Publications by authors named "Ravi Goyal"

Objective: We present an intriguing case of simultaneous, bilateral, complete ovarian torsion with synchronous endometrial adenocarcinoma in a previously healthy patient with a reported history of unilateral oophorectomy. This unique case demonstrates the limitations of pelvic imaging and patient history.

Case Report: A 32-year-old woman with a history of unilateral oophorectomy, presented to the emergency department with worsening left lower abdominal pain concerning for ovarian torsion.

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Acne vulgaris is the 8th most commonly prevailing skin disorder worldwide. Its pervasiveness has been predominant in juveniles, especially males, during adolescence and in females during adulthood. The lifestyle and nutrition adopted have been significantly reported to impact the occurrence and frequency of acne.

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Objective: Plasma metabolite profiling has uncovered several nonglycemic markers of incident type 2 diabetes (T2D). We investigated whether such biomarkers provide information about specific aspects of T2D etiology, such as impaired fasting glucose and impaired glucose tolerance, and whether their association with T2D risk varies by race.

Research Design And Methods: Untargeted plasma metabolite profiling was performed of participants in the FINRISK 2002 cohort (n = 7,564).

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African research capacity is challenged by insufficient infrastructure to solicit and manage grants from local and international funding agencies. The manuscript provides an overview and discusses lessons learned about the pioneering role of the Mozambique Institute for Health Education and Research (MIHER) as the first research support center (RSC) in supporting the management of research grants in Mozambique, emphasizing its impact on research capacity development. Using mixed methods, data were comprehensively collected to identify MIHER's primary achievements from 2010 to 2023.

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Background: HIV/AIDS has been a global health crisis for over 4 decades. Network models, which simulate human behavior and intervention impacts, have become an essential tool in guiding HIV prevention strategies and policies. However, no comprehensive survey of network models in HIV research has been conducted.

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Fetal growth restriction (FGR) is a risk factor for obesity in adult life. Importantly, growth-restricted females are more prone to obesity than males. The mechanisms involved in this sexually dimorphic programming are not known.

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Introduction: Onychomycosis (Paronychia) is a common fungal nail infection, characterised by thickened, discoloured and brittle nails often accompanied by pain and discomfort. It is one of the most prevalent fungal nail infections with the global incidence of >20 % affected commonly by Candida albicans and Candida parapsilosis. The market today is flooded with various antifungal therapies (Azoles, Imidazoles, Allylamines, etc.

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The role of long intergenic noncoding RNAs (lincRNAs) in fetal development has emerged as a significant area of study, challenging the traditional protein-centric view of gene expression. While messenger RNAs (mRNAs) have long been recognized for their role in encoding proteins, recent advances have illuminated the critical functions of lincRNAs in various biological processes. Initially identified through high-throughput sequencing technologies, lincRNAs are transcribed from intergenic regions between protein-coding genes and exhibit unique regulatory functions.

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Article Synopsis
  • Anxiety is a growing mental health issue that affects personal wellbeing and the economy, with traditional treatments showing limited effectiveness and potential side effects.
  • Non-invasive ultrasound stimulation of the vagus nerve presents a promising, low-cost alternative that has shown positive preliminary results and fewer complications compared to existing therapies.
  • The review discusses various studies on ultrasonic stimulation's effects on vagus nerve activity, highlighting the urgent need for better treatment options as anxiety rates rise in younger generations.
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Worldwide, preterm birth (PTB) is a significant cause of neonatal mortality and morbidity. Surprisingly, the rate of PTB in the United States is among the top 10 nations in the world, comparable to those of the Democratic Republic of the Congo, Bangladesh, India, and Nigeria. However, there is no predictive biomarker or understanding of the mechanisms of PTB.

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  • This study analyzes breast cancer-specific survival (BCSS) in hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer (mBC) patients, focusing on changes after the introduction of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in 2015.
  • Researchers used SEER registry data from 11,467 HR+/HER2- mBC patients, finding a 10% reduction in risk of BC-specific death for those diagnosed post-2015 compared to those diagnosed pre-2015, indicating improved survival due to CDK4/6i.
  • In contrast, no significant improvements in BC
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To assess treatment patterns and outcomes in patients with non-del(5q) lower-risk myelodysplastic syndromes. Patient medical records were reviewed in the USA, Canada (CAN), UK and the EU. Analysis included 119 patients in the USA/CAN (median age, 61.

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Article Synopsis
  • - The study aimed to estimate health state utility values (HSUVs) for opioid use disorder (OUD) by analyzing data from 1,777 individuals, using various quality of life measures.
  • - Significant reductions in HSUVs were linked to factors like extra-medical opioid use, injecting behaviors, having HIV, and age, while the impact of OUD treatment medications was not statistically significant.
  • - The findings indicated that withdrawal symptoms significantly impacted HSUVs, with higher symptom severity leading to lower utility values, highlighting the importance of considering patient input in this type of research.
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Background: In patients with heart failure with reduced ejection fraction (HFrEF), lower discharge heart rate (HR) is known to be associated with better outcomes. However, the effect of HR control on patient outcomes, and the demographic and clinical determinants of this association, are not well documented.

