2024
Rodríguez, Josué Llamas; van der Kouwe, André J W; Oltmer, Jan; Rosenblum, Emma; Mercaldo, Nathaniel; Fischl, Bruce; Marshall, Michael; Frosch, Matthew P; Augustinack, Jean C
Entorhinal vessel density correlates with phosphorylated tau and TDP-43 pathology Journal Article
In: Alzheimers Dement, vol. 20, no. 7, pp. 4649-4662, 2024, ISSN: 1552-5279.
@article{pmid38877668,
title = {Entorhinal vessel density correlates with phosphorylated tau and TDP-43 pathology},
author = {Josu\'{e} Llamas Rodr\'{i}guez and Andr\'{e} J W van der Kouwe and Jan Oltmer and Emma Rosenblum and Nathaniel Mercaldo and Bruce Fischl and Michael Marshall and Matthew P Frosch and Jean C Augustinack},
doi = {10.1002/alz.13896},
issn = {1552-5279},
year = {2024},
date = {2024-07-01},
urldate = {2024-06-01},
journal = {Alzheimers Dement},
volume = {20},
number = {7},
pages = {4649-4662},
abstract = {INTRODUCTION: The entorhinal cortex (EC) and perirhinal cortex (PC) are vulnerable to Alzheimer\'s disease. A triggering factor may be the interaction of vascular dysfunction and tau pathology.nnMETHODS: We imaged post mortem human tissue at 100 μm with 7 T magnetic resonance imaging and manually labeled individual blood vessels (mean = 270 slices/case). Vessel density was quantified and compared per EC subfield, between EC and PC, and in relation to tau and TAR DNA-binding protein 43 (TDP-43) semiquantitative scores.nnRESULTS: PC was more vascularized than EC and vessel densities were higher in posterior EC subfields. Tau and TDP-43 strongly correlated with vasculature density and subregions with severe tau at the preclinical stage had significantly greater vessel density than those with low tau burden.nnDISCUSSION: These data impact cerebrovascular maps, quantification of subfield vasculature, and correlation of vasculature and pathology at early stages. The ordered association of vessel density, and tau or TDP-43 pathology, may be exploited in a predictive context.nnHIGHLIGHTS: Vessel density correlates with phosphorylated tau (p-tau) burden in entorhinal and perirhinal cortices. Perirhinal area 35 and posterior entorhinal cortex showed greatest p-tau burden but also the highest vessel density in the preclinical phase of Alzheimer\'s disease. We combined an ex vivo magnetic resonance imaging model and histopathology to demonstrate the 3D reconstruction of intracortical vessels and its spatial relationship to the pathology.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Deng, Bin; Muldoon, Ailis; Cormier, Jayne; Mercaldo, Nathaniel D; Niehoff, Elizabeth; Moffett, Natalie; Saksena, Mansi A; Isakoff, Steven J; Carp, Stefan A
In: J Biomed Opt, vol. 29, no. 6, pp. 066001, 2024, ISSN: 1560-2281.
@article{pmid38737790,
title = {Functional hemodynamic imaging markers for the prediction of pathological outcomes in breast cancer patients treated with neoadjuvant chemotherapy},
author = {Bin Deng and Ailis Muldoon and Jayne Cormier and Nathaniel D Mercaldo and Elizabeth Niehoff and Natalie Moffett and Mansi A Saksena and Steven J Isakoff and Stefan A Carp},
doi = {10.1117/1.JBO.29.6.066001},
issn = {1560-2281},
year = {2024},
date = {2024-06-01},
journal = {J Biomed Opt},
volume = {29},
number = {6},
pages = {066001},
abstract = {SIGNIFICANCE: Achieving pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) is a significant predictor of increased likelihood of survival in breast cancer patients. Early prediction of pCR is of high clinical value as it could allow personalized adjustment of treatment regimens in non-responding patients for improved outcomes.nnAIM: We aim to assess the association between hemoglobin-based functional imaging biomarkers derived from diffuse optical tomography (DOT) and the pathological outcome represented by pCR at different timepoints along the course of NACT.nnAPPROACH: Twenty-two breast cancer patients undergoing NACT were enrolled in a multimodal DOT and X-ray digital breast tomosynthesis (DBT) imaging study in which their breasts were imaged at different compression levels. Logistic regressions were used to study the associations between DOT-derived imaging markers evaluated after the first and second cycles of chemotherapy, respectively, with pCR status determined after the conclusion of NACT at the time of surgery. Receiver operating characteristic curve analysis was also used to explore the predictive performance of selected DOT-derived markers.nnRESULTS: Normalized tumor HbT under half compression was significantly lower in the pCR group compared to the non-pCR group after two chemotherapy cycles (). In addition, the change in normalized tumor upon reducing compression from full to half mammographic force was identified as another potential indicator of pCR at an earlier time point, i.e., after the first chemo cycle (). Exploratory predictive assessments showed that AUCs using DOT-derived functional imaging markers as predictors reach as high as 0.75 and 0.71, respectively, after the first and second chemo cycle, compared to AUCs of 0.50 and 0.53 using changes in tumor size measured on DBT and MRI.nnCONCLUSIONS: These findings suggest that breast DOT could be used to assist response assessment in women undergoing NACT, a critical but unmet clinical need, and potentially enable personalized adjustments of treatment regimens.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chan, Suk-Tak; Mercaldo, Nathaniel; Longo, Maria G Figueiro; Welt, Jonathan; Avesta, Arman; Lee, Jarone; Lev, Michael H; Ratai, Eva-Maria; Wenke, Michael R; Parry, Blair A; Drake, Lynn; Anderson, Richard R; Rauch, Terry; Diaz-Arrastia, Ramon; Kwong, Kenneth K; Hamblin, Michael; Vakoc, Benjamin J; Gupta, Rajiv
In: Radiology, vol. 311, no. 2, pp. e230999, 2024, ISSN: 1527-1315.
@article{pmid38805733,
title = {Effects of Low-Level Light Therapy on Resting-State Connectivity Following Moderate Traumatic Brain Injury: Secondary Analyses of a Double-blinded Placebo-controlled Study},
author = {Suk-Tak Chan and Nathaniel Mercaldo and Maria G Figueiro Longo and Jonathan Welt and Arman Avesta and Jarone Lee and Michael H Lev and Eva-Maria Ratai and Michael R Wenke and Blair A Parry and Lynn Drake and Richard R Anderson and Terry Rauch and Ramon Diaz-Arrastia and Kenneth K Kwong and Michael Hamblin and Benjamin J Vakoc and Rajiv Gupta},
doi = {10.1148/radiol.230999},
issn = {1527-1315},
year = {2024},
date = {2024-05-01},
journal = {Radiology},
volume = {311},
number = {2},
pages = {e230999},
abstract = {Background Low-level light therapy (LLLT) has been shown to modulate recovery in patients with traumatic brain injury (TBI). However, the impact of LLLT on the functional connectivity of the brain when at rest has not been well studied. Purpose To use functional MRI to assess the effect of LLLT on whole-brain resting-state functional connectivity (RSFC) in patients with moderate TBI at acute (within 1 week), subacute (2-3 weeks), and late-subacute (3 months) recovery phases. Materials and Methods This is a secondary analysis of a prospective single-site double-blinded sham-controlled study conducted in patients presenting to the emergency department with moderate TBI from November 2015 to July 2019. Participants were randomized for LLLT and sham treatment. The primary outcome of the study was to assess structural connectivity, and RSFC was collected as the secondary outcome. MRI was used to measure RSFC in 82 brain regions in participants during the three recovery phases. Healthy individuals who did not receive treatment were imaged at a single time point to provide control values. The Pearson correlation coefficient was estimated to assess the connectivity strength for each brain region pair, and estimates of the differences in Fisher -transformed correlation coefficients (hereafter, differences) were compared between recovery phases and treatment groups using a linear mixed-effects regression model. These analyses were repeated for all brain region pairs. False discovery rate (FDR)-adjusted values were computed to account for multiple comparisons. Quantile mixed-effects models were constructed to quantify the association between the Rivermead Postconcussion Symptoms Questionnaire (RPQ) score, recovery phase, and treatment group. Results RSFC was evaluated in 17 LLLT-treated participants (median age, 50 years [IQR, 25-67 years]; nine female), 21 sham-treated participants (median age, 50 years [IQR, 43-59 years]; 11 female), and 23 healthy control participants (median age, 42 years [IQR, 32-54 years]; 13 male). Seven brain region pairs exhibited a greater change in connectivity in LLLT-treated participants than in sham-treated participants between the acute and subacute phases (range of differences, 0.37 [95% CI: 0.20, 0.53] to 0.45 [95% CI: 0.24, 0.67]; FDR-adjusted value range, .010-.047). Thirteen different brain region pairs showed an increase in connectivity in sham-treated participants between the subacute and late-subacute phases (range of differences, 0.17 [95% CI: 0.09, 0.25] to 0.26 [95% CI: 0.14, 0.39]; FDR-adjusted value range, .020-.047). There was no evidence of a difference in clinical outcomes between LLLT-treated and sham-treated participants (range of differences in medians, -3.54 [95% CI: -12.65, 5.57] to -0.59 [95% CI: -7.31, 8.49]; value range, .44-.99), as measured according to RPQ scores. Conclusion Despite the small sample size, the change in RSFC from the acute to subacute phases of recovery was greater in LLLT-treated than sham-treated participants, suggesting that acute-phase LLLT may have an impact on resting-state neuronal circuits in the early recovery phase of moderate TBI. ClinicalTrials.gov Identifier: NCT02233413 © RSNA, 2024 },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Collins, Reagan A; Herman, Tianna; Snyder, Rebecca A; Haines, Krista L; Stey, Anne; Arora, Tania K; Geevarghese, Sunil K; Phillips, Joseph D; Vicente, Diego; Griggs, Cornelia L; McElroy, Imani E; Wall, Anji E; Hughes, Tasha M; Sen, Srijan; Valinejad, Jaber; Alban, Andres; Swan, J Shannon; Mercaldo, Nathaniel; Jalali, Mohammad S; Chhatwal, Jagpreet; Gazelle, G Scott; Rangel, Erika; Yang, Chi-Fu Jeffrey; Donelan, Karen; Gold, Jessica A; West, Colin P; Cunningham, Carrie
Unspoken Truths: Mental Health Among Academic Surgeons Journal Article
In: Ann Surg, vol. 279, iss. 3, pp. 429-436, 2024, ISSN: 1528-1140.
