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Polycystic Ovarian Syndrome (PCOS): Exploring Its Impact on Obstetrical Outcomes

Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1111-1123页

作者： Ranjitha Vasa Gayatri Venkataraman Kelly Gorman Rythika Francis Elise Zwicklbauer Julia Fisher Polina Safovich Mudar Dalloul Ozgul Muneyyirci-Delale Department of Obstetrics and Gynecology SUNY Downstate Health Science University Brooklyn United States of America Department of Obstetrics and Gynecology Kings County Hospital Center NYC Health and Hospitals Brooklyn United States of America

Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of Monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p < 0.001), hypertensive disorders (OR 1.589, p < 0.001) during pregnancy, neonatal mortality (OR 1.550, p < 0.001), cesarean section (C/S) (OR 1.489, p < 0.001), and preterm prelabor rupture of membranes (PPROM) (OR 2.081, p < 0.001). With PCOS diagnosed during pregnancy, there were significantly greater odds of diabetes (OR 3.278, p < 0.001), hypertensive disorders (OR 2.935, p < 0.001) during pregnancy, and significantly decreased risk for small for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. Meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROM, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that

关键词： PCOS Polycystic Ovarian Syndrome Obstetrics Reproduction Pregnancy

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Co-occurrence based texture synthesis

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Computational Visual Media 2022年第2期8卷 289-302页

作者： Anna Darzi Itai Lang Ashutosh Taklikar Hadar Averbuch-Elor Shai Avidan Tel Aviv University Tel Aviv 6997801Israel Cornell-Tech Cornell UniversityNYCNY10044USA

As image generation techniques mature,there is a growing interest in explainable representations that are easy to understand and intuitive to *** this work,we turn to co-occurrence statistics,which have long been used for texture analysis,to learn a controllable texture synthesis *** propose a fully convolutional generative adversarial network,conditioned locally on co-occurrence statistics,to generate arbitrarily large images while having local,interpretable control over texture *** encourage fidelity to the input condition,we introduce a novel differentiable co-occurrence loss that is integrated seamlessly into our framework in an end-to-end *** demonstrate that our solution offers a stable,intuitive,and interpretable latent representation for texture synthesis,which can be used to generate smooth texture morphs between different *** further show an interactive texture tool that allows a user to adjust local characteristics of the synthesized texture by directly using the co-occurrence values.

关键词： co-occurrence texture synthesis deep learning generative adversarial networks(GANs)

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Utilization of access to colorectal cancer screening modalities in low-income populations after medicaid expansion

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World Journal of Gastrointestinal Oncology 2023年第9期15卷 1653-1661页

作者： Gerald Fletcher Joan Culpepper-Morgan Alvaro Genao Eric Alatevi Department of Gastroenterology NYC Health+Hospitals/HarlemNew YorkNY 10037United States Department of Gastroenterology NYC Health+Hospitals/Harlem506 Lenox AveNew YorkNY 10037United States

BACKGROUND Colorectal cancer(CRC)remains a relevant public health *** research suggests that racial,economic and geographic disparities impact *** the expansion of Medicaid eligibility as a key component of the Affordable Care Act(ACA),there is a dearth of information on the utilization of newly gained access to CRC screening by low-income *** study investigates the impact of the ACA’s Medicaid expansion on utilization of the various CRC screening modalities by low-income *** working hypothesis is that Medicaid expansion will increase access and utilization of CRC screening by low-income *** To investigate the impact of the Affordable Care Act and in particular the effect of Medicaid expansion on access and utilization of CRC screening modalities by Medicaid state expansion status across the United *** This was a quasi-experimental study design using data from the Behavioral Risk Factor Surveillance System,a large health system survey for participants across the United States and with over 2.8 million *** period of the study was from 2011 to 2016 which was dichotomized as pre-ACA Medicaid expansion(2011-2013)and post-ACA Medicaid expansion(2014-2016).The change in utilization of access to CRC screening strategies between the expansion periods were analyzed as the dependent *** analyses included stratification of the access by ethnicity/race,income,and education *** A greater increase in utilization of access to CRC screening was observed in Medicaid expansion states than in nonexpansion states[+2.9%;95%confidence interval(95%CI):2.12,3.69].Low-income participants showed a+4.02%(95%CI:2.96,5.07)change between the expansion periods compared with higher income groups+3.19%(1.70,4.67).Non-Hispanic Whites and Hispanics[+3.01%(95%CI:2.16,3.85)vs+5.51%(95%CI:2.81,8.20)]showed a statistically significant increase in utilization of access but not in Non-Hispanic Blac

