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1. Nemotron-4 340B Technical Report

Author

Nvidia, Adler, Bo, Agarwal, Niket, Aithal, Ashwath, Anh, Dong H., Bhattacharya, Pallab, Brundyn, Annika, Casper, Jared, Catanzaro, Bryan, Clay, Sharon, Cohen, Jonathan, Das, Sirshak, Dattagupta, Ayush, Delalleau, Olivier, Derczynski, Leon, Dong, Yi, Egert, Daniel, Evans, Ellie, Ficek, Aleksander, Fridman, Denys, Ghosh, Shaona, Ginsburg, Boris, Gitman, Igor, Grzegorzek, Tomasz, Hero, Robert, Huang, Jining, Jawa, Vibhu, Jennings, Joseph, Jhunjhunwala, Aastha, Kamalu, John, Khan, Sadaf, Kuchaiev, Oleksii, LeGresley, Patrick, Li, Hui, Liu, Jiwei, Liu, Zihan, Long, Eileen, Mahabaleshwarkar, Ameya Sunil, Majumdar, Somshubra, Maki, James, Martinez, Miguel, de Melo, Maer Rodrigues, Moshkov, Ivan, Narayanan, Deepak, Narenthiran, Sean, Navarro, Jesus, Nguyen, Phong, Nitski, Osvald, Noroozi, Vahid, Nutheti, Guruprasad, Parisien, Christopher, Parmar, Jupinder, Patwary, Mostofa, Pawelec, Krzysztof, Ping, Wei, Prabhumoye, Shrimai, Roy, Rajarshi, Saar, Trisha, Sabavat, Vasanth Rao Naik, Satheesh, Sanjeev, Scowcroft, Jane Polak, Sewall, Jason, Shamis, Pavel, Shen, Gerald, Shoeybi, Mohammad, Sizer, Dave, Smelyanskiy, Misha, Soares, Felipe, Sreedhar, Makesh Narsimhan, Su, Dan, Subramanian, Sandeep, Sun, Shengyang, Toshniwal, Shubham, Wang, Hao, Wang, Zhilin, You, Jiaxuan, Zeng, Jiaqi, Zhang, Jimmy, Zhang, Jing, Zhang, Vivienne, Zhang, Yian, and Zhu, Chen

Subjects
Computer Science - Computation and Language, Computer Science - Artificial Intelligence, Computer Science - Machine Learning
Abstract

We release the Nemotron-4 340B model family, including Nemotron-4-340B-Base, Nemotron-4-340B-Instruct, and Nemotron-4-340B-Reward. Our models are open access under the NVIDIA Open Model License Agreement, a permissive model license that allows distribution, modification, and use of the models and its outputs. These models perform competitively to open access models on a wide range of evaluation benchmarks, and were sized to fit on a single DGX H100 with 8 GPUs when deployed in FP8 precision. We believe that the community can benefit from these models in various research studies and commercial applications, especially for generating synthetic data to train smaller language models. Notably, over 98% of data used in our model alignment process is synthetically generated, showcasing the effectiveness of these models in generating synthetic data. To further support open research and facilitate model development, we are also open-sourcing the synthetic data generation pipeline used in our model alignment process.

Published
2024

3. Nemotron-4 15B Technical Report

Author

Parmar, Jupinder, Prabhumoye, Shrimai, Jennings, Joseph, Patwary, Mostofa, Subramanian, Sandeep, Su, Dan, Zhu, Chen, Narayanan, Deepak, Jhunjhunwala, Aastha, Dattagupta, Ayush, Jawa, Vibhu, Liu, Jiwei, Mahabaleshwarkar, Ameya, Nitski, Osvald, Brundyn, Annika, Maki, James, Martinez, Miguel, You, Jiaxuan, Kamalu, John, LeGresley, Patrick, Fridman, Denys, Casper, Jared, Aithal, Ashwath, Kuchaiev, Oleksii, Shoeybi, Mohammad, Cohen, Jonathan, and Catanzaro, Bryan

Subjects
Computer Science - Computation and Language, Computer Science - Artificial Intelligence, Computer Science - Machine Learning
Abstract

We introduce Nemotron-4 15B, a 15-billion-parameter large multilingual language model trained on 8 trillion text tokens. Nemotron-4 15B demonstrates strong performance when assessed on English, multilingual, and coding tasks: it outperforms all existing similarly-sized open models on 4 out of 7 downstream evaluation areas and achieves competitive performance to the leading open models in the remaining ones. Specifically, Nemotron-4 15B exhibits the best multilingual capabilities of all similarly-sized models, even outperforming models over four times larger and those explicitly specialized for multilingual tasks.

Published
2024

4. The impact of progesterone level on day of hCG injection in IVF Cycles on clinical pregnancy rate

Author

Jawa Ashmita, Swarankar Vikas, and Garg Swati

Subjects
Clinical pregnancy rate, controlled ovarian hyperstimulation, premature progesterone rise, Gynecology and obstetrics, RG1-991
Abstract

Background: Premature progesterone rise (PPR) has long been implicated as contributing to implantation failure. Despite the use of gonadotropin-releasing hormone (GnRH) analogues, subtle increases in serum progesterone (P4) levels beyond a threshold progesterone concentration were observed on the day of trigger in controlled ovarian hyperstimulation cycles. Aims: The purpose of the study was to evaluate the incidence of PPR on the day of trigger in conventional IVF/ICSI cycles and its impact on clinical pregnancy rate. Settings and Design: A total of 235 patients undergoing conventional IVF/IVF–ICSI by fresh embryo transfer cycles from January 2016 to December 2016 at the infertility unit of a tertiary care hospital were prospectively analyzed. Material and Methods: Patients included in the study were subjected to GnRH agonist long/antagonist protocol. Ovulation induction was given with rFSH and/or HMG in both the protocols. The cutoff for defining PPR was P4≥ 1.5 ng/ml, and an analysis of the role of P4on clinical pregnancy rate was performed. Statistical analysis was performed with the Statistical Package for the Social Sciences trial version 23.0 software for Windows and Primer software. Results and Conclusion: The overall clinical pregnancy rate per embryo transfer was 30.6%. The clinical pregnancy rate in the patients with P4

Published
2017
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5. Surgical and procedural antibiotic prophylaxis in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document.

Author

Farrell, Michael, Agapian, John, Appelbaum, Rachel, Filiberto, Dina, Gelbard, Rondi, Hoth, Jason, Jawa, Randeep, Kirsch, Jordan, Kutcher, Matthew, Nohra, Eden, Pathak, Abhijit, Paul, Jasmeet, Robinson, Bryce, Cuschieri, Joseph, and Stein, Deborah

Subjects
antibiotic prophylaxis, infections
Abstract

The use of prophylactic measures, including perioperative antibiotics, for the prevention of surgical site infections is a standard of care across surgical specialties. Unfortunately, the routine guidelines used for routine procedures do not always account for many of the factors encountered with urgent/emergent operations and critically ill or high-risk patients. This clinical consensus document created by the American Association for the Surgery of Trauma Critical Care Committee is one of a three-part series and reviews surgical and procedural antibiotic prophylaxis in the surgical intensive care unit. The purpose of this clinical consensus document is to provide practical recommendations, based on expert opinion, to assist intensive care providers with decision-making for surgical prophylaxis. We specifically evaluate the current state of periprocedural antibiotic management of external ventricular drains, orthopedic operations (closed and open fractures, silver dressings, local, antimicrobial adjuncts, spine surgery, subfascial drains), abdominal operations (bowel injury and open abdomen), and bedside procedures (thoracostomy tube, gastrostomy tube, tracheostomy).

Published
2024

8. A High Threshold of Biotherapeutic Aggregate Numbers is Needed to Induce an Immunogenic Response In Vitro, In Vivo, and in the Clinic

Author

Cohen, Joseph R., Brych, Stephen R., Prabhu, Siddharth, Bi, Vivian, Elbaradei, Ahmed, Tokuda, Joshua M., Xiang, Cathie, Hokom, Martha, Cui, Xiaohong, Ly, Claudia, Amos, Nathan, Sun, Jilin, Calamba, Dominador, Herskovitz, Jonathan, Capili, Allyson, Nourbakhsh, Kimya, Merlo, Anthony, Carreon, Julia, Wypych, Jette, Narhi, Linda O., Jawa, Vibha, and Joubert, Marisa K.

Published
2024
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9. Community pharmacists’ attitudes toward and practice of pharmacy-based harm reduction services in Pittsburgh, PA: a descriptive survey

Author

Caitlin O’Brien, Stephanie Klipp, Raagini Jawa, and J. Deanna Wilson

Subjects
Harm reduction, Naloxone, Non-prescription needles, Intravenous drug use, Community pharmacy services, Public aspects of medicine, RA1-1270
Abstract

Abstract Background In Pittsburgh, PA, legal changes in recent decades have set the stage for an expanded role for community pharmacists to provide harm reduction services, including distributing naloxone and non-prescription syringes (NPS). In the wake of the syndemics of the COVID-19 pandemic and worsening overdose deaths from synthetic opioids, we examine knowledge, attitudes, and practices of harm reduction services among community pharmacists in Pittsburgh and identify potential barriers of expanded pharmacy-based harm reduction services. Methods We provided flyers to 83 community pharmacies within a 5-mile radius of the University of Pittsburgh Medical Center to recruit practicing community pharmacists to participate in an anonymous electronic survey. We used a 53-question Qualtrics survey consisting of multiple-choice, 5 or 6 point-Likert scale, and open-ended questions adapted from 5 existing survey instruments. Survey measures included demographics, knowledge, attitudes, and practices of harm reduction services (specifically naloxone and NPS provision), and explored self-reported barriers to future implementation. Data was collected July–August 2022. We conducted descriptive analysis using frequencies and proportions reported for categorical variables as well as means and standard deviations (SD) for continuous variables. We analyzed open-ended responses using inductive content analysis. Results Eighty-eight community pharmacists responded to the survey. 90% of participants agreed pharmacists had a role in overdose prevention efforts, and 92% of participants had previously distributed naloxone. Although no pharmacists reported ever refusing to distribute naloxone, only 29% always provided overdose prevention counseling with each naloxone distributed. In contrast, while 87% of participants had positive attitudes toward the usefulness of NPS for reducing disease, only 73% of participants ever distributed NPS, and 54% had refused NPS to a customer. Participants endorsed a lack of time and concerns over clientele who used drugs as the most significant barriers to offering more comprehensive harm reduction services. Conclusions Our findings highlight that while most community pharmacists have embraced naloxone provision, pharmacy policies and individual pharmacists continue to limit accessibility of NPS. Future expansion efforts for pharmacy-based harm reduction services should not only address the time and labor constraints identified by community pharmacists, but also fear-based policy and stigma toward people who inject drugs and harm reduction more broadly.

