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2. Using Overlap Weights to Address Extreme Propensity Scores in Estimating Restricted Mean Counterfactual Survival Times

Author

Cao, Zhiqiang, Ghazi, Lama, Mastrogiacomo, Claudia, Forastiere, Laura, Wilson, F. Perry, and Li, Fan

Subjects
Statistics - Methodology
Abstract

While the inverse probability of treatment weighting (IPTW) is a commonly used approach for treatment comparisons in observational data, the resulting estimates may be subject to bias and excessively large variance when there is lack of overlap in the propensity score distributions. By smoothly down-weighting the units with extreme propensity scores, overlap weighting (OW) can help mitigate the bias and variance issues associated with IPTW. Although theoretical and simulation results have supported the use of OW with continuous and binary outcomes, its performance with right-censored survival outcomes remains to be further investigated, especially when the target estimand is defined based on the restricted mean survival time (RMST)-a clinically meaningful summary measure free of the proportional hazards assumption. In this article, we combine propensity score weighting and inverse probability of censoring weighting to estimate the restricted mean counterfactual survival times, and propose computationally-efficient variance estimators. We conduct simulations to compare the performance of IPTW, trimming, and OW in terms of bias, variance, and 95% confidence interval coverage, under various degrees of covariate overlap. Regardless of overlap, we demonstrate the advantage of OW over IPTW and trimming methods in bias, variance, and coverage when the estimand is defined based on RMST.

Published
2023

13. Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF)

Author

Ghazi, Lama, Desai, Nihar R., Simonov, Michael, Yamamoto, Yu, O'Connor, Kyle D., Riello, Ralph J., Huang, Joanna, Olufade, Temitope, McDermott, James, Inzucchi, Silvio E., Velazquez, Eric J., Wilson, F. Perry, and Ahmad, Tariq

Published
2022
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14. Predicted Cardiovascular Risk by the PREVENT Equations in US Adults With Stage 1 Hypertension.

Author

Muntner, Paul, Jaeger, Byron C., Foti, Kathryn, Ghazi, Lama, Bundy, Joshua D., Ligong Chen, and Safford, Monika M.

Abstract

BACKGROUND: The 2017 American College of Cardiology/American Heart Association blood pressure guideline recommends initiation of antihypertensive medication for adults with stage 1 hypertension (systolic blood pressure, 130-139 mm Hg, or diastolic blood pressure, 80-89 mm Hg) and 10-year atherosclerotic cardiovascular disease (ASCVD) risk ≥10% estimated by the pooled cohort equations (PCEs). In 2023, the American Heart Association published the predicting risk of cardiovascular disease events (PREVENT) equations to estimate ASCVD and total cardiovascular disease risk. METHODS: We analyzed US National Health and Nutrition Examination Survey data from 2013 to 2020 for 1703 adults aged 30 to 79 years without self-reported cardiovascular disease with stage 1 hypertension. We estimated 10-year ASCVD risk by the PCEs and 10-year ASCVD and total cardiovascular disease risk by the base PREVENT equations. Analyses were weighted to represent noninstitutionalized US adults with stage 1 hypertension. RESULTS: Mean 10-year ASCVD risk was 5.4% (95% CI, 5.0%-5.9%) and 2.9% (95% CI, 2.7%-3.1%) using the PCEs and PREVENT equations, respectively. The proportion with 10-year ASCVD risk of 10% to <15% and ≥15% was 8.1% and 7.8% estimated by the PCEs, respectively, and 3.0% and 0.3% estimated by the PREVENT equations, respectively. No participants had a 10-year ASCVD risk ≥10% on the PREVENT equations and <10% on the PCEs, while 12.5% had a 10-year ASCVD risk ≥10% on the PCEs and <10% on the PREVENT equations. The mean 10-year total cardiovascular disease risk estimated by the PREVENT equations was lower than the mean 10-year ASCVD risk on the PCEs. CONCLUSIONS: Among US adults with stage 1 hypertension, the 10-year predicted ASCVD risk estimated by the PREVENT equations was approximately half the risk estimated by the PCEs. [ABSTRACT FROM AUTHOR]

Published
2024
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15. The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association.

Author

Bress, Adam P., Anderson, Timothy S., Flack, John M., Ghazi, Lama, Hall, Michael E., Laffer, Cheryl L., Still, Carolyn H., Taler, Sandra J., Zachrison, Kori S., and Chang, Tara I.

Abstract

Over the past 3 decades, a substantial body of high-quality evidence has guided the diagnosis and management of elevated blood pressure (BP) in the outpatient setting. In contrast, there is a lack of comparable evidence for guiding the management of elevated BP in the acute care setting, resulting in significant practice variation. Throughout this scientific statement, we use the terms acute care and inpatient to refer to care received in the emergency department and after admission to the hospital. Elevated inpatient BP is common and can manifest either as asymptomatic or with signs of new or worsening target-organ damage, a condition referred to as hypertensive emergency. Hypertensive emergency involves acute target-organ damage and should be treated swiftly, usually with intravenous antihypertensive medications, in a closely monitored setting. However, the risk-benefit ratio of initiating or intensifying antihypertensive medications for asymptomatic elevated inpatient BP is less clear. Despite this ambiguity, clinicians prescribe oral or intravenous antihypertensive medications in approximately one-third of cases of asymptomatic elevated inpatient BP. Recent observational studies have suggested potential harms associated with treating asymptomatic elevated inpatient BP, which brings current practice into question. Despite the ubiquity of elevated inpatient BPs, few position papers, guidelines, or consensus statements have focused on improving BP management in the acute care setting. Therefore, this scientific statement aims to synthesize the available evidence, provide suggestions for best practice based on the available evidence, identify evidence-based gaps in managing elevated inpatient BP (asymptomatic and hypertensive emergency), and highlight areas requiring further research. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Trends in the Prevalence of Multiple Chronic Conditions Among US Adults With Hypertension From 1999–2000 Through 2017–2020.

