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Recent Submissions

  • The murine absolute visual threshold: behavior & retinal pathways

    LaMagna, Sam (2024-05-17)
    Connexin 36 (Cx36) gap junctions are important for governing the sensitivity of the dark-adapted retina. Despite its importance for physiological sensitivity, the degree to which retinal Cx36 governs the psychophysical absolute threshold is not known. The purpose of this work is to study to what extent inner- and outer-retinal Cx36 governs the absolute visual threshold. In Chapter 2 we developed a one-alternative forced choice (1AFC) task for measuring murine absolute visual thresholds to full-field flash stimuli. We found that our 1AFC task, in conjunction with the theory of signal detection, gave response bias-independent absolute visual threshold estimated. Using this assay, we found that decision criteria are related to response times. In Chapter 3 we used the 1AFC task and the power of transgenic mice to assess the relative contributions of inner and outer retinal Cx36 to the absolute visual threshold. We concluded that inner, not outer, retinal Cx36 is most responsible for governing the absolute visual threshold. In parallel, by testing mice with disrupted rod vision, we determined that rod OFF pathways, and not cones, set the absolute visual threshold in the absence of Cx36. Finally, we studied the impact of Cx36 on temporal summation at absolute threshold, by obtaining thresholds for a range of flash durations. Threshold-vs-duration data was then fit with a model of temporal summation that allowed us to determine whether Cx36 influences the temporal filtering properties of scotopic vision. Our model fits suggest that photoreceptor Cx36 may play a role in temporal processing at absolute visual threshold. Overall, this work sheds new light on the behavioral dynamics and neural underpinnings of rod mediated vision.
  • Battle of arms: human cytomegalovirus manipulates monocyte survival for viral dissemination.

    Geiler, Brittany (2024-05-16)
    Human cytomegalovirus (HCMV) is a highly prevalent pathogen with seropositivity rates reaching upwards of 90% in the United States. Most primary infections are asymptomatic in immunocompetent individuals, but HCMV poses a significant risk in immunocompromised and immunonaїve individuals including transplant patients and developing fetuses in utero. The key to systemic dissemination of HCMV relies upon the infection of monocytes, which function as non-permissive vehicles to deliver virus to end organ tissues. These primary infected monocytes also travel to the bone marrow, infecting CD34+ stem cells, leading to the establishment of a lifelong HCMV infection. HCMV can reactivate at any point throughout the host's lifetime, leading to HCMV-infected stem cells exiting the bone marrow as monocytes, disseminating to end-organ tissue, and perpetuating HCMV disease. In circulation, monocytes have a short life span of 48 hours that can be accelerated by the cellular death pathway, apoptosis, as a cellular defense mechanism against viral infection. Our lab has shown during primary infection, HCMV circumvents intrinsic apoptotic pathways, however, the mechanism by which HCMV blocks extrinsic apoptosis is unclear. The studies in this thesis reveal that HCMV induces cFLIP expression, inhibiting extrinsic apoptosis effector caspase 8. This effective inhibition of intrinsic and extrinsic apoptosis prompts trap-door death pathway necroptosis. However, the mechanism in which this pathway is activated and how HCMV modulates this pathway to promote cell survival is unknown. In these works, we identified TLR3 as the death receptor responsible for inducing necroptosis. To circumvent this activation, HCMV upregulates autophagy, a ubiquitous cellular recycling process. We saw the inhibition of autophagy altered nucleocytoplasmic shuttling and activation of executioner kinase, MLKL, culminating in necrotic cell death. This work highlights the delicate balance between pro-survival and pro-death elements in HCMV infected monocytes. However, investigating how HCMV modulates cellular death pathways in a primary infection monocyte model does not fully encapsulate the role of monocytes in HCMV dissemination. Once HCMV latency is established in CD34+ stem cells, this allows HCMV the ability to persist in the host for their entire life span as monocytes derived from latently infected stem cells that can re-seed HCMV to peripheral organs to establish a chronic lytic infection. To investigate this understudied secondary population of HCMV-infected monocytes, we developed a model in which primary HCMV-infected monocytes and infected monocytes derived from latently infected stem cells are on the same genetic background by differentiating a CD34+ myeloblastic cell line. Though preliminary, we believe that this model, combined with investigations of mechanisms in which HCMV promotes survival in primary infected monocytes, will allow for the development of novel therapies that specifically target HCMV-infected monocytes, thus preventing viral dissemination and the establishment of disease.
  • Emerging Technologies Supporting Cognitive Development In School-Age Children

