92 results on '"Adhikari, Samrachana"'
Search Results
2. Association between visit frequency, continuity of care, and pharmacy fill adherence in heart failure patients
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Hamo, Carine E., Mukhopadhyay, Amrita, Li, Xiyue, Zheng, Yaguang, Kronish, Ian M., Chunara, Rumi, Dodson, John, Adhikari, Samrachana, and Blecker, Saul
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- 2024
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3. Disparities in routine healthcare utilization disruptions during COVID-19 pandemic among veterans with type 2 diabetes
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Adhikari, Samrachana, Titus, Andrea R., Baum, Aaron, Lopez, Priscilla, Kanchi, Rania, Orstad, Stephanie L., Elbel, Brian, Lee, David C., Thorpe, Lorna E., and Schwartz, Mark D.
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- 2023
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4. Associations between PM2.5 and O3 exposures and new onset type 2 diabetes in regional and national samples in the United States
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McAlexander, Tara P., Ryan, Victoria, Uddin, Jalal, Kanchi, Rania, Thorpe, Lorna, Schwartz, Brian S., Carson, April, Rolka, Deborah B., Adhikari, Samrachana, Pollak, Jonathan, Lopez, Priscilla, Smith, Megan, Meeker, Melissa, and McClure, Leslie A.
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- 2023
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5. Age and sex differences in the association between neighborhood socioeconomic environment and incident diabetes: Results from the diabetes location, environmental attributes and disparities (LEAD) network
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Uddin, Jalal, Zhu, Sha, Adhikari, Samrachana, Nordberg, Cara M., Howell, Carrie R., Malla, Gargya, Judd, Suzanne E., Cherrington, Andrea L., Rummo, Pasquale E., Lopez, Priscilla, Kanchi, Rania, Siegel, Karen, De Silva, Shanika A., Algur, Yasemin, Lovasi, Gina S., Lee, Nora L., Carson, April P., Hirsch, Annemarie G., Thorpe, Lorna E., and Long, D. Leann
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- 2023
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6. Sex differences in the prognostic value of troponin and D-dimer in COVID-19 illness
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Mukhopadhyay, Amrita, Talmor, Nina, Xia, Yuhe, Berger, Jeffrey S, Iturrate, Eduardo, Adhikari, Samrachana, Pulgarin, Claudia, Quinones-Camacho, Adriana, Yuriditsky, Eugene, Horowitz, James, Jung, Albert S, Massera, Daniele, Keller, Norma M, Fishman, Glenn I, Horwitz, Leora, Troxel, Andrea B, Hochman, Judith S, and Reynolds, Harmony R
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- 2023
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7. Study design of BETTER-BP: Behavioral economics trial to enhance regulation of blood pressure
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Dodson, John A., Schoenthaler, Antoinette, Fonceva, Ana, Gutierrez, Yasmin, Shimbo, Daichi, Banco, Darcy, Maidman, Samuel, Olkhina, Ekaterina, Hanley, Kathleen, Lee, Carson, Levy, Natalie K., and Adhikari, Samrachana
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- 2022
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8. Impact of preference for yoga or cognitive behavioral therapy in patients with generalized anxiety disorder on treatment outcomes and engagement
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Szuhany, Kristin L., Adhikari, Samrachana, Chen, Alan, Lubin, Rebecca E., Jennings, Emma, Rassaby, Madeleine, Eakley, Rachel, Brown, Mackenzie L., Suzuki, Rebecca, Barthel, Abigail L., Rosenfield, David, Hoeppner, Susanne S., Khalsa, Sat Bir, Bui, Eric, Hofmann, Stefan G., and Simon, Naomi M.
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- 2022
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9. Oral Health, Diabetes, and Inflammation: Effects of Oral Hygiene Behaviour
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Luo, Huabin, Wu, Bei, Kamer, Angela R., Adhikari, Samrachana, Sloan, Frank, Plassman, Brenda L., Tan, Chenxin, Qi, Xiang, and Schwartz, Mark D.
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- 2022
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10. A quasi-experimental study of parent and child well-being in families of color in the context of COVID-19 related school closure
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Ursache, Alexandra, Barajas-Gonzalez, R. Gabriela, Adhikari, Samrachana, Kamboukos, Dimitra, Brotman, Laurie M., and Dawson-McClure, Spring
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- 2022
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11. Decline in use of high‐risk agents for tight glucose control among older adults with diabetes in New York City: 2017–2022.
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Zhang, Jeff, Kanchi, Rania, Conderino, Sarah, Levy, Natalie K., Adhikari, Samrachana, Blecker, Saul, Davis, Nichola, Divers, Jasmin, Rabin, Catherine, Weiner, Mark, Thorpe, Lorna, and Dodson, John A.
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MYOCARDIAL infarction risk factors ,HEART failure risk factors ,RISK assessment ,GLUCAGON-like peptide-1 agonists ,DRUG side effects ,GLYCOSYLATED hemoglobin ,MEDICAL prescriptions ,BODY mass index ,RESEARCH funding ,GLYCEMIC control ,HYPOGLYCEMIC agents ,INSULIN ,DESCRIPTIVE statistics ,COLORECTAL cancer ,ODDS ratio ,CHRONIC kidney failure ,TYPE 2 diabetes ,SODIUM-glucose cotransporter 2 inhibitors ,INSULIN secretagogues ,DISEASE risk factors ,OLD age - Abstract
Background: This study aimed to examine the prevalence of inappropriate tight glycemic control in older adults with type 2 diabetes and other chronic conditions in New York City, and to identify factors associated with this practice. Methods: We conducted a retrospective cohort study using the INSIGHT Clinical Research Network. The study population included 11,728 and 15,196 older adults in New York City (age ≥ 75 years) with a diagnosis of type 2 diabetes, and at least one other chronic medical condition, in 2017 and 2022, respectively. The main outcome of interest was inappropriate tight glycemic control, defined as HbA1c <7.0% (<53 mmol/mol) with prescription of at least one high‐risk agent (insulin or insulin secretagogue). Results: The proportion of older adults with inappropriate tight glycemic control decreased by nearly 19% over a five‐year period (19.4% in 2017 to 15.8% in 2022). There was a significant decrease in insulin (27.8% in 2017; 24.3% in 2022) and sulfonylurea (29.4% in 2017; 21.7% in 2022) medication prescription, and increase in use of GLP‐1 agonists (1.8% in 2017; 11.4% in 2022) and SGLT‐2 inhibitors (5.8% in 2017; 25.1% in 2022), among the total population. Factors associated with inappropriate tight glycemic control in 2022 included history of heart failure (adjusted odds ratio [aOR] 1.38), chronic kidney disease ([aOR] 1.93), colorectal cancer ([aOR] 1.38), acute myocardial infarction ([aOR] 1.28), "other" ([aOR] 0.72) or "unknown" ([aOR] 0.72) race, and a point increase in BMI ([aOR] 0.98). Conclusions: We found an encouraging trend toward less use of high‐risk medication strategies for older adults with type 2 diabetes and multiple chronic conditions. However, one in six patients in 2022 still had inappropriate tight glycemic control, indicating a need for continued efforts to optimize diabetes management in this population. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Lost in transition: A protocol for a retrospective, longitudinal cohort study for addressing challenges in opioid treatment for transition-age adults.