Published
2024
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13. Crowd-sourced machine learning prediction of long COVID using data from the National COVID Cohort CollaborativeResearch in context

Author

Timothy Bergquist, Johanna Loomba, Emily Pfaff, Fangfang Xia, Zixuan Zhao, Yitan Zhu, Elliot Mitchell, Biplab Bhattacharya, Gaurav Shetty, Tamanna Munia, Grant Delong, Adbul Tariq, Zachary Butzin-Dozier, Yunwen Ji, Haodong Li, Jeremy Coyle, Seraphina Shi, Rachael V. Philips, Andrew Mertens, Romain Pirracchio, Mark van der Laan, John M. Colford, Jr., Alan Hubbard, Jifan Gao, Guanhua Chen, Neelay Velingker, Ziyang Li, Yinjun Wu, Adam Stein, Jiani Huang, Zongyu Dai, Qi Long, Mayur Naik, John Holmes, Danielle Mowery, Eric Wong, Ravi Parekh, Emily Getzen, Jake Hightower, Jennifer Blase, Ataes Aggarwal, Joseph Agor, Amera Al-Amery, Oluwatobiloba Aminu, Adit Anand, Corneliu Antonescu, Mehak Arora, Sayed Asaduzzaman, Tanner Asmussen, Mahdi Baghbanzadeh, Frazier Baker, Bridget Bangert, Laila Bekhet, Jenny Blase, Brian Caffo, Hao Chang, Zeyuan Chen, Jiandong Chen, Jeffrey Chiang, Peter Cho, Robert Cockrell, Parker Combs, Ciara Crosby, Ran Dai, Anseh Danesharasteh, Elif Yildirim, Ryan Demilt, Kaiwen Deng, Sanjoy Dey, Rohan Dhamdhere, Andrew Dickson, Phoebe Dijour, Dong Dinh, Richard Dixon, Albi Domi, Souradeep Dutta, Mirna Elizondo, Zeynep Ertem, Solomon Feuerwerker, Danica Fliss, Jennifer Fowler, Sunyang Fu, Kelly Gardner, Neil Getty, Mohamed Ghalwash, Logan Gloster, Phil Greer, Yuanfang Guan, Colby Ham, Samer Hanoudi, Jeremy Harper, Nathaniel Hendrix, Leeor Hershkovich, Junjie Hu, Yu Huang, Tongtong Huang, Junguk Hur, Monica Isgut, Hamid Ismail, Grant Izmirlian, Kuk Jang, Christianah Jemiyo, Hayoung Jeong, Xiayan Ji, Ming Jiang, Sihang Jiang, Xiaoqian Jiang, Yuye Jiang, Akin Johnson, Zach Analyst, Saarthak Kapse, Uri Kartoun, Dukka KC, Zahra Fard, Tim Kosfeld, Spencer Krichevsky, Mike Kuo, Dale Larie, Lauren Lederer, Shan Leng, Hongyang Li, Jianfu Li, Tiantian Li, Xinwen Liang, Hengyue Liang, Feifan Liu, Daniel Liu, Gang Luo, Ravi Madduri, Vithal Madhira, Shivali Mani, Farzaneh Mansourifard, Robert Matson, Vangelis Metsis, Pablo Meyer, Catherine Mikhailova, Dante Miller, Christopher Milo, Gourav Modanwal, Ronald Moore, David Morgenthaler, Rasim Musal, Vinit Nalawade, Rohan Narain, Saideep Narendrula, Alena Obiri, Satoshi Okawa, Chima Okechukwu, Toluwanimi Olorunnisola, Tim Ossowski, Harsh Parekh, Jean Park, Saaya Patel, Jason Patterson, Chetan Paul, Le Peng, Diana Perkins, Suresh Pokharel, Dmytro Poplavskiy, Zach Pryor, Sarah Pungitore, Hong Qin, Salahaldeen Rababa, Mahbubur Rahman, Elior Rahmani, Gholamali Rahnavard, Md Raihan, Suraj Rajendran, Sarangan Ravichandran, Chandan Reddy, Abel Reyes, Ali Roghanizad, Sean Rouffa, Xiaoyang Ruan, Arpita Saha, Sahil Sawant, Melody Schiaffino, Diego Seira, Saurav Sengupta, Ruslan Shalaev, Linh Shinguyen, Karnika Singh, Soumya Sinha, Damien Socia, Halen Stalians, Charalambos Stavropoulos, Jan Strube, Devika Subramanian, Jiehuan Sun, Ju Sun, Chengkun Sun, Prathic Sundararajan, Salmonn Talebi, Edward Tawiah, Jelena Tesic, Mikaela Thiess, Raymond Tian, Luke Torre-Healy; Ming-Tse Tsai, David Tyus, Madhurima Vardhan, Benjamin Walzer, Jacob Walzer, Junda Wang, Lu Wang, Will Wang, Jonathan Wang, Yisen Wang, Chad Weatherly, Fanyou Wu, Yifeng Wu, Hao Yan, Zhichao Yang, Biao Ye, Rui Yin, Changyu Yin, Yun Yoo, Albert You, June Yu, Martin Zanaj, Zachary Zaiman, Kai Zhang, Xiaoyi Zhang, Tianmai Zhang, Degui Zhi, Yishan Zhong, Huixue Zhou, Andrea Zhou, Yuanda Zhu, Sophie Zhu, Meredith Adams, Caleb Alexander, Benjamin Amor, Alfred Anzalone, Benjamin Bates, Will Beasley, Tellen Bennett, Mark Bissell, Eilis Boudreau, Samuel Bozzette, Katie Bradwell, Carolyn Bramante, Don Brown, Penny Burgoon, John Buse, Tiffany Callahan, Kenrick Cato, Scott Chapman, Christopher Chute, Jaylyn Clark, Marshall Clark, Will Cooper, Lesley Cottrell, Karen Crowley, Mariam Deacy, Christopher Dillon, David Eichmann, Mary Emmett, Rebecca Erwin-Cohen, Patricia Francis, Evan French, Rafael Fuentes, Davera Gabriel, Joel Gagnier, Nicole Garbarini, Jin Ge, Kenneth Gersing, Andrew Girvin, Valery Gordon, Alexis Graves, Justin Guinney, Melissa Haendel, J.W. Hayanga, Brian Hendricks, Wenndy Hernandez, Elaine Hill, William Hillegass, Stephanie Hong, Dan Housman, Robert Hurley, Jessica Islam, Randeep Jawa, Steve Johnson, Rishi Kamaleswaran, Warren Kibbe, Farrukh Koraishy, Kristin Kostka, Michael Kurilla, Adam Lee, Harold Lehmann, Hongfang Liu, Charisse Madlock-Brown; Sandeep Mallipattu, Amin Manna, Federico Mariona, Emily Marti, Greg Martin, Jomol Mathew, Diego Mazzotti, Julie McMurry, Hemalkumar Mehta, Sam Michael, Robert Miller, Leonie Misquitta, Richard Moffitt, Michele Morris, Kimberly Murray, Lavance Northington, Shawn O’Neil, Amy Olex, Matvey Palchuk, Brijesh Patel, Rena Patel, Philip Payne, Jami Pincavitch, Lili Portilla, Fred Prior, Saiju Pyarajan, Lee Pyles, Nabeel Qureshi, Peter Robinson, Joni Rutter, Ofer Sadan, Nasia Safdar, Amit Saha, Joel Saltz, Mary Saltz, Clare Schmitt, Soko Setoguchi, Noha Sharafeldin, Anjali Sharathkumar, Usman Sheikh, Hythem Sidky, George Sokos, Andrew Southerland, Heidi Spratt, Justin Starren, Vignesh Subbian, Christine Suver, Cliff Takemoto, Meredith Temple-O'Connor, Umit Topaloglu, Satyanarayana Vedula, Anita Walden, Kellie Walters, Cavin Ward-Caviness, Adam Wilcox, Ken Wilkins, Andrew Williams, Chunlei Wu, Elizabeth Zampino, Xiaohan Zhang, and Richard Zhu

Subjects
Long COVID, PASC, Machine learning, COVID-19, Evaluation, Community challenge, Medicine, Medicine (General), R5-920
Abstract

Summary: Background: While many patients seem to recover from SARS-CoV-2 infections, many patients report experiencing SARS-CoV-2 symptoms for weeks or months after their acute COVID-19 ends, even developing new symptoms weeks after infection. These long-term effects are called post-acute sequelae of SARS-CoV-2 (PASC) or, more commonly, Long COVID. The overall prevalence of Long COVID is currently unknown, and tools are needed to help identify patients at risk for developing long COVID. Methods: A working group of the Rapid Acceleration of Diagnostics-radical (RADx-rad) program, comprised of individuals from various NIH institutes and centers, in collaboration with REsearching COVID to Enhance Recovery (RECOVER) developed and organized the Long COVID Computational Challenge (L3C), a community challenge aimed at incentivizing the broader scientific community to develop interpretable and accurate methods for identifying patients at risk of developing Long COVID. From August 2022 to December 2022, participants developed Long COVID risk prediction algorithms using the National COVID Cohort Collaborative (N3C) data enclave, a harmonized data repository from over 75 healthcare institutions from across the United States (U.S.). Findings: Over the course of the challenge, 74 teams designed and built 35 Long COVID prediction models using the N3C data enclave. The top 10 teams all scored above a 0.80 Area Under the Receiver Operator Curve (AUROC) with the highest scoring model achieving a mean AUROC of 0.895. Included in the top submission was a visualization dashboard that built timelines for each patient, updating the risk of a patient developing Long COVID in response to clinical events. Interpretation: As a result of L3C, federal reviewers identified multiple machine learning models that can be used to identify patients at risk for developing Long COVID. Many of the teams used approaches in their submissions which can be applied to future clinical prediction questions. Funding: Research reported in this RADx® Rad publication was supported by the National Institutes of Health. Timothy Bergquist, Johanna Loomba, and Emily Pfaff were supported by Axle Subcontract: NCATS-STSS-P00438.

