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Articles 481 - 510 of 1369

Full-Text Articles in Diagnosis

Cardiopulmonary Exercise Testing In Pulmonary Arterial Hypertension And Chronic Thromboembolic Pulmonary Hypertension, Alexis Coulis, Shir Levanon, Gurshaun Randhawa, Yevgeniy Brailovsky, Farhan Raza, Estefania Oliveros Nov 2024

Cardiopulmonary Exercise Testing In Pulmonary Arterial Hypertension And Chronic Thromboembolic Pulmonary Hypertension, Alexis Coulis, Shir Levanon, Gurshaun Randhawa, Yevgeniy Brailovsky, Farhan Raza, Estefania Oliveros

Division of Cardiology Faculty Papers

Cardiopulmonary exercise testing allows for a comprehensive assessment of the mechanism of exercise limitation in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Competitive pathophysiologic mechanisms may affect the clinical interpretation of cardiopulmonary disease as they relate to dyspnea, leg fatigue, and exercise intolerance.


Screen-Printed Wearable Sensors For Continuous Respiratory Rate Monitoring: Fabrication, Clinical Evaluation, And Point-Of-Care Potential, Ala’Aldeen Al-Halhouli, Ahmed Albagdady, Alexander Rabadi, Musab Hamdan, Jumana Abu-Khalaf, Mahmoud Abu-Abeeleh Nov 2024

Screen-Printed Wearable Sensors For Continuous Respiratory Rate Monitoring: Fabrication, Clinical Evaluation, And Point-Of-Care Potential, Ala’Aldeen Al-Halhouli, Ahmed Albagdady, Alexander Rabadi, Musab Hamdan, Jumana Abu-Khalaf, Mahmoud Abu-Abeeleh

Research outputs 2022 to 2026

In this paper, we investigated the use of screen printing for the fabrication of a non-invasive wearable sensor, aimed at achieving accurate and continuous measurement of respiratory rate. The developed sensor was clinically evaluated on 15 healthy human participants, demonstrating its potential for point-of-care testing. Wearable sensors are emerging as the future of continuous healthcare monitoring by recording crucial physiological parameters that can be processed to monitor existing health conditions and predict future ones. Having a reliable tool to monitor respiratory rate is extremely valuable for healthcare professionals since it can indicate disease progression under certain conditions like COPD (chronic …


Commentary: Obstructive Sleep Apnea In The Hemodialysis Population: Are Clinicians Putting Existing Scientific Evidence Into Practice?, Aleena Jamal, Som Singh, Fawad Qureshi Nov 2024

Commentary: Obstructive Sleep Apnea In The Hemodialysis Population: Are Clinicians Putting Existing Scientific Evidence Into Practice?, Aleena Jamal, Som Singh, Fawad Qureshi

SKMC Student Presentations and Publications

No abstract provided.


Validation Of An Artificial Intelligence-Based Prognostic Biomarker In Patients With Oligometastatic Castration-Sensitive Prostate Cancer, Jarey H. Wang, Matthew P. Deek, Adrianna A. Mendes, Yang Song, Amol Shetty, Soha Bazyar, Kim Van Der Eecken, Emmalyn Chen, Timothy N. Showalter, Trevor J. Royce, Tamara Todorovic, Huei-Chung Huang, Scott A. Houck, Rikiya Yamashita, Ana P. Kiess, Daniel Y. Song, Tamara Lotan, Theodore Deweese, Luigi Marchionni, Lei Ren, Amit Sawant, Nicole L. Simone, Alejandro Berlin, Cem Onal, Andre Esteva, Felix Y. Feng, Phuoc T. Tran, Philip Sutera, Piet Ost Nov 2024

Validation Of An Artificial Intelligence-Based Prognostic Biomarker In Patients With Oligometastatic Castration-Sensitive Prostate Cancer, Jarey H. Wang, Matthew P. Deek, Adrianna A. Mendes, Yang Song, Amol Shetty, Soha Bazyar, Kim Van Der Eecken, Emmalyn Chen, Timothy N. Showalter, Trevor J. Royce, Tamara Todorovic, Huei-Chung Huang, Scott A. Houck, Rikiya Yamashita, Ana P. Kiess, Daniel Y. Song, Tamara Lotan, Theodore Deweese, Luigi Marchionni, Lei Ren, Amit Sawant, Nicole L. Simone, Alejandro Berlin, Cem Onal, Andre Esteva, Felix Y. Feng, Phuoc T. Tran, Philip Sutera, Piet Ost

Department of Radiation Oncology Faculty Papers

BACKGROUND: There is a need for clinically actionable prognostic and predictive tools to guide the management of oligometastatic castration-sensitive prostate cancer (omCSPC).