    Bucci, Joanne (SUNY Polytechnic Institute, 2023-12)
    Over the past few years, the importance of mental health has gained unprecedented attention and priority across various sectors of society. Many children have dealt with some form of undiagnosed or untreated mental illness that interferes with their ability to learn. These disorders can seriously affect daily life and continue into adulthood, creating a precarious home, school, and social life. Due to the increased use of technology over the 2020 Covid-19 pandemic, it is now commonplace to rely on technological innovations for mental health in children. Technology has advanced to expand child engagement and interactivity, especially for children who struggle with emotional regulation, social skills, and coping strategies. Research has shown that the human brain is fully developed at age 25. The longer a child has cognitive and emotional stability, the greater it positively affects their lives. Interventions should be given early in the child’s life. And if technology is available to aid in those interventions, everyone should be able to access them. The main objective of this paper is to explore how emerging digital interventions can improve mental health in children, specifically those with deficits in cognitive development. In conjunction with this paper, the website childmindtechnologies.com has been created for practitioners, educators, and parents, aiming to facilitate the adoption of these digital interventions in various settings, whether it be at home, in school, or in clinical environments.
  • Harnessing AI for Holistic Educational Development: Designing a Comprehensive Course

    Popov, Ivan D. (SUNY Polytechnic Institute, 2023-12)
    This paper outlines the project, methods, and theoretical analysis undertaken to address the question: How can a curriculum be optimized to effectively prepare contemporary students for a professional career in graphic design? Can AI be used to build this course and make it effective, if restricted to its use as a sounding board and source of inspiration, allowing access and collaboration with the world's information and innovative teaching methods? The theoretical background reveals that the traditional lecture model is increasingly being overshadowed by holistic and hands-on approaches, and that, furthermore, it is essential to educate students about potential career paths beyond their immediate field of study. The conclusion is drawn that by integrating modern pedagogies, career development practices, and the latest technological advances in design, a curriculum can be developed that resonates with students, laying a robust foundation for their academic and professional trajectories. This paper concludes that while there are studies that address individual components of the project outcome, this comprehensive and integrative approach, assisted with the use of artificial intelligence tools, appears to be a novel contribution to the field.
  • Digital eye strain and pupillary response to blue light

    Ng, Derek (2024)
    "Abstract Purpose: Digital eye strain (DES), a multifactorial condition affecting millions worldwide, often implicates blue light as a contributing factor. While blue light blocking filters are marketed to alleviate DES symptoms, evidence supporting their efficacy remains limited. Intrinsically photosensitive retinal ganglion cells (ipRGCs), exhibiting peak sensitivity to blue light, are involved in regulating pupil constriction and circadian rhythms. Notably, blue light elicits varying ipRGC-mediated pupil responses between individuals. This study investigated a potential association between self-reported DES symptoms and individuals' ipRGC-mediated pupil responses. Method: Twenty-five visually normal subjects, 18-30 years of age, participated in the experiment. They began by reading random words on a tablet computer for 20 minutes. Before and after the reading task, participants completed a symptom survey to assess DES severity. Subsequently, they were exposed to a blue background light of varying intensities within the dome of a pupilometer. The pupil light reflex was recorded for each intensity and analyzed. Results: The pupil diameter's EC50 value in response to blue light exhibited a statistically significant correlation with the total symptom score (p=0.0003), extrinsic symptom score (p=0.006) and intrinsic symptom score (p=0.0003). Similarly, the LogEC50 value also demonstrated a statistically significant correlation with total symptom score (p=0.002), extrinsic symptom score (p=0.02), and intrinsic symptom score (p=0.001). Conclusion: Subjects with greater DES scores exhibited reduced sensitivity when adapting to blue light, indicating a potential link between ipRGC function and DES symptoms. "
  • Connecting with Your Audience: Branding Guidelines for Small Manufacturing Businesses