关键词： Medicaid expansion Colorectal cancer screening Low-income Disparities Minorities Affordable care act

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Regulating autophagy:a novel role for SETX(Senataxin)

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Neural Regeneration Research 2021年第10期16卷 2008-2009页

作者： Patricia Richard Emanuel Rosonina Stellate Therapeutics Inc. JLABS@NYCNew YorkUSA Department of Biology York UniversityTorontoCanada

Mutations in the gene encoding SETX,also known as Senataxin,are mainly linked to two distinct neurodegenerative diseases,a cerebellar ataxia known as oculomotor apraxia type 2(AOA2)and a form of juvenile amyotrophic l... 详细信息

关键词： al. diseases degenerative

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Impact of erythropoietin therapy on cardiorenal syndrome:A systematic review with meta-analysis

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World Journal of Cardiology 2023年第5期15卷 273-283页

作者： Rubal Bhangal Ivan Cancarevic Mahmoud Nassar Zaryab Umar Department of Internal Medicine Icahn School of Medicine at Mount Sinai/NYC Health+Hospitals QueensNew YorkNY 11432United States Department of Internal Medicine Icahn School of Medicine at Mount SinaiNew YorkNY 10029United States Department of Internal Medicine NYC Health+Hospital QueensNew YorkNY 11432United States

BACKGROUND Heart and kidney dysfunction frequently coexist in patients with acute heart failure due to the overlap between these two organ *** syndrome(CRS)results from pathology occurring in the heart and kidneys along with the consequences of dysfunction in one organ contributing to dysfunction in the other and vice *** To evaluate the use of erythropoietin(EPO)in patients with CRS and its effects on hemoglobin(Hb),major cardiovascular(CV)events,and hospitalization *** On February 24,2022,searches were conducted using PubMed,MEDLINE,and EMBASE,and 148 articles were identified.A total of nine studies were considered in this systematic *** assessed the included articles based on the National Heart,Lung,and Blood Institute quality assessment tools for controlled intervention and observational cohort or cross-sectional *** assessment of bias risk was conducted on the chosen studies,and data relevant to our review was *** The systematic review of these studies concluded that most existing literature indicates that EPO improves baseline Hb levels and decreases myocardial remodeling and left ventricular dysfunction without reducing CV *** addition,the effect of EPO on the hospitalization rate of patients with CRS needs to be further studied since this relationship is *** studies,such as randomized controlled clinical trials and prospective cohort studies,should be conducted to enhance the literature on the potential of EPO therapy in patients with *** Our systematic review suggests that EPO therapy may have a significant role in managing *** review highlights the potential benefits of EPO in improving baseline Hb levels,reducing the risk of major CV events,improving cardiac remodeling,myocardial function,New York Heart Association class,and B-type natriuretic peptide ***,the effect of EPO treatment on hospitalization remains unclear and needs further exploration.

关键词： Cardiorenal syndrome Anemia Cardiovascular disease End-stage renal disease Erythropoietin Congestive heart failure

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Assessment of the Visual Analogue Score in the Evaluation of the Pruritus of Cholestasis

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Journal of Clinical and Translational Hepatology 2017年第3期5卷 203-207页

作者： Nora V.Bergasa E.Anthony Jones nyc H + H Metropolitan New York NY USA New York Medical College Valhalla NY USA Department of Gastroenterology and Liver Diseases Academic Medical Center Amsterdam The Netherlands

Background and Aims:A visual analogue score (VAS),based on application of a visual analogue scale,has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease.A VAS is a numerical score of the severity of the perception of pruritus,and,hence,is inherently *** objective of this study was to assessthe reliability of a VAS as an index of pruritus in cholestatic ***:In 8 patients with chronic pruritus due to primary biliary cholangitis,values for a VAS of pruritus were compared with corresponding measurements of scratching activity,which were generated by a monitoring system specifically designed to quantitate this *** relationship between individual values for the VAS and corresponding values for scratching activity during a specific interval immediately preceding the recording of the VAS was examined by determining the Spearman's rank correlation ***:The mean Spearman's rank correlation coefficient between individual values for the VAS and corresponding mean values for scratching activity was 0.072;the range of these coefficients was-0.04 to 0.26.A VAS of pruritus is an unreliable index of scratching activity,and,hence,of the pathophysiological process responsible for the pruritus of ***:It is concluded that the use of a VAS as a primary quantitative endpoint in trials of the efficacy of potential therapies for the pruritus of cholestasis may be inappropriate.

