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  1. Article ; Online: Saving children from man-made acute malnutrition in Tigray, Ethiopia: a call to action.

    Mulugeta, Afework / Gebregziabher, Mulugeta

    The Lancet. Global health

    2022  Volume 10, Issue 4, Page(s) e469–e470

    MeSH term(s) Child ; Cross-Sectional Studies ; Ethiopia/epidemiology ; Humans ; Malnutrition/epidemiology
    Language English
    Publishing date 2022-02-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2723488-5
    ISSN 2214-109X ; 2214-109X
    ISSN (online) 2214-109X
    ISSN 2214-109X
    DOI 10.1016/S2214-109X(22)00023-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Some comments on "The analysis of multivariate longitudinal data: A review".

    Gebregziabher, Mulugeta

    Statistical methods in medical research

    2016  Volume 26, Issue 1, Page(s) 108–111

    Abstract: We provide a commentary on "The analysis of multivariate longitudinal data: a review" by Verbeke et al. The authors provide a comprehensive review of the issues in the analysis of multivariate longitudinal data and use examples to demonstrate the pros ... ...

    Abstract We provide a commentary on "The analysis of multivariate longitudinal data: a review" by Verbeke et al. The authors provide a comprehensive review of the issues in the analysis of multivariate longitudinal data and use examples to demonstrate the pros and cons of several approaches. In this commentary, we indicate some important omissions in their review paper.
    Language English
    Publishing date 2016-07-11
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1136948-6
    ISSN 1477-0334 ; 0962-2802
    ISSN (online) 1477-0334
    ISSN 0962-2802
    DOI 10.1177/0962280214539863
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Outcomes of discordant HIV screening test results at a southern academic medical center.

    Colbrunn, Danielle K / Jacks, Courtney / Curry, Scott R / Gebregziabher, Mulugeta / Meissner, Eric G

    AIDS (London, England)

    2024  

    Abstract: Objective: The aim of this study was to examine outcomes of follow-up for persons with discordant fourth-generation HIV screening test results.: Design: A retrospective chart review.: Methods: We analyzed the electronic health record at the ... ...

    Abstract Objective: The aim of this study was to examine outcomes of follow-up for persons with discordant fourth-generation HIV screening test results.
    Design: A retrospective chart review.
    Methods: We analyzed the electronic health record at the Medical University of South Carolina for a 10-year period spanning 2012-2022 to identify instances of discordant HIV screening test results, wherein initial antigen/antibody screening was positive, but reflex confirmatory testing for HIV-1 and HIV-2 antibodies was negative. We reviewed individual records to evaluate clinical follow-up and determine if the discordant test represented an acute HIV infection, a false-positive result, or was unresolved.
    Results: We identified 199 testing instances with discordant results. Most discordant results (n = 115) were subsequently determined to reflect a false-positive test, while 56 were unresolved without documented follow-up testing. Twenty-eight cases of acute HIV infection were identified of which 26 were linked to care within a month of initial testing. Two acute HIV cases were not identified in real time leading to delay in diagnosis and care. Testing done in the context of infectious symptoms and testing performed in the emergency department were associated with increased odds of a discordant test ultimately reflecting acute HIV infection.
    Conclusion: These results demonstrate the importance of appropriate and timely follow-up for discordant HIV screening test results.
    Language English
    Publishing date 2024-03-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 639076-6
    ISSN 1473-5571 ; 0269-9370 ; 1350-2840
    ISSN (online) 1473-5571
    ISSN 0269-9370 ; 1350-2840
    DOI 10.1097/QAD.0000000000003884
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Toward Precision Medicine Using a "Digital Twin" Approach: Modeling the Onset of Disease-Specific Brain Atrophy in Individuals with Multiple Sclerosis.

    Cen, Steven / Gebregziabher, Mulugeta / Moazami, Saeed / Azevedo, Christina / Pelletier, Daniel

    Research square

    2023  

    Abstract: Digital Twin (DT) is a novel concept that may bring a paradigm shift for precision medicine. In this study we demonstrate a DT application for estimating the age of onset of disease-specific brain atrophy in individuals with multiple sclerosis (MS) using ...