Published
2024
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15. Prune belly syndrome in a set of twins, a family tragedy: Case report

Author

Audu LI, Mairami AB, Mukhtar-Yola M, Otuneye A T, Tahir LM, Papka NY, Mshelia LJ, Maitala H, Igoche MI, Anyanwu PA, and Jawa ZM

Subjects
prune belly syndrome, twins, nigeria, management challenges, Medicine
Abstract

We report prune belly syndrome, a rare congenital malformation, in a set of twins delivered to a young couple with a history of three previous first trimester spontaneous abortions, discordant HIV seropositivity and antenatal ultrasound report that indicated renal abnormalities in only one of the twins. The challenges of management are discussed.

Published
2024

16. Across the Twitter-Verse: Is Twitter an Equitable Tool in Academic Medicine? A Scoping Review

Author

Istl, Alexandra C., Verma, Subhrata, Jawa, Natasha A., Mackin, Robin, Seemann, Natashia M., and Kirpalani, Amrit

Abstract

The goal of this study was to investigate what is known about the demographic characteristics of Twitter influencers in academic medicine. We conducted a literature search and scoping review exploring the demographic characteristics of Twitter influencers in academic medicine. Included studies evaluated Twitter influence by any metric and reported associated demographic characteristics. There were no date or language restrictions. Data points included metrics of influence, demographics, and study characteristics. From 1656 records, thirteen met inclusion criteria. Influence was variably defined based on followers, measures of centrality, measures of engagement, or through third-party software. Studies were conducted at single time points and relied heavily on facial recognition for classification of sex or gender, with no studies exploring race as a variable of interest. Twitter influencers in academic medicine were found to be disproportionately male: significantly fewer influencers were female at all levels of professional status. Two studies identified more female influencers among trainee populations. Female users were less likely to develop influence based on followers, retweets, likes, or other measures of engagement at academic meetings, despite equal or greater representation at these meetings. Results on associations between Twitter influence and number of publications or h-index varied considerably. No included studies explored race or ethnicity in relation to Twitter influence, which presents a significant gap in the literature. Our findings highlight the need for larger, user-engaged studies of inequities related to social media influence in academic medicine, especially as social media is increasingly incorporated into academic portfolios.

Published
2023
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17. Are trauma surgeons prepared? A survey of trauma surgeons disaster preparedness before and during the COVID-19 pandemic.

Author

Shatz, David, Kaplan, Lewis, Bulger, Eileen, Capella, Jeannette, Kuhls, Deborah, Fallat, Mary, Remick, Kyle, Newton, Christopher, Fox, Adam, Jawa, Randeep, Harvin, John, Blake, David, Bukur, Marko, Gates, Jonathan, Ficke, James, Gestring, Mark, and Doucet, Jay

Subjects
COVID-19, Disasters, Mass Casualty Incidents
Abstract

OBJECTIVE: US trauma centers (TCs) must remain prepared for mass casualty incidents (MCIs). However, trauma surgeons may lack formal MCI training. The recent COVID-19 pandemic drove multiple patient surges, overloaded Emergency Medical Services (EMS) agencies, and stressed TCs. This survey assessed trauma surgeons MCI training, experience, and system and personal preparedness before the pandemic compared with the pandemics third year. METHODS: Survey invitations were emailed to all 1544 members of the American Association for the Surgery of Trauma in 2019, and then resent in 2022 to 1575 members with additional questions regarding the pandemic. Questions assessed practice type, TC characteristics, training, experience, beliefs about personal and hospital preparedness, likelihood of MCI scenarios, interventions desired from membership organizations, and pandemic experiences. RESULTS: The response rate was 16.7% in 2019 and 12% in 2022. In 2022, surgeons felt better prepared than their hospitals for pandemic care, mass shootings, and active shooters, but remained feeling less well prepared for cyberattack and hazardous material events, compared with 2019. Only 35% of the respondents had unintentional MCI response experience in 2019 or 2022, and even fewer had experience with intentional MCI. 78% had completed a Stop the Bleed (STB) course and 63% own an STB kit. 57% had engaged in family preparedness activities; less than 40% had a family action plan if they could not come home during an MCI. 100% of the respondents witnessed pandemic-related adverse events, including colleague and coworker illness, patient surges, and resource limitations, and 17% faced colleague or coworker death. CONCLUSIONS: Trauma surgeons thought that they became better at pandemic care and rated themselves as better prepared than their hospitals for MCI care, which is an opportunity for them to take greater leadership roles. Opportunities remain to improve surgeons family and personal MCI preparedness. Surgeons most desired professional organization interventions include advocacy, national standards for TC preparedness, and online training. LEVEL OF EVIDENCE: VII, survey of expert opinion.

Published
2023

18. Academic global surgical competencies: A modified Delphi consensus study

Author

Pawlak, Natalie, Dart, Christine, Aguilar, Hernan Sacoto, Ameh, Emmanuel, Bekele, Abebe, Jimenez, Maria F, Lakhoo, Kokila, Ozgediz, Doruk, Roy, Nobhojit, Terfera, Girma, Ademuyiwa, Adesoji O, Alayande, Barnabas Tobi, Alonso, Nivaldo, Anderson, Geoffrey A, Anyanwu, Stanley NC, Aregawi, Alazar Berhe, Bandyopadhyay, Soham, Banu, Tahmina, Bedada, Alemayehu Ginbo, Belachew, Anteneh Gadisa, Botelho, Fabio, Bua, Emmanuel, Campos, Leticia Nunes, Dodgion, Chris, Drejza, Michalina, Durieux, Marcel E, Dutta, Rohini, Erdene, Sarnai, Ferreira, Rodrigo Vaz, Gathuya, Zipporah, Ghosh, Dhruva, Jawa, Randeep Singh, Johnson, Walter D, Khan, Fauzia Anis, Leon, Fanny Jamileth Navas, Long, Kristin L, Mahajan, Anshul, Maine, Rebecca G, Malolos, Grace Zurielle C, McClain, Craig D, Nabukenya, Mary T, Nthumba, Peter M, Nwomeh, Benedict C, Ojuka, Daniel Kinyuru, Penny, Norgrove, Quiodettis, Martha A, Rickard, Jennifer, Roa, Lina, Salgado, Lucas Sousa, Samad, Lubna, Seyi-Olajide, Justina Onyioza, Smith, Martin, Starr, Nichole, Stewart, Richard J, Tarpley, John L, Trostchansky, Julio L, Trostchansky, Ivan, Weiser, Thomas G, Wobenjo, Adili, Wollner, Elliot, and Jayaraman, Sudha

Subjects
Clinical Research, Peace, Justice and Strong Institutions
Abstract

Academic global surgery is a rapidly growing field that aims to improve access to safe surgical care worldwide. However, no universally accepted competencies exist to inform this developing field. A consensus-based approach, with input from a diverse group of experts, is needed to identify essential competencies that will lead to standardization in this field. A task force was set up using snowball sampling to recruit a broad group of content and context experts in global surgical and perioperative care. A draft set of competencies was revised through the modified Delphi process with two rounds of anonymous input. A threshold of 80% consensus was used to determine whether a competency or sub-competency learning objective was relevant to the skillset needed within academic global surgery and perioperative care. A diverse task force recruited experts from 22 countries to participate in both rounds of the Delphi process. Of the n = 59 respondents completing both rounds of iterative polling, 63% were from low- or middle-income countries. After two rounds of anonymous feedback, participants reached consensus on nine core competencies and 31 sub-competency objectives. The greatest consensus pertained to competency in ethics and professionalism in global surgery (100%) with emphasis on justice, equity, and decolonization across multiple competencies. This Delphi process, with input from experts worldwide, identified nine competencies which can be used to develop standardized academic global surgery and perioperative care curricula worldwide. Further work needs to be done to validate these competencies and establish assessments to ensure that they are taught effectively.