关键词： Pruritus Cholestasis Visual analogue score Scratching activity Primary biliary cholangitis Quantitative efficacy endpoint

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Adverse Effects of Sedentary Lifestyles: Inflammation, and High-Glucose Induced Oxidative Stress—A Double Blind Randomized Clinical Trial on Diabetic and Prediabetic Patients

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Health 2020年第8期12卷 1029-1048页

作者： Xanya Sofra Sheetal Badami New School for Social Research NYC NY USA City University of London London UK University of Mumbai Mumbai India

Sedentary lifestyles promote adipose tissue accumulation that generates systemic inflammation and oxidative damage. Physical activity induces cardiovascular fitness, increases muscle mass, and healthy blood glucose regulation, while reducing visceral fat, triglycerides and low-density lipoproteins. It is theoretically possible to develop a long-term multi-exercise regimen for health management and enhancement. Pragmatically, time and career restraints, individual choices, genetic factors, or demoralization due to the draconian commitment involved in weight loss, have rendered over a billion of individuals obese, or overweight, burdened by excess lipids, insulin resistance, elevated glucose levels, and inflammation, that foster a number of medical conditions including diabetes. Strenuous overtraining has ensued adverse effects, including an upsurge of proinflammatory cytokines, and hyperglycemia. We implemented an one-month long innovative method with 20 diabetic and prediabetic patients. Results demonstrated a statistically significant reduction of both fasting and PP blood glucose. Fasting and PP insulin reached optimal levels. There was a substantial decline in dyslipidemia, reflecting a reverse relationship of elevated HDL versus triglycerides descending towards the normal range. The notable visceral fat reduction was validated by sonography reports that indicated no evidence of fatty liver in seven patients previously diagnosed with hepatic steatosis. These findings have important implications in improving the health status of obese diabetic and prediabetic individuals, by helping them jumpstart an active lifestyle, or by serving as an exercise alternative to reduce lipids, blood glucose levels and insulin resistance.

关键词： Inflammation Oxidative Stress Visceral Adiposity Lipoproteins Triglycerides Blood Glucose Insulin Hepatic Steatosis Dyslipidemia Analgesia Diabetes Prediabetes Weight Loss Exercise

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Coronavirus disease 2019 and renal transplantation

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World Journal of Clinical Cases 2021年第27期9卷 7986-7997页

作者： Mahmoud Nassar Nso Nso Jonathan Ariyaratnam Jasmine Sandhu Mahmoud Mohamed Bahaaeldin Baraka Atif Ibrahim Mostafa Alfishawy David Zheng Harangad Bhangoo Karim M Soliman Matthew Li Vincent Rizzo Ahmed Daoud Department of Medicine Icahn School of Medicine at Mount Sinai(NYC Health and Hospitals:Queens)New YorkNY 10029United States Department of Medicine University of Tennessee Health Science CenterMemphisTN 38163United States Department of Oncology Southend University HospitalNHS Foundation TrustEssex SS00RYUnited Kingdom Renal Division Department of MedicineUniversity of Tennessee Health Science CenterMemphisTN 38163United States Infectious Diseases Infectious Diseases Consultants and Academic Researchers of Egypt IDCARECairo 0000Egypt Department of Medicine Medical University of South CarolinaCharlestonSC 29425United States Department of Clinical Pharmacy Icahn School of Medicine at Mount Sinai(NYC Health and Hospitals:Queens)New YorkNY 10029United States Department of Medicine Icahn School of Medicine at Mount Sinai(NYC Health and Hospitals:Queens)New YorkNY 11373United States Department of Medicine Kasr Alainy Medical SchoolCairo UniversityCairo 11562Egypt