METHODS: This is a multicenter retrospective study to assess the prognostic and predictive performance of a multimodal artificial intelligence biomarker (MMAI; the ArteraAI Prostate Test) in men with omCSPC (n = 222). The cohort also included 51 patients from the STOMP and ORIOLE phase 2 clinical trials which randomized patients to observation versus metastasis-directed therapy (MDT). MMAI scores were computed from digitized histopathology slides and clinical variables. Overall survival (OS) and time to castration-resistant prostate cancer (TTCRPC) were …


Evaluation Of Sirtuin 1 As A Predictor Of Cardiovascular Outcomes In Diabetic Patients With Limb-Threatening Ischemia, Federico Biscetti, Maria Margherita Rando, Maria Anna Nicolazzi, Enrica Rossini, Michele Santoro, Flavia Angelini, Roberto Iezzi, Luis H. Eraso, Paul J. Dimuzio, Dario Pitocco, Massimo Massetti, Antonio Gasbarrini, Andrea Flex Nov 2024

Evaluation Of Sirtuin 1 As A Predictor Of Cardiovascular Outcomes In Diabetic Patients With Limb-Threatening Ischemia, Federico Biscetti, Maria Margherita Rando, Maria Anna Nicolazzi, Enrica Rossini, Michele Santoro, Flavia Angelini, Roberto Iezzi, Luis H. Eraso, Paul J. Dimuzio, Dario Pitocco, Massimo Massetti, Antonio Gasbarrini, Andrea Flex

Department of Surgery Faculty Papers

Chronic limb-threatening ischemia (CLTI) significantly increases the risk of major adverse limb events (MALE) and major adverse cardiac events (MACE) after lower extremity revascularization (LER). This study aims to identify novel biomarkers that help to further reduce the risk of postoperative cardiovascular complications. In this prospective, nonrandomized, observational study, baseline serum levels of sirtuin 1 (SIRT1) were assessed in 147 diabetic patients scheduled for LER due to CLTI, and participants were followed for the occurrence of MALE and MACE over 12 months. Fifty-three patients experienced MALE, and 33 experienced MACE within the follow-up period. Lower baseline SIRT1 levels were significantly …


Guidelines For The Prevention, Diagnosis, And Management Of Urinary Tract Infections In Pediatrics And Adults: A Wikiguidelines Group Consensus Statement, Zachary Nelson, Abdullah Tarik Aslan, Nathan P. Beahm, Michelle Blyth, Matthew Cappiello, Danielle Casaus, Fernando Dominguez, Susan Egbert, Alexandra Hanretty, Tina Khadem, Katie Olney, Ahmed Abdul-Azim, Gloria Aggrey, Daniel T. Anderson, Mariana Barosa, Michael Bosco, Elias B. Chahine, Souradeep Chowdhury, Alyssa Christensen, Daniela De Lima Corvino, Margaret Fitzpatrick, Molly Fleece, Brent Footer, Emily Fox, Bassam Ghanem, Fergus Hamilton, Justin Hayes, Boris Jegorovic, Philipp Jent, Et Al Nov 2024

Guidelines For The Prevention, Diagnosis, And Management Of Urinary Tract Infections In Pediatrics And Adults: A Wikiguidelines Group Consensus Statement, Zachary Nelson, Abdullah Tarik Aslan, Nathan P. Beahm, Michelle Blyth, Matthew Cappiello, Danielle Casaus, Fernando Dominguez, Susan Egbert, Alexandra Hanretty, Tina Khadem, Katie Olney, Ahmed Abdul-Azim, Gloria Aggrey, Daniel T. Anderson, Mariana Barosa, Michael Bosco, Elias B. Chahine, Souradeep Chowdhury, Alyssa Christensen, Daniela De Lima Corvino, Margaret Fitzpatrick, Molly Fleece, Brent Footer, Emily Fox, Bassam Ghanem, Fergus Hamilton, Justin Hayes, Boris Jegorovic, Philipp Jent, Et Al