@article{pmid37991182,
title = {Unspoken Truths: Mental Health Among Academic Surgeons},
author = {Reagan A Collins and Tianna Herman and Rebecca A Snyder and Krista L Haines and Anne Stey and Tania K Arora and Sunil K Geevarghese and Joseph D Phillips and Diego Vicente and Cornelia L Griggs and Imani E McElroy and Anji E Wall and Tasha M Hughes and Srijan Sen and Jaber Valinejad and Andres Alban and J Shannon Swan and Nathaniel Mercaldo and Mohammad S Jalali and Jagpreet Chhatwal and G Scott Gazelle and Erika Rangel and Chi-Fu Jeffrey Yang and Karen Donelan and Jessica A Gold and Colin P West and Carrie Cunningham},
doi = {10.1097/SLA.0000000000006159},
issn = {1528-1140},
year = {2024},
date = {2024-03-01},
urldate = {2024-03-01},
journal = {Ann Surg},
volume = {279},
issue = {3},
pages = {429-436},
abstract = {OBJECTIVE: To characterize the current state of mental health within the surgical workforce in the United States (US).nnSUMMARY BACKGROUND DATA: Mental illness and suicide is a growing concern in the medical community; however, the current state is largely unknown.nnMETHODS: Cross-sectional survey of the academic surgery community assessing mental health, medical error, and suicidal ideation. The odds of suicidal ideation adjusting for sex, prior mental health diagnosis, and validated scales screening for depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol use disorder were assessed.nnRESULTS: Of 622 participating medical students, trainees, and surgeons (estimated response rate=11.4-14.0%), 26.1% (141/539) reported a previous mental health diagnosis. 15.9% (83/523) of respondents screened positive for current depression, 18.4% (98/533) for anxiety, 11.0% (56/510) for alcohol use disorder, and 17.3% (36/208) for PTSD. Medical error was associated with depression (30.7% vs. 13.3%, P\<0.001), anxiety (31.6% vs. 16.2%, P=0.001), PTSD (12.8% vs. 5.6%, P=0.018), and hazardous alcohol consumption (18.7% vs. 9.7%, P=0.022). 13.2% (73/551) of respondents reported suicidal ideation in the past year and 9.6% (51/533) in the past two weeks. On adjusted analysis, a previous history of a mental health disorder (aOR: 1.97, 95% CI: 1.04-3.65, P=0.033), and screening positive for depression (aOR: 4.30, 95% CI: 2.21-8.29, P\<0.001) or PTSD (aOR: 3.93, 95% CI: 1.61-9.44, P=0.002) were associated with increased odds of suicidal ideation over the past 12 months.nnCONCLUSIONS: Nearly 1 in 7 respondents reported suicidal ideation in the past year. Mental illness and suicidal ideation are significant problems among the surgical workforce in the US.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2023
Sikosek, Tobias; Horos, Rastislav; Trudzinski, Franziska; Jehn, Julia; Frank, Maurice; Rajakumar, Timothy; Klotz, Laura V; Mercaldo, Nathaniel; Kahraman, Mustafa; Heuvelman, Marco; Taha, Yasser; Gerwing, Jennifer; Skottke, Jasmin; Daniel-Moreno, Alberto; Sanchez-Delgado, Marta; Bender, Sophie; Rudolf, Christina; Hinkfoth, Franziska; Tikk, Kaja; Schenz, Judith; Weigand, Markus A; Feindt, Peter; Schumann, Christian; Christopoulos, Petros; Winter, Hauke; Kreuter, Michael; Schneider, Marc A; Muley, Thomas; Walterspacher, Stephan; Schuler, Martin; Darwiche, Kaid; Taube, Christian; Hegedus, Balazs; Rabe, Klaus F; Rieger-Christ, Kimberly; Jacobsen, Francine L; Aigner, Clemens; Reck, Martin; Bankier, Alexander A; Sharma, Amita; Steinkraus, Bruno R
Early Detection of Lung Cancer using small RNAs Journal Article
In: J Thorac Oncol, vol. 18, no. 11, pp. 1504-1523, 2023, ISSN: 1556-1380.
@article{pmid37437883,
title = {Early Detection of Lung Cancer using small RNAs},
author = {Tobias Sikosek and Rastislav Horos and Franziska Trudzinski and Julia Jehn and Maurice Frank and Timothy Rajakumar and Laura V Klotz and Nathaniel Mercaldo and Mustafa Kahraman and Marco Heuvelman and Yasser Taha and Jennifer Gerwing and Jasmin Skottke and Alberto Daniel-Moreno and Marta Sanchez-Delgado and Sophie Bender and Christina Rudolf and Franziska Hinkfoth and Kaja Tikk and Judith Schenz and Markus A Weigand and Peter Feindt and Christian Schumann and Petros Christopoulos and Hauke Winter and Michael Kreuter and Marc A Schneider and Thomas Muley and Stephan Walterspacher and Martin Schuler and Kaid Darwiche and Christian Taube and Balazs Hegedus and Klaus F Rabe and Kimberly Rieger-Christ and Francine L Jacobsen and Clemens Aigner and Martin Reck and Alexander A Bankier and Amita Sharma and Bruno R Steinkraus},
doi = {10.1016/j.jtho.2023.07.005},
issn = {1556-1380},
year = {2023},
date = {2023-11-01},
urldate = {2023-07-01},
journal = {J Thorac Oncol},
volume = {18},
number = {11},
pages = {1504-1523},
abstract = {BACKGROUND: Lung cancer remains the deadliest cancer in the world and survival is heavily dependent on tumor stage at the time of detection. Low-dose computed tomography (LDCT) screening can significantly reduce mortality, however, annual screening is limited by low adherence in the USA and still not broadly implemented in Europe. As a result, \<10% of lung cancers are detected through existing programs. Thus, there is great need for additional screening tests, such as a blood test that could be deployed in the primary care setting.nnMETHODS: We prospectively recruited 1,384 individuals meeting the NLST demographic eligibility criteria for lung cancer and collected stabilized whole blood to enable the pipetting-free collection of material, thus minimizing pre-analytical noise. Ultra-deep small RNA sequencing (20 million reads/sample) was performed with the addition of a method to remove highly abundant erythroid RNAs, and thus open bandwidth for the detection of less abundant species originating from plasma or the immune cellular compartment. We utilized 100 random data splits to train and evaluate an ensemble of logistic regression classifiers using small RNA expression of 943 individuals, discovered an 18-small RNA feature consensus signature (miLung), and validated this signature in an independent cohort (441 individuals). Blood cell sorting and tumor tissue sequencing were performed to deconvolve small RNAs into their source of origin.nnRESULTS: We generated diagnostic models and report a median ROC AUC of 0.86 (95% CI 0.84-0.86) in the discovery cohort, and generalized performance of 0.83 in the validation cohort. Diagnostic performance increased in a stage-dependent manner ranging from 0.73 (95% CI 0.71-0.76) for Stage I to 0.90 (95% CI 0.89-0.90) for Stage IV in the discovery cohort, and from 0.76 to 0.86 in the validation cohort. We identified a tumor-shed, plasma-bound ribosomal RNA fragment of the L1 stalk as a dominant predictor of lung cancer. The fragment is decreased following surgery with curative intent. In additional experiments, dried blood spot collection and sequencing demonstrated that small RNA analysis could potentially be conducted via home-sampling.nnCONCLUSION: These data suggest the potential of a small RNA-based blood test as a viable alternative to LDCT screening for early detection of smoking-associated lung cancer.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kocak, Burak; Baessler, Bettina; Bakas, Spyridon; Cuocolo, Renato; Fedorov, Andrey; Maier-Hein, Lena; Mercaldo, Nathaniel; Müller, Henning; Orlhac, Fanny; Santos, Daniel Pinto Dos; Stanzione, Arnaldo; Ugga, Lorenzo; Zwanenburg, Alex
CheckList for EvaluAtion of Radiomics research (CLEAR): a step-by-step reporting guideline for authors and reviewers endorsed by ESR and EuSoMII Journal Article
In: Insights Imaging, vol. 14, no. 1, pp. 75, 2023, ISSN: 1869-4101.
@article{pmid37142815,
title = {CheckList for EvaluAtion of Radiomics research (CLEAR): a step-by-step reporting guideline for authors and reviewers endorsed by ESR and EuSoMII},
author = {Burak Kocak and Bettina Baessler and Spyridon Bakas and Renato Cuocolo and Andrey Fedorov and Lena Maier-Hein and Nathaniel Mercaldo and Henning M\"{u}ller and Fanny Orlhac and Daniel Pinto Dos Santos and Arnaldo Stanzione and Lorenzo Ugga and Alex Zwanenburg},
doi = {10.1186/s13244-023-01415-8},
issn = {1869-4101},
year = {2023},
date = {2023-05-01},
journal = {Insights Imaging},
volume = {14},
number = {1},
pages = {75},
abstract = {Even though radiomics can hold great potential for supporting clinical decision-making, its current use is mostly limited to academic research, without applications in routine clinical practice. The workflow of radiomics is complex due to several methodological steps and nuances, which often leads to inadequate reporting and evaluation, and poor reproducibility. Available reporting guidelines and checklists for artificial intelligence and predictive modeling include relevant good practices, but they are not tailored to radiomic research. There is a clear need for a complete radiomics checklist for study planning, manuscript writing, and evaluation during the review process to facilitate the repeatability and reproducibility of studies. We here present a documentation standard for radiomic research that can guide authors and reviewers. Our motivation is to improve the quality and reliability and, in turn, the reproducibility of radiomic research. We name the checklist CLEAR (CheckList for EvaluAtion of Radiomics research), to convey the idea of being more transparent. With its 58 items, the CLEAR checklist should be considered a standardization tool providing the minimum requirements for presenting clinical radiomics research. In addition to a dynamic online version of the checklist, a public repository has also been set up to allow the radiomics community to comment on the checklist items and adapt the checklist for future versions. Prepared and revised by an international group of experts using a modified Delphi method, we hope the CLEAR checklist will serve well as a single and complete scientific documentation tool for authors and reviewers to improve the radiomics literature.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Yoon, Byung C; Pomerantz, Stuart R; Mercaldo, Nathaniel D; Goyal, Swati; L'Italien, Eric M; Lev, Michael H; Buch, Karen A; Buchbinder, Bradley R; Chen, John W; Conklin, John; Gupta, Rajiv; Hunter, George J; Kamalian, Shahmir C; Kelly, Hillary R; Rapalino, Otto; Rincon, Sandra P; Romero, Javier M; He, Julian; Schaefer, Pamela W; Do, Synho; González, Ramon Gilberto
Incorporating algorithmic uncertainty into a clinical machine deep learning algorithm for urgent head CTs Journal Article
In: PLoS One, vol. 18, no. 3, pp. e0281900, 2023, ISSN: 1932-6203.
@article{pmid36913348,
title = {Incorporating algorithmic uncertainty into a clinical machine deep learning algorithm for urgent head CTs},
author = {Byung C Yoon and Stuart R Pomerantz and Nathaniel D Mercaldo and Swati Goyal and Eric M L'Italien and Michael H Lev and Karen A Buch and Bradley R Buchbinder and John W Chen and John Conklin and Rajiv Gupta and George J Hunter and Shahmir C Kamalian and Hillary R Kelly and Otto Rapalino and Sandra P Rincon and Javier M Romero and Julian He and Pamela W Schaefer and Synho Do and Ramon Gilberto Gonz\'{a}lez},
doi = {10.1371/journal.pone.0281900},
issn = {1932-6203},
year = {2023},
date = {2023-03-13},
urldate = {2023-01-01},
journal = {PLoS One},
volume = {18},
number = {3},
pages = {e0281900},
abstract = {Machine learning (ML) algorithms to detect critical findings on head CTs may expedite patient management. Most ML algorithms for diagnostic imaging analysis utilize dichotomous classifications to determine whether a specific abnormality is present. However, imaging findings may be indeterminate, and algorithmic inferences may have substantial uncertainty. We incorporated awareness of uncertainty into an ML algorithm that detects intracranial hemorrhage or other urgent intracranial abnormalities and evaluated prospectively identified, 1000 consecutive noncontrast head CTs assigned to Emergency Department Neuroradiology for interpretation. The algorithm classified the scans into high (IC+) and low (IC-) probabilities for intracranial hemorrhage or other urgent abnormalities. All other cases were designated as No Prediction (NP) by the algorithm. The positive predictive value for IC+ cases (N = 103) was 0.91 (CI: 0.84-0.96), and the negative predictive value for IC- cases (N = 729) was 0.94 (0.91-0.96). Admission, neurosurgical intervention, and 30-day mortality rates for IC+ was 75% (63-84), 35% (24-47), and 10% (4-20), compared to 43% (40-47), 4% (3-6), and 3% (2-5) for IC-. There were 168 NP cases, of which 32% had intracranial hemorrhage or other urgent abnormalities, 31% had artifacts and postoperative changes, and 29% had no abnormalities. An ML algorithm incorporating uncertainty classified most head CTs into clinically relevant groups with high predictive values and may help accelerate the management of patients with intracranial hemorrhage or other urgent intracranial abnormalities.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2022
DiGennaro, Catherine; Vahdat, Vahab; Jalali, Mohammad; Toumi, Asmae; Watson, Tina; Gazelle, G Scott; Mercaldo, Nathaniel; Lubitz, Carrie C
In: Thyroid, vol. 32, iss. 10, pp. 1144-1157, 2022, ISSN: 1557-9077.