    Shaffer, Chris (SUNY Polytechnic Institute, 2023-12)
    In modern markets, products and services are regularly available to customers. There are many options available to customers when it comes to purchasing, and the key for a small business to stand out from the competition in their target market is to develop and deploy an effective brand. To develop effective branding, a company must first understand its own purpose and value, and how it can help the target audience solve a need in their lives. To achieve this a company should develop a comprehensive brand, including guidelines on how and when to deploy branding resources to ensure consistent and effective visual resources. By deploying effective branding resources and strategies, a small business can be seen as professional and modern, and help a new business stand out in crowded markets and build their brand recognition within their target markets. This project will discuss standard industry practices for developing branding materials, and will eventually demonstrate these principles through the development of a branding package for a small local business called Automated Solutions, LLC. This brand style guide can be found in the Appendix.
  • Creating a Game Development Course Using Teaching Contextually and Situated Learning Theories

    Antonette, Brandon (SUNY Polytechnic Institute, 2023-12)
    This capstone project endeavored to create a course curriculum designed to instruct intermediate level college students on how to develop a video game. This project was built upon the idea that students have a fundamental understanding of video games and an interest in furthering their skill sets in game creation. The design and development created draws inspiration from the theories of Teaching Contextually and Situated Learning. The objectives of this project were to gain experience producing teaching materials, motivating students, creating an engaging classroom discussion, learning how to implement gamification, and refining my own career ambitions. These objectives have allowed this project to serve as a future reference when developing course materials, as well as help minimize potential challenges involving course assembly. Furthermore, this project has provided insights into the advantages and disadvantages of using a course structure based around the theories of Teaching Contextually and Situated Learning. The project can be found at this URL link below: https://drive.google.com/drive/folders/1aJ0YNrGgNqNc7oCzpa-itjBcgejh4r1S?usp=sharing Here are the key takeaways from this project. Applying theories into the course material facilitates student learning. Contributing factors to student engagement are time, interest, and willingness. Implementing drastically new teaching methods too quickly reduces learning effectiveness. The teaching profession has many facets that influence the learning environment.
  • The Role of Tau Isoforms in Sub-Acute and Chronic Closed Head Injury

    Furhang, Rachel (2024-03-25)
    Traumatic brain injury (TBI) is a leading cause of death and disability in the United States and increases the risk of neurodegenerative diseases and dementia [4, 5]. There are no treatments available to prevent neurodegeneration after TBI. Hyperphosphorylation of the microtubule-associated protein tau (pTau) is a key feature of neurodegeneration triggered by TBI. The tau gene can be alternatively spliced to generate tau with 3 or 4 repeated microtubule-binding sequences (3R and 4R). Adult mice express only 4R tau, while the adult human brain expresses 3R and 4R tau. This raises the possibility that tau isoform expression may influence chronic closed-head injury pathophysiology. The central hypothesis of this work is that tau isoform expression modulates neurodegeneration following a single closed-head injury. Two specific aims (SA) test this hypothesis. SA1: What is the time course and distribution of pathological protein aggregates after a single moderate closed-head injury? SA2: Does the expression of 3R tau aggravate the development of pathological protein aggregates and memory deficits after a single moderate closed-head injury? The studies in this work show that a single closedhead injury initially induces pTau+ cells and memory deficits in wild-type (WT) mice, which chronically develop protein aggregates in the thalamus. In contrast, MAPTKI mice expressing both 3R and 4R tau initially have a greater density of pTau+ cells but no memory deficits. However, chronically injured MAPTKI mice have more protein aggregates in the corpus callosum than WT mice and develop chronic spatial memory deficits. These data suggest that a single TBI in the context of 3R tau may drive a more severe early tauopathy that develops into chronic protein aggregate accumulation with functional deficits. Further evaluation of this model could identify targets for treating neurodegenerative diseases and dementia after TBI.
  • Lead induced differences in bone properties in osteocalcin +/+ and −/− female mice