Author

Alanaeme, Chibuike J, Ghazi, Lama, Akinyelure, Oluwasegun P, Wen, Ying, Christenson, Ashley, Poudel, Bharat, Dooley, Erin E, Chen, Ligong, Hardy, Shakia T, Foti, Kathryn, Bowling, C Barrett, Long, Michelle T, Colantonio, Lisandro D, and Muntner, Paul

Subjects
CHRONIC diseases, DYSLIPIDEMIA, HEALTH & Nutrition Examination Survey, HYPERTENSION, HEPATITIS B, CHRONIC kidney failure, ADULTS
Abstract

BACKGROUND The prevalence of many chronic conditions has increased among US adults. Many adults with hypertension have other chronic conditions. METHODS We estimated changes in the age-adjusted prevalence of multiple (≥3) chronic conditions, not including hypertension, using data from the National Health and Nutrition Examination Survey, from 1999–2000 to 2017–2020, among US adults with (n = 24,851) and without (n = 24,337 hypertension. Hypertension included systolic blood pressure (BP) ≥130 mm Hg, diastolic BP ≥80 mm Hg, or antihypertensive medication use. We studied 14 chronic conditions: arthritis, asthma, cancer, coronary heart disease, chronic kidney disease, depression, diabetes, dyslipidemia, hepatitis B, hepatitis C, heart failure, lung disease, obesity, and stroke. RESULTS From 1999–2000 to 2017–2020, the age-adjusted mean number of chronic conditions increased more among US adults with vs. without hypertension (2.2 to 2.8 vs. 1.7 to 2.0; P -interaction <0.001). Also, the age-adjusted prevalence of multiple chronic conditions increased from 39.0% to 52.0% among US adults with hypertension and from 26.0% to 30.0% among US adults without hypertension (P -interaction = 0.022). In 2017–2020, after age, gender, and race/ethnicity adjustment, US adults with hypertension were 1.94 (95% confidence interval: 1.72–2.18) times as likely to have multiple chronic conditions compared to those without hypertension. In 2017–2020, dyslipidemia, obesity, and arthritis were the most common 3 co-occurring chronic conditions among US adults with and without hypertension (age-adjusted prevalence 16.5% and 3.1%, respectively). CONCLUSIONS In 2017–2020, more than half of US adults with hypertension had ≥3 additional chronic conditions, a substantial increase from 20 years ago. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Trends in All-Cause, Cardiovascular, and Noncardiovascular Mortality Among US Adults With Hypertension.

Author

Choi, Eunhee, Shimbo, Daichi, Chen, Ligong, Foti, Kathryn, Ghazi, Lama, Hardy, Shakia T., and Muntner, Paul

Abstract

BACKGROUND: Death certificate data indicate that hypertension may have increased as a contributing cause of death among US adults. Hypertension is not commonly recorded on death certificates although it contributes to a substantial proportion of cardiovascular disease (CVD) deaths. METHODS: We estimated changes in all-cause, CVD, and non-CVD mortality over 5 years of follow-up among 4 cohorts of US adults with hypertension using mortality follow-up data from National Health and Nutrition Examination Survey III in 1988 to 1994, and National Health and Nutrition Examination Survey cycles from 1999 to 2000 through 2015 to 2016 (n=20 927). Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or antihypertensive medication use. Participants were grouped according to the date of their National Health and Nutrition Examination Survey study visit (1988–1994, 1999–2004, 2005–2010, 2011–2016). RESULTS: There were 2646, 1048, and 1598 all-cause, CVD, and non-CVD deaths, respectively. After age, gender, and race/ethnicity adjustment and compared with the 1988 to 1994 cohort, the hazard ratio of all-cause mortality was 0.88 (95% CI, 0.76–1.01) for the 1999 to 2004 cohort, 0.82 (95% CI, 0.70–0.95) for the 2005 to 2010 cohort, and 0.89 (95% CI, 0.75–1.05) for the 2011 to 2016 cohort (P trend=0.123). The age, gender, and race/ethnicity-adjusted hazard ratios for CVD mortality compared with the 1988 to 1994 cohort were 0.74 (95% CI, 0.60–0.90) for the 1999 to 2004 cohort, 0.61 (95% CI, 0.50–0.74) for the 2005 to 2010 cohort, and 0.57 (95% CI, 0.44–0.74) for the 2011 to 2016 cohort (P trend <0.001). There was no evidence of a change in CVD mortality between the 2005 to 2010 and 2011 to 2016 cohorts (P =0.661). Noncardiovascular mortality did not decline over the study period (P trend=0.145). CONCLUSIONS: The decline in CVD mortality among US adults with hypertension stalled after 2005 to 2010. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Correlates of Spontaneous Blood Pressure Reduction Following Severe Inpatient Hypertension Development.