@article{pmid35999710,
title = {Assessing Bias and Limitations of Clinical Validation Studies of Molecular Diagnostic Tests for Indeterminate Thyroid Nodules: Systematic Review and Meta-Analysis},
author = {Catherine DiGennaro and Vahab Vahdat and Mohammad Jalali and Asmae Toumi and Tina Watson and G Scott Gazelle and Nathaniel Mercaldo and Carrie C Lubitz},
doi = {10.1089/thy.2022.0269},
issn = {1557-9077},
year = {2022},
date = {2022-10-01},
urldate = {2022-09-26},
journal = {Thyroid},
volume = {32},
issue = {10},
pages = {1144-1157},
abstract = {BACKGROUND: Molecular tests for thyroid nodules with indeterminate fine needle aspiration results are increasingly used in clinical practice; however, true diagnostic summaries of these tests are unknown. A systematic review and meta-analysis were completed to (1) evaluate the accuracy of commercially available molecular tests for malignancy in indeterminate thyroid nodules and (2) quantify biases and limitations in studies which validate those tests.
METHODS: PubMed, EMBASE, and Web of Science were systematically searched through July 2021. English language articles that reported original clinical validation attempts of molecular tests for indeterminate thyroid nodules were included if they reported counts of true negative, true positive, false negative, and false positive results. We performed screening and full text review, followed by assessment of eight common biases and limitations, extraction of diagnostic and histopathological information, and meta-analysis of clinical validity using a bivariate linear mixed-effects model.
RESULTS: 49 studies were included. Meta-analysis of Afirma GEC (n=38 studies) revealed a sensitivity of 0.92 (95% CI: 0.90-0.94), specificity of 0.26 (0.20-0.32), negative likelihood ratio (LR-) of 0.32 (0.23-0.44), positive likelihood ratio (LR+) of 1.24 (1.15-1.35), and AUC of 0.83 (0.74-0.89). Afirma GSC (n=10) had a sensitivity of 0.94 (0.89-0.96), specificity of 0.38 (0.27-0.50), LR- of 0.18 (0.10-0.30), LR+ of 1.52 (1.28-1.87), and AUC of 0.91 (0.62-0.92). ThyroSeq v1 and v2 (n=10) had a sensitivity of 0.86 (0.82-0.90), specificity of 0.74 (0.59-0.85), LR- of 0.19 (0.13-0.26), LR+ of 3.52 (2.08-5.92), and AUC of 0.86 (0.81-0.90). ThyroSeq v3 (n=6) had a sensitivity of 0.92 (0.86-0.95), specificity of 0.41 (0.18-0.69), LR- of 0.24 (0.09-0.62), LR+ of 1.67 (1.09-2.98), and AUC of 0.90 (0.63-0.92). 14% of studies conducted blinded histopathologic review of excised thyroid nodules, and 8% made the decision to go to surgery blind to molecular test results.
CONCLUSIONS: Meta-analyses reveal high diagnostic accuracy of molecular tests for thyroid nodule assessment of malignancy risk; however, these studies are subject to several limitations. Limitations and their potential clinical impacts must be addressed and, when feasible, adjusted for using valid statistical methodologies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
METHODS: PubMed, EMBASE, and Web of Science were systematically searched through July 2021. English language articles that reported original clinical validation attempts of molecular tests for indeterminate thyroid nodules were included if they reported counts of true negative, true positive, false negative, and false positive results. We performed screening and full text review, followed by assessment of eight common biases and limitations, extraction of diagnostic and histopathological information, and meta-analysis of clinical validity using a bivariate linear mixed-effects model.
RESULTS: 49 studies were included. Meta-analysis of Afirma GEC (n=38 studies) revealed a sensitivity of 0.92 (95% CI: 0.90-0.94), specificity of 0.26 (0.20-0.32), negative likelihood ratio (LR-) of 0.32 (0.23-0.44), positive likelihood ratio (LR+) of 1.24 (1.15-1.35), and AUC of 0.83 (0.74-0.89). Afirma GSC (n=10) had a sensitivity of 0.94 (0.89-0.96), specificity of 0.38 (0.27-0.50), LR- of 0.18 (0.10-0.30), LR+ of 1.52 (1.28-1.87), and AUC of 0.91 (0.62-0.92). ThyroSeq v1 and v2 (n=10) had a sensitivity of 0.86 (0.82-0.90), specificity of 0.74 (0.59-0.85), LR- of 0.19 (0.13-0.26), LR+ of 3.52 (2.08-5.92), and AUC of 0.86 (0.81-0.90). ThyroSeq v3 (n=6) had a sensitivity of 0.92 (0.86-0.95), specificity of 0.41 (0.18-0.69), LR- of 0.24 (0.09-0.62), LR+ of 1.67 (1.09-2.98), and AUC of 0.90 (0.63-0.92). 14% of studies conducted blinded histopathologic review of excised thyroid nodules, and 8% made the decision to go to surgery blind to molecular test results.
CONCLUSIONS: Meta-analyses reveal high diagnostic accuracy of molecular tests for thyroid nodule assessment of malignancy risk; however, these studies are subject to several limitations. Limitations and their potential clinical impacts must be addressed and, when feasible, adjusted for using valid statistical methodologies.
Rajakumar, Timothy; Horos, Rastislav; Kittner, Paul; Kahraman, Mustafa; Sikosek, Tobias; Hinkfoth, Franziska; Tikk, Kaja; Mercaldo, Nathaniel D; Stenzinger, Albrecht; Rabe, Klaus F; Reck, Martin; Thomas, Michael; Christopoulos, Petros; Steinkraus, Bruno R
In: JTO Clin Res Rep, vol. 3, no. 8, pp. 100369, 2022, ISSN: 2666-3643.
@article{pmid35880086,
title = {Brief Report: A Blood-Based MicroRNA Complementary Diagnostic Predicts Immunotherapy Efficacy in Advanced-Stage NSCLC With High Programmed Death-Ligand 1 Expression},
author = {Timothy Rajakumar and Rastislav Horos and Paul Kittner and Mustafa Kahraman and Tobias Sikosek and Franziska Hinkfoth and Kaja Tikk and Nathaniel D Mercaldo and Albrecht Stenzinger and Klaus F Rabe and Martin Reck and Michael Thomas and Petros Christopoulos and Bruno R Steinkraus},
doi = {10.1016/j.jtocrr.2022.100369},
issn = {2666-3643},
year = {2022},
date = {2022-08-01},
urldate = {2022-08-01},
journal = {JTO Clin Res Rep},
volume = {3},
number = {8},
pages = {100369},
abstract = {Introduction: Patients with advanced, non-oncogene-driven NSCLC with high programmed death-ligand 1 (PD-L1) expression are eligible for treatment with immunotherapy. There is, however, an urgent medical need for biomarkers identifying cases that require additional combination with chemotherapy. We previously uncovered a myeloid-based 5-microRNA (5-miRNA) signature that identified responders to immunotherapy in PD-L1 unstratified patients; however, its potential utility in treatment guidance for patients with PD-L1 high tumors remained unclear.
Methods: We trained (n = 68) and validated (n = 56) a 5-miRNA multivariable Cox proportional hazards model predictive of overall survival on small RNA sequencing data of whole blood samples prospectively collected before the commencement of immunotherapy for stage IV NSCLC with PD-L1 tumor proportion score greater than or equal to 50%, treated with PD-1 inhibitor monotherapy (immunotherapy alone [IO]). Specificity was demonstrated in a control cohort treated with immunochemotherapy (ICT) (n = 31).
Results: The revised 5-miRNA risk score (miRisk) stratified IO-treated patients and identified a high-risk group with significantly shorter overall survival (hazard ratio = 5.24, 95% confidence interval: 2.17-12.66, \< 0.001). There was a significant interaction between the miRisk score and type of treatment (IO or ICT, = 0.036), indicating that the miRisk score may serve as a predictive biomarker for immunotherapy response. Furthermore, the miRisk score could identify a group of high-risk patients who may benefit from treatment with ICT as opposed to IO (hazard ratio = 0.35, 95% confidence interval: 0.15-0.82, = 0.018).
Conclusions: The miRisk score can distinguish a group of patients with PD-L1 high, stage IV NSCLC likely to benefit from adding chemotherapy to immunotherapy and may support treatment decisions as a blood-based complementary diagnostic.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Methods: We trained (n = 68) and validated (n = 56) a 5-miRNA multivariable Cox proportional hazards model predictive of overall survival on small RNA sequencing data of whole blood samples prospectively collected before the commencement of immunotherapy for stage IV NSCLC with PD-L1 tumor proportion score greater than or equal to 50%, treated with PD-1 inhibitor monotherapy (immunotherapy alone [IO]). Specificity was demonstrated in a control cohort treated with immunochemotherapy (ICT) (n = 31).
Results: The revised 5-miRNA risk score (miRisk) stratified IO-treated patients and identified a high-risk group with significantly shorter overall survival (hazard ratio = 5.24, 95% confidence interval: 2.17-12.66, < 0.001). There was a significant interaction between the miRisk score and type of treatment (IO or ICT, = 0.036), indicating that the miRisk score may serve as a predictive biomarker for immunotherapy response. Furthermore, the miRisk score could identify a group of high-risk patients who may benefit from treatment with ICT as opposed to IO (hazard ratio = 0.35, 95% confidence interval: 0.15-0.82, = 0.018).
Conclusions: The miRisk score can distinguish a group of patients with PD-L1 high, stage IV NSCLC likely to benefit from adding chemotherapy to immunotherapy and may support treatment decisions as a blood-based complementary diagnostic.
Rajakumar, Timothy; Horos, Rastislav; Jehn, Julia; Schenz, Judith; Muley, Thomas; Pelea, Oana; Hofmann, Sarah; Kittner, Paul; Kahraman, Mustafa; Heuvelman, Marco; Sikosek, Tobias; Feufel, Jennifer; Skottke, Jasmin; Nötzel, Dennis; Hinkfoth, Franziska; Tikk, Kaja; Daniel-Moreno, Alberto; Ceiler, Jessika; Mercaldo, Nathaniel; Uhle, Florian; Uhle, Sandra; Weigand, Markus A; Elshiaty, Mariam; Lusky, Fabienne; Schindler, Hannah; Ferry, Quentin; Sauka-Spengler, Tatjana; Wu, Qianxin; Rabe, Klaus F; Reck, Martin; Thomas, Michael; Christopoulos, Petros; Steinkraus, Bruno R
A blood-based miRNA signature with prognostic value for overall survival in advanced stage non-small cell lung cancer treated with immunotherapy Journal Article
In: NPJ Precis Oncol, vol. 6, no. 1, pp. 19, 2022, ISSN: 2397-768X.