    Yildirim, G.; Budell, W.C.; Berezovska, O.; Yagerman, S.; Maliath, S.S.; Mastrokostas, P.; Tommasini, S.; Dowd, T.L. (Elsevier BV, 2023-06)
    Lead (Pb) toxicity is a major health problem and bone is the major reservoir. Lead is detrimental to bone, affects bone remodeling and is associated with elderly fractures. Osteocalcin (OC) affects bone remodeling, improves fracture resistance and decreases with age and in some diseases. The effect of lead in osteocalcin depleted bone is unknown and of interest. We compared bone mineral properties of control and Pb exposed (from 2 to 6 months) femora from female adult C57BL6 OC+/+ and OC-/- mice using Fourier Transform Infrared Imaging (FTIRI), Micro-computed tomography (uCT), bone biomechanical measurements and serum turnover markers (P1NP, CTX). Lead significantly increased turnover in OC+/+ and in OC-/- bones producing increased total volume, area and marrow area/total area with decreased BV/TV compared to controls. The increased turnover decreased mineral/matrix vs. Oc+/+ and increased mineral/matrix and crystallinity vs. OC-/-. PbOC-/- had increased bone formation, cross-sectional area (Imin) and decreased collagen maturity compared OC-/- and PbOC+/+. Imbalanced turnover in PbOC-/- confirmed the role of osteocalcin as a coupler of formation and resorption. Bone strength and stiffness were reduced in OC-/- and PbOC-/- due to reduced material properties vs. OC+/+ and PbOC+/+ respectively. The PbOC-/- bones had increased area to compensate for weaker material properties but were not proportionally stronger for increased size. However, at low lead levels osteocalcin plays the major role in bone strength suggesting increased fracture risk in low Pb2+ exposed elderly could be due to reduced osteocalcin as well. Years of low lead exposure or higher blood lead levels may have an additional effect on bone strength.
  • Publication rates of abstracts presented at American Shoulder and Elbow Surgeons annual open and closed conferences: 2015-2019

    Mastrokostas, Paul G.; Klein, Brandon; Cappellino, Anthony L.; Bartlett, Lucas E.; Parada, Stephen A.; Cohn, Randy M. (Elsevier BV, 2024-05)
    Background: The annual meetings hosted by the American Shoulder and Elbow Surgeons (ASES) present the latest prepublication literature in shoulder and elbow surgery, facilitating early dissemination of novel findings that impact clinical decision-making. Evaluating the publication rate of presented abstracts at ASES conferences becomes crucial in assessing the quality of research showcased, as these presentations often precede the peer-review process. Methods: The ASES conference programs from 2015-2019 were reviewed to identify presented abstracts. For each abstract, the title, author(s), conference year, and meeting type (open vs. closed) were recorded. The names of the author(s) of each abstract were searched in the PubMed and Google Scholar databases to determine if there was an associated published manuscript. For each identified manuscript, the title, author(s), date of publication, publishing journal, impact factor of the publishing journal, level of evidence, and number of citations were recorded. Results: A total of 316 abstracts were presented as podium lectures at ASES open and closed meetings between 2015 and 2019. Within 3 years of presentation, 240 (75.9%) of the presented abstracts resulted in publication. There was an increase in the proportion of abstracts resulting in publication within 3 years of the presentation from 2015-2019 (R = 0.8733, P = .053). Overall, the proportion of presented abstracts that went on to publication in peer-reviewed journals also increased (R = 0.8907, P = .043). Manuscripts of abstracts presented at open meetings had a shorter time to publication (8.78 vs. 11.82 months; P = .0160) and were cited more often (40.89 vs. 30.11, P = .0099) than those presented at closed meetings. Conclusion: There has been an increase in the publication rate of abstracts presented at ASES annual meetings in the study period. Published manuscripts of abstracts presented at ASES open conferences were published faster, and were cited more often, than closed conferences. ASES conferences allow for the presentation of high-quality prepublication literature in shoulder and elbow surgery.
  • Modern Internet Search Analytics: Is There a Difference in What Patients are Searching Regarding the Operative and Nonoperative Management of Scoliosis?