Published
2023

21. Contributors

Author

Abelson, Jennifer, primary, Aboutanos, Michel B., additional, Abraham, Peter J., additional, Abualruz, Abdul Rahman, additional, Agarwal, Suresh, additional, Agrawal, Devendra K., additional, Alverdy, John C., additional, Aly, Ahmed, additional, Amato, Stas, additional, Anstadt, Michael J., additional, Asensio, Juan A., additional, Avery, Martin, additional, Bailey, Jeffrey A., additional, Barie, Philip S., additional, Becker, Tyson, additional, Beckerman, Daniel, additional, Bedrick, Edward J., additional, Benson, Jamie, additional, Berne, John D., additional, Berry, Cherisse, additional, Berry, Stepheny, additional, Bhat, Sneha G., additional, Bowie, Jason M., additional, Bowyer, Mark W., additional, Bozeman, Matthew C., additional, Bradley, Matthew, additional, Brakenridge, Scott, additional, Brandes, Steven B., additional, Brenner, Megan, additional, Britt, L.D., additional, Brown, Carlos V., additional, Brown, Ian E., additional, Brown, J. Christian, additional, Brown, Tommy, additional, Buckman, Robert F., additional, Burlew, Clay Cothren, additional, Byers, Patricia M., additional, Caban, Kim M., additional, Cancio, Leopoldo C., additional, Cannon, Jeremy W., additional, Cantlie, Shawn M., additional, Carroll, Eben A., additional, Champion, Howard R., additional, Childs, Ed W., additional, Chiu, William C., additional, Christmas, A. Britton, additional, Cioffi, William G., additional, Cocanour, Christine S., additional, Cohen, Mitchell J., additional, Coimbra, Raul, additional, Cook, Alan, additional, Cornell, David L., additional, Cotton, Bryan A., additional, Couture, Daniel E., additional, Cox, Thomas B., additional, Cristancho, Luis Alfonso Bustamante, additional, Croce, Martin A., additional, Croft, Chasen A., additional, Cubano, Miguel A., additional, Dabestani, Parinaz J., additional, Danton, Gary H., additional, Davis, Christopher S., additional, Davis, Kimberly, additional, de Moya, Marc A., additional, Desai, Urmen, additional, Destiné, Henson, additional, Diebel, Lawrence N., additional, Doucet, Jay J., additional, DuBose, Joseph J., additional, Dubov, Wayne E., additional, Duchesne, Juan C., additional, Durham, Rodney M., additional, Durso, Anthony M., additional, Eastridge, Brian, additional, Efron, David T., additional, Efron, Philip A., additional, Elster, Eric, additional, Esposito, Thomas J., additional, Fakhry, Samir M., additional, Feliciano, David V., additional, Fernandez, Carlos, additional, Fernandez-Moure, Joseph S., additional, Fernández, Luis G., additional, Fiorentino, Michele, additional, Firstenberg, Michael S., additional, Flint, Lewis M., additional, Fredericks, Charles J., additional, Fry, Donald E., additional, Galán, Ricardo, additional, Galante, Joseph M., additional, Galvagno, Samuel M., additional, Garcia, Ana Maria, additional, García, Erwin Rodriguez, additional, García-Núñez, Col Luis Manuel, additional, Gentilello, Larry M., additional, Ghanta, Ravi K., additional, Gigena, Alejandro, additional, Gilani, Ramyar, additional, Glance, Laurent G., additional, Goldman, Matthew, additional, Gonzalez, Ernest A., additional, Gonzalez, Richard P., additional, Grabo, Daniel, additional, Gross, Ronald I., additional, Gummadi, Sriharsha, additional, Guerrero, Whitney M., additional, Gunter, Oliver L., additional, Gurney, Jennifer M., additional, Gutiérrez, Jorge A., additional, Hall, Chad, additional, Hauser, Carl J., additional, Henry, Sharon, additional, Hirshberg, Ashen, additional, Holcomb, John B., additional, Hosmer, David, additional, Hoth, J. Jason, additional, Gomez, Tatiana Hoyos, additional, Hoyt, David B., additional, Humphries, Ashley, additional, Iyengar, Rahul, additional, Jawa, Randeep S., additional, Jessie, Elliot, additional, Johannigman, Jay, additional, Aquino Jose, Victor M., additional, Jurkovich, Gregory J., additional, Kalamchi, Louay, additional, Kapil, Aditi M., additional, Karmy-Jones, Riyad, additional, Kasotakis, George, additional, Kelley, Kathryn C., additional, Keskey, Robert, additional, Kessler, John J., additional, Kim, Dennis Y., additional, Kiraly, Laszlo, additional, Kirton, Orlando C., additional, Kotaru, Tharun R., additional, Kunac, Anastasia, additional, Kwolek, Kinga, additional, Lallemand, Michael S., additional, Ledgerwood, Anna M., additional, Lee, Amanda, additional, Leeper, Christine M., additional, Li, Zhongyu, additional, Libby, Matthew, additional, Lim, Robert B., additional, Liveris, Anna, additional, Livingston, David H., additional, Lobb, Jennifer, additional, Loftus, Tyler J., additional, Lucas, Charles E., additional, Luchette, Fred A., additional, Lundeberg, Megan R., additional, Mackersie, Robert C., additional, Mackey, Kevin E., additional, Magnotti, Louis J., additional, Mah, John W., additional, Maldonado, William Sánchez, additional, Malhotra, Ajai K., additional, Malone, Debra L., additional, Marini, Corrado P., additional, Martin, Matthew J., additional, Marttos, Antonio C., additional, Martyak, Michael T., additional, Mathew, Prakash J., additional, Mattox, Kenneth L., additional, Mayberry, John C., additional, Mazzini, Federico N., additional, McNelis, John, additional, Meallet, Mario A., additional, Meerkov, Meir B.L., additional, Meizoso, Jonathan P., additional, Meredith, J. Wayne, additional, Michetti, Christopher P., additional, Miljkovic, Stephanie S., additional, Miller, Keith R., additional, Miller, Preston R., additional, Minei, Joseph P., additional, Mitchell, Frank L., additional, Moas, Victor M., additional, Mohr, Alicia M., additional, Molnar, Joseph A., additional, Moore, Ernest E., additional, Moore, Frederick A., additional, Moutinho, Manuel, additional, Moysidis, Stavros, additional, Munera, Felipe, additional, Naiditch, Jessica A., additional, Napolitano, Lena M., additional, Narayan, Mayur, additional, Nash, Nicholas A., additional, Nicholson, Kristina J., additional, Nicholson, Susannah, additional, Norwood, Scott H., additional, Nunn, Andrew M., additional, O’Shea, Anne, additional, Osler, Turner M., additional, Pachter, H. Leon, additional, Paladino, Lorenzo, additional, Panthaki, Zubin Jal, additional, Parikh, Manish, additional, Pasquale, Michael D., additional, Patel, Purvi P., additional, Peitzman, Andrew B., additional, Peralta, Ruben, additional, Perez-Alonso, Alejandro J., additional, Pestana, Ivo A., additional, Petrone, Patrizio, additional, Pierre, Edgar J., additional, Pilson, Holly, additional, Polk, Travis, additional, Puyana, Juan Carlos, additional, Quintana, David, additional, Rai, Vikrant, additional, Rajasingh, Charlotte, additional, Ranney, Stephen, additional, Reisbig, Mark D., additional, Reiser, Bibiana Jin, additional, Remick, Kyle N., additional, Rhee, Peter, additional, Rich, Norman M., additional, Richardson, J. David, additional, Richart, Charles M., additional, Rivas, Luis A., additional, Robles, Anamaria J., additional, Rodriguez, Aurelio, additional, Rosengart, Matthew, additional, Rosenthal, Martin D., additional, Rotondo, Michael F., additional, Rowe, Vincent L., additional, Rubano, Jerry A., additional, Rubiano, Andrés M., additional, Ruggero, John M., additional, Rushing, Amy, additional, Salim, Ali, additional, Saillant, Noelle Nugent, additional, Sally, Mitchell B., additional, Salsamendi, Jason, additional, Sanford, Arthur P., additional, Savetamal, Alisa, additional, Scalea, Thomas M., additional, Schecter, William, additional, Schipper, Paul H., additional, Schreiber, Martin A., additional, Schroll, Rebecca W., additional, Schulingkamp, Danielle, additional, Schulman, Carl I., additional, Schulz, John T., additional, Shackelford, Stacy A., additional, Shadis, Ryan, additional, Shapiro, Marc J., additional, Shatz, David V., additional, Shiroff, Adam M., additional, Sicard, Gregorio, additional, Sifri, Ziad C., additional, Sing, Ronald F., additional, Sisley, Amy, additional, Smith, Brian P., additional, Smith, R. Stephen, additional, Singares, Eduardo Smith, additional, Sola, Richard, additional, Spain, David A., additional, Spencer, Audrey L., additional, Stavas, Joseph, additional, Stawicki, Stanislaw P., additional, Stein, Deborah M., additional, Stewart, Nakosi, additional, Stirparo, Joseph J., additional, Strong, Bethany L., additional, Sukumar, Mithran S., additional, Tadlock, Matthew D., additional, Taylor, John R., additional, Thaller, Seth R., additional, Thomas, Bradley W., additional, Thompson, Ashley M., additional, Tieu, Brandon H., additional, Tillou, Areti, additional, Tinkoff, Glen H., additional, Tisherman, Samuel A., additional, Todd, S. Rob, additional, Tominaga, Gail T., additional, Trammell, Amy Phillips, additional, Trunkey, Donald D., additional, Tuggle, David, additional, Upchurch, Gilbert R., additional, Van, Philbert, additional, VanDerHeyden, Nicole, additional, Vanzant, Erin L., additional, Wall, Matthew J., additional, Wenzl, Florian A., additional, Whitlow, Christopher T., additional, Wiegand, Lucas R., additional, Williams, Timothy K., additional, Wilson, Jonathan L., additional, Yeh, D. Dante, additional, Youngblood, Charles F., additional, and Zhang, Wei, additional

Published
2024
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22. Applied Federated Learning: Architectural Design for Robust and Efficient Learning in Privacy Aware Settings

Author

Stojkovic, Branislav, Woodbridge, Jonathan, Fang, Zhihan, Cai, Jerry, Petrov, Andrey, Iyer, Sathya, Huang, Daoyu, Yau, Patrick, Kumar, Arvind Sastha, Jawa, Hitesh, and Guha, Anamita

Subjects
Computer Science - Machine Learning
Abstract

The classical machine learning paradigm requires the aggregation of user data in a central location where machine learning practitioners can preprocess data, calculate features, tune models and evaluate performance. The advantage of this approach includes leveraging high performance hardware (such as GPUs) and the ability of machine learning practitioners to do in depth data analysis to improve model performance. However, these advantages may come at a cost to data privacy. User data is collected, aggregated, and stored on centralized servers for model development. Centralization of data poses risks, including a heightened risk of internal and external security incidents as well as accidental data misuse. Federated learning with differential privacy is designed to avoid the server-side centralization pitfall by bringing the ML learning step to users' devices. Learning is done in a federated manner where each mobile device runs a training loop on a local copy of a model. Updates from on-device models are sent to the server via encrypted communication and through differential privacy to improve the global model. In this paradigm, users' personal data remains on their devices. Surprisingly, model training in this manner comes at a fairly minimal degradation in model performance. However, federated learning comes with many other challenges due to its distributed nature, heterogeneous compute environments and lack of data visibility. This paper explores those challenges and outlines an architectural design solution we are exploring and testing to productionize federated learning at Meta scale.

