Improving Resulted Hemoglobin A1c Rates: A Feasibility Study for Point-of-Care Hemoglobin A1c Testing at an Urban Family Medicine Office

Study Aims: Our practice’s goal is to increase the number of up to date hemoglobin A1c for diabetic patients seen at JFMA in order to help improve glycemic control The aim of this study is to see if point of care (POC) hemoglobin A1C is a feasible way to increase the number of up to date hemoglobin A1C. We looked at various factors including timing, training, and flow.https://jdc.jefferson.edu/patientsafetyposters/1037/thumbnail.jp

Patient-specific 3D Printed Liver Models for Pre-operative Planning and Improved Patient Adherence

Project Background: 3D anatomical relationships in the liver are not always visually accessible for surgeons performing resections even with advanced imaging options. Firm understanding of these relationships is essential for timely procedures, which can improve patient outcomes and lower hospital expenses. Patient-specific 3D modeling has existed for some time, though it is costly. New cost-effective techniques have surfaced which may yield opportunities for more effective preoperative planning in liver surgery and improved patient adherence. Methods: Digital patient-specific 3D reconstruction of a liver was completed by interpolating data from MRI scans using 3D Slicer, a segmenting program. The liver model was processed and 3D printed as a shell to be used as a mold. The liver shell, associated vasculature, and tumor were printed using polylactic acid (PLA) filament on an Ultimaker S5 3D printer. Transparent silicone was used as a cast, giving the model a solid form yet still allowing examination of the inside contents. Results: One completed liver model was used in pre-surgical consultation of a patient with hepatocellular carcinoma undergoing liver resection and during the surgical procedure as a guide for the surgical team. A follow-up survey concerning qualitative aspects of the model administered to the surgical team suggested high accuracy of the model compared to the anatomy observed during the procedure. Conclusion: Cost-effective techniques in producing patient specific 3D anatomical models appears not only feasible, but highly effective in improving communication between the surgical team during the procedure and also between the surgeon and the patient during pre-surgical consultation. Future research may be conducted concerning the model’s visual clarity as well as impact on patient adherence post-op

Improving Rural Bone Health and Minimizing Fracture Risk in West Virginia: Validation of the World Health Organization FRAX® Assessment Tool as a Phone Survey for Osteoporosis Detection

West Virginia ranks second nationally in population ≥ 65 years old placing our state at greater risk for osteoporosis and fracture. The gold standard for detecting osteoporosis is dual X-ray absorptiometry (DXA), yet over half of West Virginia’s counties do not have this machine. Due to access barriers, a validated phone-administered fracture prediction tool would be beneficial for osteoporosis screening. The World Health Organization’s FRAX® fracture prediction tool was administered as a phone survey to 45 patients; these results were compared to DXA bone mineral density determination. Results confirmed that the FRAX® phone survey is as reliable as DXA in detecting osteoporosis or clinically significant osteopenia: 92% positive predictive value, 100% negative predictive value, 100% sensitivity and 91% specificity when compared to the gold standard. These promising results allow for the development of telephone-based protocols to improve osteoporosis detection, referral and treatment especially in areas with health care access barriers

A Penalty-projection based Efficient and Accurate Stochastic Collocation Method for Magnetohydrodynamic Flows

We propose, analyze, and test a penalty projection-based efficient and accurate algorithm for the Uncertainty Quantification (UQ) of the time-dependent Magnetohydrodynamic (MHD) flow problems in convection-dominated regimes. The algorithm uses the Els\"asser variables formulation and discrete Hodge decomposition to decouple the stochastic MHD system into four sub-problems (at each time-step for each realization) which are much easier to solve than solving the coupled saddle point problems. Each of the sub-problems is designed in a sophisticated way so that at each time-step the system matrix remains the same for all the realizations but with different right-hand-side vectors which allows saving a huge amount of computer memory and computational time. Moreover, the scheme is equipped with ensemble eddy-viscosity and grad-div stabilization terms. The stability of the algorithm is proven rigorously. We prove that the proposed scheme converges to an equivalent non-projection-based coupled MHD scheme for large grad-div stabilization parameter values. We examine how Stochastic Collocation Methods (SCMs) can be combined with the proposed penalty projection UQ algorithm. Finally, a series of numerical experiments are given which verify the predicted convergence rates, show the algorithm's performance on benchmark channel flow over a rectangular step, and a regularized lid-driven cavity problem with high random Reynolds number and magnetic Reynolds number.Comment: 28 pages, 13 figure

Therapeutic effect of quercetin in collagen-induced arthritis

Quercetin, a bioactive flavonoid with anti-inflammatory, immunosuppressive, and protective properties, is a potential agent for the treatment of rheumatoid arthritis (RA). Collagen-induced arthritis (CIA) is the most commonly used animal model for studying the pathogenesis of RA. This study analysed the therapeutic role of quercetin in collagen-induced arthritis in C57BL/6 mice. The animals were allocated into five groups that were subjected to the following treatments: negative (untreated) control, positive control (arthritis-induced), arthritis + methotrexate, arthritis + quercetin, and arthritis + methotrexate + quercetin. Assessments of weight, oedema, joint damage, and cytokine production were used to determine the therapeutic effect of quercetin. This study demonstrated for the first time the anti-inflammatory and protective effects of quercetin in vivo in CIA. The results also showed that the concurrent administration of quercetin and methotrexate did not offer greater protection than the administration of a single agent. The use of quercetin as a monotherapeutic agent resulted in the lowest degree of joint inflammation and the highest protection. The reduced severity of the disease in animals treated with quercetin was associated with decreased levels of TNF-α, IL-1β, IL-17, and MCP-1. In conclusion, this study determined that quercetin, which was non-toxic, produced better results than methotrexate for the protection of joints from arthritic inflammation in mice. Quercetin may be an alternative treatment for RA because it modulates the main pathogenic pathways of RA

The Urban Toolkit: A Grammar-based Framework for Urban Visual Analytics

While cities around the world are looking for smart ways to use new advances in data collection, management, and analysis to address their problems, the complex nature of urban issues and the overwhelming amount of available data have posed significant challenges in translating these efforts into actionable insights. In the past few years, urban visual analytics tools have significantly helped tackle these challenges. When analyzing a feature of interest, an urban expert must transform, integrate, and visualize different thematic (e.g., sunlight access, demographic) and physical (e.g., buildings, street networks) data layers, oftentimes across multiple spatial and temporal scales. However, integrating and analyzing these layers require expertise in different fields, increasing development time and effort. This makes the entire visual data exploration and system implementation difficult for programmers and also sets a high entry barrier for urban experts outside of computer science. With this in mind, in this paper, we present the Urban Toolkit (UTK), a flexible and extensible visualization framework that enables the easy authoring of web-based visualizations through a new high-level grammar specifically built with common urban use cases in mind. In order to facilitate the integration and visualization of different urban data, we also propose the concept of knots to merge thematic and physical urban layers. We evaluate our approach through use cases and a series of interviews with experts and practitioners from different domains, including urban accessibility, urban planning, architecture, and climate science. UTK is available at urbantk.org.Comment: Accepted at IEEE VIS 2023. UTK is available at http://urbantk.or