Browsing by Author "Bhamidipalli, Surya Sruthi"
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Item A Novel Machine Learning Model for Predicting Orthodontic Treatment Duration(MDPI, 2023-08-23) Volovic, James; Badirl, Sarkhan; Ahmad, Sunna; Leavit, Landon; Mason, Taylor; Bhamidipalli, Surya Sruthi; Eckert, George; Albright, David; Turkkahraman, Hakan; Orthodontics and Oral Facial Genetics, School of DentistryIn the field of orthodontics, providing patients with accurate treatment time estimates is of utmost importance. As orthodontic practices continue to evolve and embrace new advancements, incorporating machine learning (ML) methods becomes increasingly valuable in improving orthodontic diagnosis and treatment planning. This study aimed to develop a novel ML model capable of predicting the orthodontic treatment duration based on essential pre-treatment variables. Patients who completed comprehensive orthodontic treatment at the Indiana University School of Dentistry were included in this retrospective study. Fifty-seven pre-treatment variables were collected and used to train and test nine different ML models. The performance of each model was assessed using descriptive statistics, intraclass correlation coefficients, and one-way analysis of variance tests. Random Forest, Lasso, and Elastic Net were found to be the most accurate, with a mean absolute error of 7.27 months in predicting treatment duration. Extraction decision, COVID, intermaxillary relationship, lower incisor position, and additional appliances were identified as important predictors of treatment duration. Overall, this study demonstrates the potential of ML in predicting orthodontic treatment duration using pre-treatment variables.Item Assessing Negative Attributions After Brain Injury With the Ambiguous Intentions Hostility Questionnaire(Wolters Kluwer, 2020-09) Neumann, Dawn; Sander, Angelle M.; Perkins, Susan M.; Bhamidipalli, Surya Sruthi; Witwer, Noelle; Combs, Dennis; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineOBJECTIVES: (1) To explore the construct validity of the Ambiguous Intentions Hostility Questionnaire (AIHQ) in participants with traumatic brain injury (TBI) (ie, confirm negative attributions are associated with anger and aggression); and (2) use the AIHQ to examine negative attribution differences between participants with and without TBI. SETTING: Two rehabilitation hospitals. PARTICIPANTS: Eighty-five adults with TBI and 86 healthy controls (HCs). DESIGN: Cross-sectional survey. MAIN MEASURES: The AIHQ, a measure of negative attributions (intent, hostility, and blame), anger, and aggressive responses to hypothetical scenarios. RESULTS: Attributions were significantly correlated with anticipated anger and aggressive responses to AIHQ scenarios. Compared with HCs, participants with TBI reported stronger negative attributions (P ≤ .001), anger (P = .021), and aggressive responses (P = .002) to the scenarios. CONCLUSION: Negative attributions were associated with anger and aggression responses, demonstrating construct validity of the AIHQ in the TBI population. Participants with TBI judged others' behaviors more severely than HCs, similar to prior research using a different attribution measure. The AIHQ has promise as a practical instrument for assessing negative attributions after TBI.Item Change in Medical Students’ Attitudes Towards Family Planning after a Pregnancy Options Counseling Panel(2024-04-26) Peipert, Leah J.; Brown, Lucy; King, Carli; Bhamidipalli, Surya Sruthi; Stout, Julianne; Peipert, Jeffrey F.; Caldwell, AmyINTRODUCTION: Abortion is one of the most commonly performed procedures in the U.S., but abortion education is lacking in medical curricula. Previous studies have shown that clinical exposure to abortion care in medical school can change students’ attitudes about abortion, yet few medical schools incorporate abortion education during students’ preclinical years. STUDY OBJECTIVE: This study evaluates changes in medical students’ attitudes after a virtual pregnancy counseling panel intervention during pre-clinical medical education at Indiana University School of Medicine. We hypothesized that students would feel more comfortable counseling and treating patients for unplanned pregnancy after attending the virtual panel. METHODS: Students participated in a “Pregnancy Options Panel” during their second-year course covering reproductive health. The panel consisted of OBGYNs, a pediatrician, and a social worker. Using a case study format, panelists guided discussion of appropriate care for a patient diagnosed with an unintended pregnancy. Two identical 19-item surveys consisting of multiple-choice and open-ended questions were electronically disseminated before and after the panel to assess students’ comfort and beliefs about family planning counseling and treatment. Statistical analyses were performed using non-parametric statistics (Wilcoxon signed rank and McNemar’s test) to compare before and after responses of participants. The study was IRB exempt. RESULTS: The second-year medical school class enrolled in the reproductive health course at Indiana University was composed of 366 students with 189 students (51.6%) identifying as female. Of the 366 students, 171 students (46.7%) completed surveys before and after the panel. Demographics were as follows: 60.6% female, 37.6% male, 64.9% white, 2.9% black, 84.6% non-Hispanic, and 10.7% Hispanic. After the pregnancy panel, students reported increased comfort when contemplating referral to an abortion provider, prescribing a medication abortion, and performing a surgical abortion compared to prior to the panel (p<0.01, all comparisons). Students were more likely to withhold disclosing their personal beliefs about abortion when counseling a pregnant patient (64.6% vs 42.3%, p<0.01), felt more capable of approaching the conversation about pregnancy options in a genuinely neutral manner (86.4% vs 71.6%, p<0.01), and had a significant increase in preparedness to counsel on continuing pregnancy, abortion, and adoption (p<0.01). CONCLUSIONS: Our pregnancy options counseling panel effectively guided students