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  1. Article ; Online: Cutaneous manifestations of COVID-19: A preliminary review.

    Jia, Justin L / Kamceva, Marija / Rao, Saieesh A / Linos, Eleni

    Journal of the American Academy of Dermatology

    2020  Volume 83, Issue 2, Page(s) 687–690

    MeSH term(s) Betacoronavirus/isolation & purification ; Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Coronavirus Infections/virology ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/virology ; Prevalence ; SARS-CoV-2 ; Skin Diseases/epidemiology ; Skin Diseases/virology
    Keywords covid19
    Language English
    Publishing date 2020-05-16
    Publishing country United States
    Document type Letter ; Review
    ZDB-ID 603641-7
    ISSN 1097-6787 ; 0190-9622
    ISSN (online) 1097-6787
    ISSN 0190-9622
    DOI 10.1016/j.jaad.2020.05.059
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Alignment of RVU Targets With Operating Room Block Time.

    Rao, Saieesh A / Deshpande, Nikita G / Richardson, Douglas W / Brickman, Jon / Posner, Mitchell C / Matthews, Jeffrey B / Turaga, Kiran K

    Annals of surgery open : perspectives of surgical history, education, and clinical approaches

    2023  Volume 4, Issue 1, Page(s) e260

    Abstract: Background: Surgeon productivity is measured in relative value units (RVUs). The feasibility of attaining RVU productivity targets requires surgeons to have enough allocated block time to generate RVUs. However, it is unknown how much block time is ... ...

    Abstract Background: Surgeon productivity is measured in relative value units (RVUs). The feasibility of attaining RVU productivity targets requires surgeons to have enough allocated block time to generate RVUs. However, it is unknown how much block time is required for surgeons to attain specific RVU targets. We aimed to estimate the effect of surgeon and practice environment characteristics (SPECs) on block time needed to attain fixed RVU targets.
    Methods: We computationally simulated individual surgeons' annual caseloads under a variety of SPECs in the following way. First, empirical case data were sampled from ACS NSQIP in accordance with surgeon specialty, case-mix complexity, and RVU target. Surgeons' operating schedules were then constructed according to the block length, turnover time, and scheduling flexibility of the practice environment. These 6 SPECs were concurrently varied over their ranges for a 6-way sensitivity analysis.
    Results: Annual operating schedules for 60,000,000 surgeons were simulated. The number of blocks required to attain RVU targets varied significantly with surgeon specialty and increased with increased case-mix complexity, increased turnover time, and decreased scheduling flexibility. Intraspecialty variation in block requirement with variation in environmental characteristics exceeded interspecialty variation with fixed environmental characteristics. Multivariate linear models predicted block utilization across surgical specialties with consideration for the stated factors. An online tool is shared with which to apply these results to one's particular practice.
    Conclusions: Block time required to attain RVU targets varies widely with SPECs; intraspecialty variation exceeds interspecialty variation. The feasibility of attaining RVU targets requires alignment between targets and allocated operating time with consideration for surgical specialty and other practice conditions.
    Language English
    Publishing date 2023-02-22
    Publishing country United States
    Document type Journal Article
    ISSN 2691-3593
    ISSN (online) 2691-3593
    DOI 10.1097/AS9.0000000000000260
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Cutaneous manifestations of COVID-19

    Jia, Justin L. / Kamceva, Marija / Rao, Saieesh A. / Linos, Eleni

    Journal of the American Academy of Dermatology

    A preliminary review

    2020  Volume 83, Issue 2, Page(s) 687–690

    Keywords Dermatology ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 603641-7
    ISSN 1097-6787 ; 0190-9622
    ISSN (online) 1097-6787
    ISSN 0190-9622
    DOI 10.1016/j.jaad.2020.05.059
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Zs.A 1540: Show issues Location:
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  6. Article ; Online: Social Media Responses to Elective Surgery Cancellations in the Wake of COVID-19

    Rao, Saieesh A. / Ravi, Mohan S. / Zhao, Jeffrey W. / Sturgeon, Cord / Bilimoria, Karl Y.

    Annals of Surgery

    2020  Volume 272, Issue 3, Page(s) e246–e248

    Keywords Surgery ; covid19
    Language English
    Publisher Ovid Technologies (Wolters Kluwer Health)
    Publishing country us
    Document type Article ; Online
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/sla.0000000000004106
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article: Causes, Diagnostic Testing, and Treatments Related to Clinical Deterioration Events among High-Risk Ward Patients.

