Diagnosis Commons^™

Development Of A Non-Faradaic Impedimetric Biosensor Based On Reduced Graphene Oxide For The Detection Of Brain-Derived Neurotrophic Factor (Bdnf), Mariana N. Martins

Electronic Theses and Dissertations

Neurological disorders affect millions of people worldwide. In the case of Alzheimer’s disease (AD), the rising number of cases significantly increases global healthcare costs. Therefore, early detection of biomarkers at the onset of the disease is essential for early diagnosis. This study presents an electrochemical biosensor designed for the detection of Brain-Derived Neurotrophic Factor (BDNF) in human plasma, incorporating reduced graphene oxide (rGO) to enhance signal sensitivity. Dielectrophoresis (DEP) was employed to deposit rGO flakes on the electrode surface, improving conductivity and sensor performance. Electrochemical impedance spectroscopy (EIS) was used to monitor changes in impedance associated with BDNF binding events, …

Two Cases Of Intramyocardial Dissecting Hematoma Diagnosed By Echocardiography, Jianbo Wu, Fei Bian, Xijun Zhu, Xin Du, Tao Hao, Qian Liu

Journal of Community Hospital Internal Medicine Perspectives

Intramyocardial dissecting hematoma (IDH), a rare complication of myocardial infarction, was investigated through two unique clinical cases in this study. We demonstrate echocardiography's pivotal role in emergency diagnostics by detailing its critical contribution to rapid identification. Furthermore, we propose a hypothesis regarding the anatomical subtypes of IDH, potentially offering new perspectives and insights into this rare cardiac condition.

Surgical Success Following Robotic Upper Urinary Tract Reconstruction, Results From A Global Network Of Healthcare Organizations, Zachary Prebay, Adam Schneider, Sohan S. Shah, Mauro Dispagna, Mihir S. Shah

Department of Urology Faculty Papers

INTRODUCTION: Available data on robotic ureteral reconstruction procedures is concentrated from high volume centers. To better understand generalizability of success, we used a network of healthcare organizations (HCOs) to evaluate surgical success following robotic-assisted pyeloplasty (RP), ureteral reimplantation (RR), and ureteroureterostomy/ureteroplasty (RU).

METHODS: We searched the TriNetX database for adult (>18 years old) patients undergoing RP, RR and RU. Our primary outcome was need for drain placement (nephrostomy or ureteral stent) from 4 weeks to 10 years postoperatively. We evaluated risk factors (RF) for drain placement (vascular disease, kidney disease, diabetes (DM), smoking history, radiation history, age, body mass …

Outcomes Of Relapse After Teclistamab Therapy In Multiple Myeloma, Kyle L. Yu, Matthew Ho, Luca Paruzzo, Federico Stella, Heta Patel, Zainul S Hasanali, Shivani Kapur, Adam J. Waxman, Dan T. Vogl, Edward A. Stadtmauer, Joseph A. Fraietta, Marco Ruella, Adam D. Cohen, Alfred L. Garfall, Sandra Susanibar-Adaniya

Student Papers, Posters & Projects

No abstract provided.

Artificial Intelligence To Detect Developmental Dysplasia Of Hip: A Systematic Review, Suketu Bhavsar, Bhanu B. Gowda, Maulini Bhavsar, Sanjay Patole, Shripada Rao, Chandra Rath

Research outputs 2022 to 2026

Aim: Deep learning (DL), a branch of artificial intelligence (AI), has been applied to diagnose developmental dysplasia of the hip (DDH) on pelvic radiographs and ultrasound (US) images. This technology can potentially assist in early screening, enable timely intervention and improve cost-effectiveness. We conducted a systematic review to evaluate the diagnostic accuracy of the DL algorithm in detecting DDH. Methods: PubMed, Medline, EMBASE, EMCARE, the clinicaltrials.gov (clinical trial registry), IEEE Xplore and Cochrane Library databases were searched in October 2024. Prospective and retrospective cohort studies that included children (< 16 years) at risk of or suspected to have DDH and reported hip ultrasonography (US) or X-ray images using AI were included. A review was conducted using the guidelines of the Cochrane Collaboration Diagnostic Test Accuracy Working Group. Risk of bias was assessed using the QUADAS-2 tool. Results: Twenty-three studies met inclusion criteria, with 15 (n = 8315) evaluating DDH on US images and eight (n = 7091) on pelvic radiographs. The area under the curve of the included studies ranged from 0.80 to 0.99 for pelvic radiographs and 0.90–0.99 for US images. Sensitivity and specificity for detecting DDH on radiographs ranged from 92.86% to 100% and 95.65% to 99.82%, respectively. For US images, sensitivity ranged from 86.54% to 100% and specificity from 62.5% to 100%. Conclusion: AI demonstrated comparable effectiveness to physicians in detecting DDH. However, limited evaluation on external datasets restricts its generalisability. Further research incorporating diverse datasets and real-world applications is needed to assess its broader clinical impact on DDH diagnosis.