@article{pmid35361874,
title = {A blood-based miRNA signature with prognostic value for overall survival in advanced stage non-small cell lung cancer treated with immunotherapy},
author = {Timothy Rajakumar and Rastislav Horos and Julia Jehn and Judith Schenz and Thomas Muley and Oana Pelea and Sarah Hofmann and Paul Kittner and Mustafa Kahraman and Marco Heuvelman and Tobias Sikosek and Jennifer Feufel and Jasmin Skottke and Dennis N\"{o}tzel and Franziska Hinkfoth and Kaja Tikk and Alberto Daniel-Moreno and Jessika Ceiler and Nathaniel Mercaldo and Florian Uhle and Sandra Uhle and Markus A Weigand and Mariam Elshiaty and Fabienne Lusky and Hannah Schindler and Quentin Ferry and Tatjana Sauka-Spengler and Qianxin Wu and Klaus F Rabe and Martin Reck and Michael Thomas and Petros Christopoulos and Bruno R Steinkraus},
doi = {10.1038/s41698-022-00262-y},
issn = {2397-768X},
year = {2022},
date = {2022-03-01},
journal = {NPJ Precis Oncol},
volume = {6},
number = {1},
pages = {19},
abstract = {Immunotherapies have recently gained traction as highly effective therapies in a subset of late-stage cancers. Unfortunately, only a minority of patients experience the remarkable benefits of immunotherapies, whilst others fail to respond or even come to harm through immune-related adverse events. For immunotherapies within the PD-1/PD-L1 inhibitor class, patient stratification is currently performed using tumor (tissue-based) PD-L1 expression. However, PD-L1 is an accurate predictor of response in only ~30% of cases. There is pressing need for more accurate biomarkers for immunotherapy response prediction. We sought to identify peripheral blood biomarkers, predictive of response to immunotherapies against lung cancer, based on whole blood microRNA profiling. Using three well-characterized cohorts consisting of a total of 334 stage IV NSCLC patients, we have defined a 5 microRNA risk score (miRisk) that is predictive of overall survival following immunotherapy in training and independent validation (HR 2.40, 95% CI 1.37-4.19; P < 0.01) cohorts. We have traced the signature to a myeloid origin and performed miRNA target prediction to make a direct mechanistic link to the PD-L1 signaling pathway and PD-L1 itself. The miRisk score offers a potential blood-based companion diagnostic for immunotherapy that outperforms tissue-based PD-L1 staining.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2021
Weinstein, Debra F; Choi, Jin; Mercaldo, Nathaniel; Stump, Natalie; Paras, Molly L; Berube, Rhodes A; Hur, Chin
Is Resident-Driven Inpatient Care More Expensive? Challenging a Long-Held Assumption. Journal Article
In: Academic medicine : journal of the Association of American Medical Colleges, vol. 96, iss. 8, no. 1205-1212, 2021, ISSN: 1938-808X.
@article{Weinstein2021,
title = {Is Resident-Driven Inpatient Care More Expensive? Challenging a Long-Held Assumption.},
author = {Debra F Weinstein and Jin Choi and Nathaniel Mercaldo and Natalie Stump and Molly L Paras and Rhodes A Berube and Chin Hur},
url = {https://pubmed.ncbi.nlm.nih.gov/33496432/},
doi = {10.1097/ACM.0000000000003939},
issn = {1938-808X},
year = {2021},
date = {2021-08-01},
urldate = {2021-01-01},
journal = {Academic medicine : journal of the Association of American Medical Colleges},
volume = {96},
number = {1205-1212},
issue = {8},
abstract = {The financial impact of graduate medical education (GME) on teaching hospitals remains poorly understood, while calls for increased federal support continue alongside legislative threats to reduce funding. Despite studies suggesting that residents are more "economical" than alternative providers, GME is widely believed to be an expensive investment. Assumptions that residents increase the cost of patient care have persisted in the absence of emerging evidence to the contrary. Thus, the authors sought to examine resident influence on patient care costs by comparing costs between a resident-driven service (RS) and a nonresident-covered service (NRS), with attention to clinical outcomes and how potential cost differences relate to the utilization of resources, length of stay (LOS), and other factors. This prospective study compared costs and clinical outcomes of internal medicine patients admitted to a RS versus an NRS at Massachusetts General Hospital (July 1, 2016-June 30, 2017). Total variable direct costs of inpatient admission was the primary outcome measure. LOS; 30-day readmission rate; utilization related to diagnostic radiology, pharmaceuticals, and clinical labs; and other outcome measures were also compared. Linear regression models quantified the relationship between log-transformed variable direct costs and service. Baseline characteristics of 5,448 patients on the 2 services (3,250 on a RS and 2,198 on an NRS) were similar. On a RS, patient care costs were slightly less and LOS was slightly shorter than on an NRS, with no significant differences in hospital mortality or 30-day readmission rate detected. Resource utilization was comparable between the services. These findings undermine long-held assumptions that residents increase the cost of patient care. Though not generalizable to ambulatory settings or other specialties, this study can help inform hospital decision-making around sponsorship of GME programs, especially if federal funding for GME remains capped or is subject to additional reductions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Frenk, Nathan E; Bochnakova, Teodora; Ganguli, Suvranu; Mercaldo, Nathaniel; Allegretti, Andrew S; Pratt, Daniel S; Yamada, Kei
Small-diameter TIPS combined with splenic artery embolization in the management of refractory ascites in cirrhotic patients. Journal Article
In: Diagnostic and interventional radiology (Ankara, Turkey), vol. 27, no. 2, pp. 232-237, 2021, ISSN: 1305-3612, ().
@article{EFrenk2021,
title = {Small-diameter TIPS combined with splenic artery embolization in the management of refractory ascites in cirrhotic patients.},
author = {Nathan E Frenk and Teodora Bochnakova and Suvranu Ganguli and Nathaniel Mercaldo and Andrew S Allegretti and Daniel S Pratt and Kei Yamada},
url = {https://pubmed.ncbi.nlm.nih.gov/33517259/},
doi = {10.5152/dir.2021.19530},
issn = {1305-3612},
year = {2021},
date = {2021-03-01},
journal = {Diagnostic and interventional radiology (Ankara, Turkey)},
volume = {27},
number = {2},
pages = {232-237},
abstract = {Maximally decreasing portal pressures with transjugular intrahepatic portosystemic shunt (TIPS) is associated with improved ascites control but also increased encephalopathy incidence. Since splenic venous flow contributes to portal hypertension, we assessed if combining small-diameter TIPS with splenic artery embolization could improve ascites while minimizing encephalopathy. Fifty-five patients underwent TIPS creation for refractory ascites. Subjects underwent creation of 8 mm TIPS followed by proximal splenic artery embolization (group},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2020
Duan, Yu; Xie, Xiaoyan; Li, Qian; Mercaldo, Nathaniel; Samir, Anthony E; Kuang, Ming; Lin, Manxia
In: European radiology, vol. 30, pp. 4741–4751, 2020, ISSN: 1432-1084, ().
@article{Duan2020,
title = {Differentiation of regenerative nodule, dysplastic nodule, and small hepatocellular carcinoma in cirrhotic patients: a contrast-enhanced ultrasound-based multivariable model analysis.},
author = {Yu Duan and Xiaoyan Xie and Qian Li and Nathaniel Mercaldo and Anthony E Samir and Ming Kuang and Manxia Lin},
url = {https://pubmed.ncbi.nlm.nih.gov/32307563/},
doi = {10.1007/s00330-020-06834-5},
issn = {1432-1084},
year = {2020},
date = {2020-09-01},
journal = {European radiology},
volume = {30},
pages = {4741--4751},
abstract = {To develop a contrast-enhanced ultrasound (CEUS)-based model for differentiating cirrhotic liver lesions and for active surveillance of hepatocellular carcinoma (HCC). Patients with focal liver lesions (FLLs) with biopsy/resection-proven pathology and pre-procedure CEUS were enrolled from our institution between January 2011 and November 2014. Univariable and multivariable regression models were constructed using qualitative CEUS features and/or contrast arrival time ratio (CAT ). The optimism-adjusted Harrell's generalized concordance index (C ) was used to quantify the discriminatory ability of each CEUS feature and model. A total of 149 patients (113 men and 36 women) with 162 FLLs were enrolled with mean age 53.4 ± 12.7 years. A 0.1-unit reduction in CAT was associated with a 68% increase in the odds of having a higher nodule ranking (RN \< DN \< small HCC) (OR, 0.32; 95% CI, 0.20-0.50, p \< .001). Arterial phase hypoenhancement and isoenhancement were inversely associated with a higher nodule ranking compared to hyperenhancement. Late-phase isoenhancement was associated with lower odds of a higher nodule ranking. The CEUS + CAT model (C 0.92, 0.89-0.95) provided greater discriminatory ability when compared to the CAT model (ΔC 0.09, 0.04-0.13, p \< .001) and the CEUS model (ΔC 0.03, 0.01-0.0},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zhou, Iris Y; Jordan, Veronica Clavijo; Rotile, Nicholas J; Akam, Eman; Krishnan, Smitha; Arora, Gunisha; Krishnan, Hema; Slattery, Hannah; Warner, Noah; Mercaldo, Nathaniel; Farrar, Christian T; Wellen, Jeremy; Martinez, Robert; Schlerman, Franklin; Tanabe, Kenneth K; Fuchs, Bryan C; Caravan, Peter
Advanced MRI of Liver Fibrosis and Treatment Response in a Rat Model of Nonalcoholic Steatohepatitis. Journal Article
In: Radiology, vol. 296, pp. 67–75, 2020, ISSN: 1527-1315, ().
