Bulletin of Computer Science and Electrical Engineering (BCSEE)
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Abstract 141: Contemporary Trends In Oral Anticoagulation Utilization After Acute Ischemic Stroke With Atrial Fibrillation: The Treatment Disparities In Stroke And Atrial Fibrillation Study
No full textByline: Nicole B Sur, Univ of Miami Neurology, Miami, FL; Hao Ying; Negar Asdaghi, UNIVERSITY OF MIAMI MILLER SCHOOL, Miami, FL; Hannah Gardener, Univ of Miami Med Sch, Miami, FL; Lili Zhou, Univ of Miami, Miami, FL; Carolina M Gutierrez, UNIVERISTY OF MIAMI MILLER SCH, Miami, FL; Ralph L Sacco, UNIVERSITY OF MIAMI, Miami, FL; Jose G Romano, U Miami, Pinecrest, FL; Tatjana Rundek, MILLER SCHL OF MEDICINE UNIV M, Miami, FL Background: Acute ischemic stroke (AIS) is a devastating consequence of atrial fibrillation (AF), which is preventable with oral anticoagulants (OACs). The goal of this study was to evaluate contemporary trends and disparities in OAC use at hospital discharge in patients with AIS and AF in the era of direct oral anticoagulants (DOACs). Methods: Data on 34,715 cases admitted to hospital for AIS with AF were obtained from the Florida Stroke Registry, 2017-2021. Baseline sociodemographics, medical history, stroke and hospital characteristics and anticoagulant status were compared by OAC use at discharge. Multivariable logistic regression was used to identify predictors of OAC non-use after AIS with AF after adjusting for confounders. Temporal trends in the frequency of OAC use at hospital discharge was assessed from 2010-2021. Results: From 2017-2021, a total of 21,011 (61%) patients with AIS and AF were discharged on OAC (median age 77 years; 49% female; 74% white, 13% black, 13% Hispanic). The rate of DOAC use increased from 43% to 59%, and the rate of warfarin use declined from 13% to 6% from 2017-2021. The overall use of OAC at hospital discharge increased by 9% from 2017-2021, and by 13% from 2010-2021. After adjustment, stroke hospital designation was the strongest predictor of OAC non-use with 4-fold higher odds of OAC non-use at discharge from an Acute Stroke Ready Hospital compared with a Comprehensive Stroke Center (P=0.012). Increasing age, male sex, renal insufficiency, lower CHA2DS2-VASc, NIHSS [greater than or equal] 5, mRS 3-5, ambulation status, and discharge destination were significant predictors of OAC non-use after AIS with AF. Conclusion: OAC use increased by 13% over the last decade in patients with AIS and AF in Florida. Previously identified race/ethnic disparities did not persist in 2017-2021; however, sex, stroke hospital designation, stroke severity, medical comorbidities, functional disability, and ambulation status had a significant impact on OAC use after AIS with AF.Academi
Biomechanical properties of porcine meniscus as determined via AFM: Effect of region, compartment and anisotropy
No full textThe meniscus is a fibrocartilaginous tissue that plays an essential role in load transmission, lubrication, and stabilization of the knee. Loss of meniscus function, through degeneration or trauma, can lead to osteoarthritis in the underlying articular cartilage. To perform its crucial function, the meniscus extracellular matrix has a particular organization, including collagen fiber bundles running circumferentially, allowing the tissue to withstand tensile hoop stresses developed during axial loading. Given its critical role in preserving the health of the knee, better understanding structure-function relations of the biomechanical properties of the meniscus is critical. The main objective of this study was to measure the compressive modulus of porcine meniscus using Atomic Force Microscopy (AFM); the effects of three key factors were investigated: direction (axial, circumferential), compartment (medial, lateral) and region (inner, outer). Porcine menisci were prepared in 8 groups (= 2 directions x 2 compartments x 2 regions) with n = 9 per group. A custom AFM was used to obtain force-indentation curves, which were then curve-fit with the Hertz model to determine the tissue's compressive modulus. The compressive modulus ranged from 0.75 to 4.00 MPa across the 8 groups, with an averaged value of 2.04±0.86MPa. Only direction had a significant effect on meniscus compressive modulus (circumferential > axial, p = 0.024), in agreement with earlier studies demonstrating that mechanical properties in the tissue are anisotropic. This behavior is likely the result of the particular collagen fiber arrangement in the tissue and plays a key role in load transmission capability. This study provides important information on the micromechanical properties of the meniscus, which is crucial for understanding tissue pathophysiology, as well as for developing novel treatments for tissue repair
