Medical Specialties Commons^™

Comparative Study Between Minimally Invasive Right Anterior Minithoracotomy Versus Mini-Upper Sternotomy In Isolated Aortic Valve Replacement (Early Outcome), Ashraf Abdelaziz, Hazem G. Bakr, Ibrahim M. Helmi

Journal of Medicine in Scientific Research

Background Minimally invasive surgical methods have lately become popular in heart surgery. Ministernotomy and minithoracotomy are the most commonly used incisions in minimally invasive aortic valve replacement. It is still debated if one incision is better than the other. Patients and methods A prospective comparative analysis was used to examine the outcomes of 30 patients who underwent isolated aortic valve replacement. A minimally invasive right anterior minithoracotomy approach was used in group A (n = 15), whereas a mini-upper sternotomy method was used in group B (n = 15). Results The results in both groups reveal no statistical …

A Rare Case Of Dystrophinopathy: Duchenne Muscular Dystrophy;Becker Muscular Dystrophy Intermediate Complex, Manish S. Ahuja, Neena Katoch, Rachna Gulati, Subhendu Pandit, Tathagata Bose

Journal of Medicine in Scientific Research

An 18-year-old boy with no significant perinatal history presented with insidious onset of slowly progressive flaccid paraparesis with muscle wasting in thighs. On examination, the patient had flaccid motor quadriparesis and partial atrophy of proximal thigh muscles. This was accompanied by pseudohypertrophy of calf muscles and extensor muscles in the dorsum of foot. Investigations revealed very high levels of creatinine phosphokinase in the patient (6495 IU/l in contrast to normal range of 55–170 IU/l) and in his sister (718 IU/l). Echocardiography showed dilated cardiomyopathy with severe left ventricular dysfunction. The multiplex ligation-dependent probe amplification revealed deletion of exons 3 to …

Erratum: Parents’ Knowledge, Attitude And Practices Toward Oral Health Of Their Children With Primary Dentition: A Cross Sectional Study, Marwa Foad, Mennatallah Helal, Soad Abdel Moneim

Journal of Medicine in Scientific Research

The Erratum statement can be found in the PDF file.

A Comparative Study On The Effects Of Dextrose Prolotherapy And Local Steroid Injection In Patients With Lateral Epicondylitis: A Randomized Controlled Trial, Abhishek Biswas, Ameed Equebal, Osama Neyaz, Rajkumar Yadav, Suvrat Gupta

Journal of Medicine in Scientific Research

Background Lateral epicondylitis (LE) is the most common condition of elbow pain. Multiple intralesional steroid injections help in the treatment. Prolotherapy is a traditional injection method recently categorized as regenerative treatment. However, there is scarcity of literature that compares its effectiveness with steroids. Objective The aim was to compare the effectiveness of dextrose prolotherapy (DP) against local steroid injection in patients with LE in relieving pain and improving dysfunction. Participants and methods This parallel, randomized controlled trial was conducted at Outpatient Department, National Institute for Locomotor Disabilities (Divyangjan), (erstwhile National Institute for the Orthopaedically Handicapped) Kolkata, from January 2016 to …

Could Vitamin D3 Be Effective In Prevention Of Risk Of Preeclampsia Among Pregnant Women?, Adel G. Allam, Ibrahim M. El-Maghraby

Journal of Medicine in Scientific Research

Background Preeclampsia, a pregnancy disease marked by high blood pressure and proteinuria, affects 2–8% of all pregnancies. Preeclampsia can be life-threatening for both the mother and the fetus and is still a significant cause of maternal and neonatal morbidity and mortality. The goal of this study was to assess if there was a link between maternal serum vitamin D3 levels and the severity of preeclampsia. Patients and methods A case–control study was conducted on 70 pregnant women at Shebin El Kom Teaching Hospital. All pregnant women were divided into two groups: group A included 30 apparently healthy pregnant women (control …

Correlation Between Neutrophil-To-Lymphocyte Ratio After Percutaneous Coronary Intervention And The Size Of Infarction In Patients With Acute Myocardial Infarction, Mohamed R. Badran