@article{Zhou2020,
title = {Advanced MRI of Liver Fibrosis and Treatment Response in a Rat Model of Nonalcoholic Steatohepatitis.},
author = {Iris Y Zhou and Veronica Clavijo Jordan and Nicholas J Rotile and Eman Akam and Smitha Krishnan and Gunisha Arora and Hema Krishnan and Hannah Slattery and Noah Warner and Nathaniel Mercaldo and Christian T Farrar and Jeremy Wellen and Robert Martinez and Franklin Schlerman and Kenneth K Tanabe and Bryan C Fuchs and Peter Caravan},
url = {https://pubmed.ncbi.nlm.nih.gov/32343209/},
doi = {10.1148/radiol.2020192118},
issn = {1527-1315},
year = {2020},
date = {2020-07-01},
journal = {Radiology},
volume = {296},
pages = {67--75},
abstract = {Background Liver biopsy is the reference standard to diagnose nonalcoholic steatohepatitis (NASH) but is invasive with potential complications. Purpose To evaluate molecular MRI with type 1 collagen-specific probe EP-3533 and allysine-targeted fibrogenesis probe Gd-Hyd, MR elastography, and native T1 to characterize fibrosis and to assess treatment response in a rat model of NASH. Materials and Methods MRI was performed prospectively (June-November 2018) in six groups of male Wistar rats age- and weight-matched animals received standard chow ( = 12 per group); received choline-deficient, l-amino acid-defined, high-fat diet (CDAHFD) for 6 weeks or 9 weeks ( = 8 per group); were fed 6 weeks of CDAHFD and switched to standard chow for 3 weeks ( = 12); were fed CDAHFD for 9 weeks with daily treatment of elafibranor beginning at week 6 ( = 14). Differences in imaging measurements and tissue analyses among groups were tested with one-way analysis of variance. The ability of each imaging measurement to stage fibrosis was quantified by using area under the receiver operating characteristic curve (AUC) with quantitative digital pathology (collagen proportionate area [CPA]) as reference standard. Optimal cutoff values for distinguishing advanced fibrosis were used to assess treatment response. Results AUC for distinguishing fibrotic (CPA \>4.8%) from nonfibrotic (CPA ≤4.8%) livers was 0.95 (95% confidence interval [CI]: 0.91, 1.00) for EP-3533, followed by native T1, Gd-Hyd, and MR elastography with AUCs of 0.90 (95% CI: 0.83, 0.98), 0.84 (95% CI: 0.74, 0.95), and 0.65 (95% CI: 0.51, 0.79), respectively. AUCs for discriminating advanced fibrosis (CPA \>10.3%) were 0.86 (95% CI: 0.76, 0.97), 0.96 (95% CI: 0.90, 1.01), 0.84 (95% CI: 0.70, 0.98), and 0.74 (95% CI: 0.63, 0.86) for EP-3533, Gd-Hyd, MR elastography, and native T1, respectively. Gd-Hyd MRI had the highest accuracy (24 of 26, 92%; 95% CI: 75%, 99%) in identifying responders and nonresponders in the treated groups compared with MR elastography (23 of 26, 88%; 95% CI: 70%, 98%), EP-3533 (20 of 26, 77%; 95% CI: 56%, 91%), and native T1 (14 of 26, 54%; 95% CI: 33%, 73%). Conclusion Collagen-targeted molecular MRI most accurately detected early onset of fibrosis, whereas the fibrogenesis probe Gd-Hyd proved most accurate for detecting treatment response. © RSNA, 2020},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fehlmann, Tobias; Kahraman, Mustafa; Ludwig, Nicole; Backes, Christina; Galata, Valentina; Keller, Verena; Geffers, Lars; Mercaldo, Nathaniel; Hornung, Daniela; Weis, Tanja; Kayvanpour, Elham; Abu-Halima, Masood; Deuschle, Christian; Schulte, Claudia; Suenkel, Ulrike; Thaler, Anna-Katharina; Maetzler, Walter; Herr, Christian; Fähndrich, Sebastian; Vogelmeier, Claus; Guimaraes, Pedro; Hecksteden, Anne; Meyer, Tim; Metzger, Florian; Diener, Caroline; Deutscher, Stephanie; Abdul-Khaliq, Hashim; Stehle, Ingo; Haeusler, Sebastian; Meiser, Andreas; Groesdonk, Heinrich V; Volk, Thomas; Lenhof, Hans-Peter; Katus, Hugo; Balling, Rudi; Meder, Benjamin; Kruger, Rejko; Huwer, Hanno; Bals, Robert; Meese, Eckart; Keller, Andreas
Dvaluating the Use of Circulating MicroRNA Profiles for Lung Cancer Detection in Symptomatic Patients. Journal Article
In: JAMA oncology, 2020, ISSN: 2374-2445, ().
@article{Fehlmann2020,
title = {Dvaluating the Use of Circulating MicroRNA Profiles for Lung Cancer Detection in Symptomatic Patients.},
author = {Tobias Fehlmann and Mustafa Kahraman and Nicole Ludwig and Christina Backes and Valentina Galata and Verena Keller and Lars Geffers and Nathaniel Mercaldo and Daniela Hornung and Tanja Weis and Elham Kayvanpour and Masood Abu-Halima and Christian Deuschle and Claudia Schulte and Ulrike Suenkel and Anna-Katharina Thaler and Walter Maetzler and Christian Herr and Sebastian F\"{a}hndrich and Claus Vogelmeier and Pedro Guimaraes and Anne Hecksteden and Tim Meyer and Florian Metzger and Caroline Diener and Stephanie Deutscher and Hashim Abdul-Khaliq and Ingo Stehle and Sebastian Haeusler and Andreas Meiser and Heinrich V Groesdonk and Thomas Volk and Hans-Peter Lenhof and Hugo Katus and Rudi Balling and Benjamin Meder and Rejko Kruger and Hanno Huwer and Robert Bals and Eckart Meese and Andreas Keller},
url = {https://www.ncbi.nlm.nih.gov/pubmed/32134442},
doi = {10.1001/jamaoncol.2020.0001},
issn = {2374-2445},
year = {2020},
date = {2020-03-01},
urldate = {2020-03-01},
journal = {JAMA oncology},
abstract = {The overall low survival rate of patients with lung cancer calls for improved detection tools to enable better treatment options and improved patient outcomes. Multivariable molecular signatures, such as blood-borne microRNA (miRNA) signatures, may have high rates of sensitivity and specificity but require additional studies with large cohorts and standardized measurements to confirm the generalizability of miRNA signatures. To investigate the use of blood-borne miRNAs as potential circulating markers for detecting lung cancer in an extended cohort of symptomatic patients and control participants. This multicenter, cohort study included patients from case-control and cohort studies (TREND and COSYCONET) with 3102 patients being enrolled by convenience sampling between March 3, 2009, and March 19, 2018. For the cohort study TREND, population sampling was performed. Clinical diagnoses were obtained for 3046 patients (606 patients with non-small cell and small cell lung cancer, 593 patients with nontumor lung diseases, 883 patients with diseases not affecting the lung, and 964 unaffected control participants). No samples were removed because of experimental issues. The collected data were analyzed between April 2018 and November 2019. Sensitivity and specificity of liquid biopsy using miRNA signatures for detection of lung cancer. A total of 3102 patients with a mean (SD) age of 61.1 (16.2) years were enrolled. Data on the sex of the participants were available for 2856 participants; 1727 (60.5%) were men. Genome-wide miRNA profiles of blood samples from 3046 individuals were evaluated by machine-learning methods. Three classification scenarios were investigated by splitting the samples equally into training and validation sets. First, a 15-miRNA signature from the training set was used to distinguish patients diagnosed with lung cancer from all other individuals in the validation set with an accuracy of 91.4% (95% CI, 91.0%-91.9%), a sensitivity of 82.8% (95% CI, 81.5%-84.1%), and a specificity of 93.5% (95% CI, 93.2%-93.8%). Second, a 14-miRNA signature from the training set was used to distinguish patients with lung cancer from patients with nontumor lung diseases in the validation set with an accuracy of 92.5% (95% CI, 92.1%-92.9%), sensitivity of 96.4% (95% CI, 95.9%-96.9%), and specificity of 88.6% (95% CI, 88.1%-89.2%). Third, a 14-miRNA signature from the training set was used to distinguish patients with early-stage lung cancer from all individuals without lung cancer in the validation set with an accuracy of 95.9% (95% CI, 95.7%-96.2%), sensitivity of 76.3% (95% CI, 74.5%-78.0%), and specificity of 97.5% (95% CI, 97.2%-97.7%). The findings of the study suggest that the identified patterns of miRNAs may be used as a component of a minimally invasive lung cancer test, complementing imaging, sputum cytology, and biopsy tests.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2019
Chen, Yufan; Criss, Steven; Watson, Tina; Eckel, Andrew; Palazzo, Lauren; Tramontano, Angela; Wang, Ying; Mercaldo, Nathaniel; Kong, Chung Yin
Cost and Utilization of Lung Cancer End-of-Life Care Among Racial-Ethnic Minority Groups in the United States. Journal Article
In: The oncologist, 2019, ISSN: 1549-490X, ().
@article{ChenY2019a,
title = {Cost and Utilization of Lung Cancer End-of-Life Care Among Racial-Ethnic Minority Groups in the United States.},
author = {Yufan Chen and Steven Criss and Tina Watson and Andrew Eckel and Lauren Palazzo and Angela Tramontano and Ying Wang and Nathaniel Mercaldo and Chung Yin Kong},
url = {https://www.ncbi.nlm.nih.gov/pubmed/31501272},
doi = {10.1634/theoncologist.2019-0303},
issn = {1549-490X},
year = {2019},
date = {2019-09-01},
journal = {The oncologist},
abstract = {The end-of-life period is a crucial time in lung cancer care. To have a better understanding of the racial-ethnic disparities in health care expenditures, access, and quality, we evaluated these disparities specifically in the end-of-life period for patients with lung cancer in the U.S. We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to analyze characteristics of lung cancer care among those diagnosed between the years 2000 and 2011. Linear and logistic regression models were constructed to measure racial-ethnic disparities in end-of-life care cost and utilization among non-Hispanic (NH) Asian, NH black, Hispanic, and NH white patients while controlling for other risk factors such as age, sex, and SEER geographic region. Total costs and hospital utilization were, on average, greater among racial-ethnic minorities compared with NH white patients in the last month of life. Among patients with NSCLC, the relative total costs were 1.27 (95% confidence interval [CI], 1.21-1.33) for NH black patients, 1.36 (95% CI, 1.25-1.49) for NH Asian patients, and 1.21 (95% CI, 1.07-1.38) for Hispanic patients. Additionally, the odds of being admitted to a hospital for NH black, NH Asian, and Hispanic patients were 1.22 (95% CI, 1.15-1.30), 1.47 (95% CI, 1.32-1.63), and 1.18 (95% CI, 1.01-1.38) times that of NH white patients, respectively. Similar results were found for patients with SCLC. Minority patients with lung cancer have significantly higher end-of-life medical expenditures than NH white patients, which may be explained by a greater intensity of care in the end-of-life period. This study investigated racial-ethnic disparities in the cost and utilization of medical care among lung cancer patients during the end-of-life period. Compared with non-Hispanic white patients, racial-ethnic minority patients were more likely to receive intensive care in their final month of life and had statistically significantly higher end-of-life care costs. The findings of this study may lead to a better understanding of the racial-ethnic disparities in end-of-life care, which can better inform future end-of-life interventions and help health care providers develop less intensive and more equitable care, such as culturally competent advanced care planning programs, for all patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pandharipande, Pari; Mercaldo, Nathaniel; Lietz, Anna; Seguin, Claudia L.; Neal, Chrishanae; Deville, Curtiland; Parikh, Jay R.; Sadigh, Gelareh; Sepulveda, Karla A.; Maturen, Katherine E.; Cox, Jan; Bansal, Swati; Macura, Katarzyna J.; Donelan, Karen
Identifying Barriers to Building a Diverse Physician Workforce: A National Survey of the ACR Membership Journal Article
In: Journal of the American College of Radiology, vol. 16, no. 8, pp. 1091-1101, 2019, ISSN: 1546-1440, ().
@article{PANDHARIPANDE2019,
title = {Identifying Barriers to Building a Diverse Physician Workforce: A National Survey of the ACR Membership},
author = {Pari Pandharipande and Nathaniel Mercaldo and Anna Lietz and Claudia L. Seguin and Chrishanae Neal and Curtiland Deville and Jay R. Parikh and Gelareh Sadigh and Karla A. Sepulveda and Katherine E. Maturen and Jan Cox and Swati Bansal and Katarzyna J. Macura and Karen Donelan},
url = {https://www.ncbi.nlm.nih.gov/pubmed/31173744},
doi = {https://doi.org/10.1016/j.jacr.2019.05.008},
issn = {1546-1440},
year = {2019},
date = {2019-08-01},
urldate = {2019-08-01},
journal = {Journal of the American College of Radiology},
volume = {16},
number = {8},
pages = {1091-1101},
abstract = {Purpose
The aim of this study was to identify potential barriers to building a diverse workforce in radiology and radiation oncology by conducting a national survey of physicians in these fields and studying their reported career experiences.
Methods
An electronic survey of ACR members (February 27, 2018, to April 26, 2018) was conducted in which physicians’ attitudes about their work environment, relationships, and culture were queried. The aim was to determine if responses differed by gender or race/ethnicity. In total, 900 invitations were issued; women were oversampled with the goal of equal representation. Descriptive summaries (proportions of yes/no responses) were calculated per item, per subgroup of interest. Logistic regression analysis was used to identify significant associations between gender and item-specific responses; it was not used in the race/ethnicity analysis because of the small sizes of many subgroups.