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Aleksanyan, Josh, Choi, Sugy, Lincourt, Patricia, Burke, Constance, Ramsey, Kelly S., Hussain, Shazia, Jordan, Ashly E., Morris, Maria, D'Aunno, Thomas, Glied, Sherry, McNeely, Jennifer, Elbel, Brian, Mijanovich, Tod, Adhikari, Samrachana, and Neighbors, Charles J.
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OPIOID abuse ,PATIENT decision making ,TREATMENT programs ,OPIOIDS ,SOCIAL role ,YOUNG adults - Abstract
Background: In the United States, there has been a concerning rise in the prevalence of opioid use disorders (OUD) among transition-age (TA) adults, 18 to 25-years old, with a disproportionate impact on individuals and families covered by Medicaid. Of equal concern, the treatment system continues to underperform for many young people, emphasizing the need to address the treatment challenges faced by this vulnerable population at a pivotal juncture in their life course. Pharmacotherapy is the most effective treatment for OUD, yet notably, observational studies reveal gaps in the receipt of and retention in medications for opioid use disorder (MOUD), resulting in poor outcomes for many TA adults in treatment. Few current studies on OUD treatment quality explicitly consider the influence of individual, organizational, and contextual factors, especially for young people whose social roles and institutional ties remain in flux. Methods: We introduce a retrospective, longitudinal cohort design to study treatment quality practices and outcomes among approximately 65,000 TA adults entering treatment for OUD between 2012 and 2025 in New York. We propose to combine data from multiple sources, including Medicaid claims and encounter data and a state registry of substance use disorder (SUD) treatment episodes, to examine three aspects of OUD treatment quality: 1) MOUD use, including MOUD option (e.g., buprenorphine, methadone, or extended-release [XR] naltrexone); 2) adherence to pharmacotherapy and retention in treatment; and 3) adverse events (e.g., overdoses). Using rigorous analytical methods, we will provide insights into how variation in treatment practices and outcomes are structured more broadly by multilevel processes related to communities, treatment programs, and characteristics of the patient, as well as their complex interplay. Discussion: Our findings will inform clinical decision making by patients and providers as well as public health responses to the rising number of young adults seeking treatment for OUD amidst the opioid and polysubstance overdose crisis in the U.S. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Comparing competing geospatial measures to capture the relationship between the neighborhood food environment and diet
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Rummo, Pasquale E., Algur, Yasemin, McAlexander, Tara, Judd, Suzanne E., Lopez, Priscilla M., Adhikari, Samrachana, Brown, Janene, Meeker, Melissa, McClure, Leslie A., and Elbel, Brian
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- 2021
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14. Evaluation of SARS-CoV-2 IgG antibody reactivity in patients with systemic lupus erythematosus: analysis of a multi-racial and multi-ethnic cohort
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Adhikari, Samrachana, Axelrad, Jordan, Azar, Natalie, Blank, Rebecca, Brancato, Lenore, Brodetskiy, Konstantin, Cao, Lily, Carlucci, Philip M., Carsons, Steven, Chang, Miao, Chang, Shannon, Chen, Alan, Colin, Michael, Fried, Lauren, Garner, Bruce, Goldberg, Avram, Golden, Brian, Golpanian, Michael, Haj-Ali, Mayce, Hoey, Jessica, Homsi, Yamen, Hong, Simon, Hudesman, David, Hussain, Nazia, Jaros, Brian, Katz, Susan, Kolla, Avani, Lee, Euna, Lee, Sicy, Lesser, Robert, Lipschitz, Robin, Lydon, Eileen, Malik, Fardina, Mangalick, Keshav, Mehta, Kavini, Modi, Anang, Neimann, Andrea, Novack, Joshua, Nusbaum, Julie, Peterson, Connor, Piatti, Andres, Plotz, Benjamin, Porges, Andrew, Quintana, Lindsey, Rackoff, Paula, Ramirez, Deborah, Rangel, Lauren, Reddy, Soumya, Robins, Kimberly, Rosenthal, Pamela, Samuels, Jonathan, Sandigursky, Sabina, Sekar, Vaish, Shankar, Shruti, Shen, Harry, Smiles, Stephen, Smuda, Craig, Solitar, Bruce, Solomon, Gary, Stein, Jennifer, Steuer, Alexa, Sullivan, Janine, Svigos, Katerina, Troxel, Andrea, Viennas, Stelios, Wong, Lauren, Yan, Di, Yin, Kaitlyn (Lu), Young, Trevor, Zagon, Gary, Saxena, Amit, Guttmann, Allison, Masson, Mala, Kim, Mimi Y, Haberman, Rebecca H, Castillo, Rochelle, Scher, Jose U, Deonaraine, Kristina K, Engel, Alexis J, Belmont, H Michael, Blazer, Ashira D, Buyon, Jill P, Fernandez-Ruiz, Ruth, and Izmirly, Peter M
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- 2021
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15. Constructing 'Experts' among Peers: Educational Infrastructure, Test Data, and Teachers' Interactions about Teaching
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Spillane, James P., Shirrell, Matthew, and Adhikari, Samrachana
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Teachers' on-the-job interactions with colleagues impact their effectiveness, yet little research has explored whether and how teacher performance predicts these interactions. Drawing on 5 years of social network data from one school district, we explore the relationship between teacher performance and teachers' instructional advice and information interactions. Results demonstrate that higher performing teachers are not more likely to be sought out for advice; instead, higher performing teachers are more likely to seek advice. Although school staff report they can identify the "best" teachers, they generally do not rely on student test scores, instead relying on more readily accessible indicators of performance. These findings have important implications for policy and practices that seek to promote desired interactions among teachers.
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- 2018
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16. Goal setting among older adults starting mobile health cardiac rehabilitation in the RESILIENT trial.
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Shwayder, Elianna, Dodson, John A., Tellez, Kelly, Johanek, Camila, Adhikari, Samrachana, Meng, Yuchen, Schoenthaler, Antoinette, and Jennings, Lee A.
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MOBILE apps ,ELDER care ,HEALTH services accessibility ,MYOCARDIAL ischemia ,RESEARCH funding ,STATISTICAL sampling ,INTERVIEWING ,QUESTIONNAIRES ,GOAL (Psychology) ,FUNCTIONAL status ,EVALUATION of medical care ,RANDOMIZED controlled trials ,PERSONAL space ,DESCRIPTIVE statistics ,TELEMEDICINE ,HEALTH planning ,THEMATIC analysis ,COMPARATIVE studies ,HEALTH promotion ,CARDIAC rehabilitation ,PATIENTS' attitudes - Abstract
Background: There is growing recognition that healthcare should align with individuals' health priorities; however, these priorities remain undefined, especially among older adults. The Rehabilitation Using Mobile Health for Older Adults with Ischemic Heart Disease in the Home Setting (RESILIENT) trial, designed to test the efficacy of mobile health cardiac rehabilitation (mHealth‐CR) in an older cohort, also measures the attainment of participant‐defined health outcome goals as a prespecified secondary endpoint. This study aimed to characterize the health priorities of older adults with ischemic heart disease (IHD) using goal attainment scaling—a technique for measuring individualized goal achievement—in a sample of 100 RESILIENT participants. Methods: The ongoing RESILIENT trial randomizes patients aged ≥65 years with IHD (defined as hospitalization for acute coronary syndrome and/or coronary revascularization), to receive mHealth‐CR or usual care. For the current study, we qualitatively coded baseline goal attainment scales from randomly selected batches of 20 participants to identify participants' cardiac rehabilitation outcome goals and their perceptions of barriers and action plans for goal attainment. We used a deductive framework (i.e., 4 value categories from Patient Priorities Care) and inductive approaches to code and analyze interviews until thematic saturation. Results: This sample of 100 older adults set diverse health outcome goals. Most (54.6%) prioritized physical activity, fewer (17.1%) identified symptom management, fewer still (13.7%) prioritized health metrics, mostly comprised of weight loss goals (10.3%), and the fewest (<4%) were related to clinical metrics such as reducing cholesterol or preventing hospital readmission. Participants anticipated extrinsic (access to places to exercise, time) and intrinsic (non‐cardiac pain, motivation) barriers. Action plans detailed strategies for exercise, motivation, accountability, and overcoming time constraints. Conclusions: Using goal attainment scaling, we elicited specific and measurable goals among older adults with IHD beginning cardiac rehabilitation. Priorities were predominantly functional, diverging from clinical metrics emphasized by clinicians and healthcare systems. See related Editorial by Shanahan and Naik [ABSTRACT FROM AUTHOR]
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- 2024
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17. Interleukin-1 Receptor Antagonist Gene (IL1RN) Variants Modulate the Cytokine Release Syndrome and Mortality of COVID-19.