    Mastrokostas, Paul G.; Mastrokostas, Leonidas E.; Emara, Ahmed K.; Wellington, Ian J.; Ginalis, Elizabeth; Houten, John K.; Khalsa, Amrit S.; Saleh, Ahmed; Razi, Afshin E.; Ng, Mitchell K. (SAGE Publications, 2024-04-13)
    Study design: Observational Study. Objectives: This study aimed to investigate the most searched types of questions and online resources implicated in the operative and nonoperative management of scoliosis. Methods: Six terms related to operative and nonoperative scoliosis treatment were searched on Google's People Also Ask section on October 12, 2023. The Rothwell classification was used to sort questions into fact, policy, or value categories, and associated websites were classified by type. Fischer's exact tests compared question type and websites encountered between operative and nonoperative questions. Statistical significance was set at the .05 level. Results: The most common questions concerning operative and nonoperative management were fact (53.4%) and value (35.5%) questions, respectively. The most common subcategory pertaining to operative and nonoperative questions were specific activities/restrictions (21.7%) and evaluation of treatment (33.3%), respectively. Questions on indications/management (13.2% vs 31.2%, P < .001) and evaluation of treatment (10.1% vs 33.3%, P < .001) were associated with nonoperative scoliosis management. Medical practice websites were the most common website to which questions concerning operative (31.9%) and nonoperative (51.4%) management were directed to. Operative questions were more likely to be directed to academic websites (21.7% vs 10.0%, P = .037) and less likely to be directed to medical practice websites (31.9% vs 51.4%, P = .007) than nonoperative questions. Conclusions: During scoliosis consultations, spine surgeons should emphasize the postoperative recovery process and efficacy of conservative treatment modalities for the operative and nonoperative management of scoliosis, respectively. Future research should assess the impact of website encounters on patients' decision-making.
  • COVID-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals

    Faksova, K.; Walsh, D.; Jiang, Y.; Griffin, J.; Phillips, A.; Gentile, A.; Kwong, J.C.; Macartney, K.; Naus, M.; Grange, Z.; et al. (Elsevier BV, 2024-04)
    Background: The Global COVID Vaccine Safety (GCoVS) Project, established in 2021 under the multinational Global Vaccine Data Network™ (GVDN®), facilitates comprehensive assessment of vaccine safety. This study aimed to evaluate the risk of adverse events of special interest (AESI) following COVID-19 vaccination from 10 sites across eight countries. Methods: Using a common protocol, this observational cohort study compared observed with expected rates of 13 selected AESI across neurological, haematological, and cardiac outcomes. Expected rates were obtained by participating sites using pre-COVID-19 vaccination healthcare data stratified by age and sex. Observed rates were reported from the same healthcare datasets since COVID-19 vaccination program rollout. AESI occurring up to 42 days following vaccination with mRNA (BNT162b2 and mRNA-1273) and adenovirus-vector (ChAdOx1) vaccines were included in the primary analysis. Risks were assessed using observed versus expected (OE) ratios with 95 % confidence intervals. Prioritised potential safety signals were those with lower bound of the 95 % confidence interval (LBCI) greater than 1.5. Results: Participants included 99,068,901 vaccinated individuals. In total, 183,559,462 doses of BNT162b2, 36,178,442 doses of mRNA-1273, and 23,093,399 doses of ChAdOx1 were administered across participating sites in the study period. Risk periods following homologous vaccination schedules contributed 23,168,335 person-years of follow-up. OE ratios with LBCI > 1.5 were observed for Guillain-Barré syndrome (2.49, 95 % CI: 2.15, 2.87) and cerebral venous sinus thrombosis (3.23, 95 % CI: 2.51, 4.09) following the first dose of ChAdOx1 vaccine. Acute disseminated encephalomyelitis showed an OE ratio of 3.78 (95 % CI: 1.52, 7.78) following the first dose of mRNA-1273 vaccine. The OE ratios for myocarditis and pericarditis following BNT162b2, mRNA-1273, and ChAdOx1 were significantly increased with LBCIs > 1.5. Conclusion: This multi-country analysis confirmed pre-established safety signals for myocarditis, pericarditis, Guillain-Barré syndrome, and cerebral venous sinus thrombosis. Other potential safety signals that require further investigation were identified.
  • Indirect impact of childhood 13-valent pneumococcal conjugate vaccine (PCV13) in Canadian older adults: a Canadian Immunization Research Network (CIRN) retrospective observational study