Results
The response rate was 51.2% (461 of 900). In total, 51.0% of respondents identified as women (235 of 461); the 9.5% (44 of 461) who identified as black or African American, Hispanic, or American Indian or Alaska Native were considered underrepresented minorities. Respondents’ mean age was 40.2 ± 10.4 years. Subgroups varied most in their reporting of unfair or disrespectful treatment. Women were significantly more likely than men to report such treatment attributable to gender (50.6% vs. 5.4%; odds ratio, 18.00; 95% confidence interval, 9.29-34.86; P .001), and 27.9% of underrepresented minorities compared with 2.6% of white non-Hispanic respondents reported such treatment attributable to race/ethnicity.
Conclusions
Women and underrepresented minorities disproportionately experience unfair or disrespectful treatment in the workplace. Addressing this problem is likely to be critically important for improving workforce diversity.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The aim of this study was to identify potential barriers to building a diverse workforce in radiology and radiation oncology by conducting a national survey of physicians in these fields and studying their reported career experiences.
Methods
An electronic survey of ACR members (February 27, 2018, to April 26, 2018) was conducted in which physicians’ attitudes about their work environment, relationships, and culture were queried. The aim was to determine if responses differed by gender or race/ethnicity. In total, 900 invitations were issued; women were oversampled with the goal of equal representation. Descriptive summaries (proportions of yes/no responses) were calculated per item, per subgroup of interest. Logistic regression analysis was used to identify significant associations between gender and item-specific responses; it was not used in the race/ethnicity analysis because of the small sizes of many subgroups.
Results
The response rate was 51.2% (461 of 900). In total, 51.0% of respondents identified as women (235 of 461); the 9.5% (44 of 461) who identified as black or African American, Hispanic, or American Indian or Alaska Native were considered underrepresented minorities. Respondents’ mean age was 40.2 ± 10.4 years. Subgroups varied most in their reporting of unfair or disrespectful treatment. Women were significantly more likely than men to report such treatment attributable to gender (50.6% vs. 5.4%; odds ratio, 18.00; 95% confidence interval, 9.29-34.86; P .001), and 27.9% of underrepresented minorities compared with 2.6% of white non-Hispanic respondents reported such treatment attributable to race/ethnicity.
Conclusions
Women and underrepresented minorities disproportionately experience unfair or disrespectful treatment in the workplace. Addressing this problem is likely to be critically important for improving workforce diversity.
Mercaldo, Nathaniel; Brothers, Kyle B; Carrell, David S; Clayton, Ellen W; Connolly, John J; Holm, Ingrid A; Horowitz, Carol R; Jarvik, Gail P; Kitchner, Terrie E; Li, Rongling; McCarty, Catherine A; McCormick, Jennifer B; McManus, Valerie D; Myers, Melanie F; Pankratz, Joshua J; Shrubsole, Martha J; Smith, Maureen E; Stallings, Sarah C; Williams, Janet L; Schildcrout, Jonathan S
Enrichment sampling for a multi-site patient survey using electronic health records and census data. Journal Article
In: Journal of the American Medical Informatics Association : JAMIA, vol. 26, no. 3, pp. 219-227, 2019, ISSN: 1527-974X, ().
@article{Mercaldo2018,
title = {Enrichment sampling for a multi-site patient survey using electronic health records and census data.},
author = {Nathaniel Mercaldo and Kyle B Brothers and David S Carrell and Ellen W Clayton and John J Connolly and Ingrid A Holm and Carol R Horowitz and Gail P Jarvik and Terrie E Kitchner and Rongling Li and Catherine A McCarty and Jennifer B McCormick and Valerie D McManus and Melanie F Myers and Joshua J Pankratz and Martha J Shrubsole and Maureen E Smith and Sarah C Stallings and Janet L Williams and Jonathan S Schildcrout},
url = {https://www.ncbi.nlm.nih.gov/pubmed/30590688},
doi = {10.1093/jamia/ocy164},
issn = {1527-974X},
year = {2019},
date = {2019-03-01},
urldate = {2019-03-01},
journal = {Journal of the American Medical Informatics Association : JAMIA},
volume = {26},
number = {3},
pages = {219-227},
abstract = {We describe a stratified sampling design that combines electronic health records (EHRs) and United States Census (USC) data to construct the sampling frame and an algorithm to enrich the sample with individuals belonging to rarer strata. This design was developed for a multi-site survey that sought to examine patient concerns about and barriers to participating in research studies, especially among under-studied populations (eg, minorities, low educational attainment). We defined sampling strata by cross-tabulating several socio-demographic variables obtained from EHR and augmented with census-block-level USC data. We oversampled rarer and historically underrepresented subpopulations. The sampling strategy, which included USC-supplemented EHR data, led to a far more diverse sample than would have been expected under random sampling (eg, 3-, 8-, 7-, and 12-fold increase in African Americans, Asians, Hispanics and those with less than a high school degree, respectively). We observed that our EHR data tended to misclassify minority races more often than majority races, and that non-majority races, Latino ethnicity, younger adult age, lower education, and urban/suburban living were each associated with lower response rates to the mailed surveys. We observed substantial enrichment from rarer subpopulations. The magnitude of the enrichment depends on the accuracy of the variables that define the sampling strata and the overall response rate. EHR and USC data may be used to define sampling strata that in turn may be used to enrich the final study sample. This design may be of particular interest for studies of rarer and understudied populations.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2018
Tramontano, Angela; Nipp, Ryan; Mercaldo, Nathaniel; Kong, Chung Yin; Schrag, Deborah; Hur, Chin
Survival Disparities by Race and Ethnicity in Early Esophageal Cancer. Journal Article
In: Digestive diseases and sciences, vol. 63, pp. 2880–2888, 2018, ISSN: 1573-2568, ().
@article{Tramontano2018b,
title = {Survival Disparities by Race and Ethnicity in Early Esophageal Cancer.},
author = {Angela Tramontano and Ryan Nipp and Nathaniel Mercaldo and Chung Yin Kong and Deborah Schrag and Chin Hur},
url = {https://www.ncbi.nlm.nih.gov/pubmed/30109578},
doi = {10.1007/s10620-018-5238-6},
issn = {1573-2568},
year = {2018},
date = {2018-11-01},
journal = {Digestive diseases and sciences},
volume = {63},
pages = {2880--2888},
abstract = {Survival outcome disparities among esophageal cancer patients exist, but are not fully understood. We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to determine whether survival differences among racial/ethnic patient populations persist after adjusting for demographic and clinical characteristics. Our study included T1-3N0M0 adenocarcinoma and squamous cell cancer patients diagnosed between 2003 and 2011. We compared survival among two racial/ethnic patient subgroups using Cox proportional hazards methods, adjusting for age, sex, histology, marital status, socioeconomics, SEER region, comorbidities, T stage, tumor location, diagnosis year, and treatment received. Among 2025 patients, 87.9% were White and 12.1% were Nonwhite. Median survival was 18.7 months for Whites vs 13.8 months for Nonwhites (p = 0.01). In the unadjusted model, Nonwhite patients had higher risk of mortality (HR = 1.29, 95% CI 1.11-1.49, p \< 0.0001) when compared to White patients; however, in the Cox regression adjusted model there was no significant difference (HR = 0.94, 95% CI 0.80-1.1},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Tramontano, Angela; Nipp, Ryan; Mercaldo, Nathaniel; Kong, Chung Yin; Schrag, Deborah; Hur, Chin
Survival Disparities by Race and Ethnicity in Early Esophageal Cancer. Journal Article
In: Digestive diseases and sciences, 2018, ISSN: 1573-2568, ().
@article{Tramontano2018,
title = {Survival Disparities by Race and Ethnicity in Early Esophageal Cancer.},
author = {Angela Tramontano and Ryan Nipp and Nathaniel Mercaldo and Chung Yin Kong and Deborah Schrag and Chin Hur},
url = {https://www.ncbi.nlm.nih.gov/pubmed/30109578},
doi = {10.1007/s10620-018-5238-6},
issn = {1573-2568},
year = {2018},
date = {2018-08-01},
journal = {Digestive diseases and sciences},
abstract = {Survival outcome disparities among esophageal cancer patients exist, but are not fully understood. We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to determine whether survival differences among racial/ethnic patient populations persist after adjusting for demographic and clinical characteristics. Our study included T1-3N0M0 adenocarcinoma and squamous cell cancer patients diagnosed between 2003 and 2011. We compared survival among two racial/ethnic patient subgroups using Cox proportional hazards methods, adjusting for age, sex, histology, marital status, socioeconomics, SEER region, comorbidities, T stage, tumor location, diagnosis year, and treatment received. Among 2025 patients, 87.9% were White and 12.1% were Nonwhite. Median survival was 18.7 months for Whites vs 13.8 months for Nonwhites (p = 0.01). In the unadjusted model, Nonwhite patients had higher risk of mortality (HR = 1.29, 95% CI 1.11-1.49, p \< 0.0001) when compared to White patients; however, in the Cox regression adjusted model there was no significant difference (HR = 0.94, 95% CI 0.80-1.1},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Schildcrout, Jonathan S; Schisterman, Enrique F; Mercaldo, Nathaniel; Rathouz, Paul J; Heagerty, Patrick J
Extending the case--control design to longitudinal data: stratified sampling based on repeated binary outcomes Journal Article
In: Epidemiology, vol. 29, no. 1, pp. 67–75, 2018, ().
@article{schildcrout2018extending,
title = {Extending the case--control design to longitudinal data: stratified sampling based on repeated binary outcomes},
author = {Jonathan S Schildcrout and Enrique F Schisterman and Nathaniel Mercaldo and Paul J Rathouz and Patrick J Heagerty},
url = {https://pubmed.ncbi.nlm.nih.gov/29068838/},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Epidemiology},
volume = {29},
number = {1},
pages = {67--75},
publisher = {LWW},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2017
Sanderson, Saskia C; Brothers, Kyle B; Mercaldo, Nathaniel; Clayton, Ellen Wright; Antommaria, Armand H Matheny; Aufox, Sharon A; Brilliant, Murray H; Campos, Diego; Carrell, David S; Connolly, John; others,
Public attitudes toward consent and data sharing in biobank research: a large multi-site experimental survey in the US Journal Article
In: The American Journal of Human Genetics, vol. 100, no. 3, pp. 414–427, 2017, ().
@article{sanderson2017public,
title = {Public attitudes toward consent and data sharing in biobank research: a large multi-site experimental survey in the US},
author = {Saskia C Sanderson and Kyle B Brothers and Nathaniel Mercaldo and Ellen Wright Clayton and Armand H Matheny Antommaria and Sharon A Aufox and Murray H Brilliant and Diego Campos and David S Carrell and John Connolly and others},
url = {https://pubmed.ncbi.nlm.nih.gov/28190457/},
year = {2017},
date = {2017-01-01},
urldate = {2017-01-01},
journal = {The American Journal of Human Genetics},
volume = {100},
number = {3},
pages = {414--427},
publisher = {Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2016
Banerjee, Arna; Slagle, Jason M; Mercaldo, Nathaniel; Booker, Ray; Miller, Anne; France, Daniel J; Rawn, Lisa; Weinger, Matthew B
A simulation-based curriculum to introduce key teamwork principles to entering medical students Journal Article
In: BMC Medical Education, vol. 16, no. 1, pp. 295, 2016, ().