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Attur, Mukundan, Petrilli, Christopher, Adhikari, Samrachana, Iturrate, Eduardo, Li, Xiyue, Tuminello, Stephanie, Hu, Nan, Chakravarti, Aravinda, Beck, David, and Abramson, Steven B
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SARS-CoV-2 ,CYTOKINE release syndrome ,INTERLEUKIN-1 receptors ,CORONAVIRUS diseases ,COVID-19 ,MYELOID differentiation factor 88 - Abstract
Background We examined effects of single-nucleotide variants (SNVs) of IL1RN , the gene encoding the anti-inflammatory interleukin 1 receptor antagonist (IL-1Ra), on the cytokine release syndrome (CRS) and mortality in patients with acute severe respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods IL1RN CTA haplotypes formed from 3 SNVs (rs419598, rs315952, rs9005) and the individual SNVs were assessed for association with laboratory markers of inflammation and mortality. We studied 2589 patients hospitalized with SARS-CoV-2 between March 2020 and March 2021. Results Mortality was 15.3% and lower in women than men (13.1% vs 17.3%, P =.0003). Carriers of the CTA-1/2 IL1RN haplotypes exhibited decreased inflammatory markers and increased plasma IL-1Ra. Evaluation of the individual SNVs of the IL1RN, carriers of the rs419598 C/C SNV exhibited significantly reduced inflammatory biomarker levels and numerically lower mortality compared to the C/T-T/T genotype (10.0% vs 17.8%, P =.052) in men, with the most pronounced association observed in male patients ≤74 years old, whose mortality was reduced by 80% (3.1% vs 14.0%, P =.030). Conclusions The IL1RN haplotype CTA and C/C variant of rs419598 are associated with attenuation of the CRS and decreased mortality in men with acute SARS-CoV-2 infection. The data suggest that the IL1RN pathway modulates the severity of coronavirus disease 2019 (COVID-19) via endogenous anti-inflammatory mechanisms. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Conditionally Independent Dyads (CID) network models: A latent variable approach to statistical social network analysis
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Dabbs, Beau, Adhikari, Samrachana, and Sweet, Tracy
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- 2020
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19. Constructing "Experts" Among Peers: Educational Infrastructure, Test Data, and Teachers' Interactions About Teaching
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Spillane, James P., Shirrell, Matthew, and Adhikari, Samrachana
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- 2018
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20. Bridging the evidence-to-practice gap: a stepped-wedge cluster randomized controlled trial evaluating practice facilitation as a strategy to accelerate translation of a multi-level adherence intervention into safety net practices
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Schoenthaler, Antoinette, De La Calle, Franzenith, Soto, Amanda, Barrett, Derrel, Cruz, Jocelyn, Payano, Leydi, Rosado, Marina, Adhikari, Samrachana, Ogedegbe, Gbenga, and Rosal, Milagros
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- 2021
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21. A Latent Space Network Model for Social Influence
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Sweet, Tracy and Adhikari, Samrachana
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- 2020
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22. Influence of the food environment on obesity risk in a large cohort of US veterans by community type.
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Rummo, Pasquale E., Kanchi, Rania, Adhikari, Samrachana, Titus, Andrea R., Lee, David C., McAlexander, Tara, Thorpe, Lorna E., and Elbel, Brian
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FAST food restaurants ,RANDOM effects model ,OBESITY ,ELECTRONIC health records ,CITIES & towns - Abstract
Objective: The aim of this study was to examine relationships between the food environment and obesity by community type. Methods: Using electronic health record data from the US Veterans Administration Diabetes Risk (VADR) cohort, we examined associations between the percentage of supermarkets and fast‐food restaurants with obesity prevalence from 2008 to 2018. We constructed multivariable logistic regression models with random effects and interaction terms for year and food environment variables. We stratified models by community type. Results: Mean age at baseline was 59.8 (SD = 16.1) years; 93.3% identified as men; and 2,102,542 (41.8%) were classified as having obesity. The association between the percentage of fast‐food restaurants and obesity was positive in high‐density urban areas (odds ratio [OR] = 1.033; 95% CI: 1.028–1.037), with no interaction by time (p = 0.83). The interaction with year was significant in other community types (p < 0.001), with increasing odds of obesity in each follow‐up year. The associations between the percentage of supermarkets and obesity were null in high‐density and low‐density urban areas and positive in suburban (OR = 1.033; 95% CI: 1.027–1.039) and rural (OR = 1.007; 95% CI: 1.002–1.012) areas, with no interactions by time. Conclusions: Many healthy eating policies have been passed in urban areas; our results suggest such policies might also mitigate obesity risk in nonurban areas. [ABSTRACT FROM AUTHOR]
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- 2024
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23. Considerations in Bayesian agent‐based modeling for the analysis of COVID‐19 data.
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Um, Seungha and Adhikari, Samrachana
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MARKOV chain Monte Carlo , *HIDDEN Markov models , *CRUISE ships , *DATA analysis , *INFECTIOUS disease transmission , *COVID-19 pandemic - Abstract
Agent‐based model (ABM) has been widely used to study infectious disease transmission by simulating behaviors and interactions of autonomous individuals called agents. In the ABM, agent states, for example infected or susceptible, are assigned according to a set of simple rules, and a complex dynamics of disease transmission is described by the collective states of agents over time. Despite the flexibility in real‐world modeling, ABMs have received less attention by statisticians because of the intractable likelihood functions which lead to difficulty in estimating parameters and quantifying uncertainty around model outputs. To overcome this limitation, a Bayesian framework that treats the entire ABM as a Hidden Markov Model has been previously proposed. However, existing approach is limited due to computational inefficiency and unidentifiability of parameters. We extend the ABM approach within Bayesian framework to study infectious disease transmission addressing these limitations. We estimate the hidden states, represented by individual agent's states over time, and the model parameters by applying an improved particle Markov Chain Monte Carlo algorithm, that accounts for computing efficiency. We further evaluate the performance of the approach for parameter recovery and prediction, along with sensitivity to prior assumptions under various simulation conditions. Finally, we apply the proposed approach to the study of COVID‐19 outbreak on Diamond Princess cruise ship. We examine the differences in transmission by key demographic characteristics, while considering two different networks and limited COVID‐19 testing in the cruise. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Social Network Analysis in R: A Software Review
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Adhikari, Samrachana and Dabbs, Beau
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- 2018
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25. Preoperative Risk Factors for Adverse Events in Adults Undergoing Bowel Resection for Inflammatory Bowel Disease: 15-Year Assessment of the American College of Surgeons National Surgical Quality Improvement Program.