    Nasreen, Sharifa; Wang, Jun; Marra, Fawziah; Kwong, Jeffrey C; McGeer, Allison; Sadarangani, Manish; Wilson, Sarah E; Fadel, Shaza A (BMJ, 2024-02-15)
    Background: 13-valent pneumococcal conjugate vaccine (PCV13) has been part of publicly funded childhood immunisation programmes in Ontario and British Columbia (BC) since 2010. We assessed the indirect impact of infant PCV13 programmes on invasive pneumococcal disease (IPD) and all-cause pneumonia hospitalisation in older adults (aged ≥65 years) using a retrospective observational study. Methods: We extracted monthly IPD and all-cause pneumonia cases from laboratory and health administrative databases between January 2005 and December 2018. Using a quasi-experimental difference-in-differences design, we calculated the ratio of risk ratios (RRRs) using incidence rates of IPD or all-cause pneumonia cases before (pre-PCV13 period) and after (PCV13 period) 2010 with rates of fractures as controls. Results: The rates of all IPD or PCV serotype-specific IPD for older adults in both Ontario and BC did not change in 8 years after childhood PCV13 programme implementation. All-cause pneumonia increased in Ontario (RRR 1.38, 95% CI 1.11 to 1.71) but remained unchanged in BC. Conclusions: Indirect community protection of older adults from hospitalisation with pneumococcal disease stalled despite maturation of childhood PCV13 vaccination programmes in two Canadian provinces.
  • Evolution of the data and methods in real-world COVID-19 vaccine effectiveness studies on mortality: a scoping review protocol

    Stehlik, Paulina; Dowsett, Caroline; Camacho, Ximena; Falster, Michael O; Lim, Renly; Nasreen, Sharifa; Pratt, Nicole L; Pearson, Sallie-Anne; Henry, David (BMJ, 2024-03-19)
    Background: Early evidence on COVID-19 vaccine efficacy came from randomised trials. Many important questions subsequently about vaccine effectiveness (VE) have been addressed using real-world studies (RWS) and have informed most vaccination policies globally. As the questions about VE have evolved during the pandemic so have data, study design, and analytical choices. This scoping review aims to characterise this evolution and provide insights for future pandemic planning-specifically, what kinds of questions are asked at different stages of a pandemic, and what data infrastructure and methods are used? Methods and analysis: We will identify relevant studies in the Johns Hopkins Bloomberg School of Public Health VIEW-hub database, which curates both published and preprint VE RWS identified from PubMed, Embase, Scopus, Web of Science, the WHO COVID Database, MMWR, Eurosurveillance, medRxiv, bioRxiv, SSRN, Europe PMC, Research Square, Knowledge Hub, and Google. We will include RWS of COVID-19 VE that reported COVID-19-specific or all-cause mortality (coded as 'death' in the 'effectiveness studies' data set).Information on study characteristics; study context; data sources; design and analytic methods that address confounding will be extracted by single reviewer and checked for accuracy and discussed in a small group setting by methodological and analytic experts. A timeline mapping approach will be used to capture the evolution of this body of literature.By describing the evolution of RWS of VE through the COVID-19 pandemic, we will help identify options for VE studies and inform policy makers on the minimal data and analytic infrastructure needed to support rapid RWS of VE in future pandemics and of healthcare strategies more broadly. Ethics and dissemination: As data is in the public domain, ethical approval is not required. Findings of this study will be disseminated through peer-reviewed publications, conference presentations, and working-papers to policy makers.
  • Successful Percutaneous Coronary Intervention in a Patient With Absent Right Coronary Artery Ostium: A Case Report and Literature Review

    Zaveri, Sahil; Schrem, Ezra; Aykent, Kazim; McFarlane, Samy I; Gandotra, Puneet; Budzikowski, Adam S (Springer Science and Business Media LLC, 2024-04-30)
    Coronary artery anomalies present unique interventional challenges, particularly when associated with significant coronary artery disease. This case report contributes to the limited literature on congenital coronary artery anomalies, emphasizing the need for tailored approaches to optimize patient care. We present a case of a 70-year-old male with refractory angina and a rare congenital coronary anomaly characterized by the absence of the right coronary artery ostium, necessitating reliance on the left coronary system for myocardial perfusion. Cardiac catheterization revealed mid-left anterior descending artery stenosis, prompting percutaneous coronary intervention. Despite the anatomical complexities encountered, the procedure was successfully performed. This case underscores the importance of meticulous diagnostic evaluation, advanced imaging techniques, and a multidisciplinary approach to managing patients with rare coronary anomalies. This report also emphasizes the unique diagnostic and therapeutic considerations by providing a comprehensive literature review and identifying areas for further research to advance treatment strategies and improve outcomes
  • Arrhythmias and ion channelopathies causing sudden cardiac death in Hispanic/Latino and Indigenous populations