    Abstract Digital Twin (DT) is a novel concept that may bring a paradigm shift for precision medicine. In this study we demonstrate a DT application for estimating the age of onset of disease-specific brain atrophy in individuals with multiple sclerosis (MS) using brain MRI. We first augmented longitudinal data from a well-fitted spline model derived from a large cross-sectional normal aging data. Then we compared different mixed spline models through both simulated and real-life data and identified the mixed spline model with the best fit. Using the appropriate covariate structure selected from 52 different candidate structures, we augmented the thalamic atrophy trajectory over the lifespan for each individual MS patient and a corresponding hypothetical twin with normal aging. Theoretically, the age at which the brain atrophy trajectory of an MS patient deviates from the trajectory of their hypothetical healthy twin can be considered as the onset of progressive brain tissue loss. With a 10-fold cross validation procedure through 1000 bootstrapping samples, we found the onset age of progressive brain tissue loss was, on average, 5-6 years prior to clinical symptom onset. Our novel approach also discovered two clear patterns of patient clusters: earlier onset vs. simultaneous onset of brain atrophy.
    Language English
    Publishing date 2023-05-02
    Publishing country United States
    Document type Preprint
    DOI 10.21203/rs.3.rs-2833532/v1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The international humanitarian response to famine in Tigray, Ethiopia:lessons from the Nigerian Civil War, 1967-1970.

    Phillips, James F / Roy, Charlotte M / Gebregziabher, Mulugeta

    Global health action

    2022  Volume 15, Issue 1, Page(s) 2107203

    Abstract: The Tigray crisis in Ethiopia is a grave humanitarian catastrophe with causes and consequences that resemble the Nigerian Civil War that ended with the defeat of secessionist Biafra five decades ago. As in the Biafra example, an ethnically distinct and ... ...

    Abstract The Tigray crisis in Ethiopia is a grave humanitarian catastrophe with causes and consequences that resemble the Nigerian Civil War that ended with the defeat of secessionist Biafra five decades ago. As in the Biafra example, an ethnically distinct and embattled enclave is surrounded by hostile forces and cut off from commerce of any kind, producing starvation, forced migrant encampments, and pervasive dependence on externally provided food relief. Relief action strategies developed during the Nigerian Civil War were comprised of operational components that were often insufficiently integrated into a unified system for nutritional screening, referral, acute care, nutritional rehabilitation, and team deployment. This lack of strategic integration for post-conflict relief actions merits review for possible lessons that could avert its recurrence in Tigray. If evidence-based systems for relief organization had been comprehensively applied in Biafra, the pace of post-conflict nutritional recovery could have been accelerated. Although component strategies of the Biafra-Nigeria Relief Action are being replicated by various agencies that are providing humanitarian assistance in Tigray, their collective impact could be enhanced if these strategies were integrated into a unified, evidence-driven systems response to the emergency. The elements of such a systems approach for assisting Tigray are reviewed.
    MeSH term(s) Altruism ; Ethiopia ; Famine ; Humans ; Nigeria ; Nutrition Assessment ; Nutritional Status ; Warfare
    Language English
    Publishing date 2022-08-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2540569-X
    ISSN 1654-9880 ; 1654-9880
    ISSN (online) 1654-9880
    ISSN 1654-9880
    DOI 10.1080/16549716.2022.2107203
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Estimating missing concentrations of p,p'-DDT in the 1999-2004 National Health and Nutrition Examination Survey using multiple imputation.

    Everett, Charles J / Gebregziabher, Mulugeta

    Environmental science and pollution research international

    2019  Volume 26, Issue 6, Page(s) 5885–5891

    Abstract: We investigated the association between diabetes and p,p'-DDT (dichlorodiphenyltrichloroethane) in blood of Mexican Americans who participated in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). In this sample, p,p'-DDT were ... ...