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Fernandez, Cristina, Gajic, Zoran, Esen, Eren, Remzi, Feza, Hudesman, David, Adhikari, Samrachana, McAdams-DeMarco, Mara, Segev, Dorry L., Chodosh, Joshua, Dodson, John, Shaukat, Aasma, and Faye, Adam S.
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- 2023
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26. Smartphone-based migraine behavioral therapy: a single-arm study with assessment of mental health predictors
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T. Minen, Mia, Adhikari, Samrachana, K. Seng, Elizabeth, Berk, Thomas, Jinich, Sarah, W. Powers, Scott, and B. Lipton, Richard
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- 2019
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27. Paradoxical Effects of Depression on Psoriatic Arthritis Outcomes in a Combined Psoriasis-Psoriatic Arthritis Center.
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Haberman, Rebecca H., Um, Seungha, Catron, Sydney, Chen, Alan, Lydon, Eileen, Attur, Malavikalakshmi, Neimann, Andrea L., Reddy, Soumya, Troxel, Andrea, Adhikari, Samrachana, and Scher, Jose U.
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- 2023
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28. Applied machine learning to identify differential risk groups underlying externalizing and internalizing problem behaviors trajectories: A case study using a cohort of Asian American children.
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Adhikari, Samrachana, You, Shiying, Chen, Alan, Cheng, Sabrina, and Huang, Keng-Yen
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EXTERNALIZING behavior , *SUPERVISED learning , *MACHINE learning , *AMERICANS , *MULTILEVEL models , *LOGISTIC regression analysis , *STATISTICAL learning , *CHILDHOOD obesity - Abstract
Background: Internalizing and externalizing problems account for over 75% of the mental health burden in children and adolescents in the US, with higher burden among minority children. While complex interactions of multilevel factors are associated with these outcomes and may enable early identification of children in higher risk, prior research has been limited by data and application of traditional analysis methods. In this case example focused on Asian American children, we address the gap by applying data-driven statistical and machine learning methods to study clusters of mental health trajectories among children, investigate optimal predictions of children at high-risk cluster, and identify key early predictors. Methods: Data from the US Early Childhood Longitudinal Study 2010–2011 were used. Multilevel information provided by children, families, teachers, schools, and care-providers were considered as predictors. Unsupervised machine learning algorithm was applied to identify groups of internalizing and externalizing problems trajectories. For prediction of high-risk group, ensemble algorithm, Superlearner, was implemented by combining several supervised machine learning algorithms. Performance of Superlearner and candidate algorithms, including logistic regression, was assessed using discrimination and calibration metrics via crossvalidation. Variable importance measures along with partial dependence plots were utilized to rank and visualize key predictors. Findings: We found two clusters suggesting high- and low-risk groups for both externalizing and internalizing problems trajectories. While Superlearner had overall best discrimination performance, logistic regression had comparable performance for externalizing problems but worse for internalizing problems. Predictions from logistic regression were not well calibrated compared to those from Superlearner, however they were still better than few candidate algorithms. Important predictors identified were combination of test scores, child factors, teacher rated scores, and contextual factors, which showed non-linear associations with predicted probabilities. Conclusions: We demonstrated the application of data-driven analytical approach to predict mental health outcomes among Asian American children. Findings from the cluster analysis can inform critical age for early intervention, while prediction analysis has potential to inform intervention programing prioritization decisions. However, to better understand external validity, replicability, and value of machine learning in broader mental health research, more studies applying similar analytical approach is needed. [ABSTRACT FROM AUTHOR]
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- 2023
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29. Association Between Copayment Amount and Filling of Medications for Angiotensin Receptor Neprilysin Inhibitors in Patients With Heart Failure.
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Mukhopadhyay, Amrita, Adhikari, Samrachana, Xiyue Li, Dodson, John A., Kronish, Ian M., Shah, Binita, Ramatowski, Maggie, Chunara, Rumi, Kozloff, Sam, Blecker, Saul, and Li, Xiyue
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- 2022
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30. Spatial environmental factors predict cardiovascular and all-cause mortality: Results of the SPACE study.
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Hadley, Michael B., Nalini, Mahdi, Adhikari, Samrachana, Szymonifka, Jackie, Etemadi, Arash, Kamangar, Farin, Khoshnia, Masoud, McChane, Tyler, Pourshams, Akram, Poustchi, Hossein, Sepanlou, Sadaf G., Abnet, Christian, Freedman, Neal D., Boffetta, Paolo, Malekzadeh, Reza, and Vedanthan, Rajesh
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MORTALITY ,INDOOR air pollution ,AIR pollution ,SOLAR chimneys ,PERCUTANEOUS coronary intervention ,KEROSENE as fuel ,PARTICULATE matter - Abstract
Background: Environmental exposures account for a growing proportion of global mortality. Large cohort studies are needed to characterize the independent impact of environmental exposures on mortality in low-income settings. Methods: We collected data on individual and environmental risk factors for a multiethnic cohort of 50,045 individuals in a low-income region in Iran. Environmental risk factors included: ambient fine particular matter air pollution; household fuel use and ventilation; proximity to traffic; distance to percutaneous coronary intervention (PCI) center; socioeconomic environment; population density; local land use; and nighttime light exposure. We developed a spatial survival model to estimate the independent associations between these environmental exposures and all-cause and cardiovascular mortality. Findings: Several environmental factors demonstrated associations with mortality after adjusting for individual risk factors. Ambient fine particulate matter air pollution predicted all-cause mortality (per μg/m
3 , HR 1.20, 95% CI 1.07, 1.36) and cardiovascular mortality (HR 1.17, 95% CI 0.98, 1.39). Biomass fuel use without chimney predicted all-cause mortality (reference = gas, HR 1.23, 95% CI 0.99, 1.53) and cardiovascular mortality (HR 1.36, 95% CI 0.99, 1.87). Kerosene fuel use without chimney predicted all-cause mortality (reference = gas, HR 1.09, 95% CI 0.97, 1.23) and cardiovascular mortality (HR 1.19, 95% CI 1.01, 1.41). Distance to PCI center predicted all-cause mortality (per 10km, HR 1.01, 95% CI 1.004, 1.022) and cardiovascular mortality (HR 1.02, 95% CI 1.004, 1.031). Additionally, proximity to traffic predicted all-cause mortality (HR 1.13, 95% CI 1.01, 1.27). In a separate validation cohort, the multivariable model effectively predicted both all-cause mortality (AUC 0.76) and cardiovascular mortality (AUC 0.81). Population attributable fractions demonstrated a high mortality burden attributable to environmental exposures. Interpretation: Several environmental factors predicted cardiovascular and all-cause mortality, independent of each other and of individual risk factors. Mortality attributable to environmental factors represents a critical opportunity for targeted policies and programs. [ABSTRACT FROM AUTHOR]- Published
- 2022
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31. A hierarchical latent space networkmodel for mediation.