Published
2022

23. “We were building the plane as we were flying it, and we somehow made it to the other end”: syringe service program staff experiences and well-being during the COVID-19 pandemic

Author

Wang, Andrea, Jawa, Raagini, Mackin, Sarah, Whynott, Liz, Buchholz, Connor, Childs, Ellen, and Bazzi, Angela R

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Prevention, Good Health and Well Being, COVID-19, COVID-19 Testing, Humans, Pandemics, SARS-CoV-2, Syringes, Syringe service programs, Harm reduction work, Occupational health, Well-being, Public Health and Health Services, Substance Abuse, Health services and systems, Public health
Abstract

BackgroundSyringe service programs (SSPs) provide essential harm reduction and prevention services for people who inject drugs in the USA, where SSP coverage is expanding. During the COVID-19 pandemic, US SSPs underwent unprecedented shifts in operational procedures (e.g., closures of physical sites, staff redeployment into pandemic response efforts). Given the critical role of US SSP workers in the pandemic, we sought to explore the occupational experiences and well-being of SSP staff to inform future emergency response efforts.MethodsFrom July-October 2020, we conducted semi-structured interviews with staff members of four SSPs in diverse regions of Massachusetts. Trained interviewers administered qualitative interviews virtually. Interviews were coded in NVivo v12 and thematic analysis identified common occupational experiences and related impacts on staff well-being in the context of the COVID-19 pandemic.ResultsAmong 18 participants, 12 (67%) had client-facing roles such as harm reduction specialists and six (33%) worked in program management or leadership. We found that staff were frequently anxious about SARS-CoV-2 transmission, which contributed to staff turnover. SSPs rapidly adapted and expanded their services to meet increasing client needs during the pandemic (e.g., food distribution, COVID-19 testing), leading to staff overexertion. Simultaneously, public health measures such as physical distancing led to staff concerns about reduced social connections with clients and coworkers. Through these challenges, SSPs worked to protect staff well-being by implementing flexible and tangible COVID-19-related policies (e.g., paid sick leave), mental health resources, and frequent communication regarding pandemic-related operational changes.ConclusionSSPs in the USA adapted to the COVID-19 pandemic out of necessity, resulting in operational changes that threatened staff well-being. Despite the protective factors revealed in some narratives, our findings suggest that during prolonged, complex public health emergencies, SSPs may benefit from enhanced occupational supports to prevent burnout and promote wellness for this essential public health workforce.

Published
2022

24. Crowd-sourced machine learning prediction of long COVID using data from the National COVID Cohort Collaborative

Author

Aggarwal, Ataes, Agor, Joseph, Al-Amery, Amera, Aminu, Oluwatobiloba, Anand, Adit, Antonescu, Corneliu, Arora, Mehak, Asaduzzaman, Sayed, Asmussen, Tanner, Baghbanzadeh, Mahdi, Baker, Frazier, Bangert, Bridget, Bekhet, Laila, Bhattacharya, Biplab, Blase, Jenny, Butzin-Dozier, Zachary, Caffo, Brian, Chang, Hao, Chen, Zeyuan, Chen, Jiandong, Chiang, Jeffrey, Cho, Peter, Cockrell, Robert, Combs, Parker, Coyle, Jeremy, Crosby, Ciara, Dai, Zongyu, Dai, Ran, Danesharasteh, Anseh, Yildirim, Elif, Delong, Grant, Demilt, Ryan, Deng, Kaiwen, Dey, Sanjoy, Dhamdhere, Rohan, Dickson, Andrew, Dijour, Phoebe, Dinh, Dong, Dixon, Richard, Domi, Albi, Dutta, Souradeep, Elizondo, Mirna, Ertem, Zeynep, Feuerwerker, Solomon, Fliss, Danica, Fowler, Jennifer, Fu, Sunyang, Gardner, Kelly, Getty, Neil, Ghalwash, Mohamed, Gloster, Logan, Greer, Phil, Guan, Yuanfang, Ham, Colby, Hanoudi, Samer, Harper, Jeremy, Hendrix, Nathaniel, Hershkovich, Leeor, Hightower, Jake, Hu, Junjie, Huang, Jiani, Huang, Yu, Huang, Tongtong, Hur, Junguk, Isgut, Monica, Ismail, Hamid, Izmirlian, Grant, Jang, Kuk, Jemiyo, Christianah, Jeong, Hayoung, Ji, Yunwen, Ji, Xiayan, Jiang, Ming, Jiang, Sihang, Jiang, Xiaoqian, Jiang, Yuye, Johnson, Akin, Analyst, Zach, Kapse, Saarthak, Kartoun, Uri, KC, Dukka, Fard, Zahra, Kosfeld, Tim, Krichevsky, Spencer, Kuo, Mike, Larie, Dale, Lederer, Lauren, Leng, Shan, Li, Ziyang, Li, Hongyang, Li, Haodong, Li, Jianfu, Li, Tiantian, Liang, Xinwen, Liang, Hengyue, Liu, Feifan, Liu, Daniel, Luo, Gang, Munia, Tamanna, Madduri, Ravi, Madhira, Vithal, Mani, Shivali, Mansourifard, Farzaneh, Matson, Robert, Mertens, Andrew, Metsis, Vangelis, Meyer, Pablo, Mikhailova, Catherine, Miller, Dante, Milo, Christopher, Mitchell, Elliot, Modanwal, Gourav, Moore, Ronald, Morgenthaler, David, Musal, Rasim, Naik, Mayur, Nalawade, Vinit, Narain, Rohan, Narendrula, Saideep, Obiri, Alena, Okawa, Satoshi, Okechukwu, Chima, Olorunnisola, Toluwanimi, Ossowski, Tim, Parekh, Harsh, Park, Jean, Patel, Saaya, Patterson, Jason, Paul, Chetan, Peng, Le, Perkins, Diana, Pokharel, Suresh, Poplavskiy, Dmytro, Pryor, Zach, Pungitore, Sarah, Qin, Hong, Rababa, Salahaldeen, Rahman, Mahbubur, Rahmani, Elior, Rahnavard, Gholamali, Raihan, Md, Rajendran, Suraj, Ravichandran, Sarangan, Reddy, Chandan, Reyes, Abel, Roghanizad, Ali, Rouffa, Sean, Ruan, Xiaoyang, Saha, Arpita, Sawant, Sahil, Schiaffino, Melody, Seira, Diego, Sengupta, Saurav, Shalaev, Ruslan, Shetty, Gaurav, Shi, Seraphina, Shinguyen, Linh, Singh, Karnika, Sinha, Soumya, Socia, Damien, Stalians, Halen, Stavropoulos, Charalambos, Strube, Jan, Subramanian, Devika, Sun, Jiehuan, Sun, Ju, Sun, Chengkun, Sundararajan, Prathic, Talebi, Salmonn, Tawiah, Edward, Tesic, Jelena, Thiess, Mikaela, Tian, Raymond, Torre-Healy; Ming-Tse Tsai, Luke, Tyus, David, Vardhan, Madhurima, Velingker, Neelay, Walzer, Benjamin, Walzer, Jacob, Wang, Junda, Wang, Lu, Wang, Will, Wang, Jonathan, Wang, Yisen, Weatherly, Chad, Wu, Fanyou, Wu, Yifeng, Wu, Yinjun, Xia, Fangfang, Yan, Hao, Yang, Zhichao, Ye, Biao, Yin, Rui, Yin, Changyu, Yoo, Yun, You, Albert, Yu, June, Zanaj, Martin, Zaiman, Zachary, Zhang, Kai, Zhang, Xiaoyi, Zhang, Tianmai, Zhao, Zixuan, Zhi, Degui, Zhong, Yishan, Zhou, Huixue, Zhou, Andrea, Zhu, Yuanda, Zhu, Yitan, Zhu, Sophie, Adams, Meredith, Alexander, Caleb, Amor, Benjamin, Anzalone, Alfred, Bates, Benjamin, Beasley, Will, Bennett, Tellen, Bissell, Mark, Boudreau, Eilis, Bozzette, Samuel, Bradwell, Katie, Bramante, Carolyn, Brown, Don, Burgoon, Penny, Buse, John, Callahan, Tiffany, Cato, Kenrick, Chapman, Scott, Chute, Christopher, Clark, Jaylyn, Clark, Marshall, Cooper, Will, Cottrell, Lesley, Crowley, Karen, Deacy, Mariam, Dillon, Christopher, Eichmann, David, Emmett, Mary, Erwin-Cohen, Rebecca, Francis, Patricia, French, Evan, Fuentes, Rafael, Gabriel, Davera, Gagnier, Joel, Garbarini, Nicole, Ge, Jin, Gersing, Kenneth, Girvin, Andrew, Gordon, Valery, Graves, Alexis, Guinney, Justin, Haendel, Melissa, Hayanga, J.W., Hendricks, Brian, Hernandez, Wenndy, Hill, Elaine, Hillegass, William, Hong, Stephanie, Housman, Dan, Hurley, Robert, Islam, Jessica, Jawa, Randeep, Johnson, Steve, Kamaleswaran, Rishi, Kibbe, Warren, Koraishy, Farrukh, Kostka, Kristin, Kurilla, Michael, Lee, Adam, Lehmann, Harold, Liu, Hongfang, Loomba, Johanna, Madlock-Brown; Sandeep Mallipattu, Charisse, Manna, Amin, Mariona, Federico, Marti, Emily, Martin, Greg, Mathew, Jomol, Mazzotti, Diego, McMurry, Julie, Mehta, Hemalkumar, Michael, Sam, Miller, Robert, Misquitta, Leonie, Moffitt, Richard, Morris, Michele, Murray, Kimberly, Northington, Lavance, O’Neil, Shawn, Olex, Amy, Palchuk, Matvey, Patel, Brijesh, Patel, Rena, Payne, Philip, Pfaff, Emily, Pincavitch, Jami, Portilla, Lili, Prior, Fred, Pyarajan, Saiju, Pyles, Lee, Qureshi, Nabeel, Robinson, Peter, Rutter, Joni, Sadan, Ofer, Safdar, Nasia, Saha, Amit, Saltz, Joel, Saltz, Mary, Schmitt, Clare, Setoguchi, Soko, Sharafeldin, Noha, Sharathkumar, Anjali, Sheikh, Usman, Sidky, Hythem, Sokos, George, Southerland, Andrew, Spratt, Heidi, Starren, Justin, Subbian, Vignesh, Suver, Christine, Takemoto, Cliff, Temple-O'Connor, Meredith, Topaloglu, Umit, Vedula, Satyanarayana, Walden, Anita, Walters, Kellie, Ward-Caviness, Cavin, Wilcox, Adam, Wilkins, Ken, Williams, Andrew, Wu, Chunlei, Zampino, Elizabeth, Zhang, Xiaohan, Zhu, Richard, Bergquist, Timothy, Tariq, Adbul, Philips, Rachael V., Pirracchio, Romain, van der Laan, Mark, Colford, John M., Jr., Hubbard, Alan, Gao, Jifan, Chen, Guanhua, Stein, Adam, Long, Qi, Holmes, John, Mowery, Danielle, Wong, Eric, Parekh, Ravi, Getzen, Emily, and Blase, Jennifer

