Medical Specialties Commons^™

Using A Transformer Language Model To Curate A Pulmonary Embolism Dataset From The Medical Information Mart For Intensive Care Iv: Mimic-Iv-Ext-Pe, Peiqi Wang, Omid Jafari, Ang Li, Steven Horng

Faculty, Staff and Students Publications

Background: Pulmonary embolism (PE) is a leading cause of preventable in-hospital mortality. Advances in diagnosis, risk stratification, and prevention can improve outcomes. Large, publicly available datasets are needed to move research forward, but are lacking in the field of hemostasis and thrombosis.

Objectives: In this study, we experiment using a machine learning language model to automatically add PE labels to a large dataset.

Methods: We extracted all computed tomography pulmonary angiography radiology reports (N = 19,942) from the Medical Information Mart for Intensive Care IV, a database of adult patients who presented to the emergency room or were admitted …

Otolaryngology-Assisted Approach For Anterior Cervical Discectomy And Fusion, N Eddie Liou, Alexander E Ropper

Faculty, Staff and Students Publications

First introduced in 1955, anterior cervical discectomy and fusion (ACDF) surgery has seen minimal changes over the years. Its reproducibility, impressive long-term results, and minimal complication rates have established it as one of the most frequently performed cervical spinal fusion surgeries. Yet, postoperative dysphagia remains a concern with a 60% incidence rate. An otolaryngologist's expertise regarding cervical fascial anatomy can inform the spine surgeon's approach to an ACDF to potentially reduce postoperative dysphagia rates. We describe an illustrative case of a 35-year-old woman who presented with 8/10 neck and arm pain along with numbness in her fourth and fifth digits …

Tau Depletion Diminishes Vascular Amyloid-Related Deficits In A Mouse Model Of Cerebral Amyloid Angiopathy, Jonathan Martinez-Pinto, Kathryn Vanderbosch, Muriel D Mardones, Abigail Perkins, Gonzalo Viana Di Prisco, Yamil Marambio, Ruben Vidal, Brady K Atwood, Cristian A Lasagna-Reeves

Faculty, Staff and Students Publications

Introduction: Tau is essential for amyloid beta (Aβ)-induced synaptic and cognitive deficits in Alzheimer's disease (AD), making its downregulation a therapeutic target. Cerebral amyloid angiopathy (CAA), a major vascular contributor to cognitive decline, affects over 90% of patients with AD. This study explores the impact of tau downregulation on CAA pathogenesis.

Methods: We crossed the Familial Danish Dementia mouse model (Tg-FDD), which develops vascular amyloid, with tau-null (mTau-/-) mice to generate a CAA model lacking endogenous tau (Tg-FDD/mTau-/-). Behavioral, electrophysiological, histological, and transcriptomic analyses were performed.

Results: Tau depletion ameliorated motor and synaptic impairments, reduced vascular amyloid deposition, and prevented …

Functional Genomics In Age-Related Macular Degeneration: From Genetic Associations To Understanding Disease Mechanisms, Alex Hewitt, Jianhai Du, Daniel R Saban, Caroline C W Klaver, John Ash, Dwight Stambolian, Santa J Tumminia, Jiang Qian, Deeba Husain, Sudha K Iyengar, Anneke I Den Hollander

Faculty, Staff and Students Publications

Genome-wide association studies have been remarkably successful in identifying genetic variants associated with age-related macular degeneration (AMD), demonstrating a strong genetic component largely driven by common variants. However, progress in translating these genetic findings into a deeper understanding of disease mechanisms and new therapies has been slow. Slow progress in this area can be attributed to limited knowledge of the functional impact of AMD-associated non-coding variants on gene function, the molecular mechanisms and cell types underlying disease. This review offers a comprehensive overview of functional genomics approaches to uncover the genetic, epigenetic, cellular and molecular mechanisms underlying AMD and outlines …

Screening For Oropharyngeal Cancer: The Time Is Now

Faculty, Staff and Students Publications

No abstract provided.

Screening For Oropharyngeal Cancer: The Time Is Now

Faculty, Staff and Students Publications

No abstract provided.

Evaluating The Test-Negative Design For Covid-19 Vaccine Effectiveness Using Randomized Trial Data: A Secondary Cross-Protocol Analysis Of 5 Randomized Clinical Trials, Lars Van Der Laan, Yunda Huang, Jessica Andriesen, Mayur Patel, Leigh H Fisher, Holly Janes, Nadine Rouphael, Stephen R Walsh, Deborah A Theodore, Hong-Van Tieu, Magdalena Sobieszczyk, Hana M El Sahly, Lindsey R Baden, Ann R Falsey, Thomas B Campbell, Colleen F Kelley, Catherine Mary Healy, Lilly Immergluck, Benjamin Luft, Ian Hirsch, Guy De Bruyn, Carla Truyers, Frances Priddy, Kelsey M Sumner, Brendan Flannery, Dean Follmann, Peter B Gilbert, Covid-19 Prevention Network (Covpn)

Faculty, Staff and Students Publications

Importance: The test-negative design (TND) has been widely used to assess postmarketing COVID-19 vaccine effectiveness but requires further evaluation for this application.