Author

Garg, Kanika, Staunton, Mary Kate, Peixoto, Aldo J, Wilson, Francis Perry, and Ghazi, Lama

Subjects
BLOOD pressure, BULLOUS pemphigoid, HYPERTENSION, ANTIHYPERTENSIVE agents, DEMOGRAPHIC characteristics, ODDS ratio
Abstract

BACKGROUND Severe hypertension (sHTN) is prevalent in 10% of hospitalized patients and treatment guidelines are lacking. As such, patients who develop sHTN might unnecessarily receive antihypertensive medications which could lead to worse outcomes. Our goal was to investigate correlates of spontaneous blood pressure (BP) reduction to help guide future treatment decisions and avoid harm associated with aggressive BP treatment. METHODS This is a retrospective cohort study of hospitalized adults between 2016 and 2020 who developed sHTN, SBP >180 or DBP >110 mm Hg, after admission. Spontaneous BP reduction was defined as a SBP <160 and a DBP <100 mm Hg achieved within 3 h of sHTN in the absence of antihypertensive therapy. Multivariable logistic regression was used to identify correlates of spontaneous BP reduction. RESULTS Of the 12,825 patients who developed sHTN, 44.2% had spontaneous BP reduction. After adjustment, we found that patients most likely to experience a BP drop received steroids before onset of sHTN (Odds ratio [OR]: 1.3 [1.09, 1.56]), had higher potassium levels on admission (OR: 1.2 [1.09, 1.24]) and were more likely to have a history of chronic pulmonary disease (OR: 1.1 [1.01, 1.18]) or cardiac arrythmia (OR: 1.1 [1.01, 1.18]). While numerically different, these differences were not clinically relevant. CONCLUSIONS Our findings indicate that almost half the patients who develop sHTN have spontaneous BP reduction. Conventional clinical and demographic characteristics were not strong predictors of spontaneous BP reduction following sHTN development. More research is needed to confirm our findings and help guide treatment of sHTN. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use

Author

Clark, Katherine A.A., primary, Victoria-Castro, Angela M., additional, Ghazi, Lama, additional, Yamamoto, Yu, additional, Coronel-Moreno, Claudia, additional, Kadhim, Bashar Adel, additional, Riello, Ralph J., additional, O’Connor, Kyle, additional, Ahmad, Tariq, additional, Wilson, F. Perry, additional, and Desai, Nihar R., additional

Published
2023
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30. Antihypertensive medication persistence and adherence among non-Hispanic Asian US patients with hypertension and fee-for-service Medicare health insurance.

Author

Choi, Eunhee, Mizuno, Hiroyuki, Wang, Zhixin, Fang, Chloe, Mefford, Matthew T., Reynolds, Kristi, Ghazi, Lama, Shimbo, Daichi, and Muntner, Paul

Subjects
ANTIHYPERTENSIVE agents, ETHNICITY, PATIENT compliance, ASIANS, HYPERTENSION, HEALTH insurance
Abstract

Background: Less than 50% of non-Hispanic Asian adults taking antihypertensive medication have controlled blood pressure. Methods: We compared non-persistence and low adherence to antihypertensive medication between non-Hispanic Asian and other race/ethnicity groups among US adults ≥66 years who initiated antihypertensive medication between 2011 and 2018 using a 5% random sample of Medicare beneficiaries (non-Hispanic Asian, n = 2,260; non-Hispanic White, n = 56,000; non-Hispanic Black, n = 5,792; Hispanic, n = 4,212; and Other, n = 1,423). Non-persistence was defined as not having antihypertensive medication available to take in the last 90 of 365 days following treatment initiation. Low adherence was defined as having antihypertensive medication available to take on <80% of the 365 days following initiation. Results: In 2011–2012, 2013–2014, 2015–2016 and 2017–2018, the proportion of non-Hispanic Asian Medicare beneficiaries with non-persistence was 29.1%, 25.6%, 25.4% and 26.7% (p-trend = 0.381), respectively, and the proportion with low adherence was 58.1%, 54.2%, 53.4% and 51.6%, respectively (p-trend = 0.020). In 2017–2018, compared with non-Hispanic Asian beneficiaries, non-persistence was less common among non-Hispanic White beneficiaries (risk ratio 0.74 [95%CI, 0.64–0.85]), non-Hispanic Black beneficiaries (0.80 [95%CI 0.68–0.94]) and those reporting Other race/ethnicity (0.68 [95%CI, 0.54–0.85]) but not among Hispanic beneficiaries (1.04 [95%CI, 0.88–1.23]). Compared to non-Hispanic Asian beneficiaries, non-Hispanic White beneficiaries and beneficiaries reporting Other race/ethnicity were less likely to have low adherence to antihypertensive medication (relative risk 0.78 [95%CI 0.72–0.84] and 0.84 [95%CI 0.74–0.95], respectively); there was no association for non-Hispanic Black or Hispanic beneficiaries. Conclusions: Non-persistence and low adherence to antihypertensive medication were more common among older non-Hispanic Asian than non-Hispanic White adults. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Orthostatic Hypotension in Adults With Hypertension: A Scientific Statement From the American Heart Association.

Author

Juraschek, Stephen P., Cortez, Melissa M., Flack, John M., Ghazi, Lama, Kenny, Rose Anne, Rahman, Mahboob, Spikes, Telisa, Shibao, Cyndya A., and Biaggioni, Italo