Clinician-Led Development And Feasibility Of A Neural Network For Assessing 3d Dental Cavity Preparations Assisted By Conversational Ai, Mohammed El-Hakim, Haitham Khaled, Amr Fawzy, Robert Anthonappa

Research outputs 2022 to 2026

Introduction: Artificial intelligence is emerging in dental education, but its use in preclinical assessment remains limited. Large language models like ChatGPT^® V4.5 enable non-programmers to build AI models through real-time guidance, addressing the coding barrier. Aim: This study aims to empower clinician-led, low-cost, AI-driven assessment models in preclinical restorative dentistry and to evaluate the technical feasibility of using a neural network to score 3D cavity preparations. Methods: Twenty mandibular molars (tooth 46), each with two carious lesions, were prepared and scored by two expert examiners using a 20-point rubric. The teeth were scanned with a Medit i700^® and …

Atypical Abdominal Pain: Uncovering Malignant Peritoneal Mesothelioma In Suspected Crohn's Disease: A Case Report, Catherine Loehr, Lara Boudreaux, Ann Porter Uhlhorn, Nisha Loganantharaj

School of Medicine Faculty Publications

BACKGROUND: Malignant peritoneal mesothelioma (MPM) is a rare and aggressive cancer from the serosal membranes of the abdominal cavity. In the United States, MPM accounts for about 10-15% of all mesothelioma cases, and translates into approximately 600 new cases diagnosed annually. It is typically diagnosed in Caucasian individuals, and while asbestos exposure is a well-established risk factor for pleural mesothelioma, its association with peritoneal mesothelioma remains less clear. Clinical symptoms of MPM, such as abdominal pain, bloating, and weight loss, overlap with other gastrointestinal disorders, which often leads to delayed diagnosis. This case report presents a unique instance of MPM …

Increased Risk Of Renal Disease In Patients With Hidradenitis Suppurativa: A Retrospective Cohort Study Utilizing Trinetx, Tyler Hernandez, Christopher Haas

School of Medicine Faculty Publications

No abstract provided.

Does Cognitive Frame Affect Clinical Reasoning Among Medical Students? A Cross-Sectional Study, Xiao C. Zhang, Sara A. Belko, Andrew J Monick

Department of Emergency Medicine Faculty Papers

Background Diagnostic errors affect patient safety and lead to high costs. Cognitive bias is a key source of diagnostic error, and the framing effect poses a particular clinical challenge. The extent to which individual factors affect susceptibility to the framing bias is unclear, and the role of expertise in particular is contested across the literature. Objectives This study investigated the effects of framing bias on diagnostic reasoning among medical students. We hypothesised that the effects attributable to framing would be mediated by the number of years of medical education completed. Methods Participants were randomly assigned on an automated basis with …

Management Of Stone Disease In The Spina Bifida Patient, Meghan F. Davis, Kyle L. Yu, Arun K. Srinivasan

Department of Medicine Faculty Papers

PURPOSE OF THE REVIEW: This review provides a detailed overview of the specifics of presentation, diagnosis, and management of upper and lower urinary tract stone disease for individuals with spina bifida.