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Sweet, Tracy M. and Adhikari, Samrachana
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MEDIATION ,ONLINE social networks - Abstract
For interventions that affect how individuals interact, social network data may aid in understanding the mechanisms through which an intervention is effective. Social networks may even be an intermediate outcome observed prior to end of the study. In fact, social networks may also mediate the effects of the intervention on the outcome of interest, and Sweet (2019) introduced a statistical model for social networks asmediators in network-level interventions. We build on their approach and introduce a new model in which the network is a mediator using a latent space approach. We investigate our model through a simulation study and a real-world analysis of teacher advice-seeking networks. [ABSTRACT FROM AUTHOR]
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- 2022
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32. Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples.
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Thorpe, Lorna E., Adhikari, Samrachana, Lopez, Priscilla, Kanchi, Rania, McClure, Leslie A., Hirsch, Annemarie G., Howell, Carrie R., Aowen Zhu, Alemi, Farrokh, Rummo, Pasquale, Ogburn, Elizabeth L., Algur, Yasemin, Nordberg, Cara M., Poulsen, Melissa N., Long, Leann, Carson, April P., DeSilva, Shanika A., Meeker, Melissa, Schwartz, Brian S., and Lee, David C.
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RESEARCH , *STROKE , *RESEARCH methodology , *CASE-control method , *EVALUATION research , *TYPE 2 diabetes , *FOOD supply , *SOCIOECONOMIC factors , *COMPARATIVE studies , *RESEARCH funding , *RESIDENTIAL patterns - Abstract
Objective: We examined whether relative availability of fast-food restaurants and supermarkets mediates the association between worse neighborhood socioeconomic conditions and risk of developing type 2 diabetes (T2D).Research Design and Methods: As part of the Diabetes Location, Environmental Attributes, and Disparities Network, three academic institutions used harmonized environmental data sources and analytic methods in three distinct study samples: 1) the Veterans Administration Diabetes Risk (VADR) cohort, a national administrative cohort of 4.1 million diabetes-free veterans developed using electronic health records (EHRs); 2) Reasons for Geographic and Racial Differences in Stroke (REGARDS), a longitudinal, epidemiologic cohort with Stroke Belt region oversampling (N = 11,208); and 3) Geisinger/Johns Hopkins University (G/JHU), an EHR-based, nested case-control study of 15,888 patients with new-onset T2D and of matched control participants in Pennsylvania. A census tract-level measure of neighborhood socioeconomic environment (NSEE) was developed as a community type-specific z-score sum. Baseline food-environment mediators included percentages of 1) fast-food restaurants and 2) food retail establishments that are supermarkets. Natural direct and indirect mediating effects were modeled; results were stratified across four community types: higher-density urban, lower-density urban, suburban/small town, and rural.Results: Across studies, worse NSEE was associated with higher T2D risk. In VADR, relative availability of fast-food restaurants and supermarkets was positively and negatively associated with T2D, respectively, whereas associations in REGARDS and G/JHU geographies were mixed. Mediation results suggested that little to none of the NSEE-diabetes associations were mediated through food-environment pathways.Conclusions: Worse neighborhood socioeconomic conditions were associated with higher T2D risk, yet associations are likely not mediated through food-environment pathways. [ABSTRACT FROM AUTHOR]- Published
- 2022
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33. Rehabilitation Using Mobile Health for Older Adults With Ischemic Heart Disease in the Home Setting (RESILIENT): Protocol for a Randomized Controlled Trial.
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Dodson, John A., Schoenthaler, Antoinette, Sweeney, Greg, Fonceva, Ana, Pierre, Alicia, Whiteson, Jonathan, George, Barbara, Marzo, Kevin, Drewes, Wendy, Rerisi, Elizabeth, Mathew, Reena, Aljayyousi, Haneen, Chaudhry, Sarwat I., Hajduk, Alexandra M., Gill, Thomas M., Estrin, Deborah, Kovell, Lara, Jennings, Lee A., and Adhikari, Samrachana
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MOBILE health ,MEDICAL rehabilitation ,CORONARY disease ,RANDOMIZED controlled trials ,CARDIAC rehabilitation ,EXERCISE therapy for older people - Abstract
Background: Participation in ambulatory cardiac rehabilitation remains low, especially among older adults. Although mobile health cardiac rehabilitation (mHealth-CR) provides a novel opportunity to deliver care, age-specific impairments may limit older adults' uptake, and efficacy data are currently lacking. Objective: This study aims to describe the design of the rehabilitation using mobile health for older adults with ischemic heart disease in the home setting (RESILIENT) trial. Methods: RESILIENT is a multicenter randomized clinical trial that is enrolling patients aged ≥65 years with ischemic heart disease in a 3:1 ratio to either an intervention (mHealth-CR) or control (usual care) arm, with a target sample size of 400 participants. mHealth-CR consists of a commercially available mobile health software platform coupled with weekly exercise therapist sessions to review progress and set new activity goals. The primary outcome is a change in functional mobility (6-minute walk distance), which is measured at baseline and 3 months. Secondary outcomes are health status, goal attainment, hospital readmission, and mortality. Among intervention participants, engagement with the mHealth-CR platform will be analyzed to understand the characteristics that determine different patterns of use (eg, persistent high engagement and declining engagement). Results: As of December 2021, the RESILIENT trial had enrolled 116 participants. Enrollment is projected to continue until October 2023. The trial results are expected to be reported in 2024. Conclusions: The RESILIENT trial will generate important evidence about the efficacy of mHealth-CR among older adults in multiple domains and characteristics that determine the sustained use of mHealth-CR. These findings will help design future precision medicine approaches to mobile health implementation in older adults. This knowledge is especially important in light of the COVID-19 pandemic that has shifted much of health care to a remote, internet-based setting. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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34. Revisiting performance metrics for prediction with rare outcomes.
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Adhikari, Samrachana, Normand, Sharon-Lise, Bloom, Jordan, Shahian, David, and Rose, Sherri
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KEY performance indicators (Management) , *RECEIVER operating characteristic curves , *AORTIC valve transplantation , *MACHINE learning - Abstract
Machine learning algorithms are increasingly used in the clinical literature, claiming advantages over logistic regression. However, they are generally designed to maximize the area under the receiver operating characteristic curve. While area under the receiver operating characteristic curve and other measures of accuracy are commonly reported for evaluating binary prediction problems, these metrics can be misleading. We aim to give clinical and machine learning researchers a realistic medical example of the dangers of relying on a single measure of discriminatory performance to evaluate binary prediction questions. Prediction of medical complications after surgery is a frequent but challenging task because many post-surgery outcomes are rare. We predicted post-surgery mortality among patients in a clinical registry who received at least one aortic valve replacement. Estimation incorporated multiple evaluation metrics and algorithms typically regarded as performing well with rare outcomes, as well as an ensemble and a new extension of the lasso for multiple unordered treatments. Results demonstrated high accuracy for all algorithms with moderate measures of cross-validated area under the receiver operating characteristic curve. False positive rates were < 1%, however, true positive rates were < 7%, even when paired with a 100% positive predictive value, and graphical representations of calibration were poor. Similar results were seen in simulations, with the addition of high area under the receiver operating characteristic curve (> 90%) accompanying low true positive rates. Clinical studies should not primarily report only area under the receiver operating characteristic curve or accuracy. [ABSTRACT FROM AUTHOR]
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- 2021
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35. Analysis of longitudinal advice‐seeking networks following implementation of high stakes testing.