Published
2024
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26. Clinical characteristics of celiac disease patients in qassim region

Author

Mohammed Alfawaz, Resheed Alkhiari, Abdulaziz Abdulrahman Albuhayjani, Abdulmajeed Albarrak, Muath Yousef Alharbi, Adi Abdulaziz R Aldubaiyan, Abdullah Hamad Alkharraz, Omar Abdulaziz Alolayan, Omar Alrasheedi, Nawaf Almutairi, Faisal Aljehani, Enad Alsolami, Waleed Alghamdi, and Hani Jawa

Subjects
celiac disease, life quality, gluten-free diet, Medicine
Abstract

Objective: It is well known that celiac disease has a negative influence on patients' health and quality of life. It has a wide range of presentation from symptomless to multiple organ dysfunction but mainly gastrointestinal symptoms. Consequently, it is considered a main cause of mortality, morbidity, and health burden. We aim to evaluate the quality of life affected in gluten-free diet and to identify the serological characteristics of celiac disease patients in the Qassim Region of Saudi Arabia and King Fahad Specialist Hospital. Methods: This is a cross-sectional-based study conducted in King Fahad Specialist Hospital, Saudi Arabia, composed of 58 patients with celiac disease for 9 years between August 2011 and August 2020. Results: Fifty-eight patents were included (79.3% females and 65.5% married), who were divided according to their ages into five groups. Abdominal pain, diarrhea, and/or weight loss were the major patient complaints. A total of 64% of the patients had a +ve (tTG) IgA test at the time of diagnosis, while 17% were -ve. Of the studied patients, 78% reported that they had undergone a duodenal biopsy sampling. No other significant abnormalities were detected between females and males or among the five diagnosed age groups. Conclusion: Patients with celiac disease reported poor health-related quality of life across the board. However, social interaction, emotional role functioning, and emotional well-being were the most important factors.

Published
2024
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27. Five-Year Mortality Rates Following Elective Shoulder Arthroplasty and Shoulder Arthroplasty for Fracture in Patients Over Age 65

Author

Khan, Adam Z., Zhang, Xiaoran, Macarayan, Erlyn, Best, Matthew J., Fedorka, Catherine J., Haas, Derek A., Armstrong, April D., Jawa, Andrew, O’Donnell, Evan A., Simon, Jason E., Wagner, Eric R., Malik, Momin, Gottschalk, Michael B., Updegrove, Gary F., Warner, Jon J.P., Srikumaran, Uma, Abboud, Joseph A., Abboud, Joseph A., Armstrong, April D., Belniak, Robert M., Best, Matthew J., Costouros, John, Beck da Silva Etges, Ana Paula, Fares, Mohamad, Fedorka, Catherine J., Gottschalk, Michael B., Haas, Derek A., Jones, Porter, Khan, Adam Z., Kirsch, Jacob M., Liu, Harry, Makhni, Eric C., Mazzocca, Augustus, O’Donnell, Evan A., Simon, Jason E., Srikumaran, Uma, Stieler, Evan, Updegrove, Gary F., Wagner, Eric R., Warner, Jon J.P., Woodmass, Jarret, and Zhang, Xiaoran

Published
2024
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28. Wavelength-Controlled Photocurrent Polarity Switching in BP-MoS$_2$ Heterostructure

Author

Jawa, Himani, Ghosh, Sayantan, Varghese, Abin, Sahoo, Srilagna, and Lodha, Saurabh

Subjects
Physics - Applied Physics, Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

Layered two-dimensional van der Waals (vdW) semiconductors and their heterostructures have been shown to exhibit positive photoconductance (PPC) in many studies. A few recent reports have demonstrated negative photoconductance (NPC) as well that can enable broadband photodetection besides multi-level optoelectronic logic and memory. Controllable and reversible switching between PPC and NPC is a key requirement for these applications. This report demonstrates visible-to-near infrared wavelength-driven NPC and PPC, along with reversible switching between the two, in an air stable, high mobility, broadband black phosphorus (BP) field effect transistor (FET) covered with a few layer MoS$_2$ flake. The crossover switching wavelength can be tuned by varying the MoS$_2$ bandgap through its flake thickness and the NPC and PPC photoresponsivities can be modulated using electrostatic gating as well as laser power. Recombination-driven NPC and PPC allows for reversible switching at reasonable time scales of a few seconds. Further, gate voltage-dependent negative persistent photoconductance enables synaptic behavior that is well-suited for optosynaptic applications., Comment: Main Manuscript and Supporting Information

Published
2021
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30. From Alpha to Omicron and Beyond: Associations Between SARS-CoV-2 Variants and Surgical Outcomes

Author

Wilcox, Adam B., Lee, Adam M., Graves, Alexis, Anzalone, Alfred, Manna, Amin, Saha, Amit, Olex, Amy, Zhou, Andrea, Williams, Andrew E., Southerland, Andrew, Girvin, Andrew T., Walden, Anita, Sharathkumar, Anjali A., Amor, Benjamin, Bates, Benjamin, Hendricks, Brian, Patel, Brijesh, Alexander, Caleb, Bramante, Carolyn, Ward-Caviness, Cavin, Madlock-Brown, Charisse, Suver, Christine, Chute, Christopher, Dillon, Christopher, Wu, Chunlei, Schmitt, Clare, Takemoto, Cliff, Housman, Dan, Gabriel, Davera, Eichmann, David A., Mazzotti, Diego, Brown, Don, Boudreau, Eilis, Hill, Elaine, Zampino, Elizabeth, Marti, Emily Carlson, Pfaff, Emily R., French, Evan, Koraishy, Farrukh M., Mariona, Federico, Prior, Fred, Sokos, George, Martin, Greg, Lehmann, Harold, Spratt, Heidi, Mehta, Hemalkumar, Liu, Hongfang, Sidky, Hythem, Hayanga, J.W. Awori, Pincavitch, Jami, Clark, Jaylyn, Harper, Jeremy Richard, Islam, Jessica, Ge, Jin, Gagnier, Joel, Saltz, Joel H., Saltz, Joel, Loomba, Johanna, Buse, John, Mathew, Jomol, Rutter, Joni L., McMurry, Julie A., Guinney, Justin, Starren, Justin, Crowley, Karen, Bradwell, Katie Rebecca, Walters, Kellie M., Wilkins, Ken, Gersing, Kenneth R., Cato, Kenrick Dwain, Murray, Kimberly, Kostka, Kristin, Northington, Lavance, Pyles, Lee Allan, Misquitta, Leonie, Cottrell, Lesley, Portilla, Lili, Deacy, Mariam, Bissell, Mark M., Clark, Marshall, Emmett, Mary, Saltz, Mary Morrison, Palchuk, Matvey B., Haendel, Melissa A., Adams, Meredith, Temple-O'Connor, Meredith, Kurilla, Michael G., Morris, Michele, Qureshi, Nabeel, Safdar, Nasia, Garbarini, Nicole, Sharafeldin, Noha, Sadan, Ofer, Francis, Patricia A., Burgoon, Penny Wung, Robinson, Peter, Payne, Philip R.O., Fuentes, Rafael, Jawa, Randeep, Erwin-Cohen, Rebecca, Patel, Rena, Moffitt, Richard A., Zhu, Richard L., Kamaleswaran, Rishi, Hurley, Robert, Miller, Robert T., Pyarajan, Saiju, Michael, Sam G., Bozzette, Samuel, Mallipattu, Sandeep, Vedula, Satyanarayana, Chapman, Scott, O'Neil, Shawn T., Setoguchi, Soko, Hong, Stephanie S., Johnson, Steve, Bennett, Tellen D., Callahan, Tiffany, Topaloglu, Umit, Sheikh, Usman, Gordon, Valery, Subbian, Vignesh, Kibbe, Warren A., Hernandez, Wenndy, Beasley, Will, Cooper, Will, Hillegass, William, Zhang, Xiaohan Tanner, Verhagen, Nathaniel B., Geissler, Thomas, SenthilKumar, Gopika, Gehl, Carson, Shaik, Tahseen, Flitcroft, Madelyn A., Yang, Xin, Taylor, Bradley W., Ghaferi, Amir A., Gould, Jon C., and Kothari, Anai N.