Abstract

Although orthostatic hypotension (OH) has long been recognized as a manifestation of autonomic dysfunction, a growing body of literature has identified OH as a common comorbidity of hypertension. This connection is complex, related to pathophysiology in blood pressure regulation and the manner by which OH is derived as the difference between 2 blood pressure measurements. While traditional therapeutic approaches to OH among patients with neurodegenerative disorders focus on increasing upright blood pressure to prevent cerebral hypoperfusion, the management of OH among patients with hypertension is more nuanced; resting hypertension is itself associated with adverse outcomes among these patients. Although there is substantial evidence that intensive blood pressure treatment does not cause OH in the majority of patients with essential hypertension, some classes of antihypertensive agents may unmask OH in patients with an underlying autonomic impairment. Practical steps to manage OH among adults with hypertension start with (1) a thorough characterization of its patterns, triggers, and cause; (2) review and removal of aggravating factors (often pharmacological agents not related to hypertension treatment); (3) optimization of an antihypertensive regimen; and (4) adoption of a tailored treatment strategy that avoids exacerbating hypertension. These strategies include countermaneuvers and short-acting vasoactive agents (midodrine, droxidopa). Ultimately, further research is needed on the epidemiology of OH, the impact of hypertension treatment on OH, approaches to the screening and diagnosis of OH, and OH treatment among adults with hypertension to improve the care of these patients and their complex blood pressure pathophysiology. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial

Author

Ghazi, Lama, primary, Yamamoto, Yu, additional, Fuery, Michael, additional, O’Connor, Kyle, additional, Sen, Sounok, additional, Samsky, Marc, additional, Riello, Ralph J, additional, Dhar, Ravi, additional, Huang, Joanna, additional, Olufade, Temitope, additional, McDermott, James, additional, Inzucchi, Silvio E, additional, Velazquez, Eric J, additional, Wilson, Francis Perry, additional, Desai, Nihar R, additional, and Ahmad, Tariq, additional

Published
2023
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37. Identifying Patients for Intensive Blood Pressure Treatment Based on Cognitive Benefit

Author

Ghazi, Lama, primary, Shen, Jincheng, additional, Ying, Jian, additional, Derington, Catherine G., additional, Cohen, Jordana B., additional, Marcum, Zachary A., additional, Herrick, Jennifer S., additional, King, Jordan B., additional, Cheung, Alfred K., additional, Williamson, Jeff D., additional, Pajewski, Nicholas M., additional, Bryan, Nick, additional, Supiano, Mark, additional, Sonnen, Josh, additional, Weintraub, William S., additional, Greene, Tom H., additional, and Bress, Adam P., additional

Published
2023
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38. Critical illness myopathy and trajectory of recovery in acute kidney injury requiring continuous renal replacement therapy: a prospective observational trial protocol

Author

Teixeira, J Pedro, primary, Griffin, Benjamin R, additional, Pal, Chaitanya Anil, additional, González-Seguel, Felipe, additional, Jenkins, Nathanial, additional, Jones, Beth M, additional, Yoshida, Yuri, additional, George, Naomi, additional, Israel, Hayley Puffer, additional, Ghazi, Lama, additional, Neyra, Javier A, additional, and Mayer, Kirby P, additional

Published
2023
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41. Abstract P383: Trends in Multimorbidity Among U.S. Adults With and Without Hypertension, 1999-2000 to 2017-2020

Author

Alanaeme, Chibuike J, primary, Akinyelure, Oluwasegun P, additional, Wen, Ying, additional, Christenson, Ashley, additional, Poudel, Bharat, additional, Hardy, Shakia T, additional, Foti, Kathryn, additional, Ghazi, Lama, additional, Bowling, Christopher B, additional, Long, Michelle, additional, Colantonio, Lisandro, additional, and Muntner, Paul, additional

Published
2023
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45. Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure

Author

Ahmad, Tariq, primary, Desai, Nihar R., additional, Yamamoto, Yu, additional, Biswas, Aditya, additional, Ghazi, Lama, additional, Martin, Melissa, additional, Simonov, Michael, additional, Dhar, Ravi, additional, Hsiao, Allen, additional, Kashyap, Nitu, additional, Allen, Larry, additional, Velazquez, Eric J., additional, and Wilson, F. Perry, additional

Published
2022
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49. Kidney Disease, Hypertension Treatment, and Cerebral Perfusion and Structure

