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Prediction of permanent pacemaker implantation after transcatheter aortic valve replacement:The role of machine learning

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World Journal of Cardiology 2023年第3期15卷 95-105页

作者： Pradyumna Agasthi Hasan Ashraf Sai Harika Pujari Marlene Girardo Andrew Tseng Farouk Mookadam Nithin Venepally Matthew R Buras bishoy abraham Banveet K Khetarpal Mohamed Allam Siva K Mulpuru MD Mackram F Eleid Kevin L Greason Nirat Beohar John Sweeney David Fortuin David R Jr Holmes Reza Arsanjani Department of Cardiology Mayo ClinicPhoenixAZ 85054United States Department of Internal Medicine The Brooklyn Hospital CenterBrooklynNY 11201United States Department of Biostatistics Mayo ClinicPhoenixAZ 85054United States Department of Cardiovascular Diseases Mayo ClinicRochesterMN 55905United States Department of Statistics Mayo ClinicPhoenixAZ 85054United States Department of Cardiovascular Surgery Mayo ClinicRochesterMN 55905United States Mount Sinai Medical Center Columbia UniversityMiami BeachFL 33138United States

BACKGROUND Atrioventricular block requiring permanent pacemaker(PPM)implantation is an important complication of transcatheter aortic valve replacement(TAVR).Application of machine learning could potentially be used to predict preprocedural risk for *** To apply machine learning to be used to predict pre-procedural risk for *** A retrospective study of 1200 patients who underwent TAVR(January 2014-December 2017)was performed.964 patients without prior PPM were included for a 30-d analysis and 657 patients without PPM requirement through 30 d were included for a 1-year *** the exclusion of variables with near-zero variance or≥50%missing data,167 variables were included in the random forest gradient boosting algorithm(GBM)optimized using 5-fold cross-validations repeated 10 *** receiver operator curve(ROC)for the GBM model and PPM risk score models were calculated to predict the risk of PPM at 30 d and 1 *** Of 964 patients included in the 30-d analysis without prior PPM,19.6%required PPM *** mean age of patients was 80.9±8.7 years.42.1%were *** 657 patients included in the 1-year analysis,the mean age of the patients was 80.7±*** those,42.6%of patients were female and 26.7%required PPM at 1-year *** area under ROC to predict 30-d and 1-year risk of PPM for the GBM model(0.66 and 0.72)was superior to that of the PPM risk score(0.55 and 0.54)with a P value<*** The GBM model has good discrimination and calibration in identifying patients at high risk of PPM post-TAVR.

关键词： Transcatheter aortic valve replacement Permanent pacemaker implantation Machine learning

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Comparative framework for AC-microgrid protection schemes: challenges, solutions, real applications, and future trends

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Protection and Control of Modern Power Systems 2023年第2期8卷 99-138页

作者： Ahmed N.Sheta Gabr M.Abdulsalam bishoy E.Sedhom Abdelfattah A.Eladl Electrical Engineering Department Faculty of EngineeringMansoura UniversityEl-MansouraEgypt

With the rapid development of electrical power systems in recent years,microgrids(MGs)have become increasingly *** improve network efficiency and reduce operating costs and emissions because of the integration of distributed renewable energy sources(RESs),energy storage,and source-load management *** these advances,the decentralized architecture of MGs impacts the functioning patterns of the entire system,including control strategy,energy management philosophy,and protection *** this context,developing a convenient protection strategy for MGs is challenging because of various obstacles,such as the significant variance in short-circuit values under different operating modes,two-way power flow,asynchronous reclosing,protection blinding,sympathetic tripping,and loss of *** light of these challenges,this paper reviews prior research on proposed protection schemes for AC-MGs to thoroughly evaluate network protection’s potential *** paper also provides a comprehensive overview of the MG structure and the associated protection challenges,solutions,real applications,and future trends.