@article{banerjee2016simulation,
title = {A simulation-based curriculum to introduce key teamwork principles to entering medical students},
author = {Arna Banerjee and Jason M Slagle and Nathaniel Mercaldo and Ray Booker and Anne Miller and Daniel J France and Lisa Rawn and Matthew B Weinger},
url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/sdr.1558},
year = {2016},
date = {2016-01-01},
urldate = {2016-01-01},
journal = {BMC Medical Education},
volume = {16},
number = {1},
pages = {295},
publisher = {Springer},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Shepherd, Bryan E; Liu, Qi; Mercaldo, Nathaniel; Jenkins, Cathy A; Lau, Bryan; Cole, Stephen R; Saag, Michael S; Sterling, Timothy R
Comparing results from multiple imputation and dynamic marginal structural models for estimating when to start antiretroviral therapy Journal Article
In: Statistics in medicine, vol. 35, no. 24, pp. 4335–4351, 2016, ().
@article{shepherd2016comparing,
title = {Comparing results from multiple imputation and dynamic marginal structural models for estimating when to start antiretroviral therapy},
author = {Bryan E Shepherd and Qi Liu and Nathaniel Mercaldo and Cathy A Jenkins and Bryan Lau and Stephen R Cole and Michael S Saag and Timothy R Sterling},
url = {https://pubmed.ncbi.nlm.nih.gov/27264354/},
year = {2016},
date = {2016-01-01},
urldate = {2016-01-01},
journal = {Statistics in medicine},
volume = {35},
number = {24},
pages = {4335--4351},
publisher = {Wiley Online Library},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Smith, Maureen E; Sanderson, Saskia C; Brothers, Kyle B; Myers, Melanie F; McCormick, Jennifer; Aufox, Sharon; Shrubsole, Martha J; Garrison, Nanibaa A; Mercaldo, Nathaniel; Schildcrout, Jonathan S; others,
Conducting a large, multi-site survey about patients views on broad consent: challenges and solutions Journal Article
In: BMC Medical Research Methodology, vol. 16, 2016, ().
@article{smith2016conducting,
title = {Conducting a large, multi-site survey about patients views on broad consent: challenges and solutions},
author = {Maureen E Smith and Saskia C Sanderson and Kyle B Brothers and Melanie F Myers and Jennifer McCormick and Sharon Aufox and Martha J Shrubsole and Nanibaa A Garrison and Nathaniel Mercaldo and Jonathan S Schildcrout and others},
url = {https://pubmed.ncbi.nlm.nih.gov/27881091/},
year = {2016},
date = {2016-01-01},
urldate = {2016-01-01},
journal = {BMC Medical Research Methodology},
volume = {16},
publisher = {BioMed Central},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2015
Maddox, Ryan A; Blase, JL; Mercaldo, Nathaniel; Harvey, AR; Schonberger, LB; Kukull, WA; Belay, ED
Clinically Unsuspected Prion Disease Among Patients With Dementia Diagnoses in an Alzheimer’s Disease Database Journal Article
In: American Journal of Alzheimer's Disease & Other Dementiastextregistered, vol. 30, no. 8, pp. 752–755, 2015, ().
@article{maddox2015clinically,
title = {Clinically Unsuspected Prion Disease Among Patients With Dementia Diagnoses in an Alzheimer’s Disease Database},
author = {Ryan A Maddox and JL Blase and Nathaniel Mercaldo and AR Harvey and LB Schonberger and WA Kukull and ED Belay},
url = {https://pubmed.ncbi.nlm.nih.gov/26320231/},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {American Journal of Alzheimer's Disease \& Other Dementiastextregistered},
volume = {30},
number = {8},
pages = {752--755},
publisher = {SAGE Publications Sage CA: Los Angeles, CA},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Sampson, Uchechukwu KA; Harrell, Frank E; Fazio, Sergio; Nwosu, Sam; Mercaldo, Nathaniel; Mensah, George A; Davidson, Michael H; Coll, Blai; Feinstein, Steve B
Carotid Adventitial Vasa Vasorum and Intima-Media Thickness in a Primary Prevention Population Journal Article
In: Echocardiography, vol. 32, no. 2, pp. 264–270, 2015, ().
@article{sampson2015carotid,
title = {Carotid Adventitial Vasa Vasorum and Intima-Media Thickness in a Primary Prevention Population},
author = {Uchechukwu KA Sampson and Frank E Harrell and Sergio Fazio and Sam Nwosu and Nathaniel Mercaldo and George A Mensah and Michael H Davidson and Blai Coll and Steve B Feinstein},
url = {https://pubmed.ncbi.nlm.nih.gov/24930883/},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {Echocardiography},
volume = {32},
number = {2},
pages = {264--270},
publisher = {Wiley Online Library},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Weinger, Matthew B; Slagle, Jason M; Kuntz, Audrey H; Schildcrout, Jonathan S; Banerjee, Arna; Mercaldo, Nathaniel; Bills, James L; Wallston, Kenneth A; Speroff, Theodore; Patterson, Emily S; others,
A multimodal intervention improves postanesthesia care unit handovers Journal Article
In: Anesthesia & Analgesia, vol. 121, no. 4, pp. 957–971, 2015, ().
@article{weinger2015multimodal,
title = {A multimodal intervention improves postanesthesia care unit handovers},
author = {Matthew B Weinger and Jason M Slagle and Audrey H Kuntz and Jonathan S Schildcrout and Arna Banerjee and Nathaniel Mercaldo and James L Bills and Kenneth A Wallston and Theodore Speroff and Emily S Patterson and others},
url = {https://pubmed.ncbi.nlm.nih.gov/25806398/},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {Anesthesia \& Analgesia},
volume = {121},
number = {4},
pages = {957--971},
publisher = {LWW},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2013
Rasmussen, Stephanie B; Saied, Nahel N; Jr, Clifford Bowens; Mercaldo, Nathaniel; Schildcrout, Jonathan S; Malchow, Randall J
In: Pain medicine, vol. 14, no. 8, pp. 1239–1247, 2013, ().
@article{rasmussen2013duration,
title = {Duration of upper and lower extremity peripheral nerve blockade is prolonged with dexamethasone when added to ropivacaine: a retrospective database analysis},
author = {Stephanie B Rasmussen and Nahel N Saied and Clifford Bowens Jr and Nathaniel Mercaldo and Jonathan S Schildcrout and Randall J Malchow},
url = {https://pubmed.ncbi.nlm.nih.gov/23755801/},
year = {2013},
date = {2013-01-01},
urldate = {2013-01-01},
journal = {Pain medicine},
volume = {14},
number = {8},
pages = {1239--1247},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Schumann, Roman; Mandell, M Susan; Mercaldo, Nathaniel; Michaels, Damon; Robertson, Amy; Banerjee, Arna; Pai, Ramachander; Klinck, John; Pandharipande, Pratik; Walia, Ann
Anesthesia for liver transplantation in United States academic centers: intraoperative practice Journal Article
In: Journal of clinical anesthesia, vol. 25, no. 7, pp. 542–550, 2013, ().
@article{schumann2013anesthesia,
title = {Anesthesia for liver transplantation in United States academic centers: intraoperative practice},
author = {Roman Schumann and M Susan Mandell and Nathaniel Mercaldo and Damon Michaels and Amy Robertson and Arna Banerjee and Ramachander Pai and John Klinck and Pratik Pandharipande and Ann Walia},
url = {https://pubmed.ncbi.nlm.nih.gov/23994704/},
year = {2013},
date = {2013-01-01},
urldate = {2013-01-01},
journal = {Journal of clinical anesthesia},
volume = {25},
number = {7},
pages = {542--550},
publisher = {Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2012
Lenart, Mark J; Wong, Kam; Gupta, Rajnish K; Mercaldo, Nathaniel; Schildcrout, Jonathan S; Michaels, Damon; Malchow, Randall J
The impact of peripheral nerve techniques on hospital stay following major orthopedic surgery Journal Article
In: Pain Medicine, vol. 13, no. 6, pp. 828–834, 2012, ().
@article{lenart2012impact,
title = {The impact of peripheral nerve techniques on hospital stay following major orthopedic surgery},
author = {Mark J Lenart and Kam Wong and Rajnish K Gupta and Nathaniel Mercaldo and Jonathan S Schildcrout and Damon Michaels and Randall J Malchow},
url = {https://pubmed.ncbi.nlm.nih.gov/22494645/},
year = {2012},
date = {2012-01-01},
urldate = {2012-01-01},
journal = {Pain Medicine},
volume = {13},
number = {6},
pages = {828--834},
publisher = {Blackwell Publishing Inc Malden, USA},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Walia, Ann; Mandell, M Susan; Mercaldo, Nathaniel; Michaels, Damon; Robertson, Amy; Banerjee, Arna; Pai, Ramachander; Klinck, John; Weinger, Matthew; Pandharipande, Pratik; others,
Anesthesia for liver transplantation in US academic centers: institutional structure and perioperative care Journal Article
In: Liver Transplantation, vol. 18, no. 6, pp. 737–743, 2012, ().
@article{walia2012anesthesia,
title = {Anesthesia for liver transplantation in US academic centers: institutional structure and perioperative care},
author = {Ann Walia and M Susan Mandell and Nathaniel Mercaldo and Damon Michaels and Amy Robertson and Arna Banerjee and Ramachander Pai and John Klinck and Matthew Weinger and Pratik Pandharipande and others},
url = {https://pubmed.ncbi.nlm.nih.gov/22407934/},
year = {2012},
date = {2012-01-01},
urldate = {2012-01-01},
journal = {Liver Transplantation},
volume = {18},
number = {6},
pages = {737--743},
publisher = {Wiley Online Library},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Barocas, Daniel A; Gray, Darryl T; Fowke, Jay H; Mercaldo, Nathaniel; Blume, Jeffrey D; Chang, Sam S; Cookson, Michael S; Smith, Joseph A; Penson, David F
Racial variation in the quality of surgical care for prostate cancer Journal Article
In: The Journal of urology, vol. 188, no. 4, pp. 1279–1285, 2012, ().
@article{barocas2012racial,
title = {Racial variation in the quality of surgical care for prostate cancer},
author = {Daniel A Barocas and Darryl T Gray and Jay H Fowke and Nathaniel Mercaldo and Jeffrey D Blume and Sam S Chang and Michael S Cookson and Joseph A Smith and David F Penson},
url = {https://pubmed.ncbi.nlm.nih.gov/22902011/},
year = {2012},
date = {2012-01-01},
urldate = {2012-01-01},
journal = {The Journal of urology},
volume = {188},
number = {4},
pages = {1279--1285},
publisher = {Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Billings, Frederic T; Pretorius, Mias; Schildcrout, Jonathan S; Mercaldo, Nathaniel; Byrne, John G; Ikizler, T Alp; Brown, Nancy J
Obesity and oxidative stress predict AKI after cardiac surgery Journal Article
In: Journal of the American Society of Nephrology, vol. 23, no. 7, pp. 1221–1228, 2012, ().
@article{billings2012obesity,
title = {Obesity and oxidative stress predict AKI after cardiac surgery},
author = {Frederic T Billings and Mias Pretorius and Jonathan S Schildcrout and Nathaniel Mercaldo and John G Byrne and T Alp Ikizler and Nancy J Brown},
url = {https://pubmed.ncbi.nlm.nih.gov/22626819/},
year = {2012},
date = {2012-01-01},
urldate = {2012-01-01},
journal = {Journal of the American Society of Nephrology},
volume = {23},
number = {7},
pages = {1221--1228},
publisher = {Am Soc Nephrol},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ehrenfeld, Jesse M; Cassedy, Eva A; Forbes, Victoria E; Mercaldo, Nathaniel; Sandberg, Warren S
Modified rapid sequence induction and intubation: a survey of United States current practice. Journal Article
In: Anesthesia and analgesia, vol. 115, no. 1, pp. 95–101, 2012, ().