School of Medicine Faculty Publications

IMPORTANCE: Traditional approaches to practice guidelines frequently result in dissociation between strength of recommendation and quality of evidence. OBJECTIVE: To create a clinical guideline for the diagnosis and management of urinary tract infections that addresses the gap between the evidence and recommendation strength. EVIDENCE REVIEW: This consensus statement and systematic review applied an approach previously established by the WikiGuidelines Group to construct collaborative clinical guidelines. In May 2023, new and existing members were solicited for questions on urinary tract infection prevention, diagnosis, and management. For each topic, literature searches were conducted up until early 2024 in any language. Evidence was …


Dynamic Prediction Of Kidney Allograft And Patient Survival Using Post-Transplant Estimated Glomerular Filtration Rate Trajectory, Khandoker Shuvo Bakar, Armando Teixeira-Pinto, Ryan Gately, Farzaneh Boroumand, Wai H. Lim, Germaine Wong Nov 2024

Dynamic Prediction Of Kidney Allograft And Patient Survival Using Post-Transplant Estimated Glomerular Filtration Rate Trajectory, Khandoker Shuvo Bakar, Armando Teixeira-Pinto, Ryan Gately, Farzaneh Boroumand, Wai H. Lim, Germaine Wong

Research outputs 2022 to 2026

Background: Allograft loss is the most feared outcome of kidney transplant recipients. We aimed to develop a dynamic Bayesian model using estimated glomerular filtration rate (eGFR) trajectories to predict long-Term allograft and patient survivals.

Methods: We used data from the Australian and New Zealand Dialysis and Transplant registry and included all adult kidney transplant recipients (1980-2017) in Australia (derivation cohort) and New Zealand (NZ, validation cohort). Using a joint model, the temporal changes of eGFR trajectories were used to predict patient and allograft survivals. Results: The cohort composed of 14 915 kidney transplant recipients [12 777 (86%) from Australia and …


A Large Scale Multi Institutional Study For Radiomics Driven Machine Learning For Meningioma Grading, Mert Karabacak, Shiv Patil, Rui Feng, Raj K. Shrivastava, Konstantinos Margetis Oct 2024

A Large Scale Multi Institutional Study For Radiomics Driven Machine Learning For Meningioma Grading, Mert Karabacak, Shiv Patil, Rui Feng, Raj K. Shrivastava, Konstantinos Margetis

Department of Medicine Faculty Papers

This study aims to develop and evaluate radiomics-based machine learning (ML) models for predicting meningioma grades using multiparametric magnetic resonance imaging (MRI). The study utilized the BraTS-MEN dataset's training split, including 698 patients (524 with grade 1 and 174 with grade 2-3 meningiomas). We extracted 4872 radiomic features from T1, T1 with contrast, T2, and FLAIR MRI sequences using PyRadiomics. LASSO regression reduced features to 176. The data was split into training (60%), validation (20%), and test (20%) sets. Five ML algorithms (TabPFN, XGBoost, LightGBM, CatBoost, and Random Forest) were employed to build models differentiating low-grade (grade 1) from high-grade …


Radiomics-Based Machine Learning With Natural Gradient Boosting For Continuous Survival Prediction In Glioblastoma, Mert Karabacak, Shiv Patil, Zachary C. Gersey, Ricardo J. Komotar, Konstantinos Margetis Oct 2024

Radiomics-Based Machine Learning With Natural Gradient Boosting For Continuous Survival Prediction In Glioblastoma, Mert Karabacak, Shiv Patil, Zachary C. Gersey, Ricardo J. Komotar, Konstantinos Margetis

SKMC Student Presentations and Publications

(1) Background: Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, with an aggressive disease course that requires accurate prognosis for individualized treatment planning. This study aims to develop and evaluate a radiomics-based machine learning (ML) model to estimate overall survival (OS) for patients with GBM using pre-treatment multi-parametric magnetic resonance imaging (MRI). (2) Methods: The MRI data of 865 patients with GBM were assessed, comprising 499 patients from the UPENN-GBM dataset and 366 patients from the UCSF-PDGM dataset. A total of 14,598 radiomic features were extracted from T1, T1 with contrast, T2, and FLAIR MRI sequences …


Editorial Review Of The Validation Of Thoracolumbar Injury Classification And Severity Score In The Management Of Acute And Subacute Osteoporotic Vertebral Compression Fractures, Alex R. Vaccaro Oct 2024

Editorial Review Of The Validation Of Thoracolumbar Injury Classification And Severity Score In The Management Of Acute And Subacute Osteoporotic Vertebral Compression Fractures, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.