关键词： Microgrid Active distribution network Microgrid protection Renewable energy sources Smart grids Distributed energy resources Energy storage

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Anthropometric method for estimating component sizes in total hip arthroplasty

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World Journal of Orthopedics 2021年第11期12卷 859-866页

作者： Rajpreet Sahemey Thomas S Moores Hannah Meacher bishoy Youssef Shehzaad Khan Christopher R Evans Department of Trauma and Orthopaedics University Hospitals Coventry and WarwickshireCoventry CV22DXUnited Kingdom Department of Trauma and Orthopaedics Walsall Manor HospitalWalsall WS29PSUnited Kingdom Department of Trauma and Orthopaedics Royal Stoke University HospitalStoke-on-Trent ST46QGUnited Kingdom Department of Trauma and Orthopaedics Royal National Orthopaedic HospitalStanmore HA74LPUnited Kingdom Department of Orthopaedics The Robert Jones and Agnes Hunt Orthopaedic HospitalOswestry SY107AGUnited Kingdom

BACKGROUND Preoperative templating is essential in total hip arthroplasty(THA)as it not only helps to facilitate the correct implant type and size but also determines the postoperative *** is also increasingly important from a medicolegal perspective and recommended in the British Orthopaedic Association Guide to Good *** templating has become increasingly digitised,there are no simple anthropometric models to predict implant sizes in the absence of digital *** To assess the accuracy of using an easily obtainable measurement(shoe size)to predict component sizes in THA compared with digital *** Digital radiographs from a cohort of 102 patients(40 male,62 female)who had undergone uncemented or hybrid THA at a single centre were retrospectively templated to desired cup and stem sizes using TraumaCad■.We compared the templated size to the actual size of the implant and assessed if there was any correlation with the patient’s shoe *** Statistically significant positive correlations were observed between:shoe size and templated cup size(ρ=0.92,P<0.001);shoe size with implanted cup size(ρ=0.71,P<0.001);shoe size and templated stem size(ρ=0.87,P<0.001);and shoe size with implanted stem size(ρ=0.57,P<0.001).Templated and implanted acetabular cup sizes were positively correlated(ρ=0.76,P<0.001)and were exact in 43.1%cases;80.4% of implanted cup sizes were within 1 size(+/-2 mm)of the template and 100% within 2 sizes(+/-4 mm).Positive correlation was also demonstrated between templated and implanted femoral stem sizes(ρ=0.69,P<0.001)and were exact in 52.6% cases;92.6% were within 1 size of the template and 98% within 2 *** This study has shown there to be a significant positive correlation between shoe size and templated *** measurements are easily obtainable and can be used to predict uncemented component sizes in the absence of digital methods.

关键词： Anthropometric Digital templating Hip Preoperative planning Total hip arthroplasty

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Impact of immunosuppression on incidence of post-transplant diabetes mellitus in solid organ transplant recipients:Systematic review and meta-analysis

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World Journal of Transplantation 2021年第10期11卷 432-442页

作者： Sreelakshmi Kotha bishoy Lawendy Saira Asim Charlene Gomes Jeffrey Yu Ani Orchanian-Cheff George Tomlinson Mamatha Bhat Department of Gastroenterology Guy's and St Thomas'HospitalLondon SE17JDUnited Kingdom Department of Multi-Organ Transplantation Toronto General HospitalToronto M5G 2C4Canada Multi Organ Transplant Program Toronto General HospitalToronto M5G 2C4Canada Dalla Lana School of Public Health Department of MedicineUniversity Health Network-Toronto General HospitalUniversity of TorontoToronto M5G 2C4Canada Multi-organ Transplant Toronto General HospitalToronto M5G 2C4Canada

BACKGROUND Solid organ transplantation is a life-saving intervention for end-stage organ ***-transplant diabetes mellitus(PTDM)is a common complication in solid organ transplant recipients,and significantly compromises long-term survival beyond a *** To perform a systematic review and meta-analysis to estimate incidence of PTDM and compare the effects of the 3 major immunosuppressants on incidence of *** Two hundred and six eligible studies identified 75595 patients on Tacrolimus,51242 on Cyclosporine and 3020 on *** effects meta-analyses was used to calculate *** Network meta-analysis estimated the overall risk of developing PTDM was higher with tacrolimus(OR=1.495%CI:1.0–2.0)and sirolimus(OR=1.8;95%CI:1.5–2.2)than with *** overall incidence of PTDM at years 2-3 was 17%for kidney,19%for liver and 22%for *** risk factors for PTDM most frequently identified in the primary studies were age,body mass index,hepatitis C,and African American *** Tacrolimus tends to exhibit higher diabetogenicity in the short-term(2-3 years post-transplant),whereas sirolimus exhibits higher diabetogenicity in the longterm(5-10 years post-transplant).This study will aid clinicians in recognition of risk factors for PTDM and encourage careful evaluation of the risk/benefit of different immunosuppressant regimens in transplant recipients.