RECENT FINDINGS: Recent studies highlight the significant burden of stone disease for spina bifida patients. Individuals with spina bifida require lifelong urologic care. They are more likely to have stone disease and have complications from management. This is a particularly salient issue for patients who have undergone bladder augmentation. Given the frequency and severity of these issues, it is critical that urologists be familiar with the nuances of stone …

Validation Of A Prognostic Nomogram For Locally Advanced Oropharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy With/Without Systemic Therapy, P. Bossi, R. Gili, S. Calza, L. Licitra, M. Maddalo, A. Bacigalupo, L. Belgioia, J. Cacicedo, N. Facchinetti, A. Garcia Castano, M. Oliva, P. Bonomo, G. Sanguineti, P. Franco, A. Argiris, A. Psyrri, E. Orlandi

Kimmel Cancer Center Faculty Papers

BACKGROUND: Head and neck squamous-cell carcinoma (HNSCC), particularly oropharyngeal cancer (OPC), exhibits diverse prognostic factors influenced by demographic and lifestyle variables. Prognostic nomograms, such as the one developed by Fakhry et al., incorporate clinical and biological markers to predict overall survival (OS) and progression-free survival (PFS) in OPC patients. However, their applicability to European populations remains unverified. This study aimed to externally validate Fakhry's prognostic nomogram in a large European cohort of locally advanced OPC patients treated with definitive intensity-modulated radiotherapy (IMRT) with or without systemic therapy.

METHODS: This is a retrospective external validation study conducted on 805 OPC patients …

Predicting Intravitreal Treatment Response Using Ultrawide-Field Angiographic Biomarkers In Diabetic Retinopathy, Karthik Reddy, Callie Deng, Boonkit Purt, Yue Liang, Nikhil Bommakanti, Gina Yu, Julie Rosenthal, Yannis M. Paulus

Wills Eye Hospital Papers

BACKGROUND: Diabetic retinopathy (DR) is a sight-threatening retinal disease with pathological mediation by vascular endothelial growth factor (VEGF). Intravitreal anti-VEGF injections are commonly used to manage DR. Ultra-wide-field fluorescein angiography (UWF-FA) can assess DR severity and characterize the amount of non-perfused retina (non-perfusion area, NP), neovascularization (neovascular area, NV), and foveal avascular zone (FAZ). However, the association between anti-VEGF treatment and NP, NV, and FAZ characterized by UWF-FA is not well established.

METHODS: A retrospective, single-center cohort study involved eyes of patients with Type 1 or 2 diabetes mellitus with at least one UWF-FA image. The area of the FAZ, …

Modeling Surgeon Belief Updating Under Bias: A Bayesian Simulation In Shoulder Arthroplasty, Mariano Menendez, Michael Moverman, Surena Namdari, Frederick Matsen, David Ring

Rothman Institute Papers

BACKGROUND: Shoulder surgeons often offer markedly different treatment recommendations for a given patient and pathophysiology within the context of a common body of evidence. Prior beliefs and cognitive bias may contribute to this variability. Using Bayesian decision theory informed by principles of behavioral science, we modeled how surgeons with different initial beliefs and degrees of bias update their treatment preferences in response to new evidence comparing anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) when making surgery recommendations for advanced primary glenohumeral osteoarthritis.

METHODS: We developed a Bayesian simulation involving 3 hypothetical surgeons with distinct initial beliefs: …

Community Factors And County-Level Cancer Screening, Prevalence, And Mortality, Alexandra R. Drake, Eric W. Christensen, Augusto C. Ochoa, William Small, Jinel Scott, Elizabeth Y. Rula

School of Medicine Faculty Publications

IMPORTANCE Cancer screening, prevalence, and mortality vary across US counties; the broad set of community factors associated with these differences are not well understood. OBJECTIVE To assess the relative importance of diverse community measures for explaining county-level variance in cancer screening, prevalence, and mortality rates for breast, colorectal, lung, and prostate cancers. DESIGN, SETTING, AND PARTICIPANTS This geospatial cross-sectional analysis across all US counties used random forest algorithms to estimate the relative importance of 24 community measures—including health behaviors and lifestyle, socioeconomic, and environment factors—as explanatory factors for cancer screening, prevalence, and mortality. For each cancer, county-level cancer screening and …

Development And Validation Of Clinical Screening Systems For Cushing Disease In The United States, Jorge E. Salcedo-Sifuentes, Sonal Mehta, Carter M. Suryadevara, Marvin Bergsneider, Kevin C. J. Yuen, Paul A. Gardner, Julie M. Silverstein, Albert H. Kim, James J. Evans, Garni Barkhoudarian, Juan C. Fernandez-Miranda, William T. Couldwell, Robert C. Rennert, Varun R. Kshettry, Kyle C. Wu, Carolina Benjamin, Gabriel Zada, Michael R. Chicoine, Jamie J. Van Gompel, Michael P. Catalino, Michael Karsy, Adam Mamelak, Ildiko Torok, Trevor Low, Won Kim, Donato R. Pacione, Nidhi Agrawal

Department of Neurosurgery Faculty Papers

PURPOSE: Clinical screening systems (CSSs) for Cushing syndrome (CS) validated in Europe have not been evaluated for CS or Cushing disease (CD) in the United States (US). We aimed to evaluate existing CSSs in US patients and develop two new symptom-based CSSs to identify patients with high pre-test probability of disease warranting referral for definitive biochemical workup-one for broad CS screening and one specifically for CD.