Author

Kurella Tamura, Manjula, primary, Gaussoin, Sarah, additional, Pajewski, Nicholas M., additional, Zaharchuk, Greg, additional, Freedman, Barry I., additional, Rapp, Stephen R., additional, Auchus, Alexander P., additional, Haley, William E., additional, Oparil, Suzanne, additional, Kendrick, Jessica, additional, Roumie, Christianne L., additional, Beddhu, Srinivasan, additional, Cheung, Alfred K., additional, Williamson, Jeff D., additional, Detre, John A., additional, Dolui, Sudipto, additional, Bryan, R. Nick, additional, Nasrallah, Ilya M., additional, Whelton, Paul, additional, Johnson, Karen C., additional, Snyder, Joni, additional, Bild, Diane, additional, Bonds, Denise, additional, Cook, Nakela, additional, Cutler, Jeffrey, additional, Fine, Lawrence, additional, Kaufmann, Peter, additional, Kimmel, Paul, additional, Launer, Lenore, additional, Moy, Claudia, additional, Riley, William, additional, Ryan, Laurie, additional, Tolunay, Eser, additional, Yang, Song, additional, Reboussin, David, additional, Williamson, Jeff, additional, Ambrosius, Walter T., additional, Applegate, William, additional, Evans, Greg, additional, Foy, Capri, additional, Kitzman, Dalane, additional, Lyles, Mary, additional, Pajewski, Nick, additional, Rapp, Steve, additional, Rushing, Scott, additional, Shah, Neel, additional, Sink, Kaycee M., additional, Vitolins, Mara, additional, Wagenknecht, Lynne, additional, Wilson, Valerie, additional, Perdue, Letitia, additional, Woolard, Nancy, additional, Craven, Tim, additional, Garcia, Katelyn, additional, Lovato, Laura, additional, Newman, Jill, additional, Lovato, James, additional, Lu, Lingyi, additional, McLouth, Chris, additional, Russell, Greg, additional, Amoroso, Bobby, additional, Davis, Patty, additional, Griffin, Jason, additional, Harris, Darrin, additional, King, Mark, additional, Lane, Kathy, additional, Roberson, Wes, additional, Steinberg, Debbie, additional, Ashford, Donna, additional, Babcock, Phyllis, additional, Chamberlain, Dana, additional, Christensen, Vickie, additional, Cloud, Loretta, additional, Collins, Christy, additional, Cook, Delilah, additional, Currie, Katherine, additional, Felton, Debbie, additional, Harpe, Stacy, additional, Howard, Marjorie, additional, Lewis, Michelle, additional, Nance, Pamela, additional, Puccinelli-Ortega, Nicole, additional, Russell, Laurie, additional, Walker, Jennifer, additional, Craven, Brenda, additional, Goode, Candace, additional, Troxler, Margie, additional, Davis, Janet, additional, Hutchens, Sarah, additional, Killeen, Anthony A., additional, Lukkari, Anna M., additional, Ringer, Robert, additional, Dillard, Brandi, additional, Archibeque, Norbert, additional, Warren, Stuart, additional, Sather, Mike, additional, Pontzer, James, additional, Taylor, Zach, additional, Soliman, Elsayed Z., additional, Zhang, Zhu-Ming, additional, Li, Yabing, additional, Campbell, Chuck, additional, Hensley, Susan, additional, Hu, Julie, additional, Keasler, Lisa, additional, Barr, Mary, additional, Taylor, Tonya, additional, Davatzikos, Christos, additional, Nasarallah, Ilya, additional, Desiderio, Lisa, additional, Elliott, Mark, additional, Borthakur, Ari, additional, Battapady, Harsha, additional, Erus, Guray, additional, Smith, Alex, additional, Wang, Ze, additional, Doshi, Jimit, additional, Wright, Jackson T., additional, Rahman, Mahboob, additional, Lerner, Alan J., additional, Still, Carolyn, additional, Wiggers, Alan, additional, Zamanian, Sara, additional, Bee, Alberta, additional, Dancie, Renee, additional, Thomas, George, additional, Schreiber, Martin, additional, Navaneethan, Sankar Dass, additional, Hickner, John, additional, Lioudis, Michael, additional, Lard, Michelle, additional, Marczewski, Susan, additional, Maraschky, Jennifer, additional, Colman, Martha, additional, Aaby, Andrea, additional, Payne, Stacey, additional, Ramos, Melanie, additional, Horner, Carol, additional, Drawz, Paul, additional, Raghavendra, Pratibha P., additional, Ober, Scott, additional, Mourad, Ronda, additional, Pallaki, Muralidhar, additional, Russo, Peter, additional, Raghavendra, Pratibha, additional, Fantauzzo, Pual, additional, Tucker, Lisa, additional, Schwing, Bill, additional, Sedor, John R., additional, Horwitz, Edward J., additional, Schellling, Jeffrey R., additional, O’Toole, John F., additional, Humbert, Lisa, additional, Tutolo, Wendy, additional, White, Suzanne, additional, Gay, Alishea, additional, Clark, Walter, additional, Hughes, Robin, additional, Dobre, Mirela, additional, Still, Carolyn H., additional, Williams, Monique, additional, Bhatt, Udayan, additional, Hebert, Lee, additional, Agarwal, Anil, additional, Murphy, Melissa Brown, additional, Ford, Nicole, additional, Stratton, Cynthia, additional, Baxter, Jody, additional, Lykins, Alicia A., additional, McKinley Neal Leena Hirmath, Alison, additional, Kwame, Osei, additional, Soe, Kyaw, additional, Miser, William F., additional, Sagrilla, Colleen, additional, Johnston, Jan, additional, Anaya, Amber, additional, Mintos, Ashley, additional, Howell, Angel A., additional, Rogers, Kelly, additional, Taylor, Sara, additional, Ebersbacher, Donald, additional, Long, Lucy, additional, Bednarchik, Beth, additional, Schnall, Adrian, additional, Smith, Jonathan, additional, Peysha, Lori, additional, Leach, Lisa, additional, Tribout, Megan, additional, Harwell, Carla, additional, Ellington, Pinkie, additional, Banerji, Mary