关键词： Post-transplant diabetes mellitus solid organ transplantation Tacrolimus Cyclosporin Sirolimus

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Effects of energy drinks on the cardiovascular system

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World Journal of Cardiology 2017年第11期9卷 796-806页

作者： bishoy Wassef Michelle Kohansieh Amgad N Makaryus Department of Family Medicine Eisenhower Medical Center Stern College for Women Yeshiva University Department of Cardiology Northwell Health/Nassau University Medical Center Hofstra Northwell School of Medicine

Throughout the last decade, the use of energy drinks has been increasingly looked upon with caution as potentially dangerous due to their perceived strong concentration of caffeine aside from other substances such as taurine, guarana, and L-carnitine that are largely unknown to the general public. In addition, a large number of energy drink intoxications have been reported all over the world including cases of seizures and arrhythmias. In this paper, we focus on the effect of energy drinks on the cardiovascular system and whether the current ongoing call for the products' sales and regulation of their contents should continue.

关键词： Energy drinks Caffeine Taurine Guarana Cardiovascular effects

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A Comparison of Perioperative Blood Transfusions and Other Complications Following Transverse Rectus Abdominis Myocutaneous Flaps versus Deep Inferior Epigastric Perforator Flaps

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Surgical Science 2017年第3期8卷 145-153页

作者： Rajith A. Amaratunga bishoy Soliman Thomas C. Lam Department of Plastic and Reconstructive Surgery Westmead Hospital Sydney Australia

Objective: Abdominal based free flaps such as the Transverse Rectus Abdominis Myocutaneous (TRAM) flap and Deep Inferior Epigastric Perforator (DIEP) flap are essential tools in the reconstructive armamentarium post mastectomy. These reconstructions are often prolonged, complex and associated with complications. This study aims to compare the complication rate, particularly focusing on perioperative transfusions, between TRAM and DIEP flaps performed by the senior author in our tertiary referral centre. Methods: A retrospective review was conducted of one hundred and seven consecutive TRAM and DIEP flaps from 2000 to 2014. The two groups were analysed for demographics, preoperative risk factors and post-operative complications including blood transfusions, haematomas, flap losses, redo-anastomoses, flap infections, abdominal wound sequelae and non-surgical complications. Results: Sixty-three patients underwent 67 free/muscle sparing TRAM flaps and 35 patients underwent 40 DIEP flaps. There were no statistically significant differences in patient demographics or preoperative risk factors between the two groups. Five TRAM flap cases (7.9%) required transfusion whilst no DIEP flap cases required transfusion. This difference was not found to be statistically significant (p = 0.16). However, free/muscle-sparing TRAM flaps were found to have a significantly higher overall complication rate compared to DIEP flaps (23.8% vs. 5.7%, p = 0.02). Conclusion: The current study demonstrated no difference in perioperative transfusion requirement between TRAM and DIEP cases. There was however a significantly higher rate of overall complications associated with TRAM flaps warranting the authors to conclude that care be taken when opting for this reconstructive method.

关键词： Breast Reconstruction DIEP TRAM Complications

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Prognostic Factors and Oncological Outcomes after Radical Nephroureterctomy for Upper Tract Urothelial Carcinoma: Review of Contemporary Multi-Center Series

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Open Journal of Urology 2012年第4期2卷 246-252页

作者： Ramy F. Youssef bishoy A. Gayed Vitaly Margulis Division of Urologic Oncology University of Texas Southwestern Medical Center Dallas USA

Upper tract urothelial cancers (UTUC) are uncommon and the information guiding their management used to be driven from small single center studies. Multi-center international collaborations should provide clinicians with best management practices as well as prognostic factors guiding treatment decisions and outcomes. We reviewed literature from the largest multicenter collaborations for radical nephroureterctomy (RNU) performed for management of UTUC. Our review included over 50 recent manuscripts from 2009-2012 that were published from multi-center UTUC collaboration groups. Our review aims to determine of the prognostic factors predicting oncological outcomes after RNU and to provide insights about possible maximization of cure with utilization of multimodal treatment approaches. Application of approaches comprising RNU including lymphadenectomy and systemic chemotherapy;particularly in neoadjuvant settings;might have implications on improvement of oncological outcomes in high risk patients.

关键词： Upper Tract Urothelial Carcinoma Prognosis Outcomes Nephroureterctomy

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