Publications by authors named "Sivaraman V"

Background: This study aims to assess the effectiveness of low-dose Escitalopram (10 mg) or low-dose Desvenlafaxine (25 mg) combined with mindfulness-based cognitive therapy (MBCT) in addressing challenges in treating generalized anxiety disorder (GAD), particularly in patients resistant to conventional therapies.

Methods: A prospective cohort study was conducted with individuals diagnosed with treatment-resistant GAD. group A included patients unresponsive to citalopram, imipramine, paroxetine, and sertraline, who were then treated with low-dose Escitalopram (10 mg) combined with MBCT.

View Article and Find Full Text PDF

Retinal image registration is essential for monitoring eye diseases and planning treatments, yet it remains challenging due to large deformations, minimal overlap, and varying image quality. To address these challenges, we propose RetinaRegNet, a multi-stage image registration model with zero-shot generalizability across multiple retinal imaging modalities. RetinaRegNet begins by extracting image features using a pretrained latent diffusion model.

View Article and Find Full Text PDF

Objective: We aimed to study the disease course, outcomes, and predictors of outcome in pediatric-onset antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) affecting the kidneys.

Methods: Patients eligible for this study had a diagnosis of granulomatosis with polyangiitis (GPA), microscopic polyangiitis, or ANCA-positive pauci-immune glomerulonephritis, were 18 years or younger at diagnosis, had renal disease defined by biopsy or dialysis dependence, and had clinical data at diagnosis and at either 12 or 24 months. Ambispective data from A Registry for Children with Vasculitis/Pediatric Vasculitis Initiative Registry was used.

View Article and Find Full Text PDF
Article Synopsis
  • Advances in medical imaging and endovascular techniques enable less invasive treatments for aortic diseases, but accurate 3D segmentation of the aorta is vital for effective surgical planning.
  • The paper presents Context-Infused Swin-UNet (CIS-UNet), a deep learning model that enhances multi-class segmentation by effectively distinguishing the aorta and its thirteen branches through a new Context-aware Shifted Window Self-Attention (CSW-SA) module.
  • CIS-UNet outperformed existing models in segmentation accuracy, achieving a mean Dice coefficient of 0.732 in evaluations using CT scans from 59 patients, and the researchers will share their dataset and code publicly.
View Article and Find Full Text PDF
Article Synopsis
  • Adolescents and young adults with chronic rheumatic diseases often struggle during the transition to adult care, impacting their health and wellbeing.
  • Quality improvement (QI) and clinical informatics (CI) techniques can enhance the implementation of effective transition programs in pediatric rheumatology.
  • A study demonstrated that automating patient surveys significantly improved transition readiness assessment from 12% to over 90%, allowing for better identification of patients' educational needs and establishing sustainable transition practices.
View Article and Find Full Text PDF
Article Synopsis
  • The study compares the effectiveness and toxicity of two treatments, rituximab (RTX) and cyclophosphamide (CYC), for pediatric patients with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA).
  • It analyzes data from 104 patients and finds no significant difference in remission rates or severe adverse events between the two treatment groups.
  • Limitations of the study include the lack of standardized treatment protocols and the retrospective nature of the analysis.
View Article and Find Full Text PDF

Introduction: Patients with childhood-onset systemic lupus erythematosus (c-SLE) have higher rates of depression than their peers, which has been associated with worse medical outcomes. Therefore, it is imperative that their mental health be addressed. We utilized quality improvement (QI) methodology to automate mental health screening for patients with lupus within a pediatric rheumatology clinic.

View Article and Find Full Text PDF

Introduction: Childhood-onset systemic lupus erythematosus (c-SLE) presents unique challenges due to increased risk for severe morbidity and mortality compared to adult-onset SLE. Effective disease management relies on accurate disease assessment and documentation. Our project aimed to improve the documentation of the Lupus Care Index (LCI), a disease assessment bundle, by implementing a quality improvement (QI) initiative.

View Article and Find Full Text PDF

To deploy machine learning models on-device, practitioners use compression algorithms to shrink and speed up models while maintaining their high-quality output. A critical aspect of compression in practice is model comparison, including tracking many compression experiments, identifying subtle changes in model behavior, and negotiating complex accuracy-efficiency trade-offs. However, existing compression tools poorly support comparison, leading to tedious and, sometimes, incomplete analyses spread across disjoint tools.

View Article and Find Full Text PDF

Alcohol use disorder (AUD) is defined as patterns of alcohol misuse and affects over 30 million people in the US. AUD is a systemic disease with the epidemiology of acute lung injury and excessive alcohol use established in the literature. However, the distinct mechanisms by which alcohol induces the risk of pulmonary inflammation are less clear.

View Article and Find Full Text PDF

Tobacco smoking is a major risk factor for disease development, with the user inhaling various chemicals known to be toxic. However, many of these chemicals are absent before tobacco is "burned". Similar, detailed data have only more recently being reported for the e-cigarette with regards to chemicals present before and after the e-liquid is "vaped.

View Article and Find Full Text PDF

The aim of the present study was to provide ocular biometry percentile values for Indian children between the ages of 6 and 12 and to validate the usefulness of centiles in predicting myopia development. The study was part of a longitudinal study-the Sankara Nethralaya Tamil Nadu Essilor Myopia Study (STEM), where objective refraction and ocular biometry were measured for children studying in grades 1, 4, and 6 at baseline (2019-2020). These data were used to generate ocular biometry percentile curves (both for axial length (AL) and AL/corneal curvature (AL/CR) ratios).