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Adhikari, Samrachana, Sweet, Tracy, and Junker, Brian
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PSYCHOLOGY of teachers ,ELEMENTARY school teachers ,EMIGRATION & immigration ,GOODNESS-of-fit tests ,GENDER ,BAYESIAN analysis - Abstract
Teacher interactions around instructional practices have been a topic of study for a long time. Previous studies concerning such interactions have focused on questions pertaining to cross‐sectional networks. In fact, very few studies have considered longitudinal networks and still fewer have employed longitudinal network models to study changes in such interactions. We analyse teachers' advice‐seeking networks, observed annually between 2010 and 2013, in schools within a district where several initiatives were implemented starting in 2011. We assess whether formal structures, teaching assignment and leadership position, and teacher characteristics, gender and experience, are associated with advice‐seeking ties, and the extent to which these associations change over time. To analyse the advice‐seeking networks, we implement a Bayesian longitudinal latent space network model with covariates and random sender‐receiver effects. Within the Bayesian framework, we address practical aspects of a principled network analysis such as missing ties and yearly immigration and emigration of teachers. Goodness of model fit assessment is conducted using posterior predictive checks. Our results demonstrate that while some of the associations between observed covariates and teachers' interactions varied in 2011, most were otherwise stable. In 2011, we found decreases in the associations with same grade assignment, leadership position, and teaching in the same school. [ABSTRACT FROM AUTHOR]
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- 2021
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36. Methotrexate hampers immunogenicity to BNT162b2 mRNA COVID-19 vaccine in immune-mediated inflammatory disease.
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Haberman, Rebecca H., Herati, Ramin, Simon, David, Samanovic, Marie, Blank, Rebecca B., Tuen, Michael, Koralov, Sergei B., Atreya, Raja, Tascilar, Koray, Allen, Joseph R., Castillo, Rochelle, Cornelius, Amber R., Rackoff, Paula, Solomon, Gary, Adhikari, Samrachana, Azar, Natalie, Rosenthal, Pamela, Izmirly, Peter, Samuels, Jonathan, and Golden, Brian
- Abstract
Objective: To investigate the humoral and cellular immune response to messenger RNA (mRNA) COVID-19 vaccines in patients with immune-mediated inflammatory diseases (IMIDs) on immunomodulatory treatment.Methods: Established patients at New York University Langone Health with IMID (n=51) receiving the BNT162b2 mRNA vaccination were assessed at baseline and after second immunisation. Healthy subjects served as controls (n=26). IgG antibody responses to the spike protein were analysed for humoral response. Cellular immune response to SARS-CoV-2 was further analysed using high-parameter spectral flow cytometry. A second independent, validation cohort of controls (n=182) and patients with IMID (n=31) from Erlangen, Germany, were also analysed for humoral immune response.Results: Although healthy subjects (n=208) and patients with IMID on biologic treatments (mostly on tumour necrosis factor blockers, n=37) demonstrate robust antibody responses (over 90%), those patients with IMID on background methotrexate (n=45) achieve an adequate response in only 62.2% of cases. Similarly, patients with IMID on methotrexate do not demonstrate an increase in CD8+ T-cell activation after vaccination.Conclusions: In two independent cohorts of patients with IMID, methotrexate, a widely used immunomodulator for the treatment of several IMIDs, adversely affected humoral and cellular immune response to COVID-19 mRNA vaccines. Although precise cut-offs for immunogenicity that correlate with vaccine efficacy are yet to be established, our findings suggest that different strategies may need to be explored in patients with IMID taking methotrexate to increase the chances of immunisation efficacy against SARS-CoV-2 as has been demonstrated for augmenting immunogenicity to other viral vaccines. [ABSTRACT FROM AUTHOR]- Published
- 2021
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37. Nonparametric Bayesian Instrumental Variable Analysis: Evaluating Heterogeneous Effects of Coronary Arterial Access Site Strategies.
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Adhikari, Samrachana, Rose, Sherri, and Normand, Sharon-Lise
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GROIN , *PERCUTANEOUS coronary intervention , *BLOOD vessels , *FACTOR structure , *WRIST - Abstract
Percutaneous coronary interventions (PCIs) are nonsurgical procedures to open blocked blood vessels to the heart, frequently using a catheter to place a stent. The catheter can be inserted into the blood vessels using an artery in the groin or an artery in the wrist. Because clinical trials have indicated that access via the wrist may result in fewer post procedure complications, shortening the length of stay, and ultimately cost less than groin access, adoption of access via the wrist has been encouraged. However, patients treated in usual care are likely to differ from those participating in clinical trials, and there is reason to believe that the effectiveness of wrist access may differ between males and females. Moreover, the choice of artery access strategy is likely to be influenced by patient or physician unmeasured factors. To study the effectiveness of the two artery access site strategies on hospitalization charges, we use data from a state-mandated clinical registry including 7963 patients undergoing PCI. A hierarchical Bayesian likelihood-based instrumental variable analysis under a latent index modeling framework is introduced to jointly model outcomes and treatment status. Our approach accounts for unobserved heterogeneity via a latent factor structure, and permits nonparametric error distributions with Dirichlet process mixture models. Our results demonstrate that artery access in the wrist reduces hospitalization charges compared to access in the groin, with a higher mean reduction for male patients. for this article are available online. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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38. COVID‐19 in Patients With Inflammatory Arthritis: A Prospective Study on the Effects of Comorbidities and Disease‐Modifying Antirheumatic Drugs on Clinical Outcomes.
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Haberman, Rebecca H., Castillo, Rochelle, Chen, Alan, Yan, Di, Ramirez, Deborah, Sekar, Vaish, Lesser, Robert, Solomon, Gary, Neimann, Andrea L., Blank, Rebecca B., Izmirly, Peter, Webster, Dan E., Ogdie, Alexis, Troxel, Andrea B., Adhikari, Samrachana, and Scher, Jose U.
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ARTHRITIS diagnosis ,HOSPITAL care ,IMMUNOSUPPRESSIVE agents ,INFLAMMATION ,LONGITUDINAL method ,MORTALITY ,REGRESSION analysis ,COMORBIDITY ,TREATMENT effectiveness ,DATA analysis software ,DESCRIPTIVE statistics ,COVID-19 - Abstract
Objective: To characterize the hospitalization and death rates among patients with inflammatory arthritis (IA) affected by coronavirus disease 2019 (COVID‐19) and to analyze the associations of comorbidities and immunomodulatory medications with infection outcomes. Methods: Data on clinical and demographic features, maintenance treatment, disease course, and outcomes in individuals with IA (rheumatoid arthritis and spondyloarthritis) with symptomatic COVID‐19 infection were prospectively assessed via web‐based questionnaire followed by individual phone calls and electronic medical record review. Baseline characteristics and medication use were summarized for hospitalized and ambulatory patients, and outcomes with the different medication classes were compared using multivariable logistic regression. Results: A total of 103 patients with IA were included in the study (80 with confirmed COVID‐19 and 23 with high suspicion of COVID‐19). Hospitalization was required in 26% of the participants, and 4% died. Patients who were hospitalized were significantly more likely to be older (P < 0.001) and have comorbid hypertension (P = 0.001) and chronic obstructive pulmonary disease (P = 0.02). IA patients taking oral glucocorticoids had an increased likelihood of being admitted for COVID‐19 (P < 0.001), while those receiving maintenance anticytokine biologic therapies did not. Conclusion: Among patients with underlying IA, COVID‐19 outcomes were worse in those receiving glucocorticoids but not in patients receiving maintenance anticytokine therapy. Further work is needed to understand whether immunomodulatory therapies affect COVID‐19 incidence. [ABSTRACT FROM AUTHOR]
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- 2020
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39. Smartphone‐Delivered Progressive Muscle Relaxation for the Treatment of Migraine in Primary Care: A Randomized Controlled Trial.