@article{ehrenfeld2012modified,
title = {Modified rapid sequence induction and intubation: a survey of United States current practice.},
author = {Jesse M Ehrenfeld and Eva A Cassedy and Victoria E Forbes and Nathaniel Mercaldo and Warren S Sandberg},
url = {https://pubmed.ncbi.nlm.nih.gov/22025487/},
year = {2012},
date = {2012-01-01},
urldate = {2012-01-01},
journal = {Anesthesia and analgesia},
volume = {115},
number = {1},
pages = {95--101},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2011
Matheny, Michael; McPheeters, Melissa L; Glasser, Allison; Mercaldo, Nathaniel; Weaver, Rachel B; Jerome, Rebecca N; Walden, Rachel; McKoy, J Nikki; Pritchett, Jason; Tsai, Chris
Systematic review of cardiovascular disease risk assessment tools Journal Article
In: Agency for Healthcare Research and Quality (US), vol. Report No.: 11-05155-EF-1, 2011.
@article{matheny2011systematic,
title = {Systematic review of cardiovascular disease risk assessment tools},
author = {Michael Matheny and Melissa L McPheeters and Allison Glasser and Nathaniel Mercaldo and Rachel B Weaver and Rebecca N Jerome and Rachel Walden and J Nikki McKoy and Jason Pritchett and Chris Tsai},
url = {https://pubmed.ncbi.nlm.nih.gov/21796824/},
year = {2011},
date = {2011-05-01},
urldate = {2011-01-01},
journal = {Agency for Healthcare Research and Quality (US)},
volume = {Report No.: 11-05155-EF-1},
publisher = {Agency for Healthcare Research and Quality (US)},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Baysinger, Curtis L; Pope, Jason E; Lockhart, Ellen M; Mercaldo, Nathaniel
The management of accidental dural puncture and postdural puncture headache: a North American survey Journal Article
In: Journal of clinical anesthesia, vol. 23, no. 5, pp. 349–360, 2011.
@article{baysinger2011management,
title = {The management of accidental dural puncture and postdural puncture headache: a North American survey},
author = {Curtis L Baysinger and Jason E Pope and Ellen M Lockhart and Nathaniel Mercaldo},
url = {https://pubmed.ncbi.nlm.nih.gov/21696932/},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {Journal of clinical anesthesia},
volume = {23},
number = {5},
pages = {349--360},
publisher = {Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bliwise, Donald L; Mercaldo, Nathaniel; Avidan, Alon Y; Boeve, Bradley F; Greer, Sophia A; Kukull, Walter A
Sleep disturbance in dementia with Lewy bodies and Alzheimer’s disease: a multicenter analysis Journal Article
In: Dementia and geriatric cognitive disorders, vol. 31, no. 3, pp. 239–246, 2011.
@article{bliwise2011sleep,
title = {Sleep disturbance in dementia with Lewy bodies and Alzheimer’s disease: a multicenter analysis},
author = {Donald L Bliwise and Nathaniel Mercaldo and Alon Y Avidan and Bradley F Boeve and Sophia A Greer and Walter A Kukull},
url = {https://pubmed.ncbi.nlm.nih.gov/21474933/},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {Dementia and geriatric cognitive disorders},
volume = {31},
number = {3},
pages = {239--246},
publisher = {Karger Publishers},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hyman, Steve A; Michaels, Damon R; Berry, James M; Schildcrout, Jonathan S; Mercaldo, Nathaniel; Weinger, Matthew B
Risk of Burnout in Perioperative CliniciansA Survey Study and Literature Review Journal Article
In: Anesthesiology: The Journal of the American Society of Anesthesiologists, vol. 114, no. 1, pp. 194–204, 2011.
@article{hyman2011risk,
title = {Risk of Burnout in Perioperative CliniciansA Survey Study and Literature Review},
author = {Steve A Hyman and Damon R Michaels and James M Berry and Jonathan S Schildcrout and Nathaniel Mercaldo and Matthew B Weinger},
url = {https://pubmed.ncbi.nlm.nih.gov/21178675/},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {Anesthesiology: The Journal of the American Society of Anesthesiologists},
volume = {114},
number = {1},
pages = {194--204},
publisher = {The American Society of Anesthesiologists},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Jeskey, Mary; Card, Elizabeth; Nelson, Donna; Mercaldo, Nathaniel; Sanders, Neal; Higgins, Michael S; Shi, Yaping; Michaels, Damon; Miller, Anne
Nurse adoption of continuous patient monitoring on acute post-surgical units: managing technology implementation Journal Article
In: Journal of nursing management, vol. 19, no. 7, pp. 863–875, 2011.
@article{jeskey2011nurse,
title = {Nurse adoption of continuous patient monitoring on acute post-surgical units: managing technology implementation},
author = {Mary Jeskey and Elizabeth Card and Donna Nelson and Nathaniel Mercaldo and Neal Sanders and Michael S Higgins and Yaping Shi and Damon Michaels and Anne Miller},
url = {https://pubmed.ncbi.nlm.nih.gov/21988434/},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {Journal of nursing management},
volume = {19},
number = {7},
pages = {863--875},
publisher = {Wiley Online Library},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lau, Denys T; Mercaldo, Nathaniel; Shega, Joseph W; Rademaker, Alfred; Weintraub, Sandra
Functional decline associated with polypharmacy and potentially inappropriate medications in community-dwelling older adults with dementia Journal Article
In: American Journal of Alzheimer's Disease & Other Dementiastextregistered, vol. 26, no. 8, pp. 606–615, 2011.
@article{lau2011functional,
title = {Functional decline associated with polypharmacy and potentially inappropriate medications in community-dwelling older adults with dementia},
author = {Denys T Lau and Nathaniel Mercaldo and Joseph W Shega and Alfred Rademaker and Sandra Weintraub},
url = {https://pubmed.ncbi.nlm.nih.gov/22207646/},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {American Journal of Alzheimer's Disease \& Other Dementiastextregistered},
volume = {26},
number = {8},
pages = {606--615},
publisher = {SAGE Publications Sage CA: Los Angeles, CA},
keywords = {},
pubstate = {published},
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Reynolds, Paul Q; Sanders, Neal W; Schildcrout, Jonathan S; Mercaldo, Nathaniel; Jacques, Paul J St
Expansion of the surgical Apgar score across all surgical subspecialties as a means to predict postoperative mortality. Journal Article
In: Anesthesiology, vol. 114, no. 6, pp. 1305–1312, 2011.
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2010
Lau, Denys T; Mercaldo, Nathaniel; Harris, Andrew T; Trittschuh, Emily; Shega, Joseph; Weintraub, Sandra
Polypharmacy and Potentially Inappropriate Medication Use Among Community-dwelling Elders With Đementia Journal Article
In: Alzheimer Disease & Associated Disorders, vol. 24, no. 1, pp. 56–63, 2010, ().
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date = {2010-01-01},
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Miller, A; Pilcher, D; Mercaldo, Nathaniel; Leong, T; Scheinkestel, C; Schildcrout, J
What can paper-based clinical information systems tell us about the design of computerized clinical information systems (CIS) in the ICU? Journal Article
In: Australian Critical Care, vol. 23, no. 3, pp. 130–140, 2010, ().
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title = {What can paper-based clinical information systems tell us about the design of computerized clinical information systems (CIS) in the ICU?},
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date = {2010-01-01},
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Hughes, Christopher G; Weavind, Lisa; Banerjee, Arna; Mercaldo, Nathaniel; Schildcrout, Jonathan S; Pandharipande, Pratik P.
Intraoperative risk factors for acute respiratory distress syndrome in critically ill patients Journal Article
In: Anesthesia & Analgesia, vol. 111, no. 2, pp. 464–467, 2010, ().
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title = {Intraoperative risk factors for acute respiratory distress syndrome in critically ill patients},
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year = {2010},
date = {2010-01-01},
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2009
Knopman, DS; Jack, CR; Kramer, JH; Boeve, BF; Caselli, RJ; Graff-radford, NR; Mendez, MF; Miller, BL; Mercaldo, Nathaniel
Brain and ventricular volumetric changes in frontotemporal lobar degeneration over 1 year. Journal Article
In: Neurology, vol. 72, no. 21, pp. 1843–1849, 2009, ().
@article{knopman2009brain,
title = {Brain and ventricular volumetric changes in frontotemporal lobar degeneration over 1 year.},
author = {DS Knopman and CR Jack and JH Kramer and BF Boeve and RJ Caselli and NR Graff-radford and MF Mendez and BL Miller and Nathaniel Mercaldo},
year = {2009},
date = {2009-01-01},
journal = {Neurology},
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Weintraub, Sandra; Salmon, David; Mercaldo, Nathaniel; Ferris, Steven; Graff-Radford, Neill R; Chui, Helena; Cummings, Jeffrey; DeCarli, Charles; Foster, Norman L; Galasko, Douglas; others,
The Alzheimer's Disease Centers' Uniform Data Set (UDS) Journal Article
In: Alzheimer Disease and Associated Disorders, vol. 23, no. 2, pp. 91–101, 2009, ().
@article{weintraub2009alzheimer,
title = {The Alzheimer's Disease Centers' Uniform Data Set (UDS)},
author = {Sandra Weintraub and David Salmon and Nathaniel Mercaldo and Steven Ferris and Neill R Graff-Radford and Helena Chui and Jeffrey Cummings and Charles DeCarli and Norman L Foster and Douglas Galasko and others},
year = {2009},
date = {2009-01-01},
urldate = {2009-01-01},
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number = {2},
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2008
Knopman, David S; Kramer, Joel H; Boeve, Bradley F; Caselli, Richard J; Graff-Radford, Neill R; Mendez, Mario F; Miller, Bruce L; Mercaldo, Nathaniel
Development of methodology for conducting clinical trials in frontotemporal lobar degeneration Journal Article
In: Brain, vol. 131, no. 11, pp. 2957–2968, 2008, ().
@article{knopman2008development,
title = {Development of methodology for conducting clinical trials in frontotemporal lobar degeneration},
author = {David S Knopman and Joel H Kramer and Bradley F Boeve and Richard J Caselli and Neill R Graff-Radford and Mario F Mendez and Bruce L Miller and Nathaniel Mercaldo},
year = {2008},
date = {2008-01-01},
urldate = {2008-01-01},
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Lau, Denys T; Briesacher, Becky A; Mercaldo, Nathaniel; Halpern, Leslie; Osterberg, E Charles; Jarzebowski, Mary; McKoy, June M; Mazor, Kathleen
Older patients' perceptions of medication importance and worth: an exploratory pilot study Journal Article
In: Drugs & aging, vol. 25, no. 12, pp. 1061–1075, 2008, ().
@article{lau2008older,
title = {Older patients' perceptions of medication importance and worth: an exploratory pilot study },
author = {Denys T Lau and Becky A Briesacher and Nathaniel Mercaldo and Leslie Halpern and E Charles Osterberg and Mary Jarzebowski and June M McKoy and Kathleen Mazor},
year = {2008},
date = {2008-01-01},
urldate = {2008-01-01},
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2007
Mercaldo, Nathaniel; Lau, Kit F; Zhou, Xiao H
Confidence intervals for predictive values with an emphasis to case--control studies Journal Article
In: Statistics in medicine, vol. 26, no. 10, pp. 2170–2183, 2007, ().
@article{mercaldo2007confidence,
title = {Confidence intervals for predictive values with an emphasis to case--control studies},
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