A5008184732- Vitamin D Research Studies
- Diet and metabolism studies
- Health Systems, Economic Evaluations, Quality of Life
- Machine Learning in Healthcare
- Acute Ischemic Stroke Management
- Diabetes Treatment and Management
- Metabolism, Diabetes, and Cancer
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Nutritional Studies and Diet
- Heart Failure Treatment and Management
- Statistical Methods in Clinical Trials
- Advanced Causal Inference Techniques
- Acute Myocardial Infarction Research
- Vitamin C and Antioxidants Research
- Pharmacology and Obesity Treatment
- Adipokines, Inflammation, and Metabolic Diseases
- Chronic Disease Management Strategies
- RNA regulation and disease
- Parkinson's Disease Mechanisms and Treatments
- Diabetes Management and Education
- Cardiovascular and Diving-Related Complications
- Cerebrovascular and Carotid Artery Diseases
- Cardiovascular Function and Risk Factors
- Transplantation: Methods and Outcomes
- Hospital Admissions and Outcomes
Tufts Medical Center
2016-2025
Tufts University
2011-2022
Maine Medical Center
2022
Towson University
2022
Copenhagen University Hospital
2022
Rigshospitalet
2022
Institute for Molecular Medicine Finland
2022
McGill University Health Centre
2022
Providence College
2021
Kaiser Permanente
2021
Observational studies support an association between a low blood 25-hydroxyvitamin D level and the risk of type 2 diabetes. However, whether vitamin supplementation lowers diabetes is unknown.We randomly assigned adults who met at least two three glycemic criteria for prediabetes (fasting plasma glucose level, 100 to 125 mg per deciliter; hours after 75-g oral load, 140 199 glycated hemoglobin 5.7 6.4%) no diagnostic receive 4000 IU day D3 or placebo, regardless baseline serum level. The...
Patent foramen ovale (PFO)-associated strokes comprise approximately 10% of ischemic in adults aged 18 to 60 years. While device closure decreases stroke recurrence risk overall, the best treatment for any individual is often unclear.To evaluate heterogeneity effect PFO on based previously developed scoring systems.Investigators Systematic, Collaborative, Closure Evaluation (SCOPE) Consortium pooled patient data from all 6 randomized clinical trials that compared plus medical therapy vs...
OBJECTIVE Postrandomization biases may influence the estimate of efficacy supplemental vitamin D in diabetes prevention trials. In Vitamin and Type 2 Diabetes (D2d) study, repeated measures serum 25-hydroxyvitamin [25(OH)D] level provided an opportunity to test whether intratrial exposure affected risk effect was modified by trial assignment (vitamin vs. placebo). RESEARCH DESIGN AND METHODS The D2d study compared daily supplementation with 100 μg (4,000 units) D3 versus placebo on new-onset...
OBJECTIVE To investigate the association between vitamin D status, assessed by plasma 25-hydroxyvitamin D, and risk of incident diabetes. RESEARCH DESIGN AND METHODS Prospective observational study with a mean follow-up 2.7 years in Diabetes Prevention Program (DPP), multicenter trial comparing different strategies for prevention diabetes patients prediabetes. We measured repeatedly during follow-up, combined placebo (n = 1,022) intensive lifestyle 1,017) randomized arms DPP. Variables at...
Background: Risk of the outcome is a mathematical determinant absolute treatment benefit an intervention, yet this can vary substantially within trial population, complicating interpretation results. Methods: We developed risk models using Cox or logistic regression on set large publicly available randomized controlled trials (RCTs). evaluated heterogeneity extreme quartile ratio (EQRR, rates in lowest to that highest) and skewness median mean (MMRR, patient average). also examined effects...
The delivery of burn care is a resource-intensive endeavor that requires specialized personnel and equipment. optimal geographic distribution centers has long been debated; however, the current relative to area population unknown.
In 2001, 1176 US hospitals were capable of performing primary percutaneous coronary intervention (PCI), and 79% the population lived within 60-minute ground transport these hospitals. We compared estimates with data from 2006 to explore how hospital PCI capability access have changed over time.We estimated proportion 18 years age or older, living in a drive PCI-capable hospital, we our estimate previously published report on 2001 data. Over 5-year period, number grew 1695 hospitals, relative...
Background— Recent proposals suggest that risk-stratified analyses of clinical trials be routinely performed to better enable tailoring treatment decisions individuals. Trial data can stratified using externally developed risk models (eg, Framingham score), but such are not always available. We sought determine whether internally models, directly on trial data, introduce bias compared with external models. Methods and Results— simulated a large patient population known factors outcomes....
ObjectiveTo assess whether the Prediction model Risk Of Bias ASsessment Tool (PROBAST) and a shorter version of this tool can identify clinical prediction models (CPMs) that perform poorly at external validation.Study Design SettingWe evaluated risk bias (ROB) on 102 CPMs from Tufts CPM Registry, comparing PROBAST to short form consisting six items anticipated best high ROB. We then applied all in Registry with least 1 validation (n=556) assessed change discrimination (dAUC) cohorts...