Bilothorax As An Endoscopic Retrograde Cholangiopancreatography Complication And A Review Of The Literature, Hamza Azam, Mohammed Affan Guliyara, Bapti Roy Oct 2024

Bilothorax As An Endoscopic Retrograde Cholangiopancreatography Complication And A Review Of The Literature, Hamza Azam, Mohammed Affan Guliyara, Bapti Roy

Research outputs 2022 to 2026

Bilothorax, the accumulation of bile in the pleural space, is an uncommon but serious condition often linked to biliary tract or diaphragmatic injury. This case report describes a 70-year-old female with decompensated liver cirrhosis due to primary sclerosing cholangitis, who developed a moderate sized pleural effusion following ERCP and biliary stenting. The patient's pleural effusion persisted for 2 months without respiratory symptoms, indicating a self-limited low-volume leak. She eventually underwent thoracentesis for a non-resolving unilateral effusion, which drained 435 mL of bilious fluid with an elevated pleural fluid bilirubin level, confirming the diagnosis of bilothorax. This case highlights the importance …


Transcription And Post-Translational Mechanisms: Dual Regulation Of Adiponectin-Mediated Occludin Expression In Diabetes, Yanru Duan, Demin Liu, Huahui Yu, Shihan Zhang, Yihua Xia, Zhiyong Du, Yanwen Qin, Yajing Wang, Xin-Liang Ma, Huirong Liu, Yunhui Du Oct 2024

Transcription And Post-Translational Mechanisms: Dual Regulation Of Adiponectin-Mediated Occludin Expression In Diabetes, Yanru Duan, Demin Liu, Huahui Yu, Shihan Zhang, Yihua Xia, Zhiyong Du, Yanwen Qin, Yajing Wang, Xin-Liang Ma, Huirong Liu, Yunhui Du

Department of Emergency Medicine Faculty Papers

BACKGROUND: Occludin, a crucial component of tight junctions, has emerged as a promising biomarker for the diagnosis of acute ischemic disease, highlighting its significant potential in clinical applications. In the diabetes, Occludin serves as a downstream target gene intricately regulated by the adiponectin (APN) signaling pathway. However, the specific mechanism by which adiponectin regulates Occludin expression remains unclear.

METHODS AND RESULTS: Endothelial-specific Ocln knockdown reduced APN-mediated blood flow recovery after femoral artery ligation and nullified APN's protection against high-fat diet (HFD)-triggered apoptosis and angiogenesis inhibition in vivo. Mechanically, we have meticulously elucidated APN's regulatory role in Occludin expression through a …


Impact Of Cardiovascular Imaging Results On Medication Use And Adherence: A Systematic Review And Meta-Analysis, Reindolf Anokye, Jack Dalla Via, James Dimmock, Ben Jackson, Carl Schultz, Mie Schæffer, Joanne M. Dickson, Lauren C. Blekkenhorst, Mandy Stanley, Jonathan M. Hodgson, Joshua R. Lewis Oct 2024

Impact Of Cardiovascular Imaging Results On Medication Use And Adherence: A Systematic Review And Meta-Analysis, Reindolf Anokye, Jack Dalla Via, James Dimmock, Ben Jackson, Carl Schultz, Mie Schæffer, Joanne M. Dickson, Lauren C. Blekkenhorst, Mandy Stanley, Jonathan M. Hodgson, Joshua R. Lewis

Research outputs 2022 to 2026

Introduction: Cardiovascular imaging results offer valuable information that can guide health decisions, but their impact on medication use and adherence is unclear. This systematic review and meta-analysis aimed to determine the downstream impact of cardiovascular imaging results on medication use and adherence.

Methods: Searches were conducted across databases, including MEDLINE, PsychINFO, EMBASE, and relevant references up to 2024. Data were extracted from studies comparing outcomes for individuals with diseased versus normal arteries and trials comparing outcomes for individuals who were provided imaging results versus those with no access to imaging results and analysed in 2023 and 2024. Pooled odds ratios …


Peran Pemeriksaan Penanda Tumor Cairan Pleura Dalam Diagnosis Efusi Pleura Maligna Akibat Kanker Paru Primer, Cleopas M. Rumende, Noorwati Sutandyo, Arif R. Hanafi, Samuel K. Rumende, Erwin C. Susanto, Truely P. Sitorus Sep 2024