METHODS: Data were obtained from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID)-comprising 615 patients who underwent transnasal transsphenoidal resection for CD at one of 11 US pituitary centers, the Centers …

The Importance Of Treating Migraine Attacks Early - Even In Youth: A Real-World Argument For Neuromodulation, Mario F. P. Peres, Hsiangkuo Yuan, Cristina Tassorelli

Department of Jefferson Headache Center Papers and Presentations

No abstract provided.

Septic Arthritis And Abscess Of The Temporomandibular Joint, Frank Rizzuto, Abdul Khan, Jagan D. Gupta, Neel D. Gupta, Triet M. Do, Enrique Palacios

School of Medicine Faculty Publications

No abstract provided.

Failure To Rescue After Surgery For Pancreatic Cancer: A Systematic Review And Narrative Synthesis Of Risk Factors And Safety Strategies, Masashi Uramatsu, Yoshikazu Fujisawa, Paul Barach, Hiroaki Osakabe, Moe Matsumoto, Yuichi Nagakawa

College of Population Health Faculty Papers

Background: Failure to rescue (FTR), defined as death after major postoperative complications, is a critical quality indicator in pancreatic cancer surgery. Despite advances in surgical techniques and perioperative care, FTR rates remain high and vary across institutions. Methods: This systematic review uses a narrative synthesis followed by PRISMA 2020. A PubMed search (1992-2025) identified 83 studies; after screening, 52 studies (2010-2025) were included. Eligible designs were registry-based, multicenter, single-center, or prospective audits. Given substantial heterogeneity in study designs, FTR definitions, and outcome measures, a narrative synthesis was performed; no formal risk-of-bias assessment or meta-analysis was conducted. Results: …

Clinical Utility Of Diffusion Tensor Imaging In Sport-Related Concussion: A Systematic Review, Shiv Patil, Rithvik Kata, Serhat Aydin, Mert Karabacak, Konstantinos Margetis, Sotirios Bisdas

Student Papers, Posters & Projects

OBJECTIVE: Sport-related concussion (SRC) is a prevalent form of traumatic brain injury that is associated with long-term neurological and psychiatric impairment, particularly among athletes with a history of repetitive concussions. The biological variability of SRC's impact on the brain, as well as a lack of objective biomarkers to diagnose and prognosticate concussion, has prompted interest in advanced neuroimaging methods such as diffusion tensor imaging (DTI). By measuring disruptions in water diffusivity due to head trauma, DTI can detect alterations in white matter integrity that are not visualized by conventional imaging methods. This systematic review aims to synthesize major trends and …

Migraine-Related Disability According To Headache Frequency Subclassifications: A Systematic Review And Meta-Analysis, Manjit Singh Matharu, Stephen Silberstein, Hsiangkuo Yuan, Deborah Edgar, Roos Colman, Todd Schwedt, Michel Lanteri-Minet, Mark Obermann

Department of Jefferson Headache Center Papers and Presentations

BackgroundThis systematic review and meta-analysis synthesized migraine-related disability outcomes according to headache frequency subclassifications, including low-frequency episodic migraine (LFEM), high-frequency episodic migraine (HFEM) and chronic migraine (CM).MethodsWe searched the PubMed and Cochrane Library (CENTRAL) up to 16 October 2024 for peer-reviewed non-interventional studies reporting migraine-related disability outcomes in CM and subclassifications of episodic migraine (e.g. LFEM and HFEM). Eligible studies with an HFEM subgroup were grouped by headache frequency measure (monthly migraine days [MMD] or monthly headache days [MHD]), HFEM subgroup, disability parameter and study setting. Random-effects meta-analyses were conducted on groups with three or more studies, with the results …