Journal of Medicine in Scientific Research

Background Inflammatory processes have a role in the pathogenesis of acute myocardial infarction (AMI), left ventricular remodeling, and repair. Infarct size (IS) is a strong predictor of prognosis following AMI. Several tools are used to predict IS, but most of them are expensive and inaccessible all the time. So, neutrophil-to-lymphocyte ratio (NLR) as a marker of inflammation is an easy and cheap tool to predict IS. Aim To assess if post-percutaneous coronary intervention (PCI) NLR can predict IS in patients with AMI. Patients and methods The study included 11 125 patients with AMI treated with primary PCI. We used cardiovascular …

Comparative Study Between Right-Sided Minithoracotomy Versus Upper Partial Ministernotomy In Isolated Mitral Valve Replacement (Early Outcome), Ashraf Abdelaziz, Emmanuel L. Aziz, Hazem G. Bakr

Journal of Medicine in Scientific Research

Background In recent years, minimally invasive surgical techniques have become increasingly popular in heart surgery. The most common incisions used in minimally invasive mitral valve replacement are ministernotomy and minithoracotomy. It is still up for dispute whether one incision is superior to the other. Patients and methods The results of 60 patients who had solitary mitral valve replacement were studied using a prospective comparative analysis. In group A (n = 30), a minimally invasive right anterior minithoracotomy technique was performed, whereas in group B (n = 30), a partial upper ministernotomy procedure was used. Results The results in …

Effect Of Different Modalities Of Noninvasive Respiratorys Upport In Preterm Infants With Respiratory Distress Syndrome: A Prospective Multicenter Study, Abeer E. S. Hamed, Alaa A. Rashad, Heba Allah M. Sherief, Magued A. Iskandar, Mahmoud H. Dawabah, Manar A. Eldesouky, Mohamed A. Ibrahim, Sohaila A. Abd El-Halim

Journal of Medicine in Scientific Research

Background The first few hours after birth are very critical for newborns to adapt to the extrauterine environment. However, respiratory distress syndrome (RDS) is very common in newborns, particularly in those with shorter gestation ages, sepsis, and fewer platelet counts. The evaluation of respiratory management with current noninvasive ventilation (NIV) support strategies in preterm infants present within the neonatal intensive care unit, as well as drawbacks of NIV modes including nasal continuous positive airway pressure, nasal intermittent positive pressure ventilation, and high-flow nasal cannula, is also critical for those patients. This study aimed to compare different modes of NIV to …

The Role Of Myocardial Mechanical And Qtc Dispersion In Detecting Significant Coronary Artery Disease, Mohamed R. Badran

Journal of Medicine in Scientific Research

Background Prolonged myocardial contraction and QT interval duration may be found in ischemic viable myocardium, yet it is unclear if noninvasive examination of regional nonhomogeneous myocardial mechanics and QT duration may detect patients with significant coronary artery disease (CAD). Aim To assess the ability of cardiac mechanical and QTc dispersions to identify significant CAD in patients having chest pain with no prior myocardial infarction. Patients and methods We examined 125 patients who had chest pain and evaluated by coronary angiography. They are divided into two groups. CAD group included 75 patients with significant CAD, and control group included 50 patients …

Early Versus Late Intervention In Patients With High-Risk Non-St;-Elevation Myocardial Infarction, Emmanuel Louka Aziz, Mohamed Abbas Morsy

Journal of Medicine in Scientific Research

Introduction With improvements in percutaneous coronary intervention and the advent of novel adjunctive pharmacotherapy agents (such as GP 2b/3a inhibitors, new antiplatelet agents, and intensive statin regimens), the safety and efficacy of early Percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) has improved significantly (1). Therefore, the current guidelines recommend a routine invasive strategy (angiography and revascularization if applicable) (2) in high-risk patients with non-'ST'-elevation ACS (NSTE-ACS). Aim The aim was to compare the results of early versus late intervention in patients with high-risk NSTE myocardial infarction (MI). Patients and methods This study was carried out on 60 patients …

What Is The Future Of Suicide Genetics?, Salahudeen Mirza, Gabriel R Fries

Faculty, Staff and Student Publications

No abstract provided.