Objectives: The purpose of this work was to evaluate the association between the HR control and the risk of post-discharge rehospitalization in patients hospitalized with HFrEF.

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In hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer (MBC), cyclin-dependent kinase 4/6 inhibitors (CDK4/6is) have replaced endocrine therapy alone as the standard of care; however, several barriers to treatment initiation still exist. We assessed social determinants of health (SDOH) and other factors associated with the initiation of CDK4/6i for HR+/HER2- MBC in the Medicare population. Using a retrospective cohort design, patients aged ≥65 years and diagnosed during 2015-2017 were selected from the SEER-Medicare database.

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Objective: Investigate the role of the Ryan White HIV/AIDS Program (RWHAP) - which funds services for vulnerable and historically disadvantaged populations with HIV - in reducing health inequities among people with HIV over a 10-year horizon.

Design: We use an agent-based microsimulation model to incorporate the complexity of the program and long-time horizon.

Methods: We use a composite measure (the Theil index) to evaluate the health equity implications of the RWHAP for each of four subgroups (based on race and ethnicity, age, gender, and HIV transmission category) and two outcomes (probability of being in care and treatment and probability of being virally suppressed).

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To assess real-world clinical outcomes with standard therapies for advanced non-small-cell lung cancer (aNSCLC) with METexon14 skipping mutation (METex14). In an oncologists-led retrospective review of medical records, data were abstracted and analyzed for patients initiating first-line (1L) systemic therapy after 1 January 2017. In total 287 aNSCLC patients with METex14, the real-world best overall response rate was 73.

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Purpose: In 2010, the US Food and Drug Administration approved eribulin for the treatment of metastatic breast cancer (MBC). Since then, the treatment landscape has evolved with many new therapy classes, a more recent one being the small molecule inhibitors of phosphoinositide 3 kinase (PI3K). We sought to characterize the treatment patterns and clinical outcomes of patients with MBC who received eribulin following prior treatment with a PI3K inhibitor.

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Prevailing hypoxemia and hypoglycemia in near-term fetuses with placental insufficiency-induced intrauterine growth restriction (IUGR) chronically increases norepinephrine concentrations, which lower adrenergic sensitivity and lipid mobilization postnatally, indicating a predisposition for adiposity. To determine adrenergic-induced responses, we examined the perirenal adipose tissue transcriptome from IUGR fetuses with or without hypercatecholaminemia. IUGR was induced in sheep with maternal hyperthermia, and hypercatecholaminemia in IUGR was prevented with bilateral adrenal demedullation.

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Introduction: Eribulin was approved by the FDA in 2010 for the treatment of metastatic breast cancer (MBC) in the United States (US). More recently, several immuno-oncology (IO) and antibody-drug conjugate (ADC) regimens have been approved for MBC. We assessed the treatment patterns and clinical outcomes in MBC patients treated with eribulin following treatment with an IO or ADC in US clinical practice.

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Objectives: This study investigates primary peer-referral engagement (PRE) strategies to assess which strategy results in engaging higher numbers of people with HIV (PWH) who are virally unsuppressed.

Design: We develop a modeling study that simulates an HIV epidemic (transmission, disease progression, and viral evolution) over 6 years using an agent-based model followed by simulating PRE strategies. We investigate two PRE strategies where referrals are based on social network strategies (SNS) or sexual partner contact tracing (SPCT).

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There are two prominent paradigms for the modelling of networks: in the first, referred to as the mechanistic approach, one specifies a set of domain-specific mechanistic rules that are used to grow or evolve the network over time; in the second, referred to as the probabilistic approach, one describes a model that specifies the likelihood of observing a given network. Mechanistic models (models developed based on the mechanistic approach) are appealing because they capture scientific processes that are believed to be responsible for network generation; however, they do not easily lend themselves to the use of inferential techniques when compared with probabilistic models. We introduce a general framework for converting a mechanistic network model (MNM) to a probabilistic network model (PNM).

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Background: Efforts to control the HIV epidemic can benefit from knowledge of the relationships between the characteristics of people who have transmitted HIV and those who became infected by them. Investigation of this relationship is facilitated by the use of HIV genetic linkage analyses, which allows inference about possible transmission events among people with HIV infection. Two persons with HIV (PWH) are considered linked if the genetic distance between their HIV sequences is less than a given threshold, which implies proximity in a transmission network.

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Objective: Identify system-level features in HIV migration within a host across body tissues. Evaluate heterogeneity in the presence and magnitude of these features across hosts.

Method: Using HIV DNA deep sequencing data generated across multiple tissues from 8 people with HIV, we represent the complex dependencies of HIV migration among tissues as a network and model these networks using the family of exponential random graph models (ERGMs).

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