View Article and Find Full Text PDF

A growing number of inexpensive, publicly available, validated air quality monitors are currently generating granular and longitudinal data on air quality. The expansion of interconnected networks of these monitors providing open access to longitudinal data represents a valuable data source for health researchers, citizen scientists, and community members; however, the distribution of these data collection systems will determine the groups that will benefit from them. Expansion of these and other exposure measurement networks represents a unique opportunity to address persistent inequities across racial, ethnic, and class lines, if the distribution of these devices is equitable.

View Article and Find Full Text PDF

Here we use the SCIREQ InExpose system to simulate a biologically relevant vaping model in mice to investigate the role of calcium signaling in vape-dependent pulmonary disease as well as to investigate if there is a gender-based difference of disease. Male and female mice were vaped with JUUL Menthol (3% nicotine) using the SCIREQ InExpose system for 2 weeks. Additionally, 2-APB, a known calcium signaling inhibitor, was administered as a prophylactic for lung disease and damage caused by vaping.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to evaluate the effectiveness of low-dose atropine (0.01%) in slowing down myopia progression in Indian children over a two-year period.
  • A total of 732 children aged 6 to 14 participated, with results showing that atropine significantly reduced the average myopia progression from -0.75 D to -0.24 D.
  • Younger children and those with higher initial myopia experienced greater progression and a poorer response to treatment, highlighting the significance of targeted interventions.*
View Article and Find Full Text PDF

Objective: Juvenile localized scleroderma (jLS) is a chronic autoimmune disease commonly associated with poor outcomes, including contractures, hemiatrophy, uveitis, and seizures. Despite improvements in treatment, >25% of patients with jLS have functional impairment. To improve patient evaluation, our workgroup developed the Localized scleroderma Total Severity Scale (LoTSS), an overall disease severity measure.

View Article and Find Full Text PDF

Purpose: To evaluate the effectiveness of high-dose clonazepam (1 mg) versus low-dose clonazepam (0.5 mg) with cognitive behavioral therapy for insomnia (CBT-i) in older adults with moderately severe insomnia.

Methods: A prospective cohort study was conducted in patients who did not respond to low-dose clonazepam for insomnia secondary to chronic medical conditions.

View Article and Find Full Text PDF

Background: To increase engagement of historically underrepresented groups in health sciences research, we created the North Carolina Diversity and Inclusion Pathway Program (NC-DIPP). This year-long, paid internship provides undergraduate and graduate students from 2 historically Black colleges and universities an opportunity to gain real-world experience under the mentorship of expert faculty.

Methods: To evaluate the early experiences with the NC-DIPP program, we conducted semi-structured interviews with interns and program leaders.

View Article and Find Full Text PDF

Type I interferonopathies are a broad category of conditions associated with increased type I interferon gene expression and include monogenic autoinflammatory diseases and non-Mendelian autoimmune diseases such as dermatomyositis and systemic lupus erythematosus. While a wide range of clinical presentations among type I interferonopathies exists, these conditions often share several clinical manifestations and implications for treatment. Presenting symptoms may mimic non-Mendelian autoimmune diseases, including vasculitis and systemic lupus erythematosus, leading to delayed or missed diagnosis.

View Article and Find Full Text PDF

Background: Given the impact of psychological factors on rheumatic disease, pediatric psychologists serve a vital role in promoting quality of life and managing common problems among youth with rheumatic disease. The aim of this project was to increase access to psychological services among youth with rheumatic disease at a children's hospital.

Methods: A quality improvement (QI) team identified key drivers and interventions aimed to increase access to psychological services for youth with rheumatic disease.

View Article and Find Full Text PDF
Article Synopsis
  • The study looked into what challenges parents face when trying to get their child diagnosed and treated for juvenile localized scleroderma and systemic sclerosis, which are rare skin conditions.
  • Many parents said a big problem was that doctors don’t know enough about these conditions, making it hard to get the right care.
  • Even though most families had good education and income, they still faced issues like long wait times, balancing everyday life with healthcare needs, and finding reliable information about their child’s condition.
View Article and Find Full Text PDF

Background: Vaccination of immunocompromised children (ICC) remains suboptimal.

Methods: Needs assessment surveys were administered to patients and caregivers during routine ambulatory visits to the rheumatology and gastroenterology clinics at Nationwide Children's Hospital (NCH) from January 1 through August 31, 2018, and to community primary care physicians (PCPs) at their monthly meeting and electronically.

Results: Completed surveys were received for 57 patients 31 with childhood-onset systemic lupus erythematosus (c-SLE) and 26 with inflammatory bowel disease (IBD)) and 30 PCPs.

View Article and Find Full Text PDF

Significance: In this comprehensive assessment of environmental associations with refractive status among schoolchildren in India, outdoor time was the key modifiable risk factor associated with myopia rather than time spent on near work.

Purpose: This study aimed to investigate the environmental risk factors associated with myopia among adolescent schoolchildren in South India.

Methods: Children in grades 8 to 10 from 11 schools in Tamil Nadu, South India, underwent eye examination and risk factor assessments through a modified version of the Sydney myopia questionnaire.

View Article and Find Full Text PDF

Objective: To provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs).

Methods: This guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria.

View Article and Find Full Text PDF

Objective: To provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs).

Methods: This guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria.

View Article and Find Full Text PDF