Published
2024
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32. The prevalence of postacute sequelae of coronavirus disease 2019 in solid organ transplant recipients: Evaluation of risk in the National COVID Cohort Collaborative

Author

Wilcox, Adam B., Lee, Adam M., Graves, Alexis, Anzalone, Alfred Jerrod, Manna, Amin, Saha, Amit, Olex, Amy, Zhou, Andrea, Williams, Andrew E., Southerland, Andrew, Girvin, Andrew T., Walden, Anita, Sharathkumar, Anjali A., Amor, Benjamin, Bates, Benjamin, Hendricks, Brian, Patel, Brijesh, Alexander, Caleb, Bramante, Carolyn, Ward-Caviness, Cavin, Madlock-Brown, Charisse, Suver, Christine, Chute, Christopher, Dillon, Christopher, Wu, Chunlei, Schmitt, Clare, Takemoto, Cliff, Housman, Dan, Gabriel, Davera, Eichmann, David A., Mazzotti, Diego, Brown, Don, Boudreau, Eilis, Hill, Elaine, Zampino, Elizabeth, Marti, Emily Carlson, Pfaff, Emily R., French, Evan, Koraishy, Farrukh M., Mariona, Federico, Prior, Fred, Sokos, George, Martin, Greg, Lehmann, Harold, Spratt, Heidi, Mehta, Hemalkumar, Liu, Hongfang, Sidky, Hythem, Hayanga, J.W. Awori, Pincavitch, Jami, Clark, Jaylyn, Harper, Jeremy Richard, Islam, Jessica, Ge, Jin, Gagnier, Joel, Saltz, Joel H., Saltz, Joel, Loomba, Johanna, Buse, John, Mathew, Jomol, Rutter, Joni L., McMurry, Julie A., Guinney, Justin, Starren, Justin, Crowley, Karen, Bradwell, Katie Rebecca, Walters, Kellie M., Wilkins, Ken, Gersing, Kenneth R., Cato, Kenrick Dwain, Murray, Kimberly, Kostka, Kristin, Northington, Lavance, Pyles, Lee Allan, Misquitta, Leonie, Cottrell, Lesley, Portilla, Lili, Deacy, Mariam, Bissell, Mark M., Clark, Marshall, Emmett, Mary, Saltz, Mary Morrison, Palchuk, Matvey B., Haendel, Melissa A., Adams, Meredith, Temple-O'Connor, Meredith, Kurilla, Michael G., Morris, Michele, Qureshi, Nabeel, Safdar, Nasia, Garbarini, Nicole, Sharafeldin, Noha, Sadan, Ofer, Francis, Patricia A., Burgoon, Penny Wung, Robinson, Peter, Payne, Philip R.O., Fuentes, Rafael, Jawa, Randeep, Erwin-Cohen, Rebecca, Patel, Rena, Moffitt, Richard A., Zhu, Richard L., Kamaleswaran, Rishi, Hurley, Robert, Miller, Robert T., Pyarajan, Saiju, Michael, Sam G., Bozzette, Samuel, Mallipattu, Sandeep, Vedula, Satyanarayana, Chapman, Scott, O'Neil, Shawn T., Setoguchi, Soko, Hong, Stephanie S., Johnson, Steve, Bennett, Tellen D., Callahan, Tiffany, Topaloglu, Umit, Sheikh, Usman, Gordon, Valery, Subbian, Vignesh, Kibbe, Warren A., Hernandez, Wenndy, Beasley, Will, Cooper, Will, Hillegass, William, Zhang, Xiaohan Tanner, Vinson, Amanda J., Schissel, Makayla, Anzalone, Alfred J., Dai, Ran, French, Evan T., Olex, Amy L., Lee, Stephen B., Ison, Michael, and Mannon, Roslyn B.

Published
2024
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35. Cultural competency and ethical behavior for collaboration in limited-resource settings: Guidelines from the Society of University Surgeons Academic Global Surgery Committee and the Association for Academic Global Surgery

Author

Yang, George, Bekele, Abebe, Krishnaswami, Sanjay, Ameh, Emmanuel, Sifri, Ziad, Aisuodionoe-Shadrach, Oseremen, Swaroop, Mamta, Orloff, Susan, Abdullah, Fizan, Nwomeh, Benedict, Chen, Mike, Charles, Anthony, Ezeme, Constantine, Juillard, Catherine, Menezes, Catarina, Chitalu, Mubanga, Nwariaku, Fiemu, and Jawa, Randeep S.

Published
2024
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38. Effect of vitamin E–enhanced highly cross-linked polyethylene on wear rate and particle debris in anatomic total shoulder arthroplasty: a biomechanical comparison to ultrahigh-molecular-weight polyethylene

Author

Khan, Adam Z., Maxwell, Michael J., Parrott, Russell M., Bowler, Adam R., Glass, Evan A., Miller, Drew, Vasconcellos, Daniel, Brownhill, James R., Austin, Luke S., Cuff, Derek J., Murthi, Anand M., Smith, Matthew J., Wiater, J. Michael, and Jawa, Andrew

Published
2024
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39. Five-Year Mortality Rates Following Elective Shoulder Arthroplasty and Shoulder Arthroplasty for Fracture in Patients Over Age 65

Author

Adam Z. Khan, MD, Xiaoran Zhang, MA, Erlyn Macarayan, PhD, Matthew J. Best, MD, Catherine J. Fedorka, MD, Derek A. Haas, MBA, April D. Armstrong, MD, Andrew Jawa, MD, Evan A. O’Donnell, MD, Jason E. Simon, MD, MBA, Eric R. Wagner, MD, Momin Malik, PhD, Michael B. Gottschalk, MD, Gary F. Updegrove, MD, Jon J.P. Warner, MD, Uma Srikumaran, MD, MBA, MPH, Joseph A. Abboud, MD, and the Avant-garde Health and Codman Shoulder Society Value-Based Care Group, Joseph A. Abboud, April D. Armstrong, Robert M. Belniak, Matthew J. Best, John Costouros, Ana Paula Beck da Silva Etges, Mohamad Fares, Catherine J. Fedorka, Michael B. Gottschalk, Derek A. Haas, Porter Jones, Adam Z. Khan, Jacob M. Kirsch, Harry Liu, Eric C. Makhni, Augustus Mazzocca, Evan A. O’Donnell, Jason E. Simon, Uma Srikumaran, Evan Stieler, Gary F. Updegrove, Eric R. Wagner, Jon J.P. Warner, Jarret Woodmass, and Xiaoran Zhang

Subjects
Orthopedic surgery, RD701-811
Abstract

Background:. To effectively counsel patients prior to shoulder arthroplasty, surgeons should understand the overall life trajectory and life expectancy of patients in the context of the patient’s shoulder pathology and medical comorbidities. Such an understanding can influence both operative and nonoperative decision-making and implant choices. This study evaluated 5-year mortality following shoulder arthroplasty in patients ≥65 years old and identified associated risk factors. Methods:. We utilized Centers for Medicare & Medicaid Services Fee-for-Service inpatient and outpatient claims data to investigate the 5-year mortality rate following shoulder arthroplasty procedures performed from 2014 to 2016. The impact of patient demographics, including fracture diagnosis, year fixed effects, and state fixed effects; patient comorbidities; and hospital-level characteristics on 5-year mortality rates were assessed with use of a Cox proportional hazards regression model. A p value of

Published
2024
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40. Surgical and procedural antibiotic prophylaxis in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document

Author

Deborah M Stein, John Varujan Agapian, Bryce Robinson, Matthew E Kutcher, Joseph Cuschieri, Michael Steven Farrell, Dina M Filiberto, Abhijit Pathak, Rondi Gelbard, Jason Hoth, Randeep Jawa, Jasmeet Paul, Rachel D Appelbaum, Eden Nohra, and Jordan Kirsch

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

The use of prophylactic measures, including perioperative antibiotics, for the prevention of surgical site infections is a standard of care across surgical specialties. Unfortunately, the routine guidelines used for routine procedures do not always account for many of the factors encountered with urgent/emergent operations and critically ill or high-risk patients. This clinical consensus document created by the American Association for the Surgery of Trauma Critical Care Committee is one of a three-part series and reviews surgical and procedural antibiotic prophylaxis in the surgical intensive care unit. The purpose of this clinical consensus document is to provide practical recommendations, based on expert opinion, to assist intensive care providers with decision-making for surgical prophylaxis. We specifically evaluate the current state of periprocedural antibiotic management of external ventricular drains, orthopedic operations (closed and open fractures, silver dressings, local, antimicrobial adjuncts, spine surgery, subfascial drains), abdominal operations (bowel injury and open abdomen), and bedside procedures (thoracostomy tube, gastrostomy tube, tracheostomy).

Published
2024
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41. Nonelective coronary artery bypass graft outcomes are adversely impacted by Coronavirus disease 2019 infection, but not altered processes of care: A National COVID Cohort Collaborative and National Surgery Quality Improvement Program analysisCentral MessagePerspective

Author

Emily A. Grimsley, MD, Johnathan V. Torikashvili, BS, Haroon M. Janjua, MS, Meagan D. Read, MD, Anai N. Kothari, MD, MS, Nate B. Verhagen, BS, Ricardo Pietrobon, MD, PhD, Paul C. Kuo, MD, MS, MBA, Michael P. Rogers, MD, MS, Adam B. Wilcox, Adam M. Lee, Alexis Graves, Alfred (Jerrod) Anzalone, Amin Manna, Amit Saha, Amy Olex, Andrea Zhou, Andrew E. Williams, Andrew Southerland, Andrew T. Girvin, Anita Walden, Anjali A. Sharathkumar, Benjamin Amor, Benjamin Bates, Brian Hendricks, Brijesh Patel, Caleb Alexander, Carolyn Bramante, Cavin Ward-Caviness, Charisse Madlock-Brown, Christine Suver, Christopher Chute, Christopher Dillon, Chunlei Wu, Clare Schmitt, Cliff Takemoto, Dan Housman, Davera Gabriel, David A. Eichmann, Diego Mazzotti, Don Brown, Eilis Boudreau, Elaine Hill, Elizabeth Zampino, Emily Carlson Marti, Emily R. Pfaff, Evan French, Farrukh M. Koraishy, Federico Mariona, Fred Prior, George Sokos, Greg Martin, Harold Lehmann, Heidi Spratt, Hemalkumar Mehta, Hongfang Liu, Hythem Sidky, J.W. Awori Hayanga, Jami Pincavitch, Jaylyn Clark, Jeremy Richard Harper, Jessica Islam, Jin Ge, Joel Gagnier, Joel H. Saltz, Joel Saltz, Johanna Loomba, John Buse, Jomol Mathew, Joni L. Rutter, Julie A. McMurry, Justin Guinney, Justin Starren, Karen Crowley, Katie Rebecca Bradwell, Kellie M. Walters, Ken Wilkins, Kenneth R. Gersing, Kenrick Dwain Cato, Kimberly Murray, Kristin Kostka, Lavance Northington, Lee Allan Pyles, Leonie Misquitta, Lesley Cottrell, Lili Portilla, Mariam Deacy, Mark M. Bissell, Marshall Clark, Mary Emmett, Mary Morrison Saltz, Matvey B. Palchuk, Melissa A. Haendel, Meredith Adams, Meredith Temple-O'Connor, Michael G. Kurilla, Michele Morris, Nabeel Qureshi, Nasia Safdar, Nicole Garbarini, Noha Sharafeldin, Ofer Sadan, Patricia A. Francis, Penny Wung Burgoon, Peter Robinson, Philip R.O. Payne, Rafael Fuentes, Randeep Jawa, Rebecca Erwin-Cohen, Rena Patel, Richard A. Moffitt, Richard L. Zhu, Rishi Kamaleswaran, Robert Hurley, Robert T. Miller, Saiju Pyarajan, Sam G. Michael, Samuel Bozzette, Sandeep Mallipattu, Satyanarayana Vedula, Scott Chapman, Shawn T. O'Neil, Soko Setoguchi, Stephanie S. Hong, Steve Johnson, Tellen D. Bennett, Tiffany Callahan, Umit Topaloglu, Usman Sheikh, Valery Gordon, Vignesh Subbian, Warren A. Kibbe, Wenndy Hernandez, Will Beasley, Will Cooper, William Hillegass, and Xiaohan Tanner Zhang