Objective: To determine whether the TND reliably evaluates vaccine effectiveness against symptomatic COVID-19 using placebo-controlled vaccine efficacy randomized clinical trials (RCTs).

Design, setting, and participants: This secondary cross-protocol analysis constructed TND study datasets from study sites in 16 countries across 5 continents using the blinded phase cohorts of 5 harmonized phase 3 COVID-19 Prevention Network RCTs: COVE (Coronavirus Vaccine Efficacy and Safety), AZD1222, ENSEMBLE, PREVENT-19 (Prefusion Protein Subunit Vaccine Efficacy Novavax Trial COVID-19), and VAT00008. Participants included adults …

The Central Role Of Cytochrome P450 Reductase (Cpr) In Hyperoxic Lung Injury

Faculty, Staff and Students Publications

Introduction: Hyperoxic lung injury results from excessive supplemental oxygen therapy in conditions such as bronchopulmonary dysplasia (BPD) in preterm infants and acute respiratory distress syndrome (ARDS) in adults. This review explores the role of cytochrome P450 reductase (CPR) in hyperoxic lung injury.

Areas covered: Hyperoxia induces the production of reactive oxygen species in excessive amounts, overwhelming the body's antioxidant defenses and exacerbating lung injury in ARDS/BPD. This review examines the differential roles of CPR-dependent enzymes in the context of hyperoxic lung injury. Additionally, we highlight the potential of targeting CPR to study mechanisms of lung injury and leverage gene-editing technologies …

Testing For Bleeding Disorders In Child Abuse: Aap Recommendation Adherence And Testing Results, Shannon L Carpenter, Angela Bachim, Caitlin R Mcnamara, Farah W Brink, Lori D Frasier, Nancy S Harper, Natalie Laub, Kristine A Campbell, Daniel M Lindberg, Joanne N Wood, James Anderst

Faculty, Staff and Students Publications

Objectives: Using a multicenter child abuse pediatrics research network (CAPNET), the study objectives were to characterize the adherence to American Academy of Pediatrics (AAP) recommendations for bleeding disorder testing and the frequency of bleeding disorder identification.

Methods: We performed a descriptive study of bleeding disorder evaluations among children younger than 10 years of age who presented with bruising and/or intracranial hemorrhage (ICH) concerning for abuse from February 2021-May 2022 utilizing CAPNET. Cases were classified as bruising without ICH or ICH with or without bruising. Based on AAP guidance, testing was not recommended in cases with concomitant suspicious injuries, inflicted injury …

Global Multi-Specialty Clinician Perspectives On The Implementation Of Alzheimer's Disease Blood Biomarkers, Joanne Rodda, Lindsey A. Kuchenbecker, Wyllians V. Borelli, Mari L. Demarco, Raphael M. Castilhos, Erin E. Cawston, Tinatin Chabrashvili, Melissa M. Budelier, Claudia Duran Aniotz, Chinedu Momoh

Brain and Mind Institute

Introduction: Clinicians' views on the clinical readiness of Alzheimer's disease (AD) blood biomarkers (BBMs) are not well understood.

Methods: The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment Biofluid-Based Biomarkers Professional Interest Area conducted a survey to elicit clinician opinions on AD BBM implementation, including contexts of use, assay selection, reporting, and result interpretation.

Results: Clinician respondents (n = 212) practiced in Europe (56%), North America (24%), the Caribbean and Central/South America (11%), and other continents (9%). Most respondents were medical doctors (80%) practicing in secondary or tertiary care (88%). For 56%, cerebrospinal fluid AD …

Metastatic Medulloblastoma Remodels The Local Leptomeningeal Microenvironment To Promote Further Metastatic Colonization And Growth, Alexander Bahcheli, Randy Van Ommeren, Kyle Juraschka, Maria Vladoiu, Winnie Ong, Bryn Livingston, Pasqualino De Antonellis, Michelle Ly, Borja López Holgado, Olga Sirbu, Shahrzad Bahrampour, Hyun-Kee Min, Jerry Fan, Carolina Nor, Abhirami Visvanathan, Jiao Zhang, Hao Wang, Lei Qin, Ning Huang, Jonelle Pallotta, Tajana Douglas, Esta Mak, Haipeng Su, Karen Ng, Kevin Yang Zhang, Craig Daniels, Calixto-Hope G Lucas, Charles G Eberhart, Hailong Liu, Tao Jiang, Faiyaz Notta, Vijay Ramaswamy, Jüri Reimand, Marco Gallo, Jeremy N Rich, Xiaochong Wu, Xi Huang, Michael D Taylor