    Churpek, Matthew M / Ingebritsen, Ryan / Carey, Kyle A / Rao, Saieesh A / Murnin, Emily / Qyli, Tonela / Oguss, Madeline K / Picart, Jamila / Penumalee, Leena / Follman, Benjamin D / Nezirova, Lily K / Tully, Sean T / Benjamin, Charis / Nye, Christopher / Gilbert, Emily R / Shah, Nirav S / Winslow, Christopher J / Afshar, Majid / Edelson, Dana P

    medRxiv : the preprint server for health sciences

    2024  

    Abstract: Objective: Timely intervention for clinically deteriorating ward patients requires that care teams accurately diagnose and treat their underlying medical conditions. However, the most common diagnoses leading to deterioration and the relevant therapies ... ...

    Abstract Objective: Timely intervention for clinically deteriorating ward patients requires that care teams accurately diagnose and treat their underlying medical conditions. However, the most common diagnoses leading to deterioration and the relevant therapies provided are poorly characterized. Therefore, we aimed to determine the diagnoses responsible for clinical deterioration, the relevant diagnostic tests ordered, and the treatments administered among high-risk ward patients using manual chart review.
    Design: Multicenter retrospective observational study.
    Setting: Inpatient medical-surgical wards at four health systems from 2006-2020
    Interventions: None.
    Measurements and main results: Clinical deterioration was confirmed by a trained reviewer or marked as a false alarm if no deterioration occurred for each patient. For true deterioration events, the condition causing deterioration, relevant diagnostic tests ordered, and treatments provided were collected. Of the 4,000 included patients, 2,484 (62%) had clinical deterioration confirmed by chart review. Sepsis was the most common cause of deterioration (41%; n=1,021), followed by arrhythmia (19%; n=473), while liver failure had the highest in-hospital mortality (41%). The most common diagnostic tests ordered were complete blood counts (47% of events), followed by chest x-rays (42%), and cultures (40%), while the most common medication orders were antimicrobials (46%), followed by fluid boluses (34%), and antiarrhythmics (19%).
    Conclusions: We found that sepsis was the most common cause of deterioration, while liver failure had the highest mortality. Complete blood counts and chest x-rays were the most common diagnostic tests ordered, and antimicrobials and fluid boluses were the most common medication interventions. These results provide important insights for clinical decision-making at the bedside, training of rapid response teams, and the development of institutional treatment pathways for clinical deterioration.
    Key points: Question:
    Language English
    Publishing date 2024-02-06
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2024.02.05.24301960
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Social Media Responses to Elective Surgery Cancellations in the Wake of COVID-19.

    Rao, Saieesh A / Ravi, Mohan S / Zhao, Jeffrey W / Sturgeon, Cord / Bilimoria, Karl Y

    Annals of surgery

    2020  Volume 272, Issue 3, Page(s) e246–e248

    Abstract: Objective: To assess public response to cancellations of elective surgeries following the American College of Surgeons' (ACS) recommendation on March 13.: Methods: We queried text comments from Reddit, a social media platform and the fifth most ... ...

    Abstract Objective: To assess public response to cancellations of elective surgeries following the American College of Surgeons' (ACS) recommendation on March 13.
    Methods: We queried text comments from Reddit, a social media platform and the fifth most popular website in the United States. Comments were manually reviewed to assess for relevance to elective surgery in the United States during the global coronavirus outbreak, whether the text was written by a healthcare worker (HCW), whether the user was based in the United States, and whether the text documented cancellations of surgery, expected cancellations of surgery, or surgery ongoing after the ACS announcement. Analysis of overall sentiment and negativity in comment text was performed using the Valence Aware Dictionary for sEntiment Reasoning (VADER), a validated natural language processing tool previously used in studies of health behaviors using social media. Non-parametric tests were used for subgroup comparisons based on posting date and characteristics identified during manual review.
    Results: Following manual review, 1272 comments were included for analysis. Overall sentiment among non-HCWs became significantly more negative following the ACS announcement (P = 0.037). Overall sentiment did not significantly differ between HCWs and non-HCWs prior to the ACS announcement (P = 0.98), but non-HCW sentiment became significantly more negative than HCW sentiment after the announcement (P = 0.027). Negativity scores in posts describing cancellations were significantly higher among posts written by non-HCWs than HCWs (P = 0.028).
    Conclusions: Cancellation of elective surgeries had an adverse emotional impact on non-HCWs. This finding highlights the importance of access to elective surgery to patients' emotional well-being.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/transmission ; Communicable Disease Control/organization & administration ; Elective Surgical Procedures ; Humans ; Public Opinion ; Social Media ; United States
    Keywords covid19
    Language English
    Publishing date 2020-08-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000004106
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.35/1: Show issues Location:
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  9. Article ; Online: Cost-Effectiveness Analysis of Adjuvant Therapy for BRAF-Mutant Resected Stage III Melanoma in Medicare Patients.

    Mojtahed, Saam A / Boyer, Nicole R / Rao, Saieesh A / Gajewski, Thomas F / Tseng, Jennifer / Turaga, Kiran K

    Annals of surgical oncology

    2021  Volume 28, Issue 13, Page(s) 9039–9047

    Abstract: Background: Adjuvant therapy for stage III melanoma improves several measures of patient survival. However, decisions regarding inclusion of adjuvant therapies in the formularies of public payers necessarily consider the cost-effectiveness of those ... ...

    Abstract Background: Adjuvant therapy for stage III melanoma improves several measures of patient survival. However, decisions regarding inclusion of adjuvant therapies in the formularies of public payers necessarily consider the cost-effectiveness of those treatments. The objective of this study is to evaluate the cost-effectiveness of four recently approved adjuvant therapies for BRAF-mutant stage III melanoma in the Medicare patient population.
    Methods: In this cost-effectiveness analysis, a Markov microsimulation model was used to simulate the healthcare trajectory of patients randomized to receive either first-line targeted therapy (dabrafenib-trametinib) or immunotherapy (ipilimumab, nivolumab, or pembrolizumab). The base case was a 65-year-old Medicare patient with BRAF V600E-mutant resected stage III melanoma. Possible health states included recurrence-free survival, adverse events, local recurrence, distant metastases, and death. Transition probabilities were determined from published clinical trials. Costs were estimated from reimbursement rates reported by CMS and the Red Book drug price database. Primary outcomes were costs (US$), life years, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). Model robustness was evaluated using one-way and probabilistic sensitivity analyses.
    Results: Dabrafenib-trametinib provided 1.83 QALYs over no treatment and 0.23 QALYs over the most effective immunotherapy, pembrolizumab. Dabrafenib-trametinib was associated with an ICER of $95,758/QALY over no treatment and $285,863/QALY over pembrolizumab. Pembrolizumab yielded an ICER of $68,396/QALY over no treatment and dominated other immunotherapies.
    Conclusions: Pembrolizumab is cost-effective at a conventional willingness-to-pay (WTP) threshold, but dabrafenib-trametinib is not. Though dabrafenib-trametinib offers incremental QALYs, optimization of drug pricing is necessary to ensure dabrafenib-trametinib is accessible at an acceptable WTP threshold.
    MeSH term(s) Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Cost-Benefit Analysis ; Humans ; Medicare ; Melanoma/drug therapy ; Melanoma/genetics ; Proto-Oncogene Proteins B-raf/genetics ; Quality-Adjusted Life Years ; Skin Neoplasms/drug therapy ; Skin Neoplasms/genetics ; United States
    Chemical Substances BRAF protein, human (EC 2.7.11.1) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1)
    Language English
    Publishing date 2021-06-15
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-021-10288-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Confluence of theory and experiment reveals the catalytic mechanism of the Varkud satellite ribozyme.

    Ganguly, Abir / Weissman, Benjamin P / Giese, Timothy J / Li, Nan-Sheng / Hoshika, Shuichi / Rao, Saieesh / Benner, Steven A / Piccirilli, Joseph A / York, Darrin M

    Nature chemistry

    2020  Volume 12, Issue 2, Page(s) 193–201

    Abstract: The Varkud satellite ribozyme catalyses site-specific RNA cleavage and ligation, and serves as an important model system to understand RNA catalysis. Here, we combine stereospecific phosphorothioate substitution, precision nucleobase mutation and linear ... ...

    Abstract The Varkud satellite ribozyme catalyses site-specific RNA cleavage and ligation, and serves as an important model system to understand RNA catalysis. Here, we combine stereospecific phosphorothioate substitution, precision nucleobase mutation and linear free-energy relationship measurements with molecular dynamics, molecular solvation theory and ab initio quantum mechanical/molecular mechanical free-energy simulations to gain insight into the catalysis. Through this confluence of theory and experiment, we unify the existing body of structural and functional data to unveil the catalytic mechanism in unprecedented detail, including the degree of proton transfer in the transition state. Further, we provide evidence for a critical Mg
    MeSH term(s) Biocatalysis ; Catalytic Domain/genetics ; Endoribonucleases/chemistry ; Endoribonucleases/genetics ; Magnesium/chemistry ; Molecular Dynamics Simulation ; Mutation ; Protons ; Quantum Theory ; RNA, Catalytic/chemistry ; RNA, Catalytic/genetics ; Stereoisomerism
    Chemical Substances Protons ; RNA, Catalytic ; Endoribonucleases (EC 3.1.-) ; varkud satellite ribozyme (EC 3.1.27.-) ; Magnesium (I38ZP9992A)
    Language English
    Publishing date 2020-01-20
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2464596-5
    ISSN 1755-4349 ; 1755-4330
    ISSN (online) 1755-4349
    ISSN 1755-4330
    DOI 10.1038/s41557-019-0391-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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