Peran Pemeriksaan Penanda Tumor Cairan Pleura Dalam Diagnosis Efusi Pleura Maligna Akibat Kanker Paru Primer, Cleopas M. Rumende, Noorwati Sutandyo, Arif R. Hanafi, Samuel K. Rumende, Erwin C. Susanto, Truely P. Sitorus

Jurnal Penyakit Dalam Indonesia

Introduction. Pleural effusion is a frequently acquired lung disorder and based on the type of cause it is divided into malignant and non-malignant pleural effusion. Cytological examination of pleural fluid to differentiate between malignant and non-malignant pleural effusion shows varying sensitivity. Research regarding the benefits of CEA and Cyfra 21-1 pleural fluid examination to detect malignant pleural effusion due to primary lung cancer in Indonesia is still very limited. The aims of this study is to determine the sensitivity and specificity of CEA and Cyfra 21-1 pleural fluid in diagnosing malignant pleural effusion due to primary lung camcer.

Methods …


Noninvasive Multi-Cancer Detection Using Blood-Based Cell-Free Micrornas, Jason Zhang, Hallgeir Rui, Hai Hu Sep 2024

Noninvasive Multi-Cancer Detection Using Blood-Based Cell-Free Micrornas, Jason Zhang, Hallgeir Rui, Hai Hu

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Patients diagnosed with early-stage cancers have a substantially higher chance of survival than those with late-stage diseases. However, the option for early cancer screening is limited, with most cancer types lacking an effective screening tool. Here we report a miRNA-based blood test for multi-cancer early detection based on examination of serum microRNA microarray data from cancer patients and controls. First, a large multi-cancer training set that included 1,408 patients across 7 cancer types and 1,408 age- and gender-matched non-cancer controls was used to develop a 4-microRNA diagnostic model using 10-fold cross-validation. In three independent validation sets comprising a total of …


Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West Sep 2024

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …


Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego Sep 2024

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …


Synovial Fluid Cutibacterium Acnes Antigen Is Detected Among Shoulder Samples With High Inflammation And Early Culture Growth, Krista Toler, Pearl Paranjape, Alex Mclaren, Thomas Jefferson University Sep 2024

Synovial Fluid Cutibacterium Acnes Antigen Is Detected Among Shoulder Samples With High Inflammation And Early Culture Growth, Krista Toler, Pearl Paranjape, Alex Mclaren, Thomas Jefferson University

Rothman Institute Papers

Background: An emerging paradigm suggests that positive Cutibacterium acnes shoulder cultures can result from either true infection or contamination, with true infections demonstrating a host inflammatory response and early culture growth. This clinical retrospective study examines the relationship between C. acnes antigen, C. acnes culture results, and inflammation.

Methods: From January 2021 to July 2023, 1,365 periprosthetic synovial fluid samples from 347 institutions were tested for shoulder infection at a centralized clinical laboratory. A biomarker scoring system based on the 2018 International Consensus Meeting (ICM) definition was utilized to assign each sample an inflammation score. Associations between inflammation, culture results, …


Adaptation Of The Socioecological Model To Address Disparities In Engagement Of Black Men In Prostate Cancer Genetic Testing, Amy Leader, Timothy Rebbeck, William Oh, Alpa Patel, Eric Winer, Leeann Bailey, Leonard Gomella, Crystal Lumpkins, Isla Garraway, Lisa Aiello, Monica Baskin, Heather H Cheng, Kathleen Cooney, Amanda Ganzak, Daniel George, Susan Halabi, Feighanne Hathaway, Claire Healy, Joseph W Kim, Michael Leapman, Stacy Loeb, Kara Maxwell, Christopher Mcnair, Todd Morgan, Breanne Prindeville, Howard R Soule, Whitney Steward, Sakinah Suttiratana, Mary-Ellen Taplin, Kosj Yamoah, Thierry Fortune, Kris Bennett, Joshua Blanding-Godbolt, Laura Gross, Veda Giri Sep 2024

Adaptation Of The Socioecological Model To Address Disparities In Engagement Of Black Men In Prostate Cancer Genetic Testing, Amy Leader, Timothy Rebbeck, William Oh, Alpa Patel, Eric Winer, Leeann Bailey, Leonard Gomella, Crystal Lumpkins, Isla Garraway, Lisa Aiello, Monica Baskin, Heather H Cheng, Kathleen Cooney, Amanda Ganzak, Daniel George, Susan Halabi, Feighanne Hathaway, Claire Healy, Joseph W Kim, Michael Leapman, Stacy Loeb, Kara Maxwell, Christopher Mcnair, Todd Morgan, Breanne Prindeville, Howard R Soule, Whitney Steward, Sakinah Suttiratana, Mary-Ellen Taplin, Kosj Yamoah, Thierry Fortune, Kris Bennett, Joshua Blanding-Godbolt, Laura Gross, Veda Giri

Department of Medical Oncology Faculty Papers

BACKGROUND: Black men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities. To address these critical disparities, the Socioecological Model (SEM) was employed to develop comprehensive recommendations to overcome barriers and implement equitable strategies to engage Black males in PCA GT.