Ann, additional, Ghody, Pranav, additional, Rambaud, Melissa Vahídeh, additional, Townsend, Raymond, additional, Cohen, Debbie, additional, Huan, Yonghong, additional, Duckworth, Mark, additional, Ford, Virginia, additional, Leshner, Juliet, additional, Davison, Ann, additional, Veen, Sarah Vander, additional, Gadegbeku, Crystal A., additional, Gillespie, Avi, additional, Paranjape, Anuradha, additional, Amoroso, Sandra, additional, Pfeffer, Zoe, additional, Quinn, Sally B., additional, He, Jiang, additional, Chen, Jing, additional, Lustigova, Eva, additional, Malone, Erin, additional, Krousel-Wood, Marie, additional, Deichmann, Richard, additional, Ronney, Patricia, additional, Muery, Susan, additional, Trapani, Donnalee, additional, Rocco, Michael, additional, Goff, David, additional, Rodriguez, Carlos, additional, Coker, Laura, additional, Hawfield, Amret, additional, Yeboah, Joseph, additional, Crago, Lenore, additional, Summerson, John, additional, Hege, Anita, additional, Diamond, Matt, additional, Mulloy, Laura, additional, Hodges, Marcela, additional, Collins, Michelle, additional, Weathers, Charlene, additional, Anderson, Heather, additional, Stone, Emily, additional, Walker, Walida, additional, McWilliams, Andrew, additional, Dulin, Michael, additional, Kuhn, Lindsay, additional, Standridge, Susan, additional, Lowe, Lindsay, additional, Everett, Kelly, additional, Preston, Kelry, additional, Norton, Susan, additional, Gaines, Silena, additional, Rizvi, Ali A., additional, Sides, Andrew W., additional, Herbert, Diamond, additional, Hix, Matthew M., additional, Whitmire, Melanie, additional, Arnold, Brittany, additional, Hutchinson, Philip, additional, Espiritu, Joseph, additional, Feinglos, Mark, additional, Kovalik, Eugene, additional, Gedon-Lipscomb, Georgianne, additional, Evans, Kathryn, additional, Thacker, Connie, additional, Zimmer, Ronna, additional, Furst, Mary, additional, Mason, MaryAnn, additional, Powell, James, additional, Bolin, Paul, additional, Zhang, Junhong, additional, Pinion, Mary, additional, Davis, Gail, additional, Bryant, Winifred, additional, Phelps, Presley, additional, Garris-Sutton, Connie, additional, Atkinson, Beatrice, additional, Contreras, Gabriele, additional, Suarez, Maritza, additional, Schulman, Ivonne, additional, Koggan, Don, additional, Vassallo, Jackie, additional, Peruyera, Gloria, additional, Whittington, Sheri, additional, Bethea, Cassandra, additional, Gilliam, Laura, additional, Pedley, Carolyn, additional, Zurek, Geraldine, additional, Baird, Miriam, additional, Herring, Charles, additional, Smoak, Mary Martha, additional, Williams, Julie, additional, Rogers, Samantha, additional, Gordon, Lindsay, additional, Kennedy, Erin, additional, Belle, Beverly, additional, McCorkle-Doomy, Jessica, additional, Adams, Jonathan, additional, Lopez, Ramon, additional, Janavs, Juris, additional, Rahbari-Oskoui, Frederic, additional, Chapman, Arlene, additional, Dollar, Allen, additional, Williams, Olubunmi, additional, Han, Yoosun, additional, Haley, William, additional, Fitzpatrick, Peter, additional, Blackshear, Joseph, additional, Shapiro, Brian, additional, Harrell, Anna, additional, Palaj, Arta, additional, Henderson, Katelyn, additional, Johnson, Ashley, additional, Gonzalez, Heath, additional, Robinson, Jermaine, additional, Tamariz, Leonardo, additional, Denizard, Jennifer, additional, Barakat, Rody, additional, Krishnamoorthy, Dhurga, additional, Greenway, Frank, additional, Monce, Ron, additional, Church, Timothy, additional, Hendrick, Chelsea, additional, Yoches, Aimee, additional, Sones, Leighanne, additional, Baltazar, Markee, additional, Pemu, Priscilla, additional, Jones, Connie, additional, Akpalu, Derrick, additional, Chelune, Gordon, additional, Childs, Jeffrey, additional, Gren, Lisa, additional, Randall, Anne, additional, Dember, Laura, additional, Soares, Denise, additional, Yee, Jerry, additional, Umanath, Kausik, additional, Ogletree, Naima, additional, Thaxton, Schawana, additional, Campana, Karen, additional, Sheldon, Dayna, additional, MacArthur, Krista, additional, Muhlestein, J. Brent, additional, Allred, Nathan, additional, Clements, Brian, additional, Dhar, Ritesh, additional, Meredith, Kent, additional, Le, Viet, additional, Miner, Edward, additional, Orford, James, additional, Riessen, Erik R., additional, Ballantyne, Becca, additional, Chisum, Ben, additional, Johnson, Kevin, additional, Peeler, Dixie, additional, Chertow, Glenn, additional, Tamura, Manju, additional, Chang, Tara, additional, Erickson, Kevin, additional, Shen, Jenny, additional, Stafford, Randall S., additional, Zaharchuk, Gregory, additional, Del Cid, Margareth, additional, Dentinger, Michelle, additional, Sabino, Jennifer, additional, Sahay, Rukmani, additional, Telminova, Ekaterina, additional, Weiner, Daniel E., additional, Sarnak, Mark, additional, Chan, Lily, additional, Civiletto, Amanda, additional, Heath, Alyson, additional, Kantor, Amy, additional, Jain, Priyanka, additional, Kirkpatrick, Bethany, additional, Well, Andrew, additional, Yuen, Barry, additional, Chonchol, Michel, additional, Farmer, Beverly, additional, Farmer, Heather, additional, Greenwald, Carol, additional, Malaczewski, Mikaela, additional, Lash, James, additional, Porter, Anna, additional, Ricardo, Ana, additional, Rosman, Robert