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Minen, Mia T., Adhikari, Samrachana, Padikkala, Jane, Tasneem, Sumaiya, Bagheri, Ashley, Goldberg, Eric, Powers, Scott, and Lipton, Richard B.
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MIGRAINE , *MUSCLE contraction , *PRIMARY health care , *STATISTICAL sampling , *TELEMEDICINE , *PILOT projects , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *SMARTPHONES , *RELAXATION techniques , *MOBILE apps , *DESCRIPTIVE statistics - Abstract
Objective: Scalable, accessible forms of behavioral therapy for migraine prevention are needed. We assessed the feasibility and acceptability of progressive muscle relaxation (PMR) delivered by a smartphone application (app) in the Primary Care setting. Methods: This pilot study was a non‐blinded, randomized, parallel‐arm controlled trial of adults with migraine and 4+ headache days/month. Eligible participants spoke English and owned a smartphone. All participants were given the RELAXaHEAD app which includes an electronic headache diary. Participants were randomized to receive 1 of the 2 versions of the app‐one with PMR and the other without PMR. The primary outcomes were measures of feasibility (adherence to the intervention and diary entries during the 90‐day interval) and acceptability (satisfaction levels). We conducted exploratory analyses to determine whether there was a change in Migraine Disability Assessment Scale (MIDAS) scores or a change in headache days. Results: Of 139 participants (77 PMR, 62 control), 116 (83%) were female, mean age was 41.7 ± 12.8 years. Most patients 108/139 (78%) had moderate‐severe disability. Using a 1‐5 Likert scale, participants found the app easy to use (mean 4.2 ± 0.7) and stated that they would be happy to engage in the PMR intervention again (mean 4.3 ± 0.6). For the first 6 weeks, participants practiced PMR 2‐4 days/week. Mean per session duration was 11.1 ± 8.3 minutes. Relative to the diary‐only group, the PMR group showed a greater non‐significant decline in mean MIDAS scores (−8.7 vs −22.7, P =.100) corresponding to a small‐moderate mean effect size (Cohen's d = 0.38). Conclusion: Smartphone‐delivered PMR may be an acceptable, accessible form of therapy for migraine. Mean effects show a small‐moderate mean effect size in disability scores. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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40. Prevalence and Outcomes of D-Dimer Elevation in Hospitalized Patients With COVID-19.
- Author
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Berger, Jeffrey S., Kunichoff, Dennis, Adhikari, Samrachana, Ahuja, Tania, Amoroso, Nancy, Aphinyanaphongs, Yindalon, Cao, Meng, Goldenberg, Ronald, Hindenburg, Alexander, Horowitz, James, Parnia, Sam, Petrilli, Christopher, Reynolds, Harmony, Simon, Emma, Slater, James, Yaghi, Shadi, Yuriditsky, Eugene, Hochman, Judith, and Horwitz, Leora I.
- Published
- 2020
- Full Text
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41. Renin-Angiotensin-Aldosterone System Inhibitors and Risk of Covid-19.
- Author
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Reynolds, Harmony R., Adhikari, Samrachana, Pulgarin, Claudia, Troxel, Andrea B., Iturrate, Eduardo, Johnson, Stephen B., Hausvater, Anai's, Newman, Jonathan D., Berger, Jeffrey S., Bangalore, Sripal, Katz, Stuart D., Fishman, Glenn I., Kunichoff, Dennis, Yu Chen, Ogedegbe, Gbenga, Hochman, Judith S., Hausvater, Anaïs, and Chen, Yu
- Subjects
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RENIN-angiotensin system , *ALDOSTERONE antagonists , *COVID-19 , *ADRENERGIC beta blockers , *ANGIOTENSIN-receptor blockers , *ANGIOTENSIN converting enzyme , *ACE inhibitors - Abstract
Background: There is concern about the potential of an increased risk related to medications that act on the renin-angiotensin-aldosterone system in patients exposed to coronavirus disease 2019 (Covid-19), because the viral receptor is angiotensin-converting enzyme 2 (ACE2).Methods: We assessed the relation between previous treatment with ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers, or thiazide diuretics and the likelihood of a positive or negative result on Covid-19 testing as well as the likelihood of severe illness (defined as intensive care, mechanical ventilation, or death) among patients who tested positive. Using Bayesian methods, we compared outcomes in patients who had been treated with these medications and in untreated patients, overall and in those with hypertension, after propensity-score matching for receipt of each medication class. A difference of at least 10 percentage points was prespecified as a substantial difference.Results: Among 12,594 patients who were tested for Covid-19, a total of 5894 (46.8%) were positive; 1002 of these patients (17.0%) had severe illness. A history of hypertension was present in 4357 patients (34.6%), among whom 2573 (59.1%) had a positive test; 634 of these patients (24.6%) had severe illness. There was no association between any single medication class and an increased likelihood of a positive test. None of the medications examined was associated with a substantial increase in the risk of severe illness among patients who tested positive.Conclusions: We found no substantial increase in the likelihood of a positive test for Covid-19 or in the risk of severe Covid-19 among patients who tested positive in association with five common classes of antihypertensive medications. [ABSTRACT FROM AUTHOR]- Published
- 2020
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42. Hyperbaric oxygen therapy for COVID-19 patients with respiratory distress: treated cases versus propensity-matched controls.
- Author
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Gorenstein, Scott A., Castellano, Michael L., Slone, Eric S., Gillette, Brian, Liu, Helen, Alsamarraie, Cindy, Jacobson, Alan M., Wall, Stephen P., Adhikari, Samrachana, Swartz, Jordan L., McMullen, Jenica J. S., Osorio, Marcela, Koziatek, Christian A., and Lee, David C.
- Published
- 2020
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43. Neighborhood-Level Socioeconomic Status and Prescription Fill Patterns Among Patients With Heart Failure.
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Mukhopadhyay, Amrita, Blecker, Saul, Li, Xiyue, Kronish, Ian M., Chunara, Rumi, Zheng, Yaguang, Lawrence, Steven, Dodson, John A., Kozloff, Sam, and Adhikari, Samrachana
- Published
- 2023
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44. High‐dimensional longitudinal classification with the multinomial fused lasso.
- Author
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Adhikari, Samrachana, Lecci, Fabrizio, Becker, James T., Junker, Brian W., Kuller, Lewis H., Lopez, Oscar L., and Tibshirani, Ryan J.
- Abstract
We study regularized estimation in high‐dimensional longitudinal classification problems, using the lasso and fused lasso regularizers. The constructed coefficient estimates are piecewise constant across the time dimension in the longitudinal problem, with adaptively selected change points (break points). We present an efficient algorithm for computing such estimates, based on proximal gradient descent. We apply our proposed technique to a longitudinal data set on Alzheimer's disease from the Cardiovascular Health Study Cognition Study. Using data analysis and a simulation study, we motivate and demonstrate several practical considerations such as the selection of tuning parameters and the assessment of model stability. While race, gender, vascular and heart disease, lack of caregivers, and deterioration of learning and memory are all important predictors of dementia, we also find that these risk factors become more relevant in the later stages of life. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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45. Mo1784 SKELETAL MUSCLE IS A BETTER PREDICTOR OF POSTOPERATIVE OUTCOMES AMONG OLDER ADULTS WITH IBD AS COMPARED TO PSOAS MUSCLE.