Faculty, Staff and Students Publications

Leptomeningeal metastases are the major source of morbidity and mortality for patients with medulloblastoma. The biology of the leptomeningeal metastases and the local tumour microenvironment are poorly characterized. Here we show that metastasis-associated meningeal fibroblasts (MB-MAFs) are transcriptionally distinct and signal extensively to tumour cells and the tumour microenvironment. Metastatic cells secrete platelet-derived growth factor (PDGF) ligands into the local microenvironment to chemotactically recruit meningeal fibroblasts. Meningeal fibroblasts are reprogrammed to become MB-MAFs, expressing distinct transcriptomes and secretomes, including bone morphogenetic proteins. Active bone morphogenetic protein signalling and co-implantation of tumour cells with MB-MAFs enhances the colonization of the leptomeninges …

Safety And Utility Of Robotics In Pediatric Surgery: Implementation, Luke J. Man, Kristin Lemarbe, Nathan Novotny, Anthony Stallion, Begum Akay, Pavan Brahmamdam

Posters

• Minimally invasive laparoscopic surgery is considered standard of care for adult and pediatric patients .

• Robotic surgery (RS) for adult patients has been widely adopted due to superior ergonomics, visualization, depth perception, and access to deeper anatomical structures2,3.

• Historically, RS is associated with longer operative times, higher cost, and lacks haptic feedback1,2.

• RS has had inconsistent adoption in the pediatric surgery community2.

Improving Treatment For Infant Perianal Abscesses, Artem Dadamyan, Nathan Novotny, Ngan Nguyen

Posters

Perianal abscesses: • Tender masses located at the anal verge, typically in the 3 o’clock and 9 o’clock positions1

• Develop due to infection in abnormally deep crypts of Morgagni 1

• If left untreated, can extend into the ischioanal space or intersphincteric space since these areas are continuous with the perianal space.2

• Some may develop into fistula in ano, which can be difficult to treat3 Treatment:

• The standard has always been incision and drainage (I&D), but non-invasive management of Sitz baths is increasingly being used.

The Relevance Of Age, Bmi, And Right Versus Left Ear Surgery To The Incidence Of Taste Disturbance After Stapes Surgery, Jonathan Ong, Dennis Bojrab Ii

Posters

• Many factors such as age and body mass index (BMI) have been shown to influence post-operative outcomes in patients undergoing stapedectomy/stapedotomy.

• This study examines these factors to see if they have any impact on the incidence of taste disturbance, a commonly reported complication of stapes surgery.1

• Our study predicts that BMI and age are correlated with the incidence of taste disturbance post-operatively following stapes surgery.

Do Critically Ill Patients With Guardianships Receive More Aggressive Treatment?, Misha Haq, Jacob Keeley, Enrique Calvo-Ayala

Posters

• Patients suffering from certain conditions can become unable, unwilling, or unavailable to make decisions regarding their end-of-life care1.
• • In these cases, a court appointed guardian is responsible for carrying out medical decisions on behalf of the patient2.
• Patients with guardians tend to receive more aggressive care, regardless of the benefit, because it is perceived as safer 3.
• Guidelines and laws for medical decision-making for patients with guardians are inconsistent, leaving this population vulnerable4.

Low Cpap Adherence Amongst The African American And Arabic Population In Patients With Obstructive Sleep Apnea, Nikki Nguyen, Bhavinkumar Dalal

Posters

• Obstructive sleep apnea (OSA) is a breathing disorder that occurs from a recurring decreased or completely blocked airflow during sleep leading to symptoms including excessive daytime sleepiness and impaired cognitive function1.

• Primary treatment for moderate to obstructive sleep apnea is continuous positive airway pressure (CPAP) reducing daytime sleepiness, improves neurocognitive function, and improves quality of life2.

• Current literature shows that compliance varies from 40-85% with poor adherence reducing the treatment’s effectiveness in preventing chronic health problems3.