METHODS: Clinical/research experts, national organization leaders, and community stakeholders spanning multiple regions in US and Africa …


A Presentation Of Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease (Mogad) As Optic Neuritis, Kirhyn A. Stein, Laura Garcia, Sobia Memon, Hernan Guanajuato, Johanna Mora Sep 2024

A Presentation Of Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease (Mogad) As Optic Neuritis, Kirhyn A. Stein, Laura Garcia, Sobia Memon, Hernan Guanajuato, Johanna Mora

Research Colloquium

Background: Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease (MOGAD) is a relatively new and rare autoimmune disease that causes demyelination of the central nervous system. The pathogenicity of this disease is characterized by an immune reaction against myelin oligodendrocyte glycoprotein: a component of the myelin sheath that is also expressed on the surface of oligodendrocytes. The purpose of this glycoprotein is thought to be for construction and maintenance of myelin and cell to cell communication. The destruction of oligodendrocytes and myelin in the central nervous system affects the brain, spinal cord, and optic nerves, and can cause symptoms such as acute …


Multimodal Mixing Convolutional Neural Network And Transformer For Alzheimer’S Disease Recognition, Junde Chen, Yun Wang, Adnan Zeb, M. D. Suzauddola, Yuxin Wen Sep 2024

Multimodal Mixing Convolutional Neural Network And Transformer For Alzheimer’S Disease Recognition, Junde Chen, Yun Wang, Adnan Zeb, M. D. Suzauddola, Yuxin Wen

Engineering Faculty Articles and Research

Early recognition of Alzheimer’s disease (AD) and its precursor state, mild cognitive impairment (MCI), is pivotal in interrupting the progression of the disease and providing suitable treatment. Recent development in deep learning techniques has drawn great research attention for improving the efficacy of AD recognition. However, numerous current methods solely utilize data from a single auxiliary domain, limiting their ability to harness valuable intrinsic insights from multiple domains. To cope with the challenge, this paper is devoted to establishing an innovative multimodal medical data fusion model, termed as MMDF, to perform Alzheimer’s disease recognition. Multimodal data including clinical records and …


A Clinician’S Perspective On The New Organ Mesentery And Non-Vascular Mesenteropathies, Monjur Ahmed Sep 2024

A Clinician’S Perspective On The New Organ Mesentery And Non-Vascular Mesenteropathies, Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Mesentery was discovered as a new organ in 2017. It is a continuous membranous tissue from the duodenojejunal flexure to the anorectal junction. It has distinct anatomy, physiology, and disease states. Primary mesenteropathies include vascular and non-vascular diseases. Some of them are common, and some of them are rarely seen in clinical practice. Secondary mesenteropathies occur when infection or malignancy in another organ spreads to the mesentery. Each entity has specific diagnostic and treatment protocols. Increased awareness of different mesenteropathies and an understanding of their various presentations at different stages of life can help in early diagnosis and improved clinical …


Emergency Department Slit Lamp Interdisciplinary Training Via Longitudinal Assessment In Medical Practice, Samara Hamou, Shayan Ghiaee, Christine Chung, Maureen Lloyd, Kelly Khem, Xiao Zhang Sep 2024

Emergency Department Slit Lamp Interdisciplinary Training Via Longitudinal Assessment In Medical Practice, Samara Hamou, Shayan Ghiaee, Christine Chung, Maureen Lloyd, Kelly Khem, Xiao Zhang

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Eye emergencies make up nearly 3% of US emergency department (ED) visits. While emergency physicians (EP) should diagnose and treat these ophthalmologic emergencies, many trainees report limited ocular exposure and insufficient training throughout their residency to confidently conduct a thorough slit-lamp exam.