Influence of Caribbean eddies on the Loop current system evolution
No full textThe Loop Current (LC) system dynamics are an essential component of the processes influencing circulation and transport in the Gulf of Mexico (GoM). The LC evolution is influenced by various factors, including the rich eddy field of the region and the flow exchange through the Yucatan Strait with the neighboring Caribbean Sea. These factors contribute to the complexity of the LC and, as a result, to the limitations in the predictability of the system. The focus of this study is to further elucidate the evolution of the LC, by quantifying the influence of coherent eddy fluxes originating in the Caribbean Sea. This is achieved by employing the Lagrangian-Averaged Vorticity Deviation (LAVD) method, an objective metric to evaluate eddy coherence in the Caribbean Sea that allows, for the first time, to quantify at different depths the evolution of coherent Caribbean eddies through the Yucatan Channel towards the GoM. The physical connectivity between the Caribbean Sea and the GoM is addressed using Lagrangian techniques to analyze processes that take place south of the Yucatan Channel and help quantify their strong relationship with the GoM eddy field. Coherent anticyclonic vorticity fluxes, as well as the net coherent anticyclonic volume transport between the Caribbean Sea and the GoM are associated with Loop Current Eddy (LCE) detachments through direct connectivity between the coherent Caribbean anticyclones and the forming LCE. The findings have important implications for understanding and predicting the LC system and the physical connectivity processes between the GoM and the Caribbean Sea
The Spread of Ocean Heat Uptake Efficiency Traced to Ocean Salinity
No full textOcean heat uptake (OHU) plays an important role in determining the rate of surface warming under CO2 forcing. We examined the transient response to CO2 forcing in a set of 30 climate models from Coupled Model Intercomparison Project Phase 6 (CMIP6) and found that the intermodel spread in OHU efficiency largely depends on the base‐state ocean stratification, especially in the Southern Ocean. This dependence is primarily traced to ocean salinity rather than ocean temperature. Models with weaker ocean stratification primarily due to higher upper‐ocean salinity tend to sequester heat into the deeper ocean, leading to a lower rate of surface warming, a primary reason for higher OHU efficiency; the stratification impact on total OHU is secondary. We applied the relationship between salinity and OHU efficiency for an emergent constraint on OHU efficiency, suggesting an OHU efficiency higher than the CMIP6 multimodel average and arguing against models with extremely low efficiency.
Plain Language Summary
Over 90% of the anthropogenic heat due to increased greenhouse gas emissions is stored in the ocean through the so‐called ocean heat uptake (OHU) process. How fast the land and ocean surfaces are warming to a large extent depends on how fast the heat is absorbed into the ocean. The OHU efficiency, defined to describe the ratio of global OHU change to global surface warming, shows a considerable spread among Coupled Model Intercomparison Project Phase 6 (CMIP6) climate models. This spread largely depends on the models' difference in preconditioning ocean stratification as over most ocean weaker stratification indicates more conducive sea waters for OHU. Models' spread in ocean stratification is primarily attributed to ocean salinity—especially in the upper oceans—rather than ocean temperature. Models with higher base‐state upper‐ocean salinity tend to sequester heat into the deeper ocean and thus produce less surface warming, the primary cause of higher OHU efficiency. The physical relationship between ocean salinity and OHU efficiency can be further applied to statistically constrain the latter using the observational salinity data sets. The constraint tends to narrow the uncertainty in OHU efficiency among models and argue that low efficiency models are less realistic.