- Author
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Faye, Adam S., Kim, Michelle, Dane, Bari, Delau, Olivia R., Chodosh, Joshua, Adhikari, Samrachana, McAdams-DeMarco, Mara, Segev, Dorry L., Dodson, John, and Shaukat, Aasma
- Published
- 2023
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46. DR. REYNOLDS AND COLLEAGUES REPLY.
- Author
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Reynolds, Harmony R., Adhikari, Samrachana, and Iturrate, Eduardo
- Subjects
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ACE inhibitors , *ANGIOTENSIN-receptor blockers - Abstract
The article reflects the views of author which focus on the positive association observed in our study between the use of oral anticoagulants and the risk of Covid-19. Topics include use of antihypertensive therapy is not relevant to the outcome in patients with Covid-19; and duration of hypertension or duration of treatment with specific agents will be accurately reflected in the electronic health records.
- Published
- 2020
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47. Longitudinal Analysis of Neighborhood Food Environment and Diabetes Risk in the Veterans Administration Diabetes Risk Cohort.
- Author
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Kanchi, Rania, Lopez, Priscilla, Rummo, Pasquale E., Lee, David C., Adhikari, Samrachana, Schwartz, Mark D., Avramovic, Sanja, Siegel, Karen R., Rolka, Deborah B., Imperatore, Giuseppina, Elbel, Brian, and Thorpe, Lorna E.
- Published
- 2021
- Full Text
- View/download PDF
48. Miswiring the brain: Human prenatal Δ9-tetrahydrocannabinol use associated with altered fetal hippocampal brain network connectivity.
- Author
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Thomason, Moriah E., Palopoli, Ava C., Jariwala, Nicki N., Werchan, Denise M., Chen, Alan, Adhikari, Samrachana, Espinoza-Heredia, Claudia, Brito, Natalie H., and Trentacosta, Christopher J.
- Abstract
Increasing evidence supports a link between maternal prenatal cannabis use and altered neural and physiological development of the child. However, whether cannabis use relates to altered human brain development prior to birth, and specifically, whether maternal prenatal cannabis use relates to connectivity of fetal functional brain systems, remains an open question. The major objective of this study was to identify whether maternal prenatal cannabis exposure (PCE) is associated with variation in human brain hippocampal functional connectivity prior to birth. Prenatal drug toxicology and fetal fMRI data were available in a sample of 115 fetuses [43 % female; mean age 32.2 weeks (SD = 4.3)]. Voxelwise hippocampal connectivity analysis in a subset of age and sex-matched fetuses revealed that PCE was associated with alterations in fetal dorsolateral, medial and superior frontal, insula, anterior temporal, and posterior cingulate connectivity. Classification of group differences by age 5 outcomes suggest that compared to the non-PCE group, the PCE group is more likely to have increased connectivity to regions associated with less favorable outcomes and to have decreased connectivity to regions associated with more favorable outcomes. This is preliminary evidence that altered fetal neural connectome may contribute to neurobehavioral vulnerability observed in children exposed to cannabis in utero. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
49. Factors associated with loneliness, depression, and anxiety during the early stages of the COVID‐19 pandemic.
- Author
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Raio, Candace M., Szuhany, Kristin L., Secmen, Aysu, Mellis, Alexandra M., Chen, Alan, Adhikari, Samrachana, Malgaroli, Matteo, Miron, Carly D., Jennings, Emma, Simon, Naomi M., and Glimcher, Paul W.
- Subjects
- *
SUBJECTIVE stress , *LONELINESS , *MENTAL depression , *EMOTION regulation , *MENTAL health , *ANXIETY - Abstract
The COVID‐19 pandemic was an unparalleled stressor that enhanced isolation. Loneliness has been identified as an epidemic by the US Surgeon General. This study aimed to: (1) characterize longitudinal trajectories of loneliness during the acute phase of the COVID‐19 pandemic; (2) identify longitudinal mediators of the relationship of loneliness with anxiety and depression; and (3) examine how loneliness naturally clusters and identify factors associated with high loneliness. Two hundred and twenty‐nine adults (78% female; mean age = 39.5 ± 13.8) completed an abbreviated version of the UCLA Loneliness Scale, Perceived Stress Scale, Emotion Regulation Questionnaire, State Anxiety Inventory, and Patient Health Questionnaire‐8 longitudinally between April 2020 and 2021. Trajectory analyses demonstrated relatively stable loneliness over time, while anxiety and depression symptoms declined. Longitudinal analyses indicated that loneliness effects on anxiety and depression were both partially mediated by perceived stress, while emotion regulation capacity only mediated effects on anxiety. Three stable clusters of loneliness trajectories emerged (high, moderate, and low). The odds of moderate or high loneliness cluster membership were positively associated with higher perceived stress and negatively associated with greater cognitive reappraisal use. Our results demonstrate the important interconnections between loneliness and facets of mental health throughout the early phases of the pandemic and may inform targeted future interventions for loneliness work. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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50. 1109-P: The Effect of Neighborhood Food Environment on Diabetes Risk: A Multilevel Analysis of the Veterans Administration Diabetes Risk Cohort.
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KANCHI, RANIA, LOPEZ, PRISCILLA M., RUMMO, PASQUALE E., LEE, DAVID C., ADHIKARI, SAMRACHANA, SCHWARTZ, MARK D., AVRAMOVIC, SANJA, SIEGEL, KAREN R., ROLKA, DEBORAH B., IMPERATORE, GIUSEPPINA, ELBEL, BRIAN, and THORPE, LORNA
- Abstract
Diabetes causes significant morbidity and mortality among adults in the US, yet incidence varies across the country, suggesting that neighborhood factors may contribute to geographic disparities in diabetes. In this longitudinal study, we examined the association between neighborhood food environment and risk of newly diagnosed ("incident") diabetes in different communities (high density urban, low density urban, suburban, and rural). We created a retrospective dynamic, national cohort of 6,082,018 diabetes free US veterans identified from the Veterans Affairs electronic health records, enrolled between 2008 and 2016, and followed through 2018. Incident diabetes was defined as: 2 clinical encounters with diabetes ICD codes, a documented prescription for diabetes medication other than metformin or acarbose alone, or 1 clinical encounter with diabetes ICD codes and 2 elevated A1C (≥6.5%). Five-year average counts of fast-food restaurants and supermarkets relative to all other food outlets were used to generate two census tract-level neighborhood measures. We examined the association between food environment and incident diabetes using piecewise exponential survival models with county-level random effects. The average age of cohort participants was 59 years; the majority were non-Hispanic white (76.3%) and male (92.2%). Relative density of fast-food restaurants was associated with a modest increased risk of diabetes in all community types; adjusted hazard ratios (aHR) in high density urban, low density urban, and suburban communities were each 1.1, in rural communities was 1.2 (p < 0.05 for all). Relative density of supermarkets was associated with lower diabetes risk in suburban and rural communities only (aHR 0.7, 0.8, respectively, p <0.05). Neighborhood fast food and supermarkets influenced diabetes risk among US veterans in multiple community types, suggesting potential avenues for action to address the diabetes burden. Disclosure: R. Kanchi: None. G. Imperatore: None. B. Elbel: None. L. Thorpe: None. P. M. Lopez: None. P. E. Rummo: None. D. C. Lee: None. S. Adhikari: Research Support; Self; Johnson & Johnson. M. D. Schwartz: None. S. Avramovic: None. K. R. Siegel: None. D. B. Rolka: None. Funding: Centers for Disease Control and Prevention [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
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