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Gold open access articles authored by UNC researchers and published by SAGE.
Works (419)
11. Contact-FP: A Dimerization-Dependent Fluorescent Protein Toolkit for Visualizing Membrane Contact Site Dynamics
- Title Tesim:
- Contact-FP: A Dimerization-Dependent Fluorescent Protein Toolkit for Visualizing Membrane Contact Site Dynamics
- Creator:
- Showalter, Wendy K., Smith, Sidney Y., Miner, Gregory E., Ragusa, Joey V., Cohen, Sarah, Powers, Alex E., So, Christina M., Marchan, Michelle F., Hsu, Chih-Hsuan, and Zanellati, Maria Clara
- Date of publication:
- February 4, 2024
- Abstract Tesim:
- Membrane contact sites (MCSs) are sites of close apposition between two organelles used to exchange ions, lipids, and information. Cells respond to changing environmental or developmental conditions by modulating the number, extent, or duration of MCSs. Because of their small size and dynamic nature, tools to study the dynamics of MCSs in live cells have been limited. Dimerization-dependent fluorescent proteins (ddFPs) targeted to organelle membranes are an ideal tool for studying MCS dynamics because they reversibly interact to fluoresce specifically at the interface between two organelles. Here, we build on previous work using ddFPs as sensors to visualize the morphology and dynamics of MCSs. We engineered a suite of ddFPs called Contact-FP that targets ddFP monomers to lipid droplets (LDs), the endoplasmic reticulum (ER), mitochondria, peroxisomes, lysosomes, plasma membrane, caveolae, and the cytoplasm. We show that these probes correctly localize to their target organelles. Using LDs as a test case, we demonstrate that Contact-FP pairs specifically localize to the interface between two target organelles. Titration of LD-mitochondria ddFPs revealed that these sensors can be used at high concentrations to drive MCSs or can be titrated down to minimally perturb and visualize endogenous MCSs. We show that Contact-FP probes can be used to: (1) visualize LD-mitochondria MCS dynamics, (2) observe changes in LD-mitochondria MCS dynamics upon overexpression of PLIN5, a known LD-mitochondrial tether, and (3) visualize two MCSs that share one organelle simultaneously (e.g., LD-mitochondria and LD-ER MCSs). Contact-FP probes can be optimized to visualize MCSs between any pair of organelles represented in the toolkit.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Cell Biology and Physiology
- Copyright Date:
- 2024
- Deposit Record:
- 3e8dc2f5-a8ca-4631-a659-51b96568e6fb
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/y49v-m897
- Identifier:
- https://doi.org/10.1177/25152564241228911
- ISSN:
- 2515-2564
- Journal Title:
- Contact
- Journal Volume:
- 7
- Keyword:
- biosensors, lysosomes, fluorescent proteins, endoplasmic reticulum, caveolae, lipid droplets, plasma membrane, mitochondria, peroxisomes, membrane contact sites, and organelles
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- , https://orcid.org/0000-0002-1124-4217, https://orcid.org/0000-0003-2982-3265, and https://orcid.org/0000-0003-0597-4923
- Other Affiliation:
- Person:
- Showalter, Wendy K., Smith, Sidney Y., Miner, Gregory E., Ragusa, Joey V., Cohen, Sarah, Powers, Alex E., So, Christina M., Marchan, Michelle F., Hsu, Chih-Hsuan, and Zanellati, Maria Clara
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications Inc unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
- Rights Statement Label:
- In Copyright
12. An Early and Unequal Decline: Life Course Trajectories of Cognitive Aging in the United States
- Title Tesim:
- An Early and Unequal Decline: Life Course Trajectories of Cognitive Aging in the United States
- Creator:
- Aiello, Allison E., Belsky, Daniel W., Harris, Kathleen Mullan, Plassman, Brenda L., Yang, Yang C., Shartle, Kaitlin, Stebbins, Rebecca C., Chanti-Ketterl, Marianne, and Walsh, Christine E.
- Date of publication:
- March 2024
- Abstract Tesim:
- Objectives: Cognitive aging is a lifelong process with implications for Alzheimer’s disease and dementia. This study aims to fill major gaps in research on the natural history of and social disparities in aging-related cognitive decline over the life span. Methods: We conducted integrative data analysis of four large U.S. population-based longitudinal studies of individuals aged 12 to 105 followed over two decades and modeled age trajectories of cognitive function in multiple domains. Results: We found evidence for the onset of cognitive decline in the 4th decade of life, varying gender differences with age, and persistent disadvantage among non-Hispanic Blacks, Hispanics, and those without college education. We further found improvement in cognitive function across 20th century birth cohorts but widening social inequalities in more recent cohorts. Discussion: These findings advance an understanding of early life origins of dementia risk and invite future research on strategies for promoting cognitive health for all Americans.