    Abstract We investigated the association between diabetes and p,p'-DDT (dichlorodiphenyltrichloroethane) in blood of Mexican Americans who participated in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). In this sample, p,p'-DDT were missing in 50% of subjects and we used multiple imputation (MI) to address the problem. Compared to ignoring the missing data, MI led to a more robust threshold for the p,p'-DDT reference category. Whereas previously p,p'-DDT ≤ 0.0860 ng/g was used as the reference category, using MI, we were able to use p,p'-DDT < 0.0574 ng/g as the reference category to study the association between p,p'-DDT and diabetes via logistic regression. In this analysis, p,p'-DDT ≥ 0.0750 ng/g was associated with an odds ratio of 1.99 (95% CI 1.09-3.61) for diabetes and 4.20 (95% CI 1.93-9.12) for diabetic nephropathy. The reference category for diabetes without nephropathy outcome stayed consistent after MI but our analysis confirmed that p,p'-DDT > 0.0860 ng/g was associated with diabetes without nephropathy with an odds ratio of 1.89 (95% CI 1.09-3.27). Our study showed that MI can be effectively used to deal with missing at random data in persistent organic pollutants measured in the 1999-2004 NHANES.
    MeSH term(s) Adult ; DDT/analysis ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/metabolism ; Environmental Exposure/statistics & numerical data ; Environmental Pollutants/analysis ; Female ; Humans ; Hydrocarbons, Chlorinated ; Logistic Models ; Male ; Mexican Americans/statistics & numerical data ; Nutrition Surveys ; Odds Ratio ; United States/epidemiology
    Chemical Substances Environmental Pollutants ; Hydrocarbons, Chlorinated ; DDT (CIW5S16655)
    Language English
    Publishing date 2019-01-06
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1178791-0
    ISSN 1614-7499 ; 0944-1344
    ISSN (online) 1614-7499
    ISSN 0944-1344
    DOI 10.1007/s11356-018-04078-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Shared parameter and copula models for analysis of semicontinuous longitudinal data with nonrandom dropout and informative censoring.

    Jaffa, Miran A / Gebregziabher, Mulugeta / Jaffa, Ayad A

    Statistical methods in medical research

    2021  Volume 31, Issue 3, Page(s) 451–474

    Abstract: Analysis of longitudinal semicontinuous data characterized by subjects' attrition triggered by nonrandom dropout is complex and requires accounting for the within-subject correlation, and modeling of the dropout process. While methods that address the ... ...

    Abstract Analysis of longitudinal semicontinuous data characterized by subjects' attrition triggered by nonrandom dropout is complex and requires accounting for the within-subject correlation, and modeling of the dropout process. While methods that address the within-subject correlation and missing data are available, approaches that incorporate the nonrandom dropout, also referred to informative right censoring, in the modeling step are scarce due to the computational intensity and possible intractable integration needed for its implementation. Appreciating the complexity of this problem and the need for a new methodology that is feasible for implementation, we propose to extend a framework of likelihood-based marginalized two-part models to account for informative right censoring. The censoring process is modeled using two approaches: (1) Poisson censoring for the count of visits before dropout and (2) survival time to dropout. Novel consideration was given to the proposed joint modeling approaches for the semicontinuous and censoring components of the likelihood function which included (1) shared parameter, and (2) Clayton copula. The cross-part and within-part correlations were accounted for through a complex random effect structure that models correlated random intercepts and slopes. Feasibility of implementation, and accuracy of these approaches were investigated using extensive simulation studies and clinical application.
    MeSH term(s) Computer Simulation ; Humans ; Likelihood Functions ; Longitudinal Studies ; Models, Statistical ; Patient Dropouts
    Language English
    Publishing date 2021-11-22
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1136948-6
    ISSN 1477-0334 ; 0962-2802
    ISSN (online) 1477-0334
    ISSN 0962-2802
    DOI 10.1177/09622802211060519
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Impact of Race and Ethnicity on Severe Hypoglycemia Associated with Sulfonylurea Use for Type 2 Diabetes among Veterans.

    Weeda, Erin R / Ward, Ralph / Gebregziabher, Mulugeta / Axon, R Neal / Taber, David J

    Journal of racial and ethnic health disparities

    2023  

    Abstract: Sulfonylureas are associated with hypoglycemia. Whether a racial/ethnic disparity in this safety outcome exists is unknown. We sought to assess the impact of race/ethnicity on severe hypoglycemia associated with sulfonylurea use for type 2 diabetes (T2D). ...

