Diagnosis Commons^™

Handheld Magnet Screening Of External Fixator Components: A Laboratory Assessment Of Gross Ferromagnetism Relevant To Mri Safety, Troy B. Puga, Mckenna W. Box, Lyn D. Ward, John T. Riehl

North Texas GME Research Forum 2026

Introduction Much controversy remains regarding the ability of patients with an external fixator in place to undergo Magnetic Resonance Imaging (MRI). The main concern for radiology departments is that the external fixator system components can lead to adverse events due to interactions of the external fixator and the magnet of the MRI. However, there is no clear evidence to support these claims or theories in the current literature. Yet, MRI’s are denied daily across the country for patients having an external fixator in place. Numerous patients with an external fixator would likely benefit from an MRI to prevent delayed care, …

Positive Efast—Not So Fast, Barry J. Knapp, Mitchell Vallone, Megan Duggins, Matt Jones, Jacob Knapp, Lily Kauffman, Alexander Dornstauder

Department of Emergency Medicine Faculty Publications

[Patient presentation] A 68-year-old man presented via emergency medical services (EMS) with right hip pain following a traumatic fall from his bicycle. On arrival at the emergency department, he was alert and oriented. Physical examination revealed only tenderness over the greater trochanter of the left femur, with no significant pain on passive range of motion of the left hip. Plain radiography demonstrated a left acetabular fracture (Fig 1).

Educational Case: Atypical Presentation Of Primary Hyperparathyroidism With Brown Tumor, Ariel Flotte, Jonathan Light, Harrison Klause, Richard M. Conran

Department of Biomedical and Translational Sciences Faculty Publications

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology.

35 Individuals With Huwe1-Related Neurodevelopmental Disorder And Suggested Clinical Evaluations, Mindy H. Li, Deziree L. Coleman, Kelsey Hogan, Danielle Luz, Lindsay Bhandari, Newell Belnap, Tiffany Busa, Charles Coutton, Klaus Dieterich, Svetlana Gorokhova, Clara Hildebrandt, Rachel Logan, Milena Mariani, Manuela Morleo, Vincenzo Nigro, John Pappas, Rachel Rabin, Kelly Schoch, Angelo Selicorni, Vandana Shashi, Rebecca Spillman, Jennifer Sullivan, Charlotte Tardy, Samantha A. Schrier Vergano, Brock Grill, Kristin Baranano

Department of Pediatrics Faculty Publications

HUWE1 (HECT, UBA, and WWE Domain Containing E3 Ubiquitin Protein Ligase1, OMIM 300697), located at Xp11.22, encodes a ubiquitin ligase that is highly conserved across species. Genetic variants in HUWE1 described in multiple independent studies cause X-linked intellectual disability, including in the patients identified by Juberg, Marsidi, and Brooks. This report describes 35 additional cases of individuals with variants in HUWE1 and suggested guidelines for clinical management. Our study includes several female cases, which have not been widely reported previously. Our findings confirm earlier reported clinical features including developmental delay, autism, hypotonia, short stature, and dysmorphic facial features as well …

Importance Of Placental Evaluation In Pregnancies At High Risk For Placenta Accreta Spectrum: Expert Clinical Perspective, Rebecca H. Jessel, Alesha White, Hope Y. Yu, Amie L. Hollard, Meena Khandelwal, Carolyn M. Zelop, Jennifer Philips, Alireza A. Shamshirsaz, John C. Kingdom, Alfred Abuhamad, Christina L. Herrera, Pan American Society For Placenta Accreta Spectrum (Pas2)

Department of Obstetrics & Gynecology Faculty Publications

Background

Placenta accreta spectrum (PAS) is a leading cause of obstetric morbidity and peripartum hysterectomy. Rising cesarean delivery rates, advanced maternal age, and assisted reproductive technologies have increased its incidence. Early, standardized diagnosis is essential for multidisciplinary planning and improved outcomes, yet formal screening guidelines are lacking.

Objective

To raise awareness of the importance of antenatal screening for PAS, summarize key clinical and imaging risk factors, and propose a standardized mid-trimester ultrasound protocol for high-risk patients.

Methods

An expert panel convened under the Pan-American Society for the Placenta Accreta Spectrum (PAS2) reviewed available evidence, risk stratification models, and prior consensus …

The Taper Sign: Sonographic Representation Of Uterine Dehiscence In Severe Cases Of Placenta Accreta Spectrum, Uma Deshmukh, Anna M. Modest, Alfred Abuhamad, Alireza A. Shamshirsaz, Jonathan L. Hecht, Scott A. Shainker

Department of Obstetrics & Gynecology Faculty Publications

Introduction: Prenatal diagnosis of placenta accreta spectrum (PAS) depends on reliable ultrasound markers and skilled image interpretation. Existing PAS markers emphasize placental features suggestive of abnormal adherence and require advanced image optimization. However, emerging hypotheses suggest that uterine dehiscence—not placental invasion—is the central mechanism underlying PAS, particularly in severe (Grade 3) disease. Despite this, few established ultrasound markers address this uterine dehiscence. We describe a novel ultrasound marker, the taper sign, which uniquely represents the uterine dehiscence in severe PAS with anterior placenta previa, and outline a standardized technique for image acquisition and interpretation.

Methods: This descriptive report details the …

Consensus And Controversies Of International Guidelines For The Diagnosis, Surveillance, And Management Of Fetal Growth Restriction: An Updated Comparison, Daniele Diane Mascio, Suneet P. Chauhan, Tullio Ghi, Asma Khalil, Juliana G. Martins, Sara Sorrenti, Tamara Stampalija, Fabrizio Zullo, Francesc Figueras

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE: To compare areas of consensus and disagreements across contemporary international and national guidelines on the diagnosis, surveillance, and management of fetal growth restriction (FGR).

DATA SOURCES: Electronic searches of MEDLINE from database inception up to March 2026 using MeSH terms and keywords related to FGR and guidelines. STUDY ELIGIBILITY CRITERIA: Critical, structured comparison of national or international guidelines on FGR published since 2010. Final inclusion required unanimous agreement from all authors.

STUDY APPRAISAL AND SYNTHESIS METHODS: Pre-specified extraction across domains: definition; prediction/prevention; surveillance tools and frequency; delivery timing and mode; and labor induction methods. Dual data …

Training Set Augmentation And Biology-Aware Harmonization Improve Radiomic Models For Lung Cancer Prediction In Indeterminate Nodules, Claire Huchthausen, Menglin Shi, Gabriel De Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya

Data Science Faculty Publications

CT radiomics-based machine learning has potential to predict lung cancer in pulmonary nodules (PNs) earlier than standard-of-care methods. Low malignancy rates in early-development PNs and variable image acquisition hinder development of radiomic models for diagnosing these PNs. To address these challenges, we augmented training using later-development PNs and harmonized for acquisition effects. We examine early-development benign and malignant PNs (n = 106) below the sensitivity of standard-of-care diagnosis. Classifiers predicting malignancy performed near chance when trained on ComBat-harmonized radiomic features from only early-development PNs. We then augmented training with later-development benign and malignant PNs (n = 225). We evaluated whether …

Improving Medical Diagnostics With Vision-Language Models: Convex Hull-Based Uncertainty Analysis, Ferhat Ozgur Catak, Murat Kuzlu, Taylor Patrick, Michel Audette

Engineering Technology Faculty Publications

In recent years, vision-language models (VLMs) have been applied to various fields, including healthcare, education, finance, and manufacturing, with remarkable performance. However, concerns remain regarding VLMs' consistency and uncertainty, particularly in critical applications such as healthcare, which demand a high level of trust and reliability. This paper proposes a novel approach to evaluate uncertainty in VLMs' responses using a convex hull approach on a healthcare application for visual question answering (VQA). For any VLM, temperature refers to a sampling parameter used in probabilistic generation, which controls the randomness of the model's output. The LLM-CXR model is selected as the medical …

Clinical Subtypes Of Co-Morbid Insomnia And Obstructive Sleep Apnea (Comisa): Results Of A Cluster Analysis, Yuan Shi, Xujun Feng, Fengyi Hao, Yuru Nie, Yihui Zhang, Zhaohua Chen, Siqi Guan, Larry D. Sanford, Michael V. Vitiello, Xiangdong Tang

Department of Pathology & Anatomy Faculty Publications

Background

Variations in the bidirectional relationship between obstructive sleep apnea (OSA) and insomnia in co-morbid insomnia and OSA (COMISA) may form distinct subtypes of COMISA, which have not been previously characterized. This study aims to identify and characterize subtypes of COMISA.

Methods

From a community-recruited COMISA cohort 256 individuals who met diagnosis for COMISA were used to identify subtypes using a two-step clustering methodology. Demographics and multidimension clinical characteristics were collected and compared among obtained subtypes. Logistic models were used to evaluate whether these subtypes were associated with cardiometabolic and mental disorders. A clinical cohort of 1816 COMISA patients was …

Exploring The Synergy Between Very Large Transformer And Lstm Models For Effective Medical Captioning From Videos To Text: The Impact Of Captioning In Healthcare, R. V. Aswiga, Moin Ahmed Zahir

Data Science Faculty Publications

In today’s rapidly evolving digital landscape, the demand for accurate and contextually relevant subtitles for image and video content, particularly in the medical domain, is increasingly critical. Despite the proliferation of visual data across various platforms, existing captioning systems often struggle due to variations in visual settings, complex temporal relationships, and nuanced semantics. Additionally, challenges such as limited datasets, privacy issues, and specialized annotation requirements make medical image captioning particularly difficult. To tackle these challenges, we investigate cutting-edge deep learning methodologies, specifically Transfer Learning and Transformer models, through a comparative analysis. Specifically, we focus on Transfer Learning through the MedVisionCapturer …

A Painful Diffuse Rash, Bruce M. Lo, Melanie Shoemaker, Kiersten Potter, Katherine Schaffer

Department of Emergency Medicine Faculty Publications

[Patient presentation]

A 41-year-old male with no past medical history presented with 1 week of ulcers to the left side of his face, followed by several days of a painful rash to the trunk and back after a sexual encounter. The patient denies any fever or previous rash and any illicit drug use. Initial vital signs included a temperature of 97 °F, a heart rate of 89 beats per minute, and blood pressure of 135/79 mm Hg. Physical examination revealed a macular papular rash across his trunk and back (Fig 1) and facial ulcerations with eschar (Fig 2) at the …

Standardization Of Neuromuscular Reflex Analysis—Role Of Fine-Tuned Vision-Language Model Consortium And Openai Gpt-Oss Reasoning Llm-Enabled Decision Support System, Eranga Bandara, Ross Gore, Sachin Shetty, Ravi Mukkamala, Christopher K. Rhea, Brittany S. Samulski, Amin Hass, Atmaram Yarlagadda, Shaifali Kaushik, Malith De Silva, Andriy Maznychenko, Inna Sokolowska, Kasun De Zoysa

VMASC Publications

Background/Objectives: Accurate assessment of neuromuscular reflexes, such as the Hoffmann reflex (H-reflex), plays a critical role in sports science, rehabilitation, and clinical neurology. Conventional interpretation of H-reflex electromyography (EMG) waveforms is subject to inter-rater variability and interpretive bias, limiting reliability and standardization. This study aims to develop an automated, interpretable, and robust agentic AI–driven framework for H-reflex waveform analysis. Methods: We propose a fine-tuned Vision–Language Model (VLM) consortium combined with a reasoning Large Language Model (LLM)–enabled decision support system for automated H-reflex interpretation. Multiple VLMs were fine-tuned on curated datasets of H-reflex EMG waveform images annotated with expert clinical observations, …

Central Centrifugal Cicatricial Alopecia In Pediatric Patients: A Retrospective Analysis, Radhika Gupta, Nikhita Perry, Noelle Desir, Iain Encarnacion, Jonathan Miles, Susan Taylor, Michelle Oboite, Temitaya Ogunleye

Department Dermatology Faculty Publications

[Introduction] Central centrifugal cicatricial alopecia (CCCA) is a scarring alopecia that predominantly affects middle-aged women of African descent.¹ It begins at the vertex scalp and expands centrifugally, and given that symptoms may be absent, many patients have scarring at presentation. CCCA is primarily described in adult populations, with limited reports of CCCA in children.²^-⁴ We aimed to characterize demographics, clinical findings, and histological features among pediatric patients with CCCA to facilitate earlier diagnoses, prior to irreversible alopecia.

Understanding The Impact Of Psychosocial Barriers On Colorectal Cancer Knowledge In Emerging Black Men, Chelsey Mcgill, Maria D. Thomson, Caroline Kuno, Emmanuel Taylor, Kimberly Lawrence, Alison J. Patev, Arnethea L. Sutton, Ruth Nyagaka, Oxana Palesh, Larry D. Keen Ii

Research and Infrastructure Service Enterprise (RISE) Faculty Publications

In the United States, Colorectal Cancer (CRC) is one of the most commonly diagnosed cancers and the third leading cause of death among non-Hispanic African American/Black (henceforth Black) men. Inadequate CRC knowledge leads to missing early warning signs, delaying prevention and increasing risk. Emerging adulthood (18-25) is a key period for building healthy behaviors and addressing barriers to CRC knowledge in addition to understanding attitudes and practices to CRC screening. Psychosocial barriers - including social support, medical mistrust, and perceived racial discrimination - contribute to the lack of CRC knowledge among older Black men, yet emerging adult Black men remain …

Prognostic Factors For Patients Under 45 Undergoing Surgery For Colorectal Liver Metastases: A Seer Population-Based Study, Gabrielle Grob, Fang Fang, Matvey Karpov, Eric Feliberti, Marybeth Hughes, Rachel Burke, Winifred Lo

Department Surgery Faculty Publications

Background and Objectives: Colorectal cancer (CRC) has been on the rise in adults younger than 50. Surgical resection is a potentially curative treatment option for patients with colorectal liver metastases (CRLM). The aim of this study was to describe patient and tumor characteristics associated with disease-specific survival in young patients (<  45 years) versus older patients (≥ 45 years) with isolated CRLM.

Methods: The SEER database was queried for patients with CRLM who underwent colon and liver resection from 2010 to 2021. Patients under age 20, with metastases beyond the liver, or who had not had surgery for liver metastases were excluded. Cox regression was used to analyze demographic factors, tumor …

Revisiting Nasal Polyp Scoring In Clinical Trials: Interpretive Variability And The Need For Standardization, Leigh J. Sowerby, Babak Pourmomenarabi, Antonino Maniaci, Olivia Ginty, Joseph Khristian Han

Department of Otolaryngology (ENT) Faculty Publications

[Introduction] Borish et al. provided an excellent review highlighting methodological variability among the six pivotal Phase III trials [1]. One critical yet overlooked issue is the inconsistent application of the endoscopic nasal polyp score (NPS), a primary outcome measure in all trials.

A Unified Automated And Explainable Ai Framework For Drug Discovery, Clinical Diagnostics, And Public Health Data Prediction, Lord Coffie

College of Graduate Studies: Theses & Dissertations

This thesis investigates the development of automated, explainable artificial intelligence systems to improve automated scientific discovery, clinical diagnostic support, and public health decision-making. Three independent yet thematically aligned studies were conducted across cheminformatics, radiology, and population health. Study A introduces an automated and explainable machine learning pipeline for Quantitative Structure–Activity Relationship (QSAR) modeling using RDKit-derived molecular descriptors. The pipeline performs systematic preprocessing, consensus-based feature selection (mutual information, random forest importance, RFECV), and benchmarks six supervised models—Random Forest, XGBoost, Support Vector Machine, Balanced Random Forest, EasyEnsembleClassifier, and a blended meta-ensemble, achieving AUC = 0.90 and accuracy = 0.83, while ensuring interpretability …

Wearable Biosensors For Continuous Monitoring Of Chronic Kidney Disease: Materials, Biofluids, And Digital Health Integration, Anupamaa Sivasubramanian, Shankara Narayanan, Gymama Slaughter

Center for Bioelectronics Publications

Chronic kidney disease (CKD) is a progressive and irreversible disorder affecting over 850 million individuals globally and is associated with significant morbidity, mortality, and healthcare burden. Conventional diagnostic approaches rely on intermittent laboratory measurements, including serum creatinine, estimated glomerular filtration rate (eGFR), and urinary albumin, which provide limited temporal resolution and fail to capture dynamic physiological changes. Recent advances in wearable biosensing technologies offer new opportunities for continuous, non-invasive monitoring of biochemical and physiological markers relevant to renal function. This review provides a comprehensive analysis of wearable biosensors for CKD monitoring, focusing on sensing mechanisms (electrochemical, optical, and field-effect transistor), …

Ai-Assisted Surface-Enhanced Raman Spectroscopy For Cardiovascular Diagnostics: From Plasmonic Materials To Clinical Translation, Anju Joshi, Gymama Slaughter

Center for Bioelectronics Publications

Raman spectroscopy (SERS) has emerged as a powerful analytical technique, offering molecular fingerprint specificity and ultrasensitive detection of cardiac biomarkers. Recent advances in plasmonic nanostructures, surface functionalization strategies, and flexible sensing platforms have significantly improved the analytical performance of SERS-based biosensors. In parallel, the integration of artificial intelligence (AI) and machine learning has enabled robust interpretation of complex spectral datasets, facilitating automated biomarker classification and improved diagnostic accuracy in heterogeneous biological environments. Despite these advances, the field remains fragmented, with limited integration between nanomaterial design, biomarker selection, and data-driven analysis, and persistent challenges related to reproducibility, standardization, and clinical validation. …