• Although more CPAP use is generally associated with subjective and adherence is typically defined as at least 4 hours of …

Associations Between Health Literacy And Comprehension Of Health Visits In A Community Setting, Amanda Romaya, Adel Andemeskel, Salim Abdul-Razak, Linda Dillon, Victoria Lucia

Posters

Low health literacy is a significant social determinant of health that is associated with poor health outcomes1-3. Bringing attention to health literacy will aid in promoting the health of the population. However little has been done to implement national policies and interventions that address patient health literacy, especially in a community setting4.

We hypothesized that our assessment of the identified patient population’s health literacy will not meet adequate standards and will indeed demonstrate a need for community-focused interventions

Predicting Coronary Artery Calcium Using Abdominal Aorta And Visceral Artery Calcification, Jared Dixon, Sayf Al-Katib, Kiran Nandalur, Jacob Ghannam, Ali Beydoun, Desiree Clement

Posters

CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major cardiovascular outcomes, especially useful in asymptomatic people for planning primary prevention interventions such as statins and aspirin.1 The Multiethnic Study of Atherosclerosis (MESA) demonstrated that a CAC score of 0 represents a less than 5 percent 10-year Atherosclerotic cardiovascular disease (ASCVD) risk. CAC scores 1-299 represent borderline to intermediate risk, and CAC score >300 represents a “high risk” 10 percent or greater 10-year ASCVD risk.2

When used correctly, CAC scoring is a powerful predictor of ASCVD risk and holds the key for many …

Advances In Minimally Invasive Hepatobiliary Interventions For Non-Operative Candidates, Tulasi Talluri, Philip Cieplinski, Kristian Loveridge

Posters

Cholangioscopy is a technique used for diagnosing and treating patients with pathologies of the gallbladder, liver, and pancreas. It has been available since 1976 but with limited use in interventional radiology (IR) due to issues with steerability, irrigation capabilities, requirement for more than one operator, and poor percutaneous access options; however, direct intraluminal visualization of the gallbladder, common bile ducts, and even the ampulla and duodenum has become more practical with the advent of single operator percutaneous systems. Access to the biliary system can now be made through smaller 11 French sheath/delivery systems allowing for improved maneuverability into the common …

Allergies Coinciding With Central Sensitization Syndromes (Access), Jacqueline Morey, Alemu Fite, Carl Lauter, Matthew Sims

Posters

Significance of Reported Allergies: Many reported drug allergies are mislabeled side effects or misinterpretations, leading to suboptimal treatment, antibiotic resistance, and worse patient outcomes.¹

Central Sensitization Syndromes (CSS): CSSs are chronic pain conditions linked to altered sensory perception, including pain, fatigue, and neurologic dysfunction.² These patients may be more likely to misattribute medication side effects as allergies.

Previous Findings & Hypothesis: Prior research found high allergy reporting in interstitial cystitis and fibromyalgia—both CSS conditions.⁴ We hypothesized that other CSS diagnoses also correlate with increased allergy reporting, emphasizing the need for better allergy evaluation.

Surgical Site Infection Bundle For Babies: Preliminary Data, Cullen Woodley, John Nida, Alexis Lonjin, Katelyn Ward, Diane Studzinski, Begum Akay

Posters

Surgical Site Infections (SSIs) are infections that occur in or around the area where a surgery was recently performed. They are estimated to account for 20% of all healthcare associated infection, and lead to an increase in morbidity and mortality. Perioperative care bundles show promise in reducing SSIs in adults but are not often used in neonatal surgery. Infections in babies after surgery are less common than adults but carry significant morbidity in a fragile patient.

Custom Gene Panel Sequencing Of Fevr Patients And Family Members, Rima Stepanian, Gabrielle Abdelmessih, Kim Drenser, Antonio Capone Jr, Michael T. Trese, Wendy Dailey, Ken Mitton

Posters

Familial exudative vitreoretinopathy, or FEVR, defines a group of inherited retinal diseases marked by abnormal blood vessel growth in the retina, causing poor vascular development in the peripheral retina. It is linked to increased vessel permeability and may result in retinal ischemia, exudative retinal detachment, and subsequent vision loss. It can be inherited through autosomal dominant, autosomal recessive, or X-linked recessive patterns. There is no definitive treatment or cure, but is treated based on staging of disease on an individual case-by-case basis. Genomics is a rapidly growing field in personalized medicine. Targeted next-generation sequencing (NGS) enables fast and cost-effective identification …

Understanding The Effect Of Advanced Patient Age On Outcomes And Complications Of Spinal Surgery, Alexander R. Woznicki, Daniel K. Fahim

Posters

• In 2020, 6.7 million individuals in the United States were older than 85. This is projected to increase to 12.6 million in 20601

• The risk of developing many spinal conditions increases with age2,3,4

• Decreases in disk height changes the loadbearing properties of the spine

• Decreased bone density makes the vertebrae susceptible to fracture

• Weakening of spinal ligaments predispose to disc degeneration

• Hypertrophy of the ligamentum flavum and susceptibility to disk herniation can lead to spinal stenosis

• Damage of the cervical spinal cord can manifest as weakness and clumsiness in the upper extremities and …

Effects Of Changing The Frequency Of Epidural Steroid Injections For Elderly Patients With Lumbar Radiculopathy/Lumbar Spinal Stenosis, Nitin Venkatesh, Rebecca Clemans, Roy Soto

Posters

Lower back pain is highly prevalent and a significant cause of disability.