T., additional, Cohan, Janet, additional, Barrera, Nieves Lopez, additional, Meslar, Daniel, additional, Meslar, Patricia, additional, Conroy, Margaret, additional, Unruh, Mark, additional, Hess, Rachel, additional, Jhamb, Manisha, additional, Thomas, Holly, additional, Fazio, Pam, additional, Klixbull, Elle, additional, Komlos-Weimer, Melissa, additional, Mandich, LeeAnne, additional, Vita, Tina, additional, Toto, Robert, additional, Van Buren, Peter, additional, Inrig, Julia, additional, Cruz, Martha, additional, Lightfoot, Tammy, additional, Wang, Nancy, additional, Webster, Lori, additional, Raphael, Kalani, additional, Stults, Barry, additional, Zaman, Tahir, additional, Simmons, Debra, additional, Lavasani, Tooran, additional, Filipowicz, Rebecca, additional, Wei, Guo, additional, Miller, Gracie Mary, additional, Harerra, Jenice, additional, Christensen, Jeff, additional, Giri, Ajay, additional, Chen, Xiaorui, additional, Anderton, Natalie, additional, Jensen, Arianna, additional, Lewis, Julia, additional, Burgner, Anna, additional, Dwyer, Jamie P., additional, Schulman, Gerald, additional, Herrud, Terri, additional, Leavell, Ewanda, additional, McCray, Tiffany, additional, McNeil-Simaan, Edwina, additional, Poudel, Munmun, additional, Reed, Malia, additional, Sika, Mohammed, additional, Woods, Delia, additional, Zirkenbach, Janice L., additional, Raj, Dominic S., additional, Cohen, Scott, additional, Patel, Samir, additional, Velasquez, Manuel, additional, Bastian, Roshni S., additional, Wing, Maria, additional, Roy-Chaudhury, Akshay, additional, Depner, Thomas, additional, Dalyrymple, Lorien, additional, Kaysen, George, additional, Anderson, Susan, additional, Nord, John, additional, Ix, Joachim H., additional, Goldenstein, Leonard, additional, Miracle, Cynthia M., additional, Forbang, Nketi, additional, Mircic, Maja, additional, Thomas, Brenda, additional, Tran, Tiffany, additional, Rastogi, Anjay, additional, Kim, Mihae, additional, Rashid, Mohamad, additional, Lizarraga, Bianca, additional, Hocza, Amy, additional, Sarmosyan, Kristine, additional, Norris, Jason, additional, Sharma, Tushar, additional, Chioy, Amanda, additional, Bernard, Eric, additional, Cabrera, Eleanore, additional, Lopez, Christina, additional, Nunez, Susana, additional, Riad, Joseph, additional, Schweitzer, Suzanne, additional, Sirop, Siran, additional, Thomas, Sarah, additional, Wada, Lauren, additional, Kramer, Holly, additional, Bansal, Vinod, additional, Taylor, Corliss E., additional, Segal, Mark S., additional, Hall, Karen L., additional, Kazory, Amir, additional, Gilbert, Lesa, additional, Owens, Linda, additional, Poulton, Danielle, additional, Whidden, Elaine, additional, Wiggins, Jocelyn, additional, Blaum, Caroline, additional, Nyquist, Linda, additional, Min, Lillian, additional, Gure, Tanya, additional, Lewis, Ruth, additional, Mawby, Jennifer, additional, Robinson, Eileen, additional, Lewis, Cora E., additional, Bradley, Virginia, additional, Calhoun, David, additional, Glasser, Stephen, additional, Jenkins, Kim, additional, Ramsey, Tom, additional, Qureshi, Nauman, additional, Ferguson, Karen, additional, Haider, Sumrah, additional, James, Mandy, additional, Jones, Christy, additional, Renfroe, Kim, additional, Seay, April, additional, Weigart, Carrie, additional, Thornley-Brown, Denyse, additional, Rizik, Dana, additional, Cotton, Bari, additional, Fitz-Gerald, Meredith, additional, Grimes, Tiffany, additional, Johnson, Carolyn, additional, Kennedy, Sara, additional, Mason, Chanel, additional, Rosato-Burson, Lesa, additional, Willingham, Robin, additional, Judd, Eric, additional, Breaux-Shropshire, Tonya, additional, Cook, Felice, additional, Medina, Julia, additional, Ghazi, Lama, additional, Bhatt, Hemal, additional, Lewis, James, additional, Brantley, Roman, additional, Brouilette, John, additional, Glaze, Jeffrey, additional, Hall, Stephanie, additional, Hiott, Nancy, additional, Tharpe, David, additional, Boddy, Spencer, additional, Mack, Catherine, additional, Womack, Catherine, additional, Asao, Keiko, additional, Griffin, Beate, additional, Hendrix, Carol, additional, Johnson, Karen, additional, Jones, Lisa, additional, Towers, Chelsea, additional, Punzi, Henry, additional, Cassidy, Kathy, additional, Schumacher, Kristin, additional, Irizarry, Carmen, additional, Colon, Ilma, additional, Colon-Ortiz, Pedro, additional, Colón-Hernández, Pedro J., additional, Carrasquillo-Navarro, Orlando J., additional, Carrasquillo, Merari, additional, Vazquez, Nivea, additional, Sosa-Padilla, Miguel, additional, Cintron-Pinero, Alex, additional, Ayala, Mayra, additional, Pacheco, Olga, additional, Rivera, Catalina, additional, Sotomayor-Gonzalez, Irma, additional, Claudio, Jamie, additional, Lazaro, Jose, additional, Arce, Migdalia, additional, Heres, Lourdes, additional, Perez, Alba, additional, Tavarez-Valle, Jose, additional, Arocho, Ferlinda, additional, Torres, Mercedes, additional, Vazquez, Melvaliz, additional, Aurigemma, Gerard