While clinical prediction models (CPMs) are used increasingly commonly to guide patient care, the performance and utility of these CPMs in new cohorts is poorly understood.We performed 158 external validations 104 unique across 3 domains cardiovascular disease (primary prevention, acute coronary syndrome, heart failure). Validations were publicly available trial model was assessed using measures discrimination, calibration, net benefit. To explore potential reasons for poor performance,...
Abstract Objectives β-Lactam antibiotics are commonly used in outpatient parenteral antimicrobial therapy (OPAT), but data regarding outcomes of long-term limited. The purpose this study was to compare treatment success, readmission and antibiotic switch rates patients treated with β-lactam as OPAT. Methods We carried out a retrospective review all patients, discharged from Tufts Medical Center cefazolin, ceftriaxone, ertapenem or oxacillin, between January 2009 June 2013. A competing risks...
The Patent Foramen Ovale (PFO)-Associated Stroke Causal Likelihood classification system combines information regarding noncardiac patient features (vascular risk factors, infarct topography) and PFO (shunt size presence of atrial septal aneurysm [ASA]) to classify patients into 3 validated categories responsiveness treatment with closure. However, the distinctive associations shunt ASA, alone in combination, have not been completely delineated.To evaluate association closure stroke...
The study hypothesis is to assess correlation of breast specimen weight versus volume.Consecutive patients undergoing surgery at a single tertiary referral centre during 6-month period were included. Specimen was measured in grams. Direct volume measurements performed using water displacement. Data including side the breast, age and menstrual status patient noted.Knowledge provides an objective guide facilitating achievements balance reconstructive operations. Surgeons use intraoperative...
Background— Evidence suggests that recent and projected future investments in percutaneous coronary intervention (PCI) programs at US hospitals fail to increase access timely reperfusion for patients with ST-segment elevation myocardial infarction. Methods Results— We set out estimate the annual number costs of new PCI from 2004 2008 identify characteristics hospitals, neighborhoods, states where have been introduced. estimated a discrete-time hazard model measure influence these on decision...
Objective To better risk stratify patients, using baseline characteristics, to help optimise decision‐making for men with moderate‐to‐severe lower urinary tract symptoms ( LUTS ) secondary benign prostatic hyperplasia (BPH) through a analysis of the Medical Therapy Prostatic Symptoms MTOPS trial. Patients and Methods After review literature, we identified potential factors BPH progression. Using bivariate tests in data, determined which variables retained prognostic significance. We then...
<h3>Background and Objectives</h3> Silent cerebrovascular disease (SCD), comprising silent brain infarction (SBI) white matter (WMD), is commonly found incidentally on neuroimaging scans obtained in routine clinical care. Their prognostic significance not known. We aimed to estimate the incidence of risk increase future stroke patients with discovered SCD. <h3>Methods</h3> Patients Kaiser Permanente Southern California (KPSC) health system aged ≥50 years, without prior ischemic stroke,...
Observational data support a role for vitamin D in type 2 diabetes, but evidence from trials is inconclusive.To evaluate the effect of supplementation on β-cell function and hemoglobin A1c (HbA1c) patients with well-controlled diabetes.Double-blind, randomized, placebo-controlled clinical trial.Tufts Medical Center, Boston, MA; VA Cincinnati, OH.A total 127 (mean age, 60 years) stable (HbA1c ≤7.5%) diabetes managed lifestyle only or plus metformin.Subjects were given 4000 units D3...
Several studies have demonstrated increased inhospital mortality following weekend admission. We hypothesized that the presence of resident trainees reduces trends. identified all patients with a non-elective hospital admission from 1/1/2003 through 12/31/2008. abstracted vital status on discharge and calculated Charlson comorbidity score for inpatients. compared odds inpatient day as to weekday, while considering diagnosis, patient characteristics, comorbidity, factors, care at hospitals...
Ischemic stroke patients with large vessel occlusion (LVO) could benefit from direct transportation to an intervention center for endovascular treatment, but non-LVO need rapid IV thrombolysis in the nearest center. Our aim was evaluate prehospital triage strategies suspected United States.We used a decision tree model and geographic information system estimate outcome of transported by ambulance within 4.5 hours after symptom onset. We compared following strategies: (1) Always center, (2)...
Abstract Context Observational studies suggest that low vitamin D status may be a risk factor for cancer. Objective In population with prediabetes and overweight/obesity is at higher of cancer than the general population, we sought to determine if supplementation lowers precancers. Methods The Vitamin type 2 diabetes (D2d) outcomes study (D2dCA) an ancillary D2d study, which was conducted 22 academic medical centers in United States. Participants had were free previous 5 years. randomized...