Ever since the severe acute respiratory syndrome virus causing coronavirus disease 2019(COVID-19)struck the world,global health strategies have changed *** to the Centers for Disease Control and Prevention,kidney transplant recipients are stratified as being high risk of developing fatal illness from COVID-19 *** transplant is the gold-standard treatment for end-stage kidney disease *** the pandemic,significant concerns have emerged regarding continuation of kidney transplant surgeries and management of kidney transplant recipients *** added risk of immunosuppression in this cohort was and remains a theoretical concern,posing a potential risk of transplantation rather than *** comprehensive review aims to cover most of the faced challenges in kidney transplantation in different stages of the *** addition,it will elucidate the epidemiology,nature,course of the disease,surgical consideration in donors and recipients as well as role of immunosuppression and management of COVID-19 infected kidney transplant recipients during these extraordinary circumstances.

关键词： Renal transplantation COVID-19 SARS-CoV-2 Kidney failure

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Liver transplantation during global COVID-19 pandemic

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World Journal of Clinical Cases 2021年第23期9卷 6608-6623页

作者： Mostafa Alfishawy Nso Nso Mahmoud Nassar Jonathan Ariyaratnam Sakil Bhuiyan Raheel S Siddiqui Matthew Li Howard Chung Amira Al Balakosy Ahmed Alqassieh Tibor Fülöp Vincent Rizzo Ahmed Daoud Karim M Soliman Infectious Diseases Infectious Diseases Consultants and Academic Researchers of Egypt IDCARECairo 0000Egypt Department of Medicine Icahn School of Medicine at Mount Sinai(NYC Health and Hospitals:Queens)New YorkNY 11373United States Clinical pharmacy department Icahn School of Medicine at Mount Sinai(NYC Health and Hospitals:Queens)New YorkNY 11373United States Tropical Medicine Department Ain Shams UniversityCairo 11517Egypt Department of Surgery Medical University of South CarolinaCharlestonSC 29425United States Department of Medicine Medical University of South CarolinaCharlestonSC 29425United States Department of Medicine Kasr Alainy Medical SchoolCairo UniversityCairo 11562Egypt

The coronavirus disease 2019(COVID-19)caused by severe acute respiratory disease respiratory syndrome coronavirus-2 has significantly impacted the health care systems *** transplantation(LT)has faced an unequivocal challenge during this unprecedented *** targeted review aims to cover most of the clinical issues,challenges and concerns about LT during the COVID-19 pandemic and discuss the most updated literature on this rapidly emerging subject.

关键词： COVID-19 Calcineurin inhibitors Cytokine Distributive justice End-stage liver disease Immunosuppression Liver transplantation Mortality

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Dynamic Optimization of Caregiver Schedules Based on Vital Sign Streams

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E-Health Telecommunication Systems and Networks 2013年第2期2卷 36-47页

作者： Mohamed Saad Bilal Khan Department of Math and Computer Science John Jay College (CUNY) New York USA nyc Social Network Research Group John Jay College (CUNY) New York USA

Hospital facilities use a collection of heterogeneous devices, produced by many different vendors, to monitor the state of patient vital signs. The limited interoperability of current devices makes it difficult to synthesize multivariate monitoring data into a unified array of real-time information regarding the patients state. Without an infrastructure for the integrated evaluation, display, and storage of vital sign data, one cannot adequately ensure that the assignment of caregivers to patients reflects the relative urgency of patient needs. This is an especially serious issue in critical care units (CCUs). We present a formal mathematical model of an operational critical care unit, together with metrics for evaluating the systematic impact of caregiver scheduling decisions on patient care. The model is rich enough to capture the essential features of device and patient diversity, and so enables us to test the hypothesis that integration of vital sign data could realistically yield a significant positive impact on the efficacy of critical care delivery outcome. To test the hypothesis, we employ the model within a computer simulation. The simulation enables us to compare the current scheduling processes in widespread use within CCUs, against a new scheduling algorithm that makes use of an integrated array of patient information collected by an (anticipated) vital sign data integration infrastructure. The simulation study provides clear evidence that such an infrastructure reduces risk to patients and lowers operational costs, and in so doing reveals the inherent costs of medical device non-interoperability.

关键词： Critical Care Nurse Scheduling Optimization

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