Key Points
Base‐state ocean salinity rather than temperature dominates stratification impact on climate models' spread in heat uptake efficiency
Ocean stratification impact on heat uptake efficiency is exerted more through the impact on surface warming rate than on heat uptake
Salinity‐based emergent constraint narrows the uncertainty of heat uptake efficiency and argues against climate models with low efficienc
ASO Visual Abstract: Racial Disparity in Pathologic Response Following Neoadjuvant Chemotherapy in Resected Pancreatic Cancer-A Multi-institutional Analysis from the Central Pancreatic Consortium
No full textImpact of a Digital Atopic Dermatitis Educational Intervention on Hispanic Patients and Family Members
No full textWith the increasing incidence of atopic dermatitis (AD) in the U.S., the highest prevalence of AD being found in Hispanic countries, and the rising Hispanic-American population, educational resources on eczema focused on Spanish-speaking populations are needed more than ever. As such, the primary goal of this project was to assess the beneficial impact of an educational intervention conducted through a virtual platform for Hispanic individuals living with atopic dermatitis. Utilizing WhatsApp, the study enrolled 55 participants diagnosed with AD and/or parents of children diagnosed with AD. Participants were enrolled in a seven-day educational module with daily topics on AD health knowledge. A health knowledge survey was administered before the educational program, upon completion of the program, and one month after completion. The program found a 14% increase in AD health knowledge upon completion of the program (
< 0.001). Most importantly, there was no significant difference found between the health knowledge survey submitted at program completion and one month after completion, signaling that health knowledge taught through the course was successfully retained by participants (
= 0.29). Qualitative themes involving atopic disease were additionally explored through group discussions, including mental health and peer stigma. This study is the first of its kind in dermatology utilizing the WhatsApp format. The success of retained health knowledge regarding AD demonstrates that future virtual endeavors can be effective and accessible methods of patient education overall for populations that might not have ease of access to major medical centers
Dixie Myopia in Brazil: Confederado Self-Fashioning and Erasure
No full textIn this dissertation I trace the confederado identity in Brazil from the mid-nineteenth century to the early twenty-first century. The term confederados refers to the ten to twenty-thousand Confederates who fled to Southeastern Brazil at the end of the U.S. Civil War to avoid Reconstruction. This is an anti-racist project that puts current notions of white supremacy in a historical and transnational context. I show how the construct of race has been used by hegemonic discourses to fashion identities (regional and national) by absorbing the legacies of colonialisms and the enslavement of Africans in a plantation economy. My research unsettles the historical erasure built-in to confederado identity and incorporates contemporary Black Brazilian activist voices who call for the Confederate flag’s removal from public spaces and events in the towns of Americana and Santa Bárbara D’Oeste. Chapter One situates the confederado identity from its early imaginings through the propagandist texts which were instrumental in the recruitment for the mass migration to Brazil. Chapter Two examines the confederado identity once installed in Brazil by analyzing representations in testimonials, fiction and film. Chapter Three discusses field research results, including an interpretation of a survey conducted to assess Brazilian perceptions of the confederados, key interviews and a review of a recent public hearing to ban the Confederate flag. My theoretical framework combines Critical Race Studies, Settler Colonialism and Docupoetic Creative Writing Aesthetics, applying Documentary Poetry, as both theory and form in select Creative Writing sections.</p
Examining uncertainty management in the clinical trial experiences of African American and Black Caribbean participants and the coordinators who recruit them