50-84% of adults experiencing back pain at some point.

Previously, patients with chronic lumbar radiculopathy received a maximum of 6 injections a year (q8w).

On Dec 2021, Medicare Coverage of ESIs was updated to limit ESIs to a max of 4 a year (q12w).

Stroke Risk After Lowering Elevated Blood Pressure In Transient Ischemic Attack, Alexsandra Biel, Jacob Keeley, Brett Todd

Posters

• There is a relationship between the diagnosis of TIA and the subsequent development of a stroke1–4.
• The risk of developing a stroke within 90 days of a TIA is approximately 10.5% with about half of these occurring in the first 1-2 days of the TIA3.

Risk factors that may increase the likelihood of developing a stroke following a TIA include:

• Having age over 60
• A blood pressure of 140/90 or greater
• Diabetes
• Increased TIA duration
• Increased symptomatology at the time of presentation5–8.

Manual Versus Mechanical Cardiopulmonary Resuscitation Complications After Successful Resuscitation For Out-Of-Hospital Cardiac Arrest, Connie Chen, Jacob Keeley, Julian Sit, Robert Swor

Posters

Over 300,000 people in the United States annually suffer from an out of hospital cardiac arrest (OHCA); 90% of cases are fatal.1

EMS-treated OHCA approximately has a 30% rate of Return of Spontaneous Circulation (ROSC), but not all survive to hospital admission or discharge.2

Quality cardiopulmonary resuscitation (CPR) provides vital organ reperfusion until cardiac activity can be restored.

Mechanical CPR is increasingly being used for field OHCA care. It is most often performed by the Lund University Cardiopulmonary Assist System (LUCAS) device, a piston chest compressor which incorporates a mechanism for active chest recoil.

Benefits of mechanical CPR:

• Uninterrupted …

Beyond The Epi-Pen: Prehospital Use Of Epinephrine In Anaphylaxis, Randy Hilleary, Corey Shafer, Margaret Menoch

Posters

• Prehospital epinephrine administration has been historically low by the individuals having the reaction, their caregivers, or emergency medical service (EMS) personnel
• With rising anaphylaxis cases, it becomes more imperative that there is appropriate administration of epinephrine to improve outcomes in both pediatric and adult populations

Assessing The Impact Of Street Medicine Oakland On Medical Student Perceptions Of Clinical Preparedness, Michael Marchiori, Laura Ortiz

Posters

• Medical students spend the first two years of medical school focusing on didactic learning supplemented with clinical skills training as they prepare for their hospital rotations

• Opportunities for in-field practice of clinical skills are typically sparse for medical students during their M1 and M2 didactic years

• Research suggests clinical supervisors rank professionalism and willingness as the two most important characteristics in students that promote clinical preparedness, but there is limited research on interventions that promote students’ self-perceptions of clinical preparedness1

• Medical students at Oakland University William Beaumont (OUWB) have the opportunity to volunteer with Street Medicine …

Suture Management Practices In Central Venous Catheters: A Survey Among Healthcare Professionals, Matthew Prevost, Nishaki Mehta

Posters

• Traditional suture methods (Fig. 1) for securing central venous catheters (CVCs) lack standardization, are nonadjustable postsecurement, and require dexterity → increasing risk of catheter micropistoning and central line-associated bloodstream infections (CLABSIs).

• This study examines medical practitioners' experiences and challenges with suturing CVCs

• Our hypothesis predicts that variations in responses and differences in practitioner training may influence experiences and complication rates.

Index Cost Comparison Of Laparoscopic Vs Robotic Surgery In Colon And Rectal Cancer Resection: A Retrospective Financial Investigation Of Surgical Methodology Innovation At A Single Institution, Ekene Ezeokoli, Roula Hilli, Harry J. Wasvary

Posters

Robotic assisted colorectal cancer resection (R-CR) has become increasingly commonplace in contrast to traditional laparoscopic cancer resection (L-CR). The aim of this study was to compare the total direct costs of R-CR to that of L-CR and to compare the groups with respect to costs related to LOS.