Debieche, Samuel Omokhodion, Uvie Onakpoya, Matthias Angres

General Surgery, East Africa

Cancer constitutes one of the most urgent global health crises, with over 20 million new cases diagnosed annually worldwide, claiming 10 million lives. This devastating burden disproportionately affects vulnerable populations: 75% of cancer deaths occur in low- and middle-income countries despite these regions having lower reported incidence rates. Lung cancer leads the global toll, representing 12% of all cases but 19% of deaths, followed by breast cancer (12% of cases) and colorectal cancer (9.6%). A stark geographical inequity defines the cancer landscape—while wealthy regions such as North America, Northern Europe and Australia report the highest incidence rates, Africa and Latin …

Coaching In Undergraduate And Graduate Medical Education: A Scoping Review Of Success Factors, Barriers, And Outcomes Data File, Binata Mukherjee, Jenna Pfleeger, Haidee Custodio, Maria Renee Roca, Gurupreet Khalsa, Clista Clanton

Data and Datasets

The data in this file support the findings of the following study.

Purpose: Wanting to implement a sustainable learner coaching program in academic medicine and prior exposure to coaching initiatives raised questions including planning, implementation and assessment, and resource allocation. This scoping review examines coaching across medical learners, reported program elements, success factors, and barriers.

Methods: Following PRISMA-ScR guidelines, informed by Levac et al. on Arskey and O’Malley’s framework and Braun and Clarke’s thematic analysis, PubMed, Scopus, and ERIC was searched through May 2024. Articles were screened, data extracted, and coded. A mixed methods analysis included descriptive statistics and thematic …

Does Hla-B27 Status Influence Ixekizumab Efficacy In Axial Spondyloarthritis? Results From The Coast-V, Coast-W, And Coast-X Trials, John D Reveille, Martin Rudwaleit, Proton Rahman, Jose A Maldonado-Cocco, Marina Magrey, Rebecca Bolce, Khai Jing Ng, Theresa Hunter Gibble, Jeffrey Lisse, So Young Park, Andris Kronbergs, Victoria Navarro-Compán

The Brown Foundation: Institute of Molecular Medicine

Introduction: The human leukocyte antigen (HLA)-B27 is associated with axial spondyloarthritis (axSpA) and is a predictor of response to tumor necrosis factor inhibitors. However, limited data are available on HLA-B27 and interleukin-17 inhibitors. We evaluated the influence of HLA-B27 status on ixekizumab response through 52 weeks in patients with axSpA.

Methods: Data were analyzed from three randomized placebo-controlled trials: COAST-V (NCT02696785), COAST-W (NCT02696798), and COAST-X (NCT02757352). Patients fulfilled the Assessment of SpondyloArthritis international Society (ASAS) criteria for radiographic (r)-axSpA or non-radiographic (nr)-axSpA. Patients were randomized to receive 80 mg ixekizumab every 2 weeks, 80 …

Utilization Of Evidence-Based Secondary Preventive Therapies Post-Acute Coronary Syndrome: A Heart Registry Cohort Study In Kenya, Anthony Ochola, Jasmit Shah, Jeilan Mohamed, Harun Otieno, Anders Barasa, Felix Barasa, Constantine Akwanalo, Benard Gitura, Mzee Ngunga

Internal Medicine, East Africa

Introduction: cardiovascular disease is a growing concern in Africa, with coronary artery disease emerging as a leading cause of mortality. Despite strong evidence and international guidelines recommending secondary prevention therapy post-acute coronary syndrome (ACS)-including antiplatelet agents, statins, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors-suboptimal use remains a concern, especially in low- and middle-income countries. This study aimed to quantify the use of guideline-recommended secondary prevention medications after ACS in Kenya using the data from the Kenya Heart Registry study.

Methods: a cohort study was conducted using data from the Kenya Heart Registry across three hospitals in Kenya from …

International Normative Charts For Twin Weight, Length, And Head Circumference At Birth, By Gestational Age And Sex: The Twin Neonatal Cross-Sectional Study Of The Intergrowth-21st Project, Francesca Giuliani, Sonia Deantoni, Enrico Bertino, Yasmin A. Jaffer, Manorama Purwar, Fernando C. Barros, Leila Cheikh Ismail, Wu Qingqing, Ilaria Stura, Maria Carvalho

Obstetrics and Gynaecology, East Africa

Assessing the size of twins at birth using charts developed for singletons may over diagnose small for gestational age in this sub-population. The study aimed to produce international, twin-specific, newborn size normative charts by gestational age and sex. This longitudinal observational study in eight geographically diverse settings prospectively collected data between May 2009 and August 2013 from healthy pregnant women and their newborn twins. The participants were enrolled as part of the INTERGROWTH-21st study, and recruited based on World Health Organization recommendations for evaluation of anthropometric measures. All the women met, in addition to the underlying population characteristics of low …

The Use Of A Standardized Checklist For Image Acquisition: An Obstetric Ultrasound Quality Improvement Study, Ingrid Gichere, Nidhi Leekha, Sikolia Wanyonyi

Obstetrics and Gynaecology, East Africa

Introduction A complete anatomical survey during the mid-trimester ultrasound is critical for detecting fetal anomalies. In sub-Saharan Africa, detection rates remain low, contributing to a significant disease burden. This study evaluated whether implementing a standardized electronic checklist, based on existing guidelines, would improve image acquisition.

Methods We carried out a pre- and post-intervention quasi-experimental quality improvement study. An electronic checklist replaced the previous ultrasound report template. A baseline review involved 385 mid-trimester scans conducted between November 2022 and December 2023. Following checklist implementation and targeted sonographer training, 238 scans were reassessed from July to December 2024. The image acquisition rate …

Can Tanzanian Neurosurgeons Access Tanzanian Neurosurgical Literature? A Systematic Review And Survey Of Neurosurgical Publications, Romani R. Sabas, Julie Woodfield, Chibuikem Anthony Ikwuegbuenyi, Magalie Cadieux, Consolata Shayo, Zarina Shabhay, Happiness Rabiel, Beverly Cheserem, Joel Bwemelo, Drew N. Wright

General Surgery, East Africa

Background and Objectives: Free and open access to research data and findings promotes equity in access to healthcare knowledge and equity in patient care and treatment. To benefit the health care of the population studied, research findings must be accessible to clinicians, academics, and policymakers serving those populations. The aim of this study was to assess the extent of published Tanzanian neurosurgical data and its accessibility to those practicing within the country.

Methods: A systematic review of all published neurosurgical studies from Tanzania was conducted. Authorship, funding, and open-access status were recorded. Tanzanian neurosurgeons were surveyed by telephone or in …