METHODS: We created an interdisciplinary, simulation-based mastery learning (SBML) curriculum to teach emergency attending physicians how to operate the slit lamp with multimodal learning methodology at a tertiary academic center. The EPs first demonstrate their initial slit-lamp competency with a 20-item checklist, and they then review the necessary curricular content to pass their independent readiness test before …


Thrower’S Fracture With Subsequent Compartment Syndrome Requiring Emergent 2 Compartment Upper Extremity Fasciotomy, Andrew Wise, Darwin Ang Aug 2024

Thrower’S Fracture With Subsequent Compartment Syndrome Requiring Emergent 2 Compartment Upper Extremity Fasciotomy, Andrew Wise, Darwin Ang

HCA Healthcare Journal of Medicine

Introduction

A thrower’s fracture is a mid-to-distal third humerus fracture that commonly presents as an audible pop with severe arm pain sustained during the throwing motion. Although thrower’s fracture has been described previously in the literature, this report is the first to demonstrate compartment syndrome as its potential sequel.

Case Presentation

A 25-year-old semi-professional pitcher presented to the emergency department with severe right arm pain following a pitch. He described hearing an audible pop with subsequent severe pain. He was found to have elevated compartment pressures in his upper arm and was rushed to the operating room for a 2 …


Clinical And Radiological Identification And Management Of Sapho Syndrome, Obyda Al-Housni, Jessica M. Alonso, Matthew Thornburg, Enny Cancio Aug 2024

Clinical And Radiological Identification And Management Of Sapho Syndrome, Obyda Al-Housni, Jessica M. Alonso, Matthew Thornburg, Enny Cancio

HCA Healthcare Journal of Medicine

Introduction

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an autoinflammatory disease whose acronymic name stands for the symptoms commonly seen in the disease. These symptoms typically occur simultaneously, in different combinations, in patients during exacerbations of the disease. SAPHO syndrome is a rare disease, most frequently seen in patients aged 30 to 50. It is estimated to be found in 1 in 10 000 persons in White populations, with an even lower incidence seen in non-White populations.

Case Presentation

A post-menopausal woman with a medical history of SAPHO presented to the emergency department with left foot pain and …


Minocycline-Induced Retinal Pigment Epithelium Hyperpigmentation Masquerading As Age-Related Macular Degeneration: Case Presentation And Proposed Mechanism, Michael D. Yu, Nikhil Bommakanti, Yoshihiro Yonekawa, Jose S. Pulido Aug 2024

Minocycline-Induced Retinal Pigment Epithelium Hyperpigmentation Masquerading As Age-Related Macular Degeneration: Case Presentation And Proposed Mechanism, Michael D. Yu, Nikhil Bommakanti, Yoshihiro Yonekawa, Jose S. Pulido

Wills Eye Hospital Papers

PURPOSE: We describe the case of an 80-year-old man with bilateral minocycline-induced retinal pigment epithelium (RPE) hyperpigmentation, which initially masqueraded as AMD. Secondarily, using multimodal imaging features, we propose a mechanism for the development of minocycline-induced RPE hyperpigmentation.

OBSERVATIONS: The patient was referred with concern for AMD given the presence of macular drusenoid deposits on optical coherence tomography. However, funduscopic evaluation showed dense granular parafoveal hyperpigmentation, with a diffuse slate-colored hyperpigmentation throughout the peripheral fundus. Short-wavelength fundus autofluorescence of the macula disclosed no irregularities (as would be expected with drusen) while on near-infrared reflectance (NIR) imaging, numerous hyperreflective foci were …


Appropriateness Of Imaging For Low-Risk Prostate Cancer-Real World Data From The Pennsylvania Urologic Regional Collaboration (Purc), Raidizon Mercedes, Dennis Head, Elizabeth Zook, Eric Eidelman, Jeffrey Tomaszewski, Serge Ginzburg, Robert Uzzo, Marc Smaldone, John Danella, Thomas Guzzo, Daniel Lee, Laurence Belkoff, Jeffrey Walker, Adam Reese, Mihir Shah, Bruce Jacobs, Jay Raman Aug 2024

Appropriateness Of Imaging For Low-Risk Prostate Cancer-Real World Data From The Pennsylvania Urologic Regional Collaboration (Purc), Raidizon Mercedes, Dennis Head, Elizabeth Zook, Eric Eidelman, Jeffrey Tomaszewski, Serge Ginzburg, Robert Uzzo, Marc Smaldone, John Danella, Thomas Guzzo, Daniel Lee, Laurence Belkoff, Jeffrey Walker, Adam Reese, Mihir Shah, Bruce Jacobs, Jay Raman