Performance Of Six Clinical Physiological Scoring Systems In Predicting In-Hospital Mortality In Elderly And Very Elderly Patients With Acute Upper Gastrointestinal Bleeding In Emergency Department, Po-Han Wu, Shang-Kai Hung, Chien-An Ko, Chia-Peng Chang, Cheng-Ting Hsiao, Jui-Yuan Chung, Hao-Wei Kou, Wan-Hsuan Chen, Chiao-Hsuan Hsieh, Kai-Hsiang Ku, Kai-Hsiang Wu

Faculty, Staff and Student Publications

Background and Objectives: The aim of this study is to compare the performance of six clinical physiological-based scores, including the pre-endoscopy Rockall score, shock index (SI), age shock index (age SI), Rapid Acute Physiology Score (RAPS), Rapid Emergency Medicine Score (REMS), and Modified Early Warning Score (MEWS), in predicting in-hospital mortality in elderly and very elderly patients in the emergency department (ED) with acute upper gastrointestinal bleeding (AUGIB). Materials and Methods: Patients older than 65 years who visited the ED with a clinical diagnosis of AUGIB were enrolled prospectively from July 2016 to July 2021. The six scores were calculated …

Hypomorphic Brca2 And Rad51c Double Mutant Mice Display Fanconi Anemia, Cancer And Polygenic Replication Stress, Karl-Heinz Tomaszowski, Sunetra Roy, Carolina Guerrero, Poojan Shukla, Caezaan Keshvani, Yue Chen, Martina Ott, Xiaogang Wu, Jianhua Zhang, Courtney D Dinardo, Detlev Schindler, Katharina Schlacher

Faculty, Staff and Student Publications

The prototypic cancer-predisposition disease Fanconi Anemia (FA) is identified by biallelic mutations in any one of twenty-three FANC genes. Puzzlingly, inactivation of one Fanc gene alone in mice fails to faithfully model the pleiotropic human disease without additional external stress. Here we find that FA patients frequently display FANC co-mutations. Combining exemplary homozygous hypomorphic Brca2/Fancd1 and Rad51c/Fanco mutations in mice phenocopies human FA with bone marrow failure, rapid death by cancer, cellular cancer-drug hypersensitivity and severe replication instability. These grave phenotypes contrast the unremarkable phenotypes seen in mice with single gene-function inactivation, revealing an unexpected synergism between Fanc mutations. Beyond …

Smad2/3 Signaling In The Uterine Epithelium Controls Endometrial Cell Homeostasis And Regeneration, Maya L Kriseman, Suni Tang, Zian Liao, Peixin Jiang, Sydney E Parks, Dominique I Cope, Fei Yuan, Fengju Chen, Ramya P Masand, Patricia D Castro, Michael M Ittmann, Chad J Creighton, Zhi Tan, Diana Monsivais

Faculty, Staff and Students Publications

The regenerative potential of the endometrium is attributed to endometrial stem cells; however, the signaling pathways controlling its regenerative potential remain obscure. In this study, genetic mouse models and endometrial organoids are used to demonstrate that SMAD2/3 signaling controls endometrial regeneration and differentiation. Mice with conditional deletion of SMAD2/3 in the uterine epithelium using Lactoferrin-iCre develop endometrial hyperplasia at 12-weeks and metastatic uterine tumors by 9-months of age. Mechanistic studies in endometrial organoids determine that genetic or pharmacological inhibition of SMAD2/3 signaling disrupts organoid morphology, increases the glandular and secretory cell markers, FOXA2 and MUC1, and alters the genome-wide distribution …

Better Survival In Morbidly Obese Patients With Atrial Fibrillation Treated With Non-Vitamin K-Dependent Oral Anticoagulants, Monirah A. Albabtain, Zaid Alanazi, Nawaf Al Mutairi, Yahya Al Hebaishi, Ola Alyafi, Haneen Alghasoon, Amr A. Arafat

