DigitalCommons@The Texas Medical Center
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Machine Learning Models Predict Long COVID Outcomes Based on Baseline Clinical and Immunologic Factors
No full textBackground: The post-acute sequelae of SARS-CoV-2 (PASC), also known as long COVID, remain a significant health issue that is incompletely understood. Predicting which acutely infected individuals will develop long COVID is challenging due to the absence of established biomarkers, clear disease mechanisms, or well-defined sub-phenotypes. Machine learning (ML) models may address this gap by leveraging clinical data to enhance diagnostic precision.
Methods: Clinical data, including antibody titers and viral load measurements collected at the time of hospital admission, are used to predict the likelihood of acute COVID-19 progressing to long COVID. Machine learning models are trained and evaluated for predictive performance. Feature importance analysis is performed to identify the most influential predictors.
Results: The machine learning models achieve median AUROC values ranging from 0.64 to 0.66 and AUPRC values between 0.51 and 0.54, demonstrating predictive capabilities. Low antibody titers and high viral loads at hospital admission emerge as the strongest predictors of long COVID outcomes. Comorbidities-such as chronic respiratory, cardiac, and neurologic diseases-and female sex are also identified as significant risk factors.
Conclusions: Machine learning models identify patients at risk for developing long COVID based on baseline clinical characteristics. These models guide early interventions, improve patient outcomes, and mitigate the long-term public health impacts of SARS-CoV-2
Increasing HPV Vaccination Rates of Patients Nine and Ten-Years-Old at Pediatric Clinic Using Pre-Visit Phone Calls and Motivational Interviewing
No full textPurpose:
This quality improvement project aimed to increase the initiation rates of human papillomavirus (HPV) vaccination of nine- and ten-year-olds at the pediatric clinic by making pre-visit calls and using motivational interviewing (MI).
Background:
In 2022, the HPV vaccination rate for adolescents at this pediatric clinic was 93%, surpassing the Healthy People 2030 goal of 80%. In this same clinic, however, the 2022 HPV vaccination rates among children aged 9 and 10 years old were significantly lower at 32 %. This project aimed to increase the HPV rate by 3% after intervention at the pediatric clinic.
Methodology:
Staff completed online motivational interviewing (MI) training. Parents of nine- and ten-year-olds received pre-visit calls to advise of the visit and the opportunity for HPV vaccination. MI was utilized to focus parents on the goal of HPV vaccination. PDSA cycles were conducted monthly. Changes in MI were made based on feedback. Vaccination rates were calculated by comparing the number of those vaccinated with the number of those eligible for vaccination.
Results:
In 2024, vaccination initiation rates had dropped to 27.69 % pre-intervention and 53.84 % post-intervention. Results revealed a 26.15 % increase in HPV vaccination initiation rates.
Implications:
The results of this quality improvement project demonstrated a significant increase in HPV vaccination initiation rates and suggest that pre-visit phone calls and MI may improve these rates. This improves the health outcomes for individual children and contributes to broader public health goals of reducing the cancer burden.