No full textClinical research studies experience low accrual rates for African American and Black Caribbean participants. These low rates could result in treatment regimens that are less effective for these groups. This study applied a communication lens to the decision-making processes that occur when the groups are being recruited for studies. Attention was paid to how participants managed their uncertainty in decision-making. Focus group discussions were conducted with 48 participants, with exclusive groups for African American, Black Caribbean, and clinical research coordinator (CRC) participants. Respondents were asked semi-structured questions. While the CRCs were asked about their practices recruiting within these groups, the patients were asked about their experiences being recruited. Three themes were derived from the data. Participants experienced uncertainty when the quality of information was lacking. Many participants realized they had little knowledge about research and struggled with understanding medical terms; therefore, they sought to manage uncertainty by asking questions. Additionally, participants experienced uncertainty because of sources of uncertainty, including family experiences and historical narratives. Participants also offered strategies for managing uncertainty. For instance, recruiters must incorporate matriarchal figures and use clear information about the purpose, process, and potential outcomes. Altogether, our findings indicate that research on the cause of the low number of African American and Black Caribbean participants in research studies needs to examine how uncertainty is experienced and managed during the research recruitment process.•Study participants become uncertain about research based on the quality of information received.•Participants and their families ask questions about a trial's motives, procedures, and effects.•Family experiences and historical narratives are sources of uncertainty for Black participants.•Black patients defer participation until they witness the study's effects on others.•Maternal figures and simpler language help manage uncertainty in clinical research
Democratizing Public Health: Participatory Policymaking Institutions, Mosquito Control, and Zika in the Americas
No full textThe Zika virus is a mosquito-borne virus spread primarily by
Aedes
mosquitoes. Zika cases have been detected throughout the mosquito’s range, with an epidemic occurring from 2015 to 2017 in Brazil. Many Zika cases are mild or asymptomatic, but infections in pregnant women can cause microcephaly in children, and a small percentage of cases result in Guillan–Barré syndrome. There is currently little systematic information surrounding the municipal spread of the Zika Virus in Brazil. This article uses coarsened exact matching with negative binomial estimation and ordinary least squares estimation to assess the determinants of Zika incidence across the ~280,000 cases confirmed and recorded by Brazil’s Ministry of Health in 2016 and 2017. These data come from Freedom of Information Act (FOIA) requests in Brazil and have not been published. We use data on the universe of individual Zika cases in Brazil and Geographic Information Systems (GIS) software to examine the virus at the municipal level across 5570 municipalities and construct a unique, unusually rich dataset covering daily Zika transmission. Additionally, our dataset includes corresponding local data on democratic governance, mosquito control efforts, and environmental conditions to estimate their relationship to Zika transmission. The results demonstrate that the presence of subnational democratic, participatory policymaking institutions and high levels of local state capacity are associated with low rates of Zika contraction. These models control for local healthcare spending and economic conditions, among other factors, that also influence Zika contraction rates. In turn, these findings provide a better understanding of what works for local health governance and mosquito control and makes important data public so that scholars and practitioners can perform their own analyses. Stronger models of Zika transmission will then inform mosquito abatement efforts across the Global South, as well as provide a blueprint for combatting Dengue fever, which is also transmitted by
Aedes
mosquitoes
Genetic testing for infantile nystagmus syndrome with or without associated findings
No full textTo review the published literature assessing the clinical utility of genetic testing in individuals with infantile nystagmus syndrome (INS), defined as binocular conjugate nystagmus and onset prior to 6 months of age, with or without associated findings.
A literature search was last conducted in October 2022. The results were limited to articles published in English. The search yielded 517 abstracts, of which 72 papers were reviewed in full text. Of these papers, 4 met the criteria for inclusion and were graded by a study methodologist.
The 4 studies that met inclusion criteria used next-generation sequencing with gene panels ranging from 31 to 336 genes. The overall molecular diagnostic rate ranged from 35% to 60% in the included studies, although the yield was higher when genetic testing was guided by clinical phenotyping (approximately 80%) and in the subsets of patients with a family history (up to 88%). As many as 30% of patients tested had a reclassification of the diagnosis based on the genetic testing results.
Genetic testing has the potential to provide a definitive diagnosis and identify treatable conditions in patients presenting with INS, especially when considered in conjunction with clinical phenotyping and family history