Journal of the Saudi Heart Association

Background: The efficacy and safety of non-vitamin K-dependent anticoagulants (NOAC) are not well investigated in the obese population, and fixed dosing could lead to under-anticoagulation. Our objective was to evaluate the effect of obesity on anticoagulation outcomes and survival in non-valvular atrial fibrillation (AF) patients. Methods: We enrolled 755 patients who required anticoagulation for AF from 2015 to 2016. We grouped the patients into four groups. Group 1 (n= 297) included patients with BMI< 40 Kg/m2 treated with NOACs, Group 2 (n= 358) included patients on warfarin with BMI< 40 Kg/m2, Group 3 (n= 57) had patients on NOACs with BMI≥ 40 Kg/m2 and Group 4 (n= 43) included patients on warfarin and BMI≥ 40 Kg/m2. Study outcomes were the composite endpoint of stroke, bleeding, and survival. Results: Competing risk regression showed that stroke and bleeding were not affected by obesity or treatment (SHR: 1.09 (95% CI: 0.79- 1.51); P= 0.62). Older age was the predictor of stroke/bleeding (HR:1.03 (95% CI:1.01- 1.06); P= 0.02). Predictors of mortality were heart failure (HR:2.23 (95% CI:1.25- 3.97); P= 0.007), lower creatinine clearance (HR: 0.98 (95% CI:0.97- 0.98): P< 0.001), non-obese patients on warfarin (HR:3.51 (95%CI:1.6- 7.7): P=0.002) and obese patients on warfarin (HR: 6.7 (95% CI:2.51- 17.92); P< 0.001). Conclusion: NOACs could have a similar risk profile to warfarin in obese and non-obese patients with non-valvular AF but could have better survival. Larger randomized trials are recommended.

Rheumatoid Vasculitis Presenting With Incidental Renal Infarcts: Case Report And Literature Review, Fatima Halilu, Howard Hauptman

Journal of Community Hospital Internal Medicine Perspectives

Rheumatoid vasculitis is a rare and late complication of rheumatoid arthritis, affecting small to medium sized vessels. Inflammation in the vessel wall produces an occlusive vasculopathy with downstream infarction. We present the case of a 70-year-old female with long standing stable RA status post recent COVID-19 vaccination admitted with community acquired Legionnaires disease found to have an incidental renal infarct on chest imaging without a clear etiology. She improved from a respiratory standpoint but then had a fever spike with repeat imaging showing a second renal infarct and CT angiography showing extensive beading with aneurysmal dilation in the bilateral hepatic …

Comparing Five Equations To Calculate Estimated Glomerular Filtration Rate To Predict Acute Kidney Injury Following Total Joint Arthroplasty., Kevin L Mekkawy, Yash P Chaudhry, Sandesh S Rao, Micheal Raad, Raj M Amin, Harpal S Khanuja

Orthopedic Surgery Resident Research

BACKGROUND: Acute kidney injury (AKI) following total joint arthroplasty (TJA) is associated with increased morbidity and mortality. Estimated glomerular filtration rate (eGFR) is used as an indicator of renal function. The purpose of this study was (1) to assess each of the five equations that are used in calculating eGFR, and (2) to evaluate which equation may best predict AKI in patients following TJA.

METHODS: The National Surgical Quality Improvement Program (NSQIP) was queried for all 497,261 cases of TJA performed from 2012 to 2019 with complete data. The Modification of Diet in Renal Disease (MDRD) II, re-expressed MDRD II, …

Otologic Manifestations In The Setting Of Seronegative Small Vessel Vasculitis: A Case Report, Kathleen Gillmore, Samiat Awosanya, Ayan Kumar, Catherine Teskin, Rebecca Chiffer

Student Papers, Posters & Projects

Some patients with autoimmune disease will experience otologic symptoms, such as pain and hearing loss. We present a patient with ANCA-associated vasculitis who required surgery for a suspicious mastoid lesion associated with her disease.