    Zaveri, Sahil; Chahine, Mohamed; Boutjdir, Mohamed (Wiley, 2024-04-23)
    The limited literature and increasing interest in studies on cardiac electrophysiology, explicitly focusing on cardiac ion channelopathies and sudden cardiac death in diverse populations, has prompted a comprehensive examination of existing research. Our review specifically targets Hispanic/Latino and Indigenous populations, which are often underrepresented in healthcare studies. This review encompasses investigations into genetic variants, epidemiology, etiologies, and clinical risk factors associated with arrhythmias in these demographic groups. The review explores the Hispanic paradox, a phenomenon linking healthcare outcomes to socioeconomic factors within Hispanic communities in the United States. Furthermore, it discusses studies exemplifying this observation in the context of arrhythmias and ion channelopathies in Hispanic populations. Current research also sheds light on disparities in overall healthcare quality in Indigenous populations. The available yet limited literature underscores the pressing need for more extensive and comprehensive research on cardiac ion channelopathies in Hispanic/Latino and Indigenous populations. Specifically, additional studies are essential to fully characterize pathogenic genetic variants, identify population-specific risk factors, and address health disparities to enhance the detection, prevention, and management of arrhythmias and sudden cardiac death in these demographic groups.
  • Prevalence of concomitant rheumatologic diseases and autoantibody specificities among racial and ethnic groups in SLE patients

    Denvir, Brendan; Carlucci, Philip M.; Corbitt, Kelly; Buyon, Jill P.; Belmont, H. Michael; Gold, Heather T.; Salmon, Jane E.; Askanase, Anca; Bathon, Joan M.; Geraldino-Pardilla, Laura; et al. (Frontiers Media SA, 2024-03-06)
    Objective: Leveraging the Manhattan Lupus Surveillance Program (MLSP), a population-based registry of cases of systemic lupus erythematosus (SLE) and related diseases, we investigated the proportion of SLE with concomitant rheumatic diseases, including Sjögren's disease (SjD), antiphospholipid syndrome (APLS), and fibromyalgia (FM), as well as the prevalence of autoantibodies in SLE by sex and race/ethnicity. Methods: Prevalent SLE cases fulfilled one of three sets of classification criteria. Additional rheumatic diseases were defined using modified criteria based on data available in the MLSP: SjD (anti-SSA/Ro positive and evidence of keratoconjunctivitis sicca and/or xerostomia), APLS (antiphospholipid antibody positive and evidence of a blood clot), and FM (diagnosis in the chart). Results: 1,342 patients fulfilled SLE classification criteria. Of these, SjD was identified in 147 (11.0%, 95% CI 9.2-12.7%) patients with women and non-Latino Asian patients being the most highly represented. APLS was diagnosed in 119 (8.9%, 95% CI 7.3-10.5%) patients with the highest frequency in Latino patients. FM was present in 120 (8.9%, 95% CI 7.3-10.5) patients with non-Latino White and Latino patients having the highest frequency. Anti-dsDNA antibodies were most prevalent in non-Latino Asian, Black, and Latino patients while anti-Sm antibodies showed the highest proportion in non-Latino Black and Asian patients. Anti-SSA/Ro and anti-SSB/La antibodies were most prevalent in non-Latino Asian patients and least prevalent in non-Latino White patients. Men were more likely to be anti-Sm positive. Conclusion: Data from the MLSP revealed differences among patients classified as SLE in the prevalence of concomitant rheumatic diseases and autoantibody profiles by sex and race/ethnicity underscoring comorbidities associated with SLE.
  • GPT-4 as a Source of Patient Information for Anterior Cervical Discectomy and Fusion: A Comparative Analysis Against Google Web Search