Key words: Adolescent, Primary Care Provider, Papillomavirus Vaccines, HPV Vaccin
Finding and Using Validated Surveys in Health Science Research
No full textJoin us as we introduce techniques for identifying and using validated surveys in health sciences research. Learn strategies for finding reliable, evidence-based measurement tools in the databases and gain tips on how to evaluate their quality and relevance
Progress and Challenges in Profiling Protein-RNA and Protein-Associated RNA-RNA Interactions
No full textRNA binding proteins (RBPs) play essential roles in post-transcriptional gene regulation by interacting with a wide range of RNA targets. In addition to regulating RNA processing via individual RBP-RNA interactions, there is a growing appreciation of the regulatory impact of protein-associated RNA-RNA interactions that include both well-studied examples of small regulatory RNAs (e.g. microRNAs, snRNAs, snoRNAs, piRNAs) guiding ribonucleoprotein complexes to their targets as well as structured RNA elements defining the interaction landscape for an RBP. To elucidate the full scope of RBP-RNA interactions, CLIP ( crosslinking and immunoprecipitation)-based methods have emerged as powerful tools. Even with the wide application of CLIP and variant approaches, these methods are still under significant ongoing advancement to better accommodate diverse biological systems and experimental demands and improve scalability. In particular, recent years have seen an emergent focus on improved techniques to globally profile protein-associated RNA-RNA interactions. In this review, we provide a summary of recent improvements in traditional CLIP methods that improve the mapping of RBP-RNA interactions, with particular focus on those that specifically enable the profiling of protein-associated RNA-RNA interactions. We discuss the unique challenges involved in mapping protein-associated RNA-RNA interactions and highlight different ways current approaches address these challenges in order to offer a practical framework for researchers seeking to investigate RBP-associated RNA interactions
Empowering Through Structured Boundaries: An Integral Model for Fostering Balanced Eating and Nutritional Well-Being
No full textPurpose: Treating obesity in complex disorders requires individualized health management plans. Effective obesity management in the Smith-Magenis syndrome (SMS) population has multiple inherent barriers related to their cognitive impairments, anxiety, behavioral disturbances, and sleep disorders. However, to date, no research exists related to strategies caregivers successfully employ to help individuals with SMS manage their food intake and mitigate associated behaviors.
Methods: We performed a qualitative thematic analysis of group interviews from 23 caregivers representing 21 individuals with SMS. Hybrid thematic analysis revealed that successful strategies employed by caregivers in this unique population revolved around a global theme of Empowering Through Structured Boundaries.
Results: Four themes emerged: Fostering Balanced Eating, Structuring Environments, Setting the Stage for Success, and Managing Challenges and Resistance. Together, our analysis shows that successful strategies utilized by caregivers often involve setting up explicit boundaries, both literal and figurative, that provide choice empowerment to the individual with SMS. Additionally, anticipatory guidance, deflection, and positive language were utilized throughout different contexts.
Conclusions: These data are the first to define and disseminate a variety of successful strategies utilized by caregivers of individuals with SMS to decrease food-related disruptive behaviors.
Supplementary information: The online version contains supplementary material available at 10.1007/s44162-025-00145-3
Improving the Screening of Intimate Partner Violence Among Women: A Quality Improvement Project in a Primary Care Setting
No full textPURPOSE The purpose of this project was to improve the screening rate and the detection of positive screens for intimate partner violence among women by 50% over three months at UT Physicians International District, Houston, Texas, by developing a process that will enhance the safety of victims.
BACKGROUND Intimate partner violence is a significant social problem affecting women and minorities in the United States. However, many patients are not screened due to a lack of staff training, fear of patient reactions, reluctance to disclose, and absence of effective screening methods. This project employs the Plan-Do-Study-Act (PDSA) cycle to test and enhance IPV screening processes. The project was implemented with a clinical staff of 25 people at a primary care clinic.
METHODOLOGY The project involves educating healthcare staff using a targeted presentation, adopting the HARK screening tool in the patient intake processes, and incorporating these procedures in the EHR system. The screening results are calculated before and after the intervention to determine the effectiveness of the changes.
RESULTS Post-intervention data showed an increase from a baseline of 25% to 77% in screening rates. Pre-education and post-education surveys indicated significant improvement in the staff\u27s ability to handle IPV cases, with the majority being able to name two indicators of IPV and accurately reflect the clinic’s screening policy.
IMPLICATIONS: By effectively identifying and addressing barriers to IPV screening, this project aims to enhance patient safety and support within the clinic and serves as a model for similar interventions in other healthcare settings, potentially leading to widespread improvements in IPV management.
The project successfully enhanced IPV screening rates and staff competency in IPV management. The methods used in the study can be adapted and implemented in other UT Healthcare systems struggling with IPV screening and management. Future quality improvement projects should focus on detecting positive screens to improve patient safety
From Asylums to Hospitals to Prisons: The History of Institutional Psychiatric Care in America
No full textLunch & Learn Webinar Series
No full textTake your CINAHL searches to the next level in this hands-on library training. Learn practical techniques for effectively combining subject headings, keywords, and filters to create strong, efficient search strategies that support evidence-based research and clinical decision-making.
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