Progranulin Oncogenic Network In Solid Tumors, Elisa Ventura, Giacomo Ducci, Reyes Benot Dominguez, Valentina Ruggiero, Antonino Belfiore, Elena Sacco, Marco Vanoni, Renato V. Iozzo, Antonio Giordano, Andrea Morrione

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Progranulin is a pleiotropic growth factor with important physiological roles in embryogenesis and maintenance of adult tissue homeostasis. While-progranulin deficiency is associated with a broad range of pathological conditions affecting the brain, such as frontotemporal dementia and neuronal ceroid lipofuscinosis, progranulin upregulation characterizes many tumors, including brain tumors, multiple myeloma, leiomyosarcoma, mesothelioma and epithelial cancers such as ovarian, liver, breast, bladder, adrenal, prostate and kidney carcinomas. The increase of progranulin levels in tumors might have diagnostic and prognostic significance. In cancer, progranulin has a pro-tumorigenic role by promoting cancer cell proliferation, migration, invasiveness, anchorage-independent growth and resistance to chemotherapy. In …

Overall Survival With Daratumumab, Lenalidomide, And Dexamethasone In Previously Treated Multiple Myeloma (Pollux): A Randomized, Open-Label, Phase Iii Trial, Meletios A Dimopoulos, Albert Oriol, Hareth Nahi, Jesus San-Miguel, Nizar J Bahlis, Saad Z Usmani, Neil Rabin, Robert Z Orlowski, Kenshi Suzuki, Torben Plesner, Sung-Soo Yoon, Dina Ben Yehuda, Paul G Richardson, Hartmut Goldschmidt, Donna Reece, Tahamtan Ahmadi, Xiang Qin, Wendy Garvin Mayo, Xue Gai, Jodi Carey, Robin Carson, Philippe Moreau

Faculty, Staff and Student Publications

Purpose: With the initial analysis of POLLUX at a median follow-up of 13.5 months, daratumumab in combination with lenalidomide and dexamethasone (D-Rd) significantly prolonged progression-free survival versus lenalidomide and dexamethasone (Rd) alone in patients with relapsed or refractory multiple myeloma (RRMM). We report updated efficacy and safety results at the time of final analysis for overall survival (OS).

Methods: POLLUX was a multicenter, randomized, open-label, phase III study during which eligible patients with ≥ 1 line of prior therapy were randomly assigned 1:1 to D-Rd or Rd until disease progression or unacceptable toxicity. After positive primary analysis and protocol amendment, …

Long-Term Morbidity And Mortality Among Survivors Of Neuroblastoma Diagnosed During Infancy: A Report From The Childhood Cancer Survivor Study, Danielle Novetsky Friedman, Pamela J Goodman, Wendy M Leisenring, Lisa R Diller, Susan L Cohn, Rebecca M Howell, Susan A Smith, Emily S Tonorezos, Suzanne L Wolden, Joseph P Neglia, Kirsten K Ness, Todd M Gibson, Paul C Nathan, Brent R Weil, Leslie L Robison, Kevin C Oeffinger, Gregory T Armstrong, Charles A Sklar, Tara O Henderson

Faculty, Staff and Student Publications

Purpose: To describe the risk of late mortality, subsequent malignant neoplasms (SMNs), and chronic health conditions (CHCs) in survivors of neuroblastoma diagnosed in infancy by treatment era and exposures.

Methods: Among 5-year survivors of neuroblastoma in the Childhood Cancer Survivor Study diagnosed age < 1 year between 1970 and 1999, we examined the cumulative incidence of late (> 5 years from diagnosis) mortality, SMN, and CHCs (grades 2-5 and 3-5). Multivariable Cox regression models estimated hazard ratios (HRs) and 95% CIs by decade and treatment (surgery-alone v chemotherapy with or without surgery [C ± S] v radiation with or without chemotherapy ± surgery [R ± C ± S]) among survivors and between survivors and 5,051 …

Brain Injury Accelerates The Onset Of A Reversible Age-Related Microglial Phenotype Associated With Inflammatory Neurodegeneration, Rodney M Ritzel, Yun Li, Yun Jiao, Zhuofan Lei, Sarah J Doran, Junyun He, Rami A Shahror, Rebecca J Henry, Romeesa Khan, Chunfeng Tan, Shaolin Liu, Bogdan A Stoica, Alan I Faden, Gregory Szeto, David J Loane, Junfang Wu