Einstein Health Papers

Imaging for prostate cancer defines the extent of disease. Guidelines recommend against imaging low-risk prostate cancer patients with a computed tomography (CT) scan or bone scan due to the low probability of metastasis. We reviewed imaging performed for men diagnosed with low-risk prostate cancer across the Pennsylvania Urologic Regional Collaborative (PURC), a physician-led data sharing and quality improvement collaborative. The data of 10 practices were queried regarding the imaging performed in men diagnosed with prostate cancer from 2015 to 2022. The cohort included 13,122 patients with 3502 (27%) low-risk, 2364 (18%) favorable intermediate-risk, 3585 (27%) unfavorable intermediate-risk, and 3671 (28%) …


Influence Of Cbct Different Radiation Doses On Mandibular Soft Tissue Thickness Measurements, Marwa Ezz Elarab, Mahinaz Reda Abdelhamed Aug 2024

Influence Of Cbct Different Radiation Doses On Mandibular Soft Tissue Thickness Measurements, Marwa Ezz Elarab, Mahinaz Reda Abdelhamed

Dentistry

Purposes: Study the influence of changing CBCT radiation doses (using ultra low dose and high dose systems) on soft tissues thickness measurements and compare the results with the direct measurements method. Methods:9 fresh pig mandiblue were utilized for each of two CBCT scan systems (Planmeca Promax 3D MID). Nine disposable needles were inserted into the gingival tissue of each jaw until reaching resistance from the underlying bone. A mark on each needle at its entrance point into the soft tissue was created using a permanent marker. Jaws were scanned twice, using ultra low (Rad UL) and high (Rad H) exposure …


Syphilitic Gumma Presenting As Squamous Cell Carcinoma Of Vulva: A Case Report, R.M. Nuss, A.J. Lazenby, Holly C. Provost, Tara Castellano Aug 2024

Syphilitic Gumma Presenting As Squamous Cell Carcinoma Of Vulva: A Case Report, R.M. Nuss, A.J. Lazenby, Holly C. Provost, Tara Castellano

School of Medicine Faculty Publications

Introduction: Tertiary syphilis, a late form of the disease with neurologic, cutaneous, and cardiovascular manifestations, is rarely seen in the United States in modern times. Also called the “great imitator,” syphilis tends to mimic other disease processes, which can lead to a delay in proper diagnosis and treatment. Case: We present the case of a 59-year-old woman who presented for evaluation of possible squamous cell carcinoma of the vulva. After multiple inconclusive biopsies and extensive workup with multiple providers, she was instead found to have cutaneous and neurologic tertiary syphilis. A correct diagnosis was delayed in this patient due to …


Transformer-Based Deep Learning Prediction Of 10-Degree Humphrey Visual Field Tests From 24-Degree Data, Min Shi, Anagha Lokhande, Yu Tian, Yan Luo, Mohammad Eslami, Saber Kazeminasab, Tobias Elze, Lucy Shen, Louis Pasquale, Sarah Wellik, Carlos Gustavo De Moraes, Jonathan Myers, Nazlee Zebardast, David Friedman, Michael Boland, Mengyu Wang Aug 2024

Transformer-Based Deep Learning Prediction Of 10-Degree Humphrey Visual Field Tests From 24-Degree Data, Min Shi, Anagha Lokhande, Yu Tian, Yan Luo, Mohammad Eslami, Saber Kazeminasab, Tobias Elze, Lucy Shen, Louis Pasquale, Sarah Wellik, Carlos Gustavo De Moraes, Jonathan Myers, Nazlee Zebardast, David Friedman, Michael Boland, Mengyu Wang

Wills Eye Hospital Papers

PURPOSE: To predict 10-2 Humphrey visual fields (VFs) from 24-2 VFs and associated non-total deviation features using deep learning.

METHODS: We included 5189 reliable 24-2 and 10-2 VF pairs from 2236 patients, and 28,409 reliable pairs of macular OCT scans and 24-2 VF from 19,527 eyes of 11,560 patients. We developed a transformer-based deep learning model using 52 total deviation values and nine VF test features to predict 68 10-2 total deviation values. The mean absolute error, root mean square error, and the R2 were evaluation metrics. We further evaluated whether the predicted 10-2 VFs can improve the structure-function relationship …