Subjects
nonelective coronary artery bypass grafting, COVID-19, pandemic, outcomes, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Objective: The effects of Coronavirus disease 2019 (COVID-19) infection and altered processes of care on nonelective coronary artery bypass grafting (CABG) outcomes remain unknown. We hypothesized that patients with COVID-19 infection would have longer hospital lengths of stay and greater mortality compared with COVID-negative patients, but that these outcomes would not differ between COVID-negative and pre-COVID controls. Methods: The National COVID Cohort Collaborative 2020-2022 was queried for adult patients undergoing CABG. Patients were divided into COVID-negative, COVID-active, and COVID-convalescent groups. Pre-COVID control patients were drawn from the National Surgical Quality Improvement Program database. Adjusted analysis of the 3 COVID groups was performed via generalized linear models. Results: A total of 17,293 patients underwent nonelective CABG, including 16,252 COVID-negative, 127 COVID-active, 367 COVID-convalescent, and 2254 pre-COVID patients. Compared to pre-COVID patients, COVID-negative patients had no difference in mortality, whereas COVID-active patients experienced increased mortality. Mortality and pneumonia were higher in COVID-active patients compared to COVID-negative and COVID-convalescent patients. Adjusted analysis demonstrated that COVID-active patients had higher in-hospital mortality, 30- and 90-day mortality, and pneumonia compared to COVID-negative patients. COVID-convalescent patients had a shorter length of stay but a higher rate of renal impairment. Conclusions: Traditional care processes were altered during the COVID-19 pandemic. Our data show that nonelective CABG in patients with active COVID-19 is associated with significantly increased rates of mortality and pneumonia. The equivalent mortality in COVID-negative and pre-COVID patients suggests that pandemic-associated changes in processes of care did not impact CABG outcomes. Additional research into optimal timing of CABG after COVID infection is warranted.

Published
2023
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42. Implementing harm reduction kits in an office-based addiction treatment program

Author

Margaret Shang, Brent Thiel, Jane M. Liebschutz, Kevin L. Kraemer, Ariana Freund, and Raagini Jawa

Subjects
Harm reduction, Safer use equipment, Office-based addiction treatment, Substance use disorder, Addiction, Public aspects of medicine, RA1-1270
Abstract

Abstract Background The rising rates of drug use-related complications call for a paradigm shift in the care for people who use drugs. While addiction treatment and harm reduction have historically been siloed in the US, co-location of these services in office-based addiction treatment (OBAT) settings offers a more realistic and patient-centered approach. We describe a quality improvement program on integrating harm reduction kits into an urban OBAT clinic. Methods After engaging appropriate stakeholders and delivering clinician and staff trainings on safer use best practices, we developed a clinical workflow for universal offering and distribution of pre-packaged kits coupled with patient-facing educational handouts. We assessed: (1) kit uptake with kit number and types distributed; and (2) implementation outcomes of feasibility, acceptability, appropriateness, and patient perceptions. Results One-month post-implementation, 28% (40/141) of completed in-person visits had at least one kit request, and a total of 121 kits were distributed. Staff and clinicians found the program to be highly feasible, acceptable, and appropriate, and patient perceptions were positive. Conclusions Incorporating kits in OBAT settings is an important step toward increasing patient access and utilization of life-saving services. Our program uncovered a significant unmet need among our patients, suggesting that kit integration within addiction treatment can improve the standard of care for people who use drugs.

Published
2023
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43. Venous thromboembolic disease in admitted blunt trauma patients: what matters?

Author

Camille Lineberry, Dimitri Alexis, Ambika Mukhi, Kevin Duh, Mathew Tharakan, James A. Vosswinkel, and Randeep S. Jawa

Subjects
Trauma, Venous thromboembolism, Deep venous Thrombosis, Pulmonary Embolism, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Abstract Background Venous thromboembolic events (VTE) are a significant cause of morbidity and mortality following traumatic injury. We examined demographic characteristics, chemoprophylaxis, and outcomes of VTE patients with blunt trauma requiring hospitalization. Methods A retrospective review of adult blunt trauma hospitalizations with and without VTE between 2012 and 2019 was conducted. Deaths in the emergency department were excluded. Univariate and multivariable analyses, including machine learning classification algorithms for VTE, were performed. Results Of 10,926 admitted adult blunt trauma patients, 177 had VTE events. VTE events occurred at a median of 6 [IQR 3–11] days, with 7.3% occurring within 1 day of admission. VTE patients were more often male, and more often underwent surgery. They had higher injury severity as well as longer intensive care unit and hospital lengths of stay. While VTE occurred throughout the spectrum of injury severity, 27.7% had low injury severity (ISS

Published
2023
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48. Technological Advances in SPECT and SPECT/CT Imaging

Author

Yassine Bouchareb, Afrah AlSaadi, Jawa Zabah, Anjali Jain, Aziza Al-Jabri, Peter Phiri, Jian Qing Shi, Gayathri Delanerolle, and Srinivasa Rao Sirasanagandla

Subjects
SPECT/CT, SPECT, collimator design, solid-state detectors, reconstruction algorithms, artificial intelligence, Medicine (General), R5-920
Abstract

Single photon emission tomography/computed tomography (SPECT/CT) is a mature imaging technology with a dynamic role in the diagnosis and monitoring of a wide array of diseases. This paper reviews the technological advances, clinical impact, and future directions of SPECT and SPECT/CT imaging. The focus of this review is on signal amplifier devices, detector materials, camera head and collimator designs, image reconstruction techniques, and quantitative methods. Bulky photomultiplier tubes (PMTs) are being replaced by position-sensitive PMTs (PSPMTs), avalanche photodiodes (APDs), and silicon PMs to achieve higher detection efficiency and improved energy resolution and spatial resolution. Most recently, new SPECT cameras have been designed for cardiac imaging. The new design involves using specialised collimators in conjunction with conventional sodium iodide detectors (NaI(Tl)) or an L-shaped camera head, which utilises semiconductor detector materials such as CdZnTe (CZT: cadmium–zinc–telluride). The clinical benefits of the new design include shorter scanning times, improved image quality, enhanced patient comfort, reduced claustrophobic effects, and decreased overall size, particularly in specialised clinical centres. These noticeable improvements are also attributed to the implementation of resolution-recovery iterative reconstructions. Immense efforts have been made to establish SPECT and SPECT/CT imaging as quantitative tools by incorporating camera-specific modelling. Moreover, this review includes clinical examples in oncology, neurology, cardiology, musculoskeletal, and infection, demonstrating the impact of these advancements on clinical practice in radiology and molecular imaging departments.

Published
2024
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49. Nemotron-4 340B Technical Report.

Author

Bo Adler, Niket Agarwal, Ashwath Aithal, Dong H. Anh, Pallab Bhattacharya, Annika Brundyn, Jared Casper, Bryan Catanzaro, Sharon Clay, Jonathan M. Cohen, Sirshak Das, Ayush Dattagupta, Olivier Delalleau, Leon Derczynski, Yi Dong, Daniel Egert, Ellie Evans, Aleksander Ficek, Denys Fridman, Shaona Ghosh, Boris Ginsburg, Igor Gitman, Tomasz Grzegorzek, Robert Hero, Jining Huang, Vibhu Jawa, Joseph Jennings, Aastha Jhunjhunwala, John Kamalu, Sadaf Khan, Oleksii Kuchaiev, Patrick LeGresley, Hui Li, Jiwei Liu, Zihan Liu 0001, Eileen Long, Ameya Sunil Mahabaleshwarkar, Somshubra Majumdar, James Maki, Miguel Martinez, Maer Rodrigues de Melo, Ivan Moshkov, Deepak Narayanan, Sean Narenthiran, Jesus Navarro, Phong Nguyen, Osvald Nitski, Vahid Noroozi, Guruprasad Nutheti, Christopher Parisien, Jupinder Parmar, Mostofa Patwary, Krzysztof Pawelec, Wei Ping, Shrimai Prabhumoye, Rajarshi Roy 0003, Trisha Saar, Vasanth Rao Naik Sabavat, Sanjeev Satheesh, Jane Polak Scowcroft, Jason Sewall, Pavel Shamis, Gerald Shen, Mohammad Shoeybi, Dave Sizer, Misha Smelyanskiy, Felipe Soares, Makesh Narsimhan Sreedhar, Dan Su 0003, Sandeep Subramanian, Shengyang Sun, Shubham Toshniwal, Hao Wang, Zhilin Wang, Jiaxuan You, Jiaqi Zeng, Jimmy Zhang, Jing Zhang 0023, Vivienne Zhang, Yian Zhang, and Chen Zhu 0001

Published
2024
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50. Nemotron-4 15B Technical Report.

Author

Jupinder Parmar, Shrimai Prabhumoye, Joseph Jennings, Mostofa Patwary, Sandeep Subramanian, Dan Su 0003, Chen Zhu 0001, Deepak Narayanan, Aastha Jhunjhunwala, Ayush Dattagupta, Vibhu Jawa, Jiwei Liu, Ameya Mahabaleshwarkar, Osvald Nitski, Annika Brundyn, James Maki, Miguel Martinez, Jiaxuan You, John Kamalu, Patrick LeGresley, Denys Fridman, Jared Casper, Ashwath Aithal, Oleksii Kuchaiev, Mohammad Shoeybi, Jonathan M. Cohen, and Bryan Catanzaro

Published
2024
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