Faculty, Staff and Student Publications

Lipofuscin is an autofluorescent (AF) pigment formed by lipids and misfolded proteins, which accumulates in postmitotic cells with advanced age. Here, we immunophenotyped microglia in the brain of old C57BL/6 mice (>18 months old) and demonstrate that in comparison to young mice, one-third of old microglia are AF, characterized by profound changes in lipid and iron content, phagocytic activity, and oxidative stress. Pharmacological depletion of microglia in old mice eliminated the AF microglia following repopulation and reversed microglial dysfunction. Age-related neurological deficits and neurodegeneration after traumatic brain injury (TBI) were attenuated in old mice lacking AF microglia. Furthermore, increased …

Differential Spatial Gene And Protein Expression Associated With Recurrence Following Chemoradiation For Localized Anal Squamous Cell Cancer, Sharia Hernandez, Prajnan Das, Emma B Holliday, Li Shen, Wei Lu, Benny Johnson, Craig A Messick, Cullen M Taniguchi, John Skibber, Ethan B Ludmir, Y Nancy You, Grace Li Smith, Brian Bednarski, Larisa Kostousov, Eugene J Koay, Bruce D Minsky, Matthew Tillman, Shaelynn Portier, Cathy Eng, Albert C Koong, George J Chang, Wai Chin Foo, Jing Wang, Luisa Solis Soto, Van K Morris

Faculty, Staff and Student Publications

The identification of transcriptomic and protein biomarkers prognosticating recurrence risk after chemoradiation of localized squamous cell carcinoma of the anus (SCCA) has been limited by a lack of available fresh tissue at initial presentation. We analyzed archival FFPE SCCA specimens from pretreatment biopsies prior to chemoradiation for protein and RNA biomarkers from patients with localized SCCA who recurred (N = 23) and who did not recur (N = 25). Tumor cells and the tumor microenvironment (TME) were analyzed separately to identify biomarkers with significantly different expression between the recurrent and non-recurrent groups. Recurrent patients had higher mean protein expression of …

Structure-Based Regulatory Role For The 5'Utr Of Rcnmv Rna2, Jennifer S H Im, Jasmine R Sheppard, K Andrew White

Faculty, Staff and Student Publications

Red clover necrotic mosaic virus (RCNMV) is a segmented positive-strand RNA virus consisting of RNA1 and RNA2. Previous studies demonstrated that efficient translation of RCNMV RNA2 requires de novo synthesis of RNA2 during infections, suggesting that RNA2 replication is required for its translation. We explored a potential mechanism underlying the regulation of replication-associated translation of RNA2 by examining RNA elements in its 5' untranslated region (5'UTR). Structural analysis of the 5'UTR suggested that it can form two mutually exclusive configurations: a more thermodynamically stable conformation, termed the 5'-basal stem structure (5'BS), in which 5'-terminal sequences are base paired, and an …

Towards A Biomarker For Acute Arterial Thrombosis Using Complete Blood Count And White Blood Cell Differential Parameters In Mice, Hee Jeong Jang, Dawid Schellingerhout, Jiwon Kim, Jinyong Chung, Dong-Eog Kim

Faculty, Staff and Student Publications

There is no blood biomarker diagnostic of arterial thrombosis. We investigated if arterial thrombosis per se was associated with alterations in complete blood count (CBC) and white blood cell (WBC) differential count in mice. Twelve-week-old C57Bl/6 mice were used for FeCl3-mediated carotid thrombosis (n = 72), sham-operation (n = 79), or non-operation (n = 26). Monocyte count (/µL) at 30-min after thrombosis (median 160 [interquartile range 140-280]) was ~ 1.3-fold higher than at 30-min after sham-operation (120 [77.5-170]), and twofold higher than in non-operated mice (80 [47.5-92.5]). At day-1 and -4 post-thrombosis, compared with 30-min, monocyte count decreased by about …

Prognostic Landscape Of Mitochondrial Genome In Myelodysplastic Syndrome After Stem-Cell Transplantation, Jing Dong, Christopher Staffi Buradagunta, Tao Zhang, Stephen Spellman, Yung-Tsi Bolon, Amy E Dezern, Shahinaz M Gadalla, H Joachim Deeg, Aziz Nazha, Corey Cutler, Chao Cheng, Raul Urrutia, Paul Auer, Wael Saber