through a common reproductive health scenario counseling a patient with unintended pregnancy. Second year preclinical medical students felt more prepared to counsel patients neutrally and without influence of their own beliefs after attending the educational event. Students additionally felt more comfortable referring to an abortion provider, prescribing a medical abortion, and performing a surgical abortion after the panel, emphasizing how exposure to family planning scenarios can influence future physicians’ comfort providing non-judgmental counseling and abortion care. Expert panels comprised of health professionals with diverse clinical and social perspectives on pregnancy options can serve as an instructional model for preparing medical students for their obstetric and gynecological clinical clerkship and improving pre-clinical medical curriculum on the often-neglected topic of abortion.Item Emotional distress, stress, anxiety, and the impact of the COVID-19 pandemic on early- to mid-career women in healthcare sciences research(Cambridge University Press, 2022-06-13) Bittar, Noor; Cohee, Andrea; Bhamidipalli, Surya Sruthi; Savoy, April; Ismail, Heba M.; Pediatrics, School of MedicineObjectives: The main objective of this study was to report stress and anxiety levels during the COVID-19 pandemic on early- to mid-career women researchers in healthcare sciences research and determine the associated factors. Methods: A 50-item self-administered internet questionnaire was developed using a mix of Likert-type scales and open-ended response questions. The survey was distributed June 10-August 3, 2020. Anxiety and stress as well as personal/family demands were assessed through validated measures (Patient Reported Outcomes Measurement Information System [PROMIS]-Anxiety Short Form and Perceived Stress Scale [PSS]) and open-ended responses. Results: One hundred and fifty-one early-career women in healthcare sciences research completed the survey; mean respondent age was 37.3 ± 5.2 years; and all had a college degree or higher, 50.3% holding a PhD and 35.8% MD. Race and ethnicity were reported in 128; the majority were White (74.0%). One-third (31.2%) reported being "very much" concerned about reaching their research productivity goals and 30.1% were "very much" concerned about academic promotion and tenure. Fifty percent reported a "moderate" PROMIS anxiety score and 72.1% reported a "moderate" PSS score. For the open-ended responses, 65.6% reported a worry about their professional goals because of the COVID-19 pandemic. Major concerns revolved around finances, childcare, and job security. Conclusions: Throughout the pandemic, early- and mid-career women in healthcare sciences research have reported moderate to high overall stress, anxiety, and worries. These concerns appear related to household settings, additional responsibilities, financial concerns, and reduced research productivity. Institutions and funding agencies should take these concerns into consideration and offer support.Item Emotional distress, stress, anxiety, and the impact of the COVID-19 pandemic on early- to mid-career women in healthcare sciences research(Cambridge University Press, 2022-06-13) Bittar, Noor; Cohee, Andrea; Bhamidipalli, Surya Sruthi; Savoy, April; Ismail, Heba M.; Pediatrics, School of MedicineObjectives: The main objective of this study was to report stress and anxiety levels during the COVID-19 pandemic on early- to mid-career women researchers in healthcare sciences research and determine the associated factors. Methods: A 50-item self-administered internet questionnaire was developed using a mix of Likert-type scales and open-ended response questions. The survey was distributed June 10-August 3, 2020. Anxiety and stress as well as personal/family demands were assessed through validated measures (Patient Reported Outcomes Measurement Information System [PROMIS]-Anxiety Short Form and Perceived Stress Scale [PSS]) and open-ended responses. Results: One hundred and fifty-one early-career women in healthcare sciences research completed the survey; mean respondent age was 37.3 ± 5.2 years; and all had a college degree or higher, 50.3% holding a PhD and 35.8% MD. Race and ethnicity were reported in 128; the majority were White (74.0%). One-third (31.2%) reported being "very much" concerned about reaching their research productivity goals and 30.1% were "very much" concerned about academic promotion and tenure. Fifty percent reported a "moderate" PROMIS anxiety score and 72.1% reported a "moderate" PSS score. For the open-ended responses, 65.6% reported a worry about their professional goals because of the COVID-19 pandemic. Major concerns revolved around finances, childcare, and job security. Conclusions: Throughout the pandemic, early- and mid-career women in healthcare sciences research have reported moderate to high overall stress, anxiety, and worries. These concerns appear related to household settings, additional responsibilities, financial concerns, and reduced research productivity. Institutions and funding agencies should take these concerns into consideration and offer support.Item Evaluating Negative Attributions in Persons With Brain Injury: A Comparison of 2 Measures(Wolters Kluwer, 2021-05) Neumann, Dawn; Sander, Angelle M.; Witwer, Noelle; Jang, Jeong Hoon; Bhamidipalli, Surya Sruthi; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineObjectives: To compare construct and predictive validity, readability, and time-to-administer of 2 negative attribution measures in participants with traumatic brain injury (TBI). Setting: Two TBI rehabilitation hospitals. Participants: Eighty-five adults with complicated mild to severe TBI. Main Measures: Negative attributions (intent, hostility, and blame) and anger responses to hypothetical scenarios were measured with the Epps scenarios and the Ambiguous Intention Hostility Questionnaire (AIHQ). Trait aggression was measured with the Buss-Perry Aggression Questionnaire (BPAQ). Results: Associations between attributions and anger responses (ie, construct validity) within each measure were significant (Epps: r = 0.61-0.74; AIHQ: r = 0.