P., additional, Takis-Smith, Rebecca, additional, Andrieni, Julia, additional, Bodkin, Noelle, additional, Chaudhary, Kiran, additional, Hu, Paula, additional, Kostis, John, additional, Cosgrove, Nora, additional, Bankowski, Denise, additional, Boleyn, Monica, additional, Casazza, Laurie, additional, Giresi, Victoria, additional, Patel, Tosha, additional, Squindo, Erin, additional, Wu, Yan, additional, Henson, Zeb, additional, Wofford, Marion, additional, Lowery, Jessica, additional, Minor, Deborah, additional, Harkins, Kimberley, additional, Auchus, Alexander, additional, Flessner, Michael, additional, Adair, Cathy, additional, Asher, Jordan, additional, Loope, Debbie, additional, Cobb, Rita, additional, Venegas, Reiner, additional, Bigger, Thomas, additional, Bello, Natalie, additional, Homma, Shunichi, additional, Donovan, Daniel, additional, Lopez-Jimenez, Carlos, additional, Tirado, Amilcar, additional, Getaneh, Asqual, additional, Tang, Rocky, additional, Durant, Sabrina, additional, Maurer, Mathew, additional, Teruya, Sergio, additional, Helmke, Stephen, additional, Alvarez, Julissa, additional, Campbell, Ruth, additional, Pisoni, Roberto, additional, Sturdivant, Rachel, additional, Brooks, Deborah, additional, Counts, Caroline, additional, Hunt, Vickie, additional, Spillers, Lori, additional, Brautigam, Donald, additional, Kitchen, Timothy, additional, Gorman, Timothy, additional, Sayers, Jessica, additional, Button, Sarah, additional, Chiarot, June, additional, Fischer, Rosemary, additional, Lyon, Melissa, additional, Resnick, Maria, additional, Hodges, Nicole, additional, Ferreira, Jennifer, additional, Cushman, William, additional, Wall, Barry, additional, Nichols, Linda, additional, Burns, Robert, additional, Martindale-Adams, Jennifer, additional, Berlowitz, Dan, additional, Clark, Elizabeth, additional, Walsh, Sandy, additional, Geraci, Terry, additional, Huff, Carol, additional, Shaw, Linda, additional, Servilla, Karen, additional, Vigil, Darlene, additional, Barrett, Terry, additional, Sweeney, Mary Ellen, additional, Johnson, Rebecca, additional, McConnell, Susan, additional, Salles, Khadijeh Shahid, additional, Watson, Francoise, additional, Schenk, Cheryl, additional, Whittington, Laura, additional, Maher, Maxine, additional, Williams, Jonathan, additional, Swartz, Stephen, additional, Conlin, Paul, additional, Alexis, George, additional, Lamkin, Rebecca, additional, Underwood, Patti, additional, Gomes, Helen, additional, Rosendorff, Clive, additional, Atlas, Stephen, additional, Khan, Saadat, additional, Gonzalez, Waddy, additional, Barcham, Samih, additional, Kwon, Lawrence, additional, Matar, Matar, additional, Adhami, Anwar, additional, Basile, Jan, additional, John, Joseph, additional, Ham, Deborah, additional, Baig, Hadi, additional, Saklayen, Mohammed, additional, Yap, Jason, additional, Neff, Helen, additional, Miller, Carol, additional, Zheng-Phelan, Ling, additional, Gappy, Saib, additional, Rau, Shiva, additional, Raman, Arathi, additional, Berchou, Vicki, additional, Jones, Elizabeth, additional, Olgren, Erin, additional, Marbury, Cynthia, additional, Yudd, Michael, additional, Sastrasinh, Sithiporn, additional, Michaud, Jennine, additional, Fiore, Jessica, additional, Kutza, Marianne, additional, Shorr, Ronald, additional, Mount, Rattana, additional, Dunn, Helen, additional, Stinson, Susan, additional, Hunter, Jessica, additional, Taylor, Addison, additional, Bates, Jeffery, additional, Anderson, Catherine, additional, Kirchner, Kent, additional, Stubbs, Jodi, additional, Hinton, Ardell, additional, Spencer, Anita, additional, Sharma, Santosh, additional, Wiegmann, Thomas, additional, Mehta, Smita, additional, Krause, Michelle, additional, Dishongh, Kate, additional, Childress, Richard, additional, Gyamlani, Geeta, additional, Niakan, Atossa, additional, Thompson, Cathy, additional, Moody, Janelle, additional, Gresham, Carolyn, additional, Whittle, Jeffrey, additional, Barnas, Gary, additional, Wolfgram, Dawn, additional, Cortese, Heidi, additional, Johnson, Jonette, additional, Roumie, Christianne, additional, Hung, Adriana, additional, Wharton, Jennifer, additional, Niesner, Kurt, additional, Katz, Lois, additional, Richardson, Elizabeth, additional, Brock, George, additional, Holland, Joanne, additional, Dixon, Troy, additional, Zias, Athena, additional, Spiller, Christine, additional, Baker, Penelope, additional, Felicetta, James, additional, Rehman, Shakaib, additional, Bingham, Kelli, additional, Watnick, Suzanne, additional, Cohen, David, additional, Weiss, Jessica, additional, Johnston, Tera, additional, Giddings, Stephen, additional, Yamout, Hala, additional, Klein, Andrew, additional, Rowe, Caroline, additional, Vargo, Kristin, additional, Waidmann, Kristi, additional, Papademetriou, Vasilios, additional, Elkhoury, Jean Pierre, additional, Gregory, Barbara, additional, Amodeo, Susan, additional, Bloom, Mary, additional, Goldfarb-Waysman, Dalia, additional, Treger, Richard, additional, Kashefi, Mehran, additional, Huang, Christina, additional, Knibloe, Karen, additional, Ishani, Areef, additional, Slinin, Yelena, additional, Olney, Christine, additional, Rust, Jacqueline, additional, Fanti, Paolo, additional, Dyer, Christopher, additional, Bansal, Shweta, additional, Dunnam, Monica, additional, Hu, Lih-Lan, additional, and Zarate-Abbott, Perla, additional

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2022
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