Publications by authors named "Suraj K Jaladanki"

Gut barrier dysfunction occurs commonly in patients with critical disorders, leading to the translocation of luminal toxic substances and bacteria to the bloodstream. Connexin 43 (Cx43) acts as a gap junction protein and is crucial for intercellular communication and the diffusion of nutrients. The levels of cellular Cx43 are tightly regulated by multiple factors, including polyamines, but the exact mechanism underlying the control of Cx43 expression remains largely unknown.

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Background: Patients with heart failure (HF) are at high risk for adverse outcomes when they have COVID-19. Reports of COVID-19 vaccine-related cardiac complications may contribute to vaccine hesitancy in patients with HF.

Methods: To analyze the impact of COVID-19 vaccine status on clinical outcomes in patients with HF, we conducted a retrospective cohort study of the association of COVID-19 vaccination status with hospitalizations, intensive care unit admission and mortality after adjustment for covariates.

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Article Synopsis
  • Deep learning models in healthcare need large, balanced datasets to work effectively, but COVID-19 data is often imbalanced, presenting a challenge for model training.! -
  • Traditional cross-entropy loss (CEL) can struggle with imbalanced data, but the study shows that using contrastive loss (CL) enhances the performance of CEL, particularly with COVID-19 electronic health records.! -
  • The research demonstrates that CL models consistently perform better than CEL models in predicting patient outcomes like mortality and ICU transfers, achieving notable improvements in precision and recall metrics.!
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Background Despite advances in cardiovascular disease and risk factor management, mortality from ischemic heart failure (HF) in patients with coronary artery disease (CAD) remains high. Given the partial role of genetics in HF and lack of reliable risk stratification tools, we developed and validated a polygenic risk score for HF in patients with CAD, which we term HF-PRS. Methods and Results Using summary statistics from a recent genome-wide association study for HF, we developed candidate PRSs in the Mount Sinai Bio CAD patient cohort (N=6274) by using the pruning and thresholding method and LDPred.

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Federated learning is a technique for training predictive models without sharing patient-level data, thus maintaining data security while allowing inter-institutional collaboration. We used federated learning to predict acute kidney injury within three and seven days of admission, using demographics, comorbidities, vital signs, and laboratory values, in 4029 adults hospitalized with COVID-19 at five sociodemographically diverse New York City hospitals, between March-October 2020. Prediction performance of federated models was generally higher than single-hospital models and was comparable to pooled-data models.

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Effective treatments targeting disease etiology are urgently needed for Alzheimer's disease (AD). Although candidate AD genes have been identified and altering their levels may serve as therapeutic strategies, the consequence of such alterations remain largely unknown. Herein, we analyzed CRISPR knockout/RNAi knockdown screen data for over 700 cell lines and evaluated cellular dependencies of 104 AD-associated genes previously identified by genome-wide association studies (GWAS) and gene expression network studies.

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Purpose: Limited mechanical ventilators (MV) during the Coronavirus disease (COVID-19) pandemic have led to the use of non-invasive ventilation (NIV) in hypoxemic patients, which has not been studied well. We aimed to assess the association of NIV versus MV with mortality and morbidity during respiratory intervention among hypoxemic patients admitted with COVID-19.

Methods: We performed a retrospective multi-center cohort study across 5 hospitals during March-April 2020.

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Background And Objectives: AKI treated with dialysis initiation is a common complication of coronavirus disease 2019 (COVID-19) among hospitalized patients. However, dialysis supplies and personnel are often limited.

Design, Setting, Participants, & Measurements: Using data from adult patients hospitalized with COVID-19 from five hospitals from the Mount Sinai Health System who were admitted between March 10 and December 26, 2020, we developed and validated several models (logistic regression, Least Absolute Shrinkage and Selection Operator (LASSO), random forest, and eXtreme GradientBoosting [XGBoost; with and without imputation]) for predicting treatment with dialysis or death at various time horizons (1, 3, 5, and 7 days) after hospital admission.

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Background/aims: Acute kidney injury (AKI) in critically ill patients is common, and continuous renal replacement therapy (CRRT) is a preferred mode of renal replacement therapy (RRT) in hemodynamically unstable patients. Prediction of clinical outcomes in patients on CRRT is challenging. We utilized several approaches to predict RRT-free survival (RRTFS) in critically ill patients with AKI requiring CRRT.

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated Coronavirus Disease 2019 (COVID-19) is a public health emergency. Acute kidney injury (AKI) is a common complication in hospitalized patients with COVID-19 although mechanisms underlying AKI are yet unclear. There may be a direct effect of SARS-CoV-2 virus on the kidney; however, there is currently no data linking SARS-CoV-2 viral load (VL) to AKI.

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Article Synopsis
  • Machine Learning models need large and balanced datasets to effectively analyze healthcare data, but COVID-19-related data is often unbalanced, especially within electronic health records (EHR).
  • Traditional methods like cross-entropy loss struggle with classification accuracy under these conditions, leading researchers to explore contrastive loss as a potential solution.
  • This study, using EHR data from five hospitals, demonstrates that contrastive loss significantly improves model performance for predicting COVID-19 patient outcomes compared to cross-entropy loss, particularly when dealing with severe class imbalance.
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Article Synopsis
  • Machine learning models require large datasets, often limited by data silos across healthcare institutions, particularly in COVID-19 research focused on single hospitals.
  • The study utilized federated learning to predict 7-day mortality in hospitalized COVID-19 patients, using data from five hospitals within the Mount Sinai Health System without aggregating sensitive patient data.
  • Results showed that the LASSO model performed better at three hospitals and the multilayer perceptron (MLP) model outperformed at all five, indicating that federated learning can create effective predictive models while protecting patient privacy.
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Article Synopsis
  • The study aimed to analyze clinical characteristics and outcomes of hospitalized COVID-19 patients, comparing those who died in the hospital to those who were discharged alive.
  • Data was collected from five hospitals in the Mount Sinai Health System for patients confirmed with COVID-19 between February and April 2020, focusing on demographics, clinical features, and mortality rates.
  • Results showed that nearly half of the 2199 hospitalized patients were discharged, with a 29% overall mortality rate, higher rates of pre-existing conditions and lower lymphocyte percentages observed in patients who died compared to those who recovered.
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Machine learning (ML) models require large datasets which may be siloed across different healthcare institutions. Using federated learning, a ML technique that avoids locally aggregating raw clinical data across multiple institutions, we predict mortality within seven days in hospitalized COVID-19 patients. Patient data was collected from Electronic Health Records (EHRs) from five hospitals within the Mount Sinai Health System (MSHS).

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Background & Aims: The protective intestinal mucosal barrier consists of multiple elements including mucus and epithelial layers and immune defense; nonetheless, barrier dysfunction is common in various disorders. The imprinted and developmentally regulated long noncoding RNA H19 is involved in many cell processes and diseases. Here, we investigated the role of H19 in regulating Paneth and goblet cells and autophagy, and its impact on intestinal barrier dysfunction induced by septic stress.

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The disruption of the intestinal epithelial barrier function occurs commonly in various pathologies, but the exact mechanisms responsible are unclear. The H19 long noncoding RNA (lncRNA) regulates the expression of different genes and has been implicated in human genetic disorders and cancer. Here, we report that H19 plays an important role in controlling the intestinal epithelial barrier function by serving as a precursor for microRNA 675 (miR-675).

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