Faculty, Staff and Students Publications

Despite mitochondrial DNA (mtDNA) mutations are common events in cancer, their global frequency and clinical impact have not been comprehensively characterized in patients with myelodysplastic neoplasia (also known as myelodysplastic syndromes, MDS). Here we performed whole-genome sequencing (WGS) on samples obtained before allogenic hematopoietic cell transplantation (allo-HCT) from 494 patients with MDS who were enrolled in the Center for International Blood and Marrow Transplant Research. We evaluated the impact of mtDNA mutations on transplantation outcomes, including overall survival (OS), relapse, relapse-free survival (RFS), and transplant-related mortality (TRM). A random survival forest algorithm was applied to evaluate the prognostic performance of …

Data Mining Framework For Discovering And Clustering Phenotypes Of Atypical Diabetes, Hemang M Parikh, Cassandra L Remedios, Christiane S Hampe, Ashok Balasubramanyam, Susan P Fisher-Hoch, Ye Ji Choi, Sanjeet Patel, Joseph B Mccormick, Maria J Redondo, Jeffrey P Krischer

Faculty, Staff and Students Publications

Context: Some individuals present with forms of diabetes that are "atypical" (AD), which do not conform to typical features of either type 1 diabetes (T1D) or type 2 diabetes (T2D). These forms of AD display a range of phenotypic characteristics that likely reflect different endotypes based on unique etiologies or pathogenic processes.

Objective: To develop an analytical approach to identify and cluster phenotypes of AD.

Methods: We developed Discover Atypical Diabetes (DiscoverAD), a data mining framework, to identify and cluster phenotypes of AD. DiscoverAD was trained against characteristics of manually classified patients with AD among 278 adults with diabetes within …

Effective Connectivity Of Functional Mri Via Deep Learning Methods, Kai-Cheng Chuang

LSU Doctoral Dissertations

Effective connectivity, based on functional magnetic resonance imaging (fMRI) time series signals, is the quantification of how strongly brain activity in a certain source brain region contributes to brain activity in a target brain region, independent of the contributions of other source regions. Current methods to solve this problem have several limitations. They are either unable to model nonlinear relationships between source and target signals, unable to efficiently quantify time lags in source-target relationships, unable to identify time-varying relationships, or fail to account for variability in the hemodynamic response function that converts neuron activity to a measurable signal. In this …

Trends In Male And Female Urethral Endoscopic Management And Urethroplasty Using The Trinetx Database, Adam M. Ostrovsky, Zachary J. Prebay, Paul H. Chung

Department of Urology Faculty Papers

Background: How quickly providers adapt to new practice guidelines is not well known. The objective of this study was to evaluate temporal trends in the performance of urethral endoscopic management and urethroplasty surrounding the release of the American Urological Association (AUA) Male Urethral Stricture Guidelines in 2017. We also evaluate in parallel trends in female urethral stricture disease, where AUA guidelines are not present. We hypothesized that the ratio of urethroplasty versus urethral endoscopic management in both males and females is increasing and that guidelines do not result in immediate changes in management trends. Methods: Endoscopic management and urethroplasty data …

Disparity In Checkpoint Inhibitor Utilization Among Commercially Insured Adult Patients With Metastatic Lung Cancer, Meng Li, Kaiping Liao, Alice J Chen, Tina Cascone, Yu Shen, Qian Lu, Ya-Chen Tina Shih

Faculty, Staff and Student Publications

BACKGROUND: There is a lack of evidence from nationwide samples on the disparity of initiating immune checkpoint inhibitors (ICIs) after metastatic lung cancer diagnosis.

METHODS: We identified metastatic lung cancer patients diagnosed between 2015 and 2020 from a large, nationwide commercial claims database. We analyzed the time from metastatic lung cancer diagnosis to ICI therapy using Cox proportional hazard models. Independent variables included county-level measures (quintiles of percentage of racialized population, quintiles of percentage of population below poverty, urbanity, and density of medical oncologists) and patient characteristics (age, sex, Charlson comorbidity index, Medicare Advantage, and year of diagnosis). All tests …