    Abstract Sulfonylureas are associated with hypoglycemia. Whether a racial/ethnic disparity in this safety outcome exists is unknown. We sought to assess the impact of race/ethnicity on severe hypoglycemia associated with sulfonylurea use for type 2 diabetes (T2D). Using Veterans Affairs and Medicare data, Veterans initially receiving metformin monotherapy for T2D between 2004 and 2006 were identified. Sulfonylurea use (either alone or via the addition of a prescription for a sulfonylurea to metformin) was captured and compared to remaining on metformin alone during the follow-up period (2007-2016). Hazard ratios (HR) and 95% confidence intervals (CI) from longitudinal competing risk Cox models were used to measure the association between sulfonylurea use and severe hypoglycemia defined as hospitalization for hypoglycemia. A total of 113,668 Veterans with T2D were included. A higher risk of severe hypoglycemia was associated with the receipt of sulfonylurea prescriptions versus remaining on metformin alone across all groups. The effect was largest among Hispanic Veterans (HR: 7.59, 95%CI:4.32-13.33), followed by Veterans in the other race/ethnicity cohort (HR: 4.57, 95%CI:2.50-8.36) and Non-Hispanic Black Veterans (HR: 3.67, 95%CI:2.78-4.85). The effect was smallest among Non-Hispanic White Veterans (HR: 3.11, 95%CI:2.77-3.48). In conclusion, a higher risk of severe hypoglycemia associated with sulfonylurea prescriptions was observed across all analyses. The relationship was most pronounced for Hispanic Veterans, who had nearly 8 times the risk of severe hypoglycemia with sulfonylureas versus remaining on metformin alone.
    Language English
    Publishing date 2023-05-02
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2760524-3
    ISSN 2196-8837 ; 2197-3792
    ISSN (online) 2196-8837
    ISSN 2197-3792
    DOI 10.1007/s40615-023-01619-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Author Correction: Toward precision medicine using a "digital twin" approach: modeling the onset of disease-specific brain atrophy in individuals with multiple sclerosis.

    Cen, Steven / Gebregziabher, Mulugeta / Moazami, Saeed / Azevedo, Christina J / Pelletier, Daniel

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 22334

    Language English
    Publishing date 2023-12-15
    Publishing country England
    Document type Published Erratum
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-47966-0
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  10. Article ; Online: Toward precision medicine using a "digital twin" approach: modeling the onset of disease-specific brain atrophy in individuals with multiple sclerosis.

    Cen, Steven / Gebregziabher, Mulugeta / Moazami, Saeed / Azevedo, Christina J / Pelletier, Daniel

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 16279

    Abstract: Digital Twin (DT) is a novel concept that may bring a paradigm shift for precision medicine. In this study we demonstrate a DT application for estimating the age of onset of disease-specific brain atrophy in individuals with multiple sclerosis (MS) using ...

    Abstract Digital Twin (DT) is a novel concept that may bring a paradigm shift for precision medicine. In this study we demonstrate a DT application for estimating the age of onset of disease-specific brain atrophy in individuals with multiple sclerosis (MS) using brain MRI. We first augmented longitudinal data from a well-fitted spline model derived from a large cross-sectional normal aging data. Then we compared different mixed spline models through both simulated and real-life data and identified the mixed spline model with the best fit. Using the appropriate covariate structure selected from 52 different candidate structures, we augmented the thalamic atrophy trajectory over the lifespan for each individual MS patient and a corresponding hypothetical twin with normal aging. Theoretically, the age at which the brain atrophy trajectory of an MS patient deviates from the trajectory of their hypothetical healthy twin can be considered as the onset of progressive brain tissue loss. With a tenfold cross validation procedure through 1000 bootstrapping samples, we found the onset age of progressive brain tissue loss was, on average, 5-6 years prior to clinical symptom onset. Our novel approach also discovered two clear patterns of patient clusters: earlier onset versus simultaneous onset of brain atrophy.
    MeSH term(s) Humans ; Child, Preschool ; Child ; Multiple Sclerosis/diagnostic imaging ; Multiple Sclerosis/pathology ; Cross-Sectional Studies ; Precision Medicine ; Brain/diagnostic imaging ; Brain/pathology ; Magnetic Resonance Imaging/methods ; Central Nervous System Diseases/pathology ; Seizures/pathology ; Atrophy/pathology
    Language English
    Publishing date 2023-09-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-43618-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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