    Mastrokostas, Paul G.; Mastrokostas, Leonidas E.; Emara, Ahmed K.; Wellington, Ian J.; Ginalis, Elizabeth; Houten, John K.; Khalsa, Amrit S.; Saleh, Ahmed; Razi, Afshin E.; Ng, Mitchell K. (SAGE Publications, 2024-03-21)
    Study design: Comparative study. Objectives: This study aims to compare Google and GPT-4 in terms of (1) question types, (2) response readability, (3) source quality, and (4) numerical response accuracy for the top 10 most frequently asked questions (FAQs) about anterior cervical discectomy and fusion (ACDF). Methods: "Anterior cervical discectomy and fusion" was searched on Google and GPT-4 on December 18, 2023. Top 10 FAQs were classified according to the Rothwell system. Source quality was evaluated using JAMA benchmark criteria and readability was assessed using Flesch Reading Ease and Flesch-Kincaid grade level. Differences in JAMA scores, Flesch-Kincaid grade level, Flesch Reading Ease, and word count between platforms were analyzed using Student's t-tests. Statistical significance was set at the .05 level. Results: Frequently asked questions from Google were varied, while GPT-4 focused on technical details and indications/management. GPT-4 showed a higher Flesch-Kincaid grade level (12.96 vs 9.28, P = .003), lower Flesch Reading Ease score (37.07 vs 54.85, P = .005), and higher JAMA scores for source quality (3.333 vs 1.800, P = .016). Numerically, 6 out of 10 responses varied between platforms, with GPT-4 providing broader recovery timelines for ACDF. Conclusions: This study demonstrates GPT-4's ability to elevate patient education by providing high-quality, diverse information tailored to those with advanced literacy levels. As AI technology evolves, refining these tools for accuracy and user-friendliness remains crucial, catering to patients' varying literacy levels and information needs in spine surgery.
  • Development of a Pediatric Digital Eye Strain Questionnaire

    Aguilar, Stephanie (2024)
    "Objectives: The aim of the present study was to create a valid and reliable method of determining to what extent children experience symptoms of digital eye strain (DES). Methods: The initial version of the pediatric digital eye strain questionnaire was developed using a literature review, consultation with experts and a pretest performed on 6-8-year-olds. A pilot test using a revised version of the questionnaire was performed on 70 6-12-year-old participants. Content validity was established by discussion with an expert. Construct validity was evaluated by performance of the pediatric DES questionnaire and the Computer Vision Syndrome Questionnaire (CVS-Q) by optometry students. Test-retest repeatability was tested using Bland Altman analysis and a significant cutoff score was established using the linear regression equation to determine the value equivalent to the previously assigned cutoff for the CVS-Q of 6. Results: The questionnaire evaluated 12 DES symptoms’ frequency in a simple, self-administrable method. The mean total score of the pilot test was 7. 45% of the participants in the pilot test had a significant score for DES. The questionnaire had excellent test-retest repeatability and construct validity r=0.81 (p<0.001). No significant correlation was found between the reported total number of hours of screen time per week and the total symptom score (r = 0.30, p = 0.47). Conclusions: This study indicates that almost half of children may be experiencing adverse ocular symptoms associated with screen use. The questionnaire provides a valid and reliable method for identification of DES symptoms in children ages 6-12 years. Optometrists, pediatricians and parents alike may find use for this questionnaire to evaluate for digital eye strain in children. "
  • Implementing a NIDS System for protecting computer and wireless networks using various machine learning approaches

    Eppich, Joseph (SUNY Polytechnic Institute, 2024-05)
    In modern Wireless Networks, security is critical. With the ever-evolving attacks on wireless networks, both public and private, the use of Network Intrusion Detection Systems is at an all-time high. While NIDS is needed more than ever, its current security structure is starting to show signs of becoming obsolete. With the alarming rate of attacks in the modern digital space, NIDS needs to have a way to react effectively. Setting up NIDS is too slow and can cause many issues when defending against these attacks, leaving wireless networks vulnerable. Three approaches are often discussed NIDS: signature-based, anomaly-based, as well as hybrid. Implementing Machine Learning would fall under an updated version of Anomaly Learning. The hope from these actions is that they will allow new attacks to be caught without user interference. This paper will discuss various forms of Machine Learning, NIDS, and the implementation of both into each other. This paper will discuss our current options in Machine Learning NIDS and explain how they’ve evolved thus far and the advantages at each stage. This paper, while mainly focusing on the machine learning implementation of NIDS, will touch briefly on how this implementation could strengthen current security in wireless networks.

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