- Resource type:
- Article
- Affiliation Label Tesim:
- Carolina Population Center
- Copyright Date:
- 2023
- Deposit Record:
- 3e8dc2f5-a8ca-4631-a659-51b96568e6fb
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/tsgr-1d40
- Identifier:
- https://doi.org/10.1177/08982643231184593
- ISSN:
- 0898-2643 and 1552-6887
- Journal Issue:
- 3-4
- Journal Title:
- Journal of Aging and Health
- Journal Volume:
- 36
- Keyword:
- and educational disparities, life course trajectories, dementia risk, gender, cognitive decline, race/ethnicity, and cognitive aging
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- , https://orcid.org/0000-0001-5463-2212, https://orcid.org/0000-0002-7132-1843, https://orcid.org/0000-0001-7266-6694, and https://orcid.org/0000-0002-3663-1360
- Other Affiliation:
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA, , and Department of Psychiatry & Behavioral Science, School of Medicine, Duke University, Durham, NC, USA
- Page End:
- 245
- Page Start:
- 230
- Person:
- Aiello, Allison E., Belsky, Daniel W., Harris, Kathleen Mullan, Plassman, Brenda L., Yang, Yang C., Shartle, Kaitlin, Stebbins, Rebecca C., Chanti-Ketterl, Marianne, and Walsh, Christine E.
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications
- Rights Statement Label:
- In Copyright
13. Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey
- Title Tesim:
- Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey
- Creator:
- Prieto, Lucas, Masa, Rainier, Inoue, Megumi, Nosrat, Sarah, Baruah, Dicky, Operario, Don, and Mehak, Samreen
- Date of publication:
- March 2024
- Abstract Tesim:
- This study explored differences among older adults in mental health by sexual minority status. Data came from the 2021 U.S. National Health Interview Survey. The study sample included older adults (or those aged ≥50 years, N = 15,559), and of those, two percent (n = 380) self-identified as lesbian, gay, or bisexual (LGB). Older LGB adults had significantly higher odds of reporting a diagnosis of depression and anxiety and experiencing serious psychological distress than older non-LGB adults. Additionally, older LGB adults reported higher odds of experiencing depression and anxiety more frequently than older non-LGB adults. Significant covariates included age, sex, housing, food security, and social support. Increased risk for mental illness may be long-term consequences of stigma and discrimination that this population has experienced over the life course. The combination of structural interventions and affirming mental healthcare that recognizes the cumulative negative experience among older LGB adults is necessary to achieve mental health equity.
- Resource type:
- Article
- Affiliation Label Tesim:
- School of Social Work
- Copyright Date:
- 2023
- Deposit Record:
- c74bef77-65d2-437f-ab47-80cd6bbeca4e
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/jbhx-a603
- Identifier:
- https://doi.org/10.1177/07334648231203838
- ISSN:
- 0733-4648 and 1552-4523
- Journal Issue:
- 3
- Journal Title:
- Journal of Applied Gerontology
- Journal Volume:
- 43
- Keyword:
- health disparities, mental health, socioeconomic status, and lesbian, gay, bisexual, transgender, and queer
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- https://orcid.org/0000-0002-7641-7713, https://orcid.org/0000-0002-0484-3107, https://orcid.org/0000-0001-8077-6711, https://orcid.org/0009-0002-4800-9744, and
- Other Affiliation:
- Department of Social Work, George Mason University, Fairfax, VA, USA, , and Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Page End:
- 286
- Page Start:
- 276
- Person:
- Prieto, Lucas, Masa, Rainier, Inoue, Megumi, Nosrat, Sarah, Baruah, Dicky, Operario, Don, and Mehak, Samreen
- Publisher:
- SAGE Publications
- Rights Holder:
- Southern Gerontological Society
- Rights Statement Label:
- In Copyright
14. Remembering Friend, Mentor, and Scholar Sam Bass Warner Jr., 1928–2023
- Title Tesim:
- Remembering Friend, Mentor, and Scholar Sam Bass Warner Jr., 1928–2023
- Creator:
- Vale, Lawrence and Whittemore, Andrew
- Date of publication:
- February 2024
- Abstract Tesim:
- For the urban historian, it is heartening to see awareness of the injustices of urban renewal, redlining, freeway siting, and other historic practices figure prominently in public conversations today—recognition of our turbulent urban and planning history is even beginning to inform governments’ current policies. Sam Bass Warner Jr. was among the first group of scholars to turn a critical eye on the historical development of American cities, and works of his, including Streetcar Suburbs (1962), The Private City (1968), and The Urban Wilderness (1972), became seminal pieces in the nascent, largely uncharted field of American urban and planning history during the 1960s and 1970s. Beginning with these influential debuts, Sam’s six-decade career remained dedicated to bringing urban and planning history out of obscurity and into the place we see it today.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of City and Regional Planning
- Copyright Date:
- 2023
- Deposit Record:
- e5b881b9-3f18-499b-a50e-299f67f45493
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/w3bw-r271
- Identifier:
- https://doi.org/10.1177/15385132231194951
- ISSN:
- 1538-5132 and 1552-6585
- Journal Issue:
- 1
- Journal Title:
- Journal of Planning History
- Journal Volume:
- 23
- Keyword:
- planning practice, suburbs, places, planning eras/approaches, 19th century planning, North America, planning education, regions, and post-war planning
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- and https://orcid.org/0000-0003-2546-9051
- Other Affiliation:
- Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA and
- Page End:
- 72
- Page Start:
- 71
- Person:
- Vale, Lawrence and Whittemore, Andrew
- Publisher:
- SAGE Publications
- Rights Holder:
- SAGE Publications
- Rights Statement Label:
- In Copyright
15. Injury Patterns, Imaging Usage, and Disparities Associated With Car Restraint Use in Children
- Title Tesim:
- Injury Patterns, Imaging Usage, and Disparities Associated With Car Restraint Use in Children
- Creator:
- McCauley, Christopher J., Schiro, Sharon E., McLean, Sean E., Nakayama, Don K., and Purcell, Laura N.
- Date of publication:
- December 2023
- Abstract Tesim:
- Background Motor vehicle collision (MVC) is a leading cause of accidental death in children. Despite effective forms of child safety restraint (eg, car seat and booster seat), studies demonstrate poor compliance with guidelines. The goal of this study was to delineate injury patterns, imaging usage, and potential demographic disparities associated with child restraint use following MVC. Methods A retrospective review of the North Carolina Trauma Registry was performed to determine demographic factors and outcomes associated with improper restraint of children (0-8 years) involved in MVC from 2013 to 2018. Bivariate analysis was performed by the appropriateness of restraint. Multivariable Poisson regression identified demographic factors for the relative risk of inappropriate restraint. Results Inappropriately restrained patients were older (5.1 years v. 3.6 yrs, P < .001) and weighed more (44.1 lbs v. 35.3 lbs, P < .001). A higher proportion of African American (56.9% v. 39.3%, P < .001) and Medicaid (52.2% v. 39.0%, P < .001) patients were inappropriately restrained. Multivariable Poisson regression showed that African American patients (RR 1.43), Asian patients (RR 1.51), and Medicaid payor status (RR 1.25) were associated with a higher risk of inappropriate restraint. Inappropriately restrained patients had a longer length of stay, but injury severity score and mortality were no different. Discussion African American children, Asian children, and Medicaid insurance payor status patients had an increased risk of inappropriate restraint use in MVC. This study describes unequal restraint patterns in children, which suggests opportunity for targeted patient education and necessitates research to further delineate the underlying etiology of these differences.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Surgery
- Copyright Date:
- 2023
- Deposit Record:
- e5b881b9-3f18-499b-a50e-299f67f45493
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/v7vf-vn96
- Identifier:
- https://doi.org/10.1177/00031348231175455
- ISSN:
- 0003-1348 and 1555-9823
- Journal Issue:
- 12
- Journal Title:
- The American Surgeon™
- Journal Volume:
- 89
- Keyword:
- socioeconomic, trauma, and pediatric surgery
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- Other Affiliation:
- Page End:
- 5864
- Page Start:
- 5858
- Person:
- McCauley, Christopher J., Schiro, Sharon E., McLean, Sean E., Nakayama, Don K., and Purcell, Laura N.
- Publisher:
- SAGE Publications
- Rights Holder:
- Southeastern Surgical Congress
- Rights Statement Label:
- In Copyright
16. The Use of Sequential Surveys to Shorten Implementation Time for Healthcare System-Level Enhanced Recovery After Surgery (ERAS) Pathways
- Title Tesim:
- The Use of Sequential Surveys to Shorten Implementation Time for Healthcare System-Level Enhanced Recovery After Surgery (ERAS) Pathways
- Creator:
- McNaull, Peggy P., Adams, Ursula C., McGinigle, Katharine L., Moulthrop, Amy J., Straube, Lacey E., Phillips, Michael R., and Malay, Brendan
- Date of publication:
- December 2023
- Abstract Tesim:
- Background Enhanced Recovery After Surgery (ERAS) pathways improve healthcare quality, safety, and cost-effectiveness. We hypothesized that the RAND Method (a hybrid Delphi approach), involving anonymous sequential surveys and face-to-face meetings, would allow for more rapid agreement and initiation of new ERAS pathways. Methods Using the ERAS Society guidelines for cesarean section as a baseline, our institution’s ERAS Leadership Team (ELT) compiled published literature and institutional practices to design a 32-component survey that was sent to obstetricians, nurse midwives, anesthesiologists, pharmacists, and nurses. Components that did not reach 90% consensus were included in a second survey the following week, and meetings were held to review results. At the conclusion of this process, time to agreement was retrospectively compared to the colorectal ERAS pathway process at this institution. Results ERAS pathway components were compiled and reviewed by 121 stakeholders at 7 hospitals using iterative surveys with review meetings over a 13-week period. Survey response rates were 61% and 50% in the initial and follow-up surveys, respectively. There was agreement on 28/32 and 32/32 items on the initial and follow-up surveys. Using the RAND Method, time to agreement decreased by 54.1% (24 vs 13 weeks) compared to prior system-wide efforts to standardize the colorectal surgery ERAS pathway. Discussion With rapidly expanding healthcare systems, effective methods to gain consensus and adopt ERAS pathways are critical to implementation of ERAS guidelines. We demonstrate that the RAND Method allows for a transparent and efficient means of agreement across a diverse group of clinicians practicing in several settings.
- Resource type:
- Article
- Affiliation Label Tesim:
- School of Medicine
- Copyright Date:
- 2023
- Deposit Record:
- e5b881b9-3f18-499b-a50e-299f67f45493
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/ntwk-f921
- Identifier:
- https://doi.org/10.1177/00031348231156765
- ISSN:
- 1555-9823 and 0003-1348
- Journal Issue:
- 12
- Journal Title:
- The American Surgeon™
- Journal Volume:
- 89
- Keyword:
- OBGYN, Surgical Quality, general surgery, and enhanced recovery after surgery
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- and https://orcid.org/0000-0002-8424-0671
- Other Affiliation:
- and UNC Health, Care Redesign, Chapel Hill, NC, USA
- Page End:
- 5473
- Page Start:
- 5466
- Person:
- McNaull, Peggy P., Adams, Ursula C., McGinigle, Katharine L., Moulthrop, Amy J., Straube, Lacey E., Phillips, Michael R., and Malay, Brendan
- Publisher:
- SAGE Publications
- Rights Holder:
- Southeastern Surgical Congress
- Rights Statement Label:
- In Copyright
17. “Free-Floating Anus”: A Flap-Free Approach for Definitive Excision of Circumferential Giant Condyloma Acuminata
- Title Tesim:
- “Free-Floating Anus”: A Flap-Free Approach for Definitive Excision of Circumferential Giant Condyloma Acuminata
- Creator:
- Comer, Lydia H., Varvoglis, Dimitrios N., Hoang, Van, Luo, William Y., and Guillem, José G.
- Date of publication:
- December 2023
- Abstract Tesim:
- Giant condyloma acuminata (GCA), or Buschke-Löwenstein tumor, is a rare exophytic cauliflower-like growth in the anogenital region. The spectrum of treatment options is wide, ranging from the application of topical ointments to the performance of an abdominoperineal resection. Currently, wide local excision is the most common approach and may entail the creation of a protective loop ileostomy or implementation of flaps or grafts that facilitate closure. We describe a unique surgical approach for the management of circumferential GCA void of the use a protective loop ileostomy, flaps, or grafts. Our report highlights that the implementation of a radical, circumferential, wide excision resulting in “free-floating anus” and healing via secondary intention can ultimately lead to excellent functional and cosmetic results and therefore may be considered a minimally invasive surgical option for patients afflicted with a large, circumferential GCA.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Surgery
- Copyright Date:
- 2023
- Deposit Record:
- e5b881b9-3f18-499b-a50e-299f67f45493
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/smhk-vc47
- Identifier:
- https://doi.org/10.1177/00031348231199173
- ISSN:
- 0003-1348 and 1555-9823
- Journal Issue:
- 12
- Journal Title:
- The American Surgeon™
- Journal Volume:
- 89
- Keyword:
- giant condyloma acuminata, free-floating anus, ileostomy-free, and Buschke-Löwenstein tumor
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- and https://orcid.org/0000-0002-9439-6530
- Other Affiliation:
- Page End:
- 6392
- Page Start:
- 6389
- Person:
- Comer, Lydia H., Varvoglis, Dimitrios N., Hoang, Van, Luo, William Y., and Guillem, José G.
- Publisher:
- SAGE Publications
- Rights Holder:
- Southeastern Surgical Congress
- Rights Statement Label:
- In Copyright
18. Richard Nixon’s Left Knee and Its Impact on American History
- Title Tesim:
- Richard Nixon’s Left Knee and Its Impact on American History
- Creator:
- Pappas, Theodore N., Pascarella, Luigi, and Barr, Justin
- Date of publication:
- December 2023
- Abstract Tesim:
- Richard Nixon injured his left knee in a limousine door while campaigning in North Carolina in 1960, resulting in septic arthritis that required a multi-day admission to Walter Reed Hospital. Still ill for the first presidential debate that fall, Nixon lost the contest based more on his appearance than his performance. Partly as a result of this debate, he was defeated by John F. Kennedy in the general election. Because of his leg wound, Nixon developed chronic DVTs in that limb, including a severe thrombus in 1974 that embolized to his lung, required surgery, and prevented him from testifying at the Watergate Trial. Episodes like this one highlight the value of studying the health of famous figures, where even the most minor injuries have the potential to influence world history.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Surgery
- Copyright Date:
- 2023
- Deposit Record:
- e5b881b9-3f18-499b-a50e-299f67f45493
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/1tq1-8s67
- Identifier:
- https://doi.org/10.1177/00031348231161769
- ISSN:
- 1555-9823 and 0003-1348
- Journal Issue:
- 12
- Journal Title:
- The American Surgeon™
- Journal Volume:
- 89
- Keyword:
- Kennedy, DVT, Nixon, presidential debate, and Watergate
- License Label:
- Attribution 4.0 International
- ORCID:
- and https://orcid.org/0000-0003-0143-0603
- Other Affiliation:
- Department of Surgery, Duke University, Durham, NC, USA, , and Department of Surgery, Toronto General Hospital, Toronto, ON, Canada
- Page End:
- 5564
- Page Start:
- 5559
- Person:
- Pappas, Theodore N., Pascarella, Luigi, and Barr, Justin
- Publisher:
- SAGE Publications
- Rights Holder:
- Southeastern Surgical Congress
- Rights Statement Label:
- In Copyright
19. Central Line-Associated Bloodstream Infection Risk Factors in a Pediatric Population
- Title Tesim:
- Central Line-Associated Bloodstream Infection Risk Factors in a Pediatric Population
- Creator:
- Caruso, Deanna M., Akinkuotu, Adesola C., Trembath, Hannah E., Hayes Dixon, Andrea A., McLean, Sean E., and Phillips, Michael R.
- Date of publication:
- January 2024
- Abstract Tesim:
- Background Central venous line (CVL) placement in children is often necessary for treatment and may be complicated by central line-associated bloodstream infection (CLABSI). We hypothesize that line type and clinical and demographic factors at line placement impact CLABSI rates. Methods This is a single-institution case-control study of pediatric patients (≤18 years old) admitted between January 1, 2015, and December 31, 2019. Case patients had a documented CLABSI. Control patients had a CVL placed during the study period and were matched by sex and age in a 2:1 ratio. Bivariate and multivariate logistic regression analysis was performed. Results We identified 78 patients with a CLABSI and 140 patients without a CLABSI. After controlling for pertinent covariates, patients undergoing tunneled or non-tunneled CVL had higher odds of CLABSI than those undergoing PICC (OR 2.51, CI 1.12-5.64 and OR 3.88, CI 1.06-14.20 respectively), and patients undergoing port placement had decreased odds of CLABSI compared to PICC (OR .05, CI 0.01-.51). There were lower odds of CLABSI when lines were placed for intravenous medications compared to those placed for solid tumor malignancy (OR .15, CI .03-.79). Race and age were not statistically significant risk factors. Discussion Central lines placed for medication administration compared to solid tumors, PICC compared to tunneled and non-tunneled central lines, and ports compared to PICC were associated with lower odds of CLABSI. Future improvement efforts should focus on PICC and port placement in appropriate patients to decrease CLABSI rates.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Surgery
- Copyright Date:
- 2023
- Deposit Record:
- e5b881b9-3f18-499b-a50e-299f67f45493
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/2xs1-v318
- Identifier:
- https://doi.org/10.1177/00031348231192070
- ISSN:
- 0003-1348 and 1555-9823
- Journal Issue:
- 1
- Journal Title:
- The American Surgeon™
- Journal Volume:
- 90
- Keyword:
- CLABSI, pediatric surgery, and pediatric central line
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- and https://orcid.org/0000-0001-8655-3551
- Other Affiliation:
- Page End:
- 74
- Page Start:
- 69
- Person:
- Caruso, Deanna M., Akinkuotu, Adesola C., Trembath, Hannah E., Hayes Dixon, Andrea A., McLean, Sean E., and Phillips, Michael R.
- Publisher:
- SAGE Publications
- Rights Holder:
- Southeastern Surgical Congress
- Rights Statement Label:
- In Copyright
20. Prediction of Ureteral Injury During Colorectal Surgery Using Machine Learning
- Title Tesim:
- Prediction of Ureteral Injury During Colorectal Surgery Using Machine Learning
- Creator:
- Joisa, Chinmaya U., Chen, Kevin A., Gomez, Shawn M., Stem, Jonathan M., Guillem, Jose G., and Kapadia, Muneera R.
- Date of publication:
- December 2023
- Abstract Tesim:
- Background Ureteral injury (UI) is a rare but devastating complication during colorectal surgery. Ureteral stents may reduce UI but carry risks themselves. Risk predictors for UI could help target the use of stents, but previous efforts have relied on logistic regression (LR), shown moderate accuracy, and used intraoperative variables. We sought to use an emerging approach in predictive analytics, machine learning, to create a model for UI. Methods Patients who underwent colorectal surgery were identified in the National Surgical Quality Improvement Program (NSQIP) database. Patients were split into training, validation, and test sets. The primary outcome was UI. Three machine learning approaches were tested including random forest (RF), gradient boosting (XGB), and neural networks (NN), and compared with traditional LR. Model performance was assessed using area under the curve (AUROC). Results The data set included 262,923 patients, of whom 1519 (.578%) experienced UI. Of the modeling techniques, XGB performed the best, with an AUROC score of .774 (95% CI .742-.807) compared with .698 (95% CI .664-.733) for LR. Random forest and NN performed similarly with scores of .738 and .763, respectively. Type of procedure, work RVUs, indication for surgery, and mechanical bowel prep showed the strongest influence on model predictions. Conclusions Machine learning-based models significantly outperformed LR and previous models and showed high accuracy in predicting UI during colorectal surgery. With proper validation, they could be used to support decision making regarding the placement of ureteral stents preoperatively.
- Resource type:
- Article
- Affiliation Label Tesim:
- Joint Department of Biomedical Engineering and Department of Surgery
- Copyright Date:
- 2023
- Deposit Record:
- e5b881b9-3f18-499b-a50e-299f67f45493
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/717f-wy45
- Identifier:
- https://doi.org/10.1177/00031348231173981
- ISSN:
- 1555-9823 and 0003-1348
- Journal Issue:
- 12
- Journal Title:
- The American Surgeon™
- Journal Volume:
- 89
- Keyword:
- colorectal surgery, machine learning, ureteral injury, and artificial intelligence
- License Label:
- Attribution-NonCommercial 4.0 International
- ORCID:
- Other Affiliation:
- Page End:
- 5710
- Page Start:
- 5702
- Person:
- Joisa, Chinmaya U., Chen, Kevin A., Gomez, Shawn M., Stem, Jonathan M., Guillem, Jose G., and Kapadia, Muneera R.
- Publisher:
- SAGE Publications
- Rights Holder:
- Southeastern Surgical Congress
- Rights Statement Label:
- In Copyright
Collection Details
- Total items
-
419
- Size
-
unknown
- Date created
-
February 2, 2022