30 results on '"Garg, T"'
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2. Abstract No. 596 Quantifying the Burden of Hereditary Hemorrhagic Telangiectasia on Quality of Life and Psychological Health: A Cross-Sectional Study
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Linares Bolsegui, M., primary, Gong, A., additional, Lee, E., additional, Tan, M., additional, Gowda, P., additional, Garg, T., additional, Kemble, S., additional, and Weiss, C., additional
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- 2024
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3. Structural, optical and magnetic investigations of [CoFe2O4]0.2-[BaTiO3]0.8 core-shell magnetoelectric nanocomposites
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Goyal, Lickmichand M., primary and Garg, T., additional
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- 2024
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4. Structural, optical and magnetic investigations of [CoFe2O4]0.2-[BaTiO3]0.8 core-shell magnetoelectric nanocomposites.
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Goyal, Lickmichand M. and Garg, T.
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TARGETED drug delivery , *NANOCOMPOSITE materials - Abstract
Magnetoelectric core-shell nanocomposites have drawn significant interest in the field of nano medicine and targeted drug delivery. In this work, we have synthesized CoFe2O4-BaTiO3 nanocomposite by chemical route and carried out their structural, optical and magnetic studies. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Structural, optical and magnetic investigations of [CoFe2O4]0.2-[BaTiO3]0.8core-shell magnetoelectric nanocomposites
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Goyal, Lickmichand M. and Garg, T.
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- 2024
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6. "Faith and a sunny day": Association of patient frailty with strain experienced by informal caregivers of older adults with non-muscle-invasive bladder cancer.
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Garg T, Maheshwari C, Frank K, Johns A, Rabinowitz K, Danella JF, Becker H, Kirchner HL, Nielsen ME, Cohen HJ, Murphy TE, and McMullen CK
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Introduction: Few studies have evaluated the potential effects of aging-related conditions like frailty in older adults with cancer on informal caregivers. Our objective was to evaluate the association between the sum total of the aging-related conditions of older adults with non-muscle-invasive bladder cancer (NMIBC) and the strain reported by their informal caregivers., Materials and Methods: We conducted an explanatory sequential mixed methods cross-sectional survey study that recruited 81 dyads of older adults with NMIBC (age ≥ 65 at diagnosis) and their informal caregivers. Our outcome was measured by the Caregiver Strain Index (CSI), a self-reported measure of informal caregivers. Our exposure was the patient's deficit accumulation index (DAI), a validated composite measure of frailty derived from a geriatric assessment. A multivariable negative binomial regression was conducted to model CSI. We conducted qualitative thematic content analysis of responses to open-ended survey questions to understand specific types of caregiver strain and to identify coping strategies., Results: Mean ages of patients and caregivers were 79.4 years and 72.5 years, respectively. Most caregivers were spouses (75.3 %) and lived with the patient (80.2 %). Of patients, 54.3 % were robust, 29.6 % were pre-frail, and 16.1 % were frail. In the multivariable model, we found that patient DAI was significantly associated with CSI (adjusted incidence rate ratio 1.05, 95 % CI 1.02-1.09). The top three sources of strain identified by caregivers were emotional adjustments, medical management, and family adjustments. Coping strategies for each included self-management of emotions, self-education about bladder cancer, and social support, respectively., Discussion: In this cross-sectional study, we found that worsening frailty in an older adult with NMIBC was associated with greater informal caregiver strain. Informal caregivers reported challenges with emotional management, family dynamics, and medical tasks. These findings may inform longitudinal research and interventions to support informal caregivers who provide care for older adults with NMIBC., Competing Interests: Declaration of Competing Interest Matthew E. Nielsen serves as a paid consultant to the American Urological Association and to the American College of Physicians High Value Care Task Force and as a consultant/advisor to Grand Rounds (stock options). Tullika Garg was a Web MD paid consultant in 2020, and currently receives research funding from the Flume Catheter Company, LLC. Through 2021, Dr. Garg's immediate family member was an employee and stockholder of DRPLZ. All other authors report no conflicts., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
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- 2024
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7. Climate change exacerbates the environmental impacts of agriculture.
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Yang Y, Tilman D, Jin Z, Smith P, Barrett CB, Zhu YG, Burney J, D'Odorico P, Fantke P, Fargione J, Finlay JC, Rulli MC, Sloat L, Jan van Groenigen K, West PC, Ziska L, Michalak AM, Lobell DB, Clark M, Colquhoun J, Garg T, Garrett KA, Geels C, Hernandez RR, Herrero M, Hutchison WD, Jain M, Jungers JM, Liu B, Mueller ND, Ortiz-Bobea A, Schewe J, Song J, Verheyen J, Vitousek P, Wada Y, Xia L, Zhang X, and Zhuang M
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- Crops, Agricultural growth & development, Environment, Agrochemicals, Soil chemistry, Climate Change, Agriculture, Greenhouse Gases
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Agriculture's global environmental impacts are widely expected to continue expanding, driven by population and economic growth and dietary changes. This Review highlights climate change as an additional amplifier of agriculture's environmental impacts, by reducing agricultural productivity, reducing the efficacy of agrochemicals, increasing soil erosion, accelerating the growth and expanding the range of crop diseases and pests, and increasing land clearing. We identify multiple pathways through which climate change intensifies agricultural greenhouse gas emissions, creating a potentially powerful climate change-reinforcing feedback loop. The challenges raised by climate change underscore the urgent need to transition to sustainable, climate-resilient agricultural systems. This requires investments that both accelerate adoption of proven solutions that provide multiple benefits, and that discover and scale new beneficial processes and food products.
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- 2024
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8. Prerequisite for reproducible science: a call to embrace code sharing.
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Gun A and Garg T
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Competing Interests: We have no conflicts of interests to declare.
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- 2024
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9. An investigation into the effectiveness of Mood Lifters in the context of trauma exposure.
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Garg T, Votta CM, Prakash N, and Deldin PJ
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- Humans, Male, Female, Adult, Young Adult, Adverse Childhood Experiences, Middle Aged, Psychological Trauma therapy, Outcome Assessment, Health Care, Stress Disorders, Post-Traumatic therapy, Depression therapy, Anxiety therapy
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A large proportion of adults experiencing mental health problems do not receive care due to structural and attitudinal barriers. Mood Lifters (ML) is an evidence-based mental wellness program designed to reduce depression, anxiety, and stress symptoms. This study aims to extend the literature by examining whether ML reduces posttraumatic stress disorder (PTSD) symptoms, and if childhood trauma (CT) affects treatment outcomes. We hypothesized that ML will be effective for all symptoms. However, we predicted that those who endorse higher levels of CT would experience a diminished impact of ML on their symptoms. Graduate students and young professionals ( N = 221), a demographic that is known to have greater mental health concerns, were randomly assigned to either the waitlist condition ( n = 78) or the intervention condition ( n = 143). Before and after ML participation, participants completed a series of questionnaires about their symptoms. ML reduced symptoms of PTSD for participants who received the intervention relative to the waitlist. Further, we also observed that while the overall regression models with CT predict posttreatment scores for all the clinical symptoms, the CT variable itself was predictive of only posttreatment anxiety. Unexpectedly, given that CT is often associated with less improvement, we found that those at all levels of CT experienced similar reductions in depression, anxiety and PTSD symptoms. Taken together, ML is a viable option to help people reduce depression, anxiety, stress, and PTSD regardless of the level of CT exposure. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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- 2024
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10. Clinical Spectrum of Dermatological Disorders at an Urban Health Center in East Delhi.
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Soni S, Garg T, Acharya A, and Sarkar R
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Dermatological disorders constitute a significant proportion of primary health care (PHC) setups. The pattern of dermatological disorders varies among different countries and different parts of the same country owing to climatic and geographical variations, level of education, access to health care, etc. To study the clinical spectrum of patients presenting with dermatological disorders at an urban health center (UHC) in East Delhi. To identify the various risk factors associated with dermatological disorders in study subjects. A total of 1,148 patients who reported skin diseases for the first time at the Dermatology Outpatient Clinic at UHC in East Delhi were recruited. Detailed demographic data, history, and examination and potential risk factors of skin diseases (socioeconomic status, level of education, occupation, comorbidities, and addictions) were recorded on a predesigned proforma. A total of 616 (53.7%) patients had infectious dermatoses and 532 (46.3%) had non-infectious dermatoses. Among the infectious dermatoses, fungal diseases (44.8%) were the most common followed by parasitic infections (31.17%) and bacterial infections (9.74%). Among the non-infectious group, eczematous disorders (28.01%) were the most common, followed by pigmentary disorders (21.62%) and acne (19.55%). A significant association between level of education, occupation, and comorbidities with the distribution of infectious and non-infectious dermatoses was found. As a significant proportion of patients with a vivid spectrum of dermatological disorders present at the PHC setups, therefore dermatologists supervise that specialty clinics should be held regularly at these centers along with the availability of all the basic investigations to aid diagnosis and management., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Community Medicine.)
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- 2024
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11. Imaging Genomics and Multiomics: A Guide for Beginners Starting Radiomics-Based Research.
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Singh S, Mohajer B, Wells SA, Garg T, Hanneman K, Takahashi T, AlDandan O, McBee MP, and Jawahar A
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- Humans, Neoplasms diagnostic imaging, Neoplasms genetics, Algorithms, Diagnostic Imaging methods, Genomics, Biomedical Research, Multiomics, Radiomics, Imaging Genomics methods
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Radiomics uses advanced mathematical analysis of pixel-level information from radiologic images to extract existing information in traditional imaging algorithms. It is intended to find imaging biomarkers related to the genomics of tumors or disease patterns that improve medical care by advanced detection of tumor response patterns in tumors and to assess prognosis. Radiomics expands the paradigm of medical imaging to help with diagnosis, management of diseases and prognostication, leveraging image features by extracting information that can be used as imaging biomarkers to predict prognosis and response to treatment. Radiogenomics is an emerging area in radiomics that investigates the association between imaging characteristics and gene expression profiles. There are an increasing number of research publications using different radiomics approaches without a clear consensus on which method works best. We aim to describe the workflow of radiomics along with a guide of what to expect when starting a radiomics-based research project., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)
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- 2024
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12. The relationship between object-based spatial ability and virtual navigation performance.
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Garg T, Velasco PF, Patai EZ, Malcolm CP, Kovalets V, Bohbot VD, Coutrot A, Hegarty M, Hornberger M, and Spiers HJ
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- Humans, Female, Male, Young Adult, Adult, Memory, Short-Term physiology, Spatial Memory physiology, Maze Learning physiology, Space Perception physiology, Adolescent, Mobile Applications, Spatial Navigation physiology
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Spatial navigation is a multi-faceted behaviour drawing on many different aspects of cognition. Visuospatial abilities, such as mental rotation and visuospatial working memory, in particular, may be key factors. A range of tests have been developed to assess visuospatial processing and memory, but how such tests relate to navigation ability remains unclear. This understanding is important to advance tests of navigation for disease monitoring in various disorders (e.g., Alzheimer's disease) where spatial impairment is an early symptom. Here, we report the use of an established mobile gaming app, Sea Hero Quest (SHQ), as a measure of navigation ability in a sample of young, predominantly female university students (N = 78; 20; female = 74.3%; mean age = 20.33 years). We used three separate tests of navigation embedded in SHQ: wayfinding, path integration and spatial memory in a radial arm maze. In the same participants, we also collected measures of mental rotation (Mental Rotation Test), visuospatial processing (Design Organization Test) and visuospatial working memory (Digital Corsi). We found few strong correlations across our measures. Being good at wayfinding in a virtual navigation test does not mean an individual will also be good at path integration, have a superior memory in a radial arm maze, or rate themself as having a strong sense of direction. However, we observed that participants who were good in the wayfinding task of SHQ tended to perform well on the three visuospatial tasks examined here, and to also use a landmark strategy in the radial maze task. These findings help clarify the associations between different abilities involved in spatial navigation., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Garg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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13. Socioeconomic and Demographic Effects on SARS-CoV-2 Testing: Evidence From the State of Uttar Pradesh, India.
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Pandey RR, Agarwal M, Wahl BP, Garg T, and Jain A
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Background The rapid global spread of SARS-CoV-2 highlighted critical challenges in healthcare systems worldwide, with differences in testing access and utilization becoming particularly evident. This study investigates the socioeconomic and demographic factors influencing SARS-CoV-2 testing service access and utilization during the second wave of the pandemic in Uttar Pradesh (UP), India. Methods The study was conducted from July to October 2023 in two districts of Uttar Pradesh (UP). These districts were chosen because one had the highest and the other the lowest SARS-CoV-2 testing rates per million population as reported from March to June 2021. The study population included consenting adult individuals with self-reported symptoms indicative of SARS-CoV-2 infection during March-June 2021. The study excluded individuals under 18 years, those who did not consent, pregnant or lactating mothers, and those with communication-impairing medical conditions. Data were collected using a structured questionnaire based on Andersen's Behavioural Model of Health Services Use. We used chi-squared tests for all categorical variables to obtain p-values and Poisson regression to identify factors influencing testing rates. Results We screened 4,595 individuals and identified 675 eligible participants for this study. Adjusted prevalence ratios derived from multiple variate Poisson regression models showed that participants in Sitapur had a 0.47 (95% CI: 0.39-0.57) times the prevalence of being tested than those in Lucknow. Furthermore, individuals from other backward castes and scheduled castes had a 1.15 (95% CI: 0.99-1.34) and 1.22 (95% CI: 0.95-1.56) times prevalence of being tested for SARS-CoV-2, respectively, when compared to the general caste population. Scheduled Tribes showed a higher prevalence of being tested, contrasting with existing literature. Households with low, middle, and high income showed a 1.46 (95% CI: 1.12-1.89), 1.52 (95% CI: 1.14-2.02), and 1.73 (95% CI: 1.23-2.45) times the prevalence of SARS-CoV-2 testing compared to those below the poverty line, respectively. Behavioral factors such as media use showed an inverse relationship with testing prevalence; individuals who did not watch TV at all had a 0.83 (95% CI: 0.70-0.99) times prevalence of being tested compared to frequent viewers, and similarly, those not using the internet on mobiles had a 0.82 (95% CI: 0.67-0.99) times prevalence than daily users. Individuals using private healthcare facilities had a 0.87 (95% CI: 0.77-0.99) times prevalence of SARS-CoV-2 testing compared to those using government facilities. Conclusions These findings highlight the importance of public health strategies that address socio-economic and behavioral disparities to ensure equitable testing access across all community groups., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Pandey et al.)
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- 2024
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14. Whole-lesion assessment of volume and signal changes after sclerotherapy of extremity venous malformations.
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Khalil A, Laguna A, I Mehta T, Gowda PC, Gong AJ, Weinstein RM, Garg T, Ring NY, England RW, George Linguraru M, Jones CK, and Weiss CR
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- Child, Humans, Sclerosing Solutions therapeutic use, Retrospective Studies, Veins, Treatment Outcome, Sclerotherapy, Vascular Malformations diagnostic imaging, Vascular Malformations therapy
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Purpose: To investigate quantitative changes in MRI signal intensity (SI) and lesion volume that indicate treatment response and correlate these changes with clinical outcomes after percutaneous sclerotherapy (PS) of extremity venous malformations (VMs)., Methods: VMs were segmented manually on pre- and post-treatment T2-weighted MRI using 3D Slicer to assess changes in lesion volume and SI. Clinical outcomes were scored on a 7-point Likert scale according to patient perception of symptom improvement; treatment response (success or failure) was determined accordingly., Results: Eighty-one patients with VMs underwent 125 PS sessions. Treatment success occurred in 77 patients (95 %). Mean (±SD) changes were -7.9 ± 24 cm
3 in lesion volume and -123 ± 162 in SI (both, P <.001). Mean reduction in lesion volume was greater in the success group (-9.4 ± 24 cm3 ) than in the failure group (21 ± 20 cm3 ) (P =.006). Overall, lesion volume correlated with treatment response (ρ = -0.3, P =.004). On subgroup analysis, volume change correlated with clinical outcomes in children (ρ = -0.3, P =.03), in sodium tetradecyl sulfate-treated lesions (ρ = -0.5, P =.02), and in foot lesions (ρ = -0.6, P =.04). SI change correlated with clinical outcomes in VMs treated in 1 PS session (ρ = -0.3, P =.01) and in bleomycin-treated lesions (ρ = -0.4, P =.04)., Conclusions: Change in lesion volume is a reliable indicator of treatment response. Lesion volume and SI correlate with clinical outcomes in specific subgroups., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)- Published
- 2024
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15. Assessing the defecation practices of unsheltered individuals and their contributions to microbial water quality in an arid, urban watershed.
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Hinds JB, Garg T, Hutmacher S, Nguyen A, Zheng Z, Griffith J, Steele J, González Fernández A, and Schiff K
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- Humans, Environmental Monitoring, Water Microbiology, Feces, Water Pollution, Water Quality, Defecation
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Outdoor defecation by people experiencing homelessness is frequently perceived as a potentially large source of human fecal pollution and a significant source of health risk in urban waterbodies with recreational contact. The goal of this study was to count the number of people experiencing homelessness and quantifies their sanitation habits in an urban river corridor setting, then use this information for estimating human fecal pollutant loading on a watershed scale. Two types of census counts were conducted including periodic point-in-time counts over six years and weekly counts of encampments. While the population census varied from count-to-count, the range of population estimates in the river corridor varied from 109 to 349 individuals during the six-year span, which mirrored the weekly counts of encampments. A face-to-face survey of people experiencing homelessness assessed the sanitation habits of the unsheltered population (N = 63), including outdoor defecation frequency and containment practices. Overall, 95 % of survey respondents reported defecating outdoors; 36 % practiced outdoor defecation between 4 and 7 days/week and 27 % practiced outdoor defecation <1 day/week. Of those that did practice outdoor defecation, 75 % contained their feces in a bucket or bag, thereby limiting fecal material contributions to the river; 6.7 % reported defecating on low ground near the river that could wash off when flood waters rise during a storm event. Only a single survey respondent reported defecating directly into the river. Based on literature values for average HF183 output for an adult human, and the average rainfall in the urban watershed, the total watershed contribution of HF183 averaged 1.2 × 10
10 gene copies per storm event (95 % CI: 0.9 × 1010 -1.6 × 1010 ) along the 41 km stretch of river in this study. This human fecal loading estimate is at least two orders of magnitude less than cumulative HF183 loading from all human sources measured at the bottom of the watershed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)- Published
- 2024
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16. Using Virtual Reality to Study Spatial Mapping and Threat Learning.
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Marino CE, Rjabtsenkov P, Sharp C, Ali Z, Pineda E, Bavdekar S, Garg T, Jordan K, Halvorsen M, Aponte C, Blue J, Zhu X, and Jimenez BS
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Using spatial mapping processes to learn about threat and safety in an environment is crucial for survival. Research using conditioning paradigms has explored the effects of state (transient arousal) and trait anxiety (anxiety as an aspect of personality) on threat learning and acquisition. However, results are mixed, and little is known regarding why some individuals do not learn to discriminate between threat and safety during contextual conditioning. We used a virtual reality (VR) contextual threat conditioning paradigm to elucidate the effects of state and trait anxiety on contextual threat learning. 70 healthy participants (46 female) navigated and "picked" flowers in a VR environment. Flowers picked in the dangerous zone (half of the environment) were paired with an electric shock (or "bee sting") to the hand; flowers picked in the safe zone were never paired with a shock. Participants also collected and returned neutral objects as a measure of spatial memory. Galvanic skin response (GSR) was measured throughout the task and anxiety was assessed via the State Trait Anxiety Inventory (STAI). Participants were categorized as learners if they correctly identified the two zones after the task. Non-learners, compared to learners, performed significantly worse during the spatial memory task and demonstrated significantly higher state anxiety scores and GSR levels throughout the task. Learners showed higher skin conductance response (SCR) in the dangerous zone compared to the safe zone while non-learners showed no SCR differences between zones. These results indicate that state anxiety may impair spatial mapping, disrupting contextual threat learning., Competing Interests: Conflict of interest The authors declare no competing financial interests.
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- 2024
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17. Efficacy of 15% trichloroacetic acid peel versus 35% glycolic acid peel in acanthosis Nigricans: A randomized open-label study.
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Bharati B, Sarkar R, Garg T, Goyal R, and Mendiratta V
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Introduction: Acanthosis Nigricans (AN) is an acquired disorder of keratinization. It presents as hyperpigmentation, velvety texture of skin that can involve any part of the body including the face. Different topical, systemic therapies, or physical therapies including laser have been explored. However, there are not many randomized controlled studies for the majority of therapy alternatives besides lifestyle modifications and weight reduction., Objectives: The aim of this study was to compare the effectiveness of 15% trichloroacetic acid (TCA) and 35% glycolic acid (GA) peel for AN., Materials and Methods: Forty participants were included and randomized into two groups. In groups A and B, peeling with 15% TCA and 35% GA was done, respectively. The effectiveness of each peel was assessed using changes in the Acanthosis Nigricans Area and Severity Index Score (ANASI) and Physician Assessment Score. Statistical analysis included Wilcoxon-Mann-Whitney test, Friedman test, and generalized estimating equations., Results: The overall change in ANASI over time was compared in the two groups using the generalized estimating equations method. A significant difference was observed in the trend of ANASI over time between the two groups ( P < 0.001). TCA peel group showed more change in ANASI as compared with GA peel group., Conclusion: In our research, 15% TCA has a better efficacy when compared with 35% GA peel after three sessions of chemical peeling. We therefore recommend the use of 15% TCA peel in AN as a safe and effective treatment option. However, more comprehensive randomized control studies are required for supporting data., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cutaneous and Aesthetic Surgery.)
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- 2024
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18. Analysis of Medical Malpractice Claims Involving Interventional Radiologists: A Comprehensive Analysis From Two National Legal Databases.
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Khan A, Garg T, Khunte M, Bajaj S, Wu X, Mezrich J, and Malhotra A
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- Humans, Angioplasty, Databases, Factual, Radiologists, United States, Malpractice
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Purpose: The nature of lawsuits involving interventional radiologists (IRs) is not well understood. The purposes of this article are to provide an overview of the causes of action underlying medical malpractice lawsuits related to IRs and to characterize the associated factors and outcomes., Methods: Two large legal databases were used to search for US legal cases in which there were jury awards and settlements involving IRs in the United States. Cases were screened to include only those cases in which the cause of action involved negligence on the part of IRs., Results: A total of 389 published case summaries were identified, of which 93 were eligible to be included in the analysis. In 46% of the cases (43 of 93), medical malpractice was alleged against an individual IR, whereas in 43% (40 of 93), it was alleged against both an individual IR and a health care institution. Thirty-five percent of IR malpractice cases (33 of 93) involved the performance of a vascular procedure, most commonly embolization procedures (30% [n = 10]), stenting or angioplasty (21% [n = 7]), and diagnostic arteriography and angiography (18% [n = 6]). Twenty-six percent of cases (24 of 93) involved IR performance of a biopsy. Eighteen percent of cases (17 of 93) involved a failure to gain informed consent in addition to an allegation of medical negligence during treatment. Eleven percent of cases (10 of 93) were resolved by settlement, with an average settlement amount of $877,500 (range, $200,000-$2,700,000). Among the 72 cases that went to trial, 74% (53 of 72) resulted in judgments for the defendants, and 26% (19 of 72) resulted in judgements for the plaintiffs, with an average award of $2,012,243 (range, $101,667-$6,400,000)., Conclusions: Vascular procedures and biopsies were the most frequent reasons for malpractice lawsuits involving IRs. Failure to gain informed consent in addition to an allegation of medical negligence during treatment was not infrequent. Although the majority of published medical malpractice claims involving IRs resulted in judgments in favor of the defendants, the average amount awarded to plaintiffs was higher compared with previous data reported for all physicians., (Copyright © 2023 American College of Radiology. Published by Elsevier Inc. All rights reserved.)
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- 2024
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19. Interruptions in bladder cancer care during the COVID-19 public health emergency.
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Gore JL, Follmer K, Reynolds J, Nash M, Anderson CB, Catto JWF, Chamie K, Daneshmand S, Dickstein R, Garg T, Gilbert SM, Guzzo TJ, Kamat AM, Kates MR, Lane BR, Lotan Y, Mansour AM, Master VA, Montgomery JS, Morris DS, Nepple KG, O'Neil BB, Patel S, Pohar K, Porten SP, Riggs SB, Sankin A, Scarpato KR, Shore ND, Steinberg GD, Strope SA, Taylor JM, Comstock BA, Kessler LG, Wolff EM, and Smith AB
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- Humans, Adjuvants, Immunologic therapeutic use, Administration, Intravesical, BCG Vaccine therapeutic use, Neoplasm Invasiveness, Neoplasm Recurrence, Local pathology, Pandemics, Public Health, COVID-19 epidemiology, Urinary Bladder Neoplasms therapy, Urinary Bladder Neoplasms drug therapy
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Background: Academic and community urology centers participating in a pragmatic clinical trial in non-muscle-invasive bladder cancer completed monthly surveys assessing restrictions in aspects of bladder cancer care due to the COVID-19 Public Health Emergency. Our objective was to describe pandemic-related restrictions on bladder cancer care., Methods: We invited 32 sites participating in a multicenter pragmatic bladder cancer trial to complete monthly surveys distributed through REDCap beginning in May 2020. These surveys queried sites on whether they were experiencing restrictions in the use of elective surgery, transurethral resection of bladder tumors (TURBT), radical cystectomy, office cystoscopy, and intravesical bacillus Calmette-Guerin (BCG) availability. Responses were collated with descriptive statistics., Results: Of 32 eligible sites, 21 sites had at least a 50% monthly response rate over the study period and were included in the analysis. Elective surgery was paused at 76% of sites in May 2020, 48% of sites in January 2021, and 52% of sites in January 2022. Over those same periods, coinciding with COVID-19 incidence waves, TURBT was restricted at 10%, 14%, and 14% of sites, respectively, radical cystectomy was restricted at 10%, 14%, and 19% of sites, respectively, and cystoscopy was restricted at 33%, 0%, and 10% of sites, respectively., Conclusions: Bladder cancer care was minimally restricted compared with more pronounced restrictions seen in general elective surgeries during the COVID-19 pandemic., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2024
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20. Advancements and progress in juvenile idiopathic arthritis: A Review of pathophysiology and treatment.
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Huang HYR, Wireko AA, Miteu GD, Khan A, Roy S, Ferreira T, Garg T, Aji N, Haroon F, Zakariya F, Alshareefy Y, Pujari AG, Madani D, and Papadakis M
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- Child, Animals, Humans, Infant, Phenotype, Biomarkers, Arthritis, Juvenile diagnosis, Arthritis, Juvenile therapy
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Juvenile idiopathic arthritis (JIA) is a chronic clinical condition characterized by arthritic features in children under the age of 16, with at least 6 weeks of active symptoms. The etiology of JIA remains unknown, and it is associated with prolonged synovial inflammation and structural joint damage influenced by environmental and genetic factors. This review aims to enhance the understanding of JIA by comprehensively analyzing relevant literature. The focus lies on current diagnostic and therapeutic approaches and investigations into the pathoaetiologies using diverse research modalities, including in vivo animal models and large-scale genome-wide studies. We aim to elucidate the multifactorial nature of JIA with a strong focus towards genetic predilection, while proposing potential strategies to improve therapeutic outcomes and enhance diagnostic risk stratification in light of recent advancements. This review underscores the need for further research due to the idiopathic nature of JIA, its heterogeneous phenotype, and the challenges associated with biomarkers and diagnostic criteria. Ultimately, this contribution seeks to advance the knowledge and promote effective management strategies in JIA., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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21. Recent Outcomes and Challenges of Artificial Intelligence, Machine Learning, and Deep Learning in Neurosurgery.
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Awuah WA, Adebusoye FT, Wellington J, David L, Salam A, Weng Yee AL, Lansiaux E, Yarlagadda R, Garg T, Abdul-Rahman T, Kalmanovich J, Miteu GD, Kundu M, and Mykolaivna NI
- Abstract
Neurosurgeons receive extensive technical training, which equips them with the knowledge and skills to specialise in various fields and manage the massive amounts of information and decision-making required throughout the various stages of neurosurgery, including preoperative, intraoperative, and postoperative care and recovery. Over the past few years, artificial intelligence (AI) has become more useful in neurosurgery. AI has the potential to improve patient outcomes by augmenting the capabilities of neurosurgeons and ultimately improving diagnostic and prognostic outcomes as well as decision-making during surgical procedures. By incorporating AI into both interventional and non-interventional therapies, neurosurgeons may provide the best care for their patients. AI, machine learning (ML), and deep learning (DL) have made significant progress in the field of neurosurgery. These cutting-edge methods have enhanced patient outcomes, reduced complications, and improved surgical planning., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)
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- 2024
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22. Guillain-Barre syndrome following COVID-19 vaccination: a study of 70 case reports.
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Sah BK, Fatima Z, Sah RK, Syed B, Garg T, Chowdhury S, Ghosh B, Kunwar B, Shree A, Sah VK, and Raut A
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Background and Objective: Guillain-Barre syndrome (GBS) has been found to have some interesting association with vaccinations. This paper mainly focuses on exploring different associations between COVID-19 vaccination and GBS., Methods: Electronic databases such as PubMed, Google Scholar, Cochrane, and Embase were searched using MESH terms for case reports published till 1 August 2023 from which 70 case reports were documented involving 103 individuals from 23 different countries., Result and Discussion: The case reports were from a wide range of individuals aged from 13 to 87 years with an average age of 53±20 interquartile range years along with male predominance. The average time between receiving the vaccine and the onset of symptoms was 13.08±2.14 days. Prominent clinical features included back pain, facial diplegia, weakness, and paraesthesia whereas the main diagnostic studies were cerebrospinal fluid (CSF) analysis and electromagnetic studies. The principal diagnostic clue was albumin-cytological dissociation in CSF while being negative for anti-ganglioside antibodies or SARS-CoV-2. Available treatment options consisted of intravenous immunoglobulin and Plasmapheresis. Patients with comorbidities such as diabetes mellitus, hypertension, dyslipidemia, permanent atrial fibrillation, hypothyroidism, Hashimoto's thyroiditis, Chronic Obstructive Pulmonary Disease, asthma, osteoporosis, migraine, rheumatoid arthritis, osteoarthritis, ulcerative colitis, coeliac disease, seizures, bipolar disorder, endometriosis, multiple sclerosis, bell's palsy, squamous cell carcinoma, prostate cancer were included in our study., Conclusion: Overall, this review evaluated innovative and clinically relevant associations between COVID-19 vaccination and GBS. Understanding of this uncommon potential side effect of COVID-19 vaccination is crucial for prompt diagnosis and appropriate treatment. Importantly, GBS should not be considered a contraindication to vaccination. This underscores the importance of ongoing research to enhance the safety and efficacy of COVID-19 vaccination efforts., Competing Interests: There are no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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23. Prospective Study of Polytetrafluoroethylene-Covered Microplugs and Detachable Coils for Embolization of Pulmonary Arteriovenous Malformations: Technical Results, Procedure Times, and Costs.
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Gong AJ, Bosworth EC, Garg T, and Weiss CR
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- Humans, Adult, Prospective Studies, Polytetrafluoroethylene, Pulmonary Artery diagnostic imaging, Treatment Outcome, Arteriovenous Malformations diagnostic imaging, Arteriovenous Malformations therapy, Arteriovenous Fistula therapy, Embolization, Therapeutic methods, Pulmonary Artery abnormalities, Pulmonary Veins diagnostic imaging, Pulmonary Veins abnormalities
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Purpose: To determine time to occlusion and procedure costs of embolization of pulmonary arteriovenous malformations (PAVMs) using a polytetrafluoroethylene-covered microplug compared with embolization using detachable coils., Materials and Methods: In this prospective study, 37 patients (mean age, 39.1 years [SD ± 17.6]) with 82 PAVMs underwent embolization with microplug or detachable coils between April 2019 and January 2023. Technical success, procedure time intervals, and costs were analyzed., Results: In 37 patients, 82 PAVMs and 101 feeding arteries were successfully treated (microplug, 64; microplug + another device, 5; detachable coils alone, 32). Time from embolic device inserted into the catheter to device deployed and time to occlusion differed significantly between microplug and detachable coil cohorts (P < .0001 for both). Embolization with ≥1 microplug had a significantly shorter occlusion time than embolization with detachable coils (median, 10.0 minutes saved per feeding artery) (P < .0001). Compared with detachable coil embolization, microplug embolization saved a median of 9.0 minutes per feeding artery (P < .0001) and reduced room cost by a median of $429 per feeding artery (P < .0001). Device costs per feeding artery did not differ significantly between microplug ($2,790) and detachable coil embolization ($3,147) (P = .87)., Conclusions: Compared with coils, microplugs had an equally high technical success rate but significant time to occlusion and room costs savings per feeding artery. Total room cost and device cost together did not differ significantly between microplugs and coils. Microplugs may be considered technically effective and at least cost-neutral for PAVM embolization where clinically appropriate., (Copyright © 2023 SIR. Published by Elsevier Inc. All rights reserved.)
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- 2024
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24. Mechanical and Thermal Analysis of Duroplastic Matrix Composites over a Range of Temperatures.
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Krzak A, Nowak AJ, Heljak M, Antonowicz J, Garg T, and Sumption M
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It is commonly acknowledged that polymer composites in service are often subjected to not only intricate mechanical loads but also harsh environmental conditions. The mechanical and thermal properties of five particular composites are explored here. The composites are composed of laminates of glass cloth type "E" sheet infilled with a duroplastic matrix. This is a thermoset polymer-epoxy resin with different molecular weights. The composites were fabricated by IZOERG company, which is based in Poland. The final articles were 1.5 mm thick by 60 cm long and 30 cm wide, with the glass layers arranged parallel to the thickness. Young's modulus and tensile strength were measured at room temperature. Using the thermal analysis of dynamic mechanical properties (DMTA), the values of the storage modulus and the loss modulus were determined, and the damping factor was used to determine the glass transition temperature (Tg). It was revealed that the nature of changes in the storage modulus, loss modulus, and damping factor of composite materials depends on the type of epoxy resin used. Thermal expansion is a crucial parameter when choosing a material for application in cryogenic conditions. Thanks to the TMA method, thermal expansion coefficients for composite materials were determined. The results show that the highest value of the coefficient of thermal expansion leads the laminate EP_4_2 based on brominated epoxy resin cured with novolac P. Duroplastic composites were characterized at cryogenic temperatures, and the results are interesting for developing cryogenic applications, including electric motors, generators, magnets, and other devices.
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- 2024
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25. Geriatric assessment-derived deficit accumulation and patient-reported treatment burden in older adults with bladder cancer.
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Garg T, Frank K, Johns A, Rabinowitz K, Danella JF, Kirchner HL, Nielsen ME, McMullen CK, Murphy TE, and Cohen HJ
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- Humans, Aged, Geriatric Assessment, Cross-Sectional Studies, Patient Reported Outcome Measures, Non-Muscle Invasive Bladder Neoplasms, Urinary Bladder Neoplasms therapy
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Background: When a person's workload of healthcare exceeds their resources, they experience treatment burden. At the intersection of cancer and aging, little is known about treatment burden. We evaluated the association between a geriatric assessment-derived Deficit Accumulation Index (DAI) and patient-reported treatment burden in older adults with early-stage, non-muscle-invasive bladder cancer (NMIBC)., Methods: We conducted a cross-sectional survey of older adults with NMIBC (≥65 years). We calculated DAI using the Cancer and Aging Research Group's geriatric assessment and measured urinary symptoms using the Urogenital Distress Inventory-6 (UDI-6). The primary outcome was Treatment Burden Questionnaire (TBQ) score. A negative binomial regression with LASSO penalty was used to model TBQ. We further conducted qualitative thematic content analysis of responses to an open-ended survey question ("What has been your Greatest Challenge in managing medical care for your bladder cancer") and created a joint display with illustrative quotes by DAI category., Results: Among 119 patients, mean age was 78.9 years (SD 7) of whom 56.3% were robust, 30.3% pre-frail, and 13.4% frail. In the multivariable model, DAI and UDI-6 were significantly associated with TBQ. Individuals with DAI above the median (>0.18) had TBQ scores 1.94 times greater than those below (adjusted IRR 1.94, 95% CI 1.33-2.82). Individuals with UDI-6 greater than the median (25) had TBQ scores 1.7 times greater than those below (adjusted IRR 1.70, 95% CI 1.16-2.49). The top 5 themes in the Greatest Challenge question responses were cancer treatments (22.2%), cancer worry (19.2%), urination bother (18.2%), self-management (18.2%), and appointment time (11.1%)., Conclusions: DAI and worsening urinary symptoms were associated with higher treatment burden in older adults with NMIBC. These data highlight the need for a holistic approach that reconciles the burden from aging-related conditions with that resulting from cancer treatment., (© 2023 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)
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- 2024
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26. Assessment of Cardiovascular Risk Factors in Women Having Female Pattern Hair Loss.
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Verma D, Mendiratta V, Garg T, Tripathi S, and Tomer S
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Background: Many studies have associated male androgenetic alopecia with the risk of cardiovascular disorders but very few studies have addressed this association in women with FPHL., Materials and Methods: This was a cross-sectional hospital-based study in which a total of 50 women (18-45 years) were recruited. The objective was to measure carotid intima-media thickness (CIMT) by doppler ultrasound, Body mass index (BMI), waist circumference, lipid profile, fasting blood sugar (FBS), insulin, testosterone, Sex hormone binding globulin (SHBG), hs-CRP, ESR and fibrinogen, in pre-menopausal women having FPHL and to correlate these parameters with severity of FPHL. The prevalence of Metabolic syndrome (MetS) and Insulin resistance were evaluated., Results: Metabolic syndrome and insulin resistance were found in 12 (24%) and 17 (34%) cases respectively. Hypercholesterolemia, elevated LDL levels and hypertriglyceridemia, low HDL levels and hyperinsulinemia were found in 11 (22%), 31 (62%), 9 (18%), 17 (34%) and 7 (14%) cases respectively. 8 (16%) cases were diabetics. Elevated ESR, increased fibrinogen levels and elevated hs-CRP were found in 43 (86%), 10 (20%) and 21 (42%) cases respectively. CIMT was found to be within its normal range. Correlation of CIMT, anthropometric indices (BMI and WC), biochemical markers (serum cholesterol, triglycerides, FBS, and fibrinogen), and presence of metabolic syndrome with severity of FPHL in terms of Ludwig grade was found to be statistically significant., Conclusions: The determination of metabolic syndrome, insulin resistance and acute phase reactants such as hs-CRP and fibrinogen may be useful screening methods to detect increased cardiovascular risk in women with FPHL., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Dermatology.)
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- 2024
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27. Health-Related Quality of Life Outcome Measures in Individuals With Hereditary Hemorrhagic Telangiectasia: A Scoping Review.
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Gong AJ, Garg T, Khalil A, Gowda PC, Mathai SC, Rowan NR, Merlo CA, and Weiss CR
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- Humans, Quality of Life, Prospective Studies, Cross-Sectional Studies, Case-Control Studies, Retrospective Studies, Outcome Assessment, Health Care, Gastrointestinal Hemorrhage complications, Randomized Controlled Trials as Topic, Epistaxis therapy, Telangiectasia, Hereditary Hemorrhagic epidemiology, Telangiectasia, Hereditary Hemorrhagic therapy, Telangiectasia, Hereditary Hemorrhagic complications
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Background: Studies evaluating health-related quality of life (HRQOL) in patients with hereditary hemorrhagic telangiectasia (HHT) have expanded rapidly in the past decade. These studies have evaluated QOL aspects ranging from the general QOL for patients living with HHT to intervention-specific outcomes. However, few tools have been fully validated across the spectrum of disease manifestations and interventions in HHT., Objective: In this scoping review, we aim to map the literature on HHT-QOL metrics, identify gaps, inform future QOL research, and facilitate future metric development., Methods: We analyzed articles in English that assessed at least 1 measure of general HRQOL, including physical health, mental health, social health, or intervention-specific QOL in patients with HHT. Searches across 2 bibliographic databases (PubMed and Scopus) yielded 186 articles after duplicates were removed. Sixty-three studies met eligibility criteria: 22 prospective studies (34.9%), 20 retrospective studies (31.7%), 12 cross-sectional studies (17.5%), 6 randomized controlled trials or secondary analyses of a randomized controlled trials (9.5%), 2 qualitative studies (3.2%), and 1 case-control study (1.6%). Two additional studies-1 prospective and 1 cross-sectional study-were identified at the October 2022 14th International HHT Conference and included, making a total of 65 studies., Results: The 65 eligible studies used 30 QOL instruments. Twenty studies characterized baseline HRQOL, and 45 studies evaluated QOL before and after treatment. Of those 45 studies, 37 evaluated HRQOL before and after therapies targeting epistaxis and nasal symptoms, 4 targeted therapies for liver arteriovenous malformations and high-output heart failure, 3 evaluated therapies for both epistaxis and gastrointestinal bleeding, and 1 evaluated treatment targeting gastrointestinal bleeding alone., Conclusions: Comparison of results across studies remains challenging given the heterogeneity in outcomes measures. Further development of HHT-specific patient-reported outcomes instruments that capture the global illness experience of HHT is needed., Competing Interests: Declaration of Conflicting InterestsThe authors would like to declare the following conflict of interest with respect to the research, authorship, and/or publication of this article: Unrelated funding from Cure HHT.
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- 2024
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28. Expanding molecular diagnostic coverage for tuberculosis by combining computer-aided chest radiography and sputum specimen pooling: a modeling study from four high-burden countries.
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Codlin AJ, Vo LNQ, Garg T, Banu S, Ahmed S, John S, Abdulkarim S, Muyoyeta M, Sanjase N, Wingfield T, Iem V, Squire B, and Creswell J
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Background: In 2022, fewer than half of persons with tuberculosis (TB) had access to molecular diagnostic tests for TB due to their high costs. Studies have found that the use of artificial intelligence (AI) software for chest X-ray (CXR) interpretation and sputum specimen pooling can each reduce the cost of testing. We modeled the combination of both strategies to estimate potential savings in consumables that could be used to expand access to molecular diagnostics., Methods: We obtained Xpert testing and positivity data segmented into deciles by AI probability scores for TB from the community- and healthcare facility-based active case finding conducted in Bangladesh, Nigeria, Viet Nam, and Zambia. AI scores in the model were based on CAD4TB version 7 (Zambia) and qXR (all other countries). We modeled four ordinal screening and testing approaches involving AI-aided CXR interpretation to indicate individual and pooled testing. Setting a false negative rate of 5%, for each approach we calculated additional and cumulative savings over the baseline of universal Xpert testing, as well as the theoretical expansion in diagnostic coverage., Results: In each country, the optimal screening and testing approach was to use AI to rule out testing in deciles with low AI scores and to guide pooled vs individual testing in persons with moderate and high AI scores, respectively. This approach yielded cumulative savings in Xpert tests over baseline ranging from 50.8% in Zambia to 57.5% in Nigeria and 61.5% in Bangladesh and Viet Nam. Using these savings, diagnostic coverage theoretically could be expanded by 34% to 160% across the different approaches and countries., Conclusions: Using AI software data generated during CXR interpretation to inform a differentiated pooled testing strategy may optimize TB diagnostic test use, and could extend molecular tests to more people who need them. The optimal AI thresholds and pooled testing strategy varied across countries, which suggests that bespoke screening and testing approaches may be needed for differing populations and settings., Supplementary Information: The online version contains supplementary material available at 10.1186/s44263-024-00081-2., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2024.)
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- 2024
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29. Supplemental ERAS application for radiology residency match: A primer.
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Lakhani DA, Murugesan A, Patel S, Garg T, Balar AB, Sadovnikov I, Swaney KJ, Yedavalli V, Hogg JP, and Yousem DM
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- Humans, Motivation, Internship and Residency, Radiology
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The supplemental ERAS application that includes three components: past experiences, geographic preferences, and program signals was introduced in 2022 to complement the standard ERAS CV material. The goal was to help programs identify optimal candidates to interview and to improve the chances of applicants being invited for interviews at programs that align with their goals and interests. Based on limited data, Program signal is the most emphasized component by the programs. Applicants should realize that programs have used signals to determine who to interview (aligned with AAMC guidance), and to determine the program's candidate rank list (contrary to AAMC guidance). We have herein suggested options for leveraging benefits from the ERAS supplemental application which has now been incorporated into the full ERAS application., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2024
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30. Single Specialty-Operated Renal Stone Removal: Initial Experience from 3 Interventional Radiology Centers.
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Altun I, Garg T, Shaikh J, DePalma AAR, Herren JL, Hubbell GM, and Nezami N
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- Male, Humans, Female, Retrospective Studies, Radiology, Interventional, Kidney, Treatment Outcome, Kidney Calculi diagnostic imaging, Kidney Calculi surgery, Nephrostomy, Percutaneous adverse effects, Nephrostomy, Percutaneous methods
- Abstract
This retrospective analysis of the feasibility and safety of percutaneous renal stone removal using single-use flexible ureteroscopes was conducted at 3 academic centers. Twelve patients (58% men) underwent 14 percutaneous renal stone removal procedures between December 2021 and March 2023. All patients experienced symptom improvement and resolution of obstruction after stone removal. The procedural success rate was 92%. Only 1 patient required an additional stone removal procedure. No major adverse events occurred during or after the procedures. The percutaneous nephrostomy removal rate was 92%, with a median tube removal time of 5 weeks. The median procedural and pulsed fluoroscopy times were 106.5 and 16.3 minutes, respectively. Preliminary findings demonstrated that percutaneous renal stone removal using single-use endoscopes by interventional radiologists is feasible and safe., (Copyright © 2023 SIR. Published by Elsevier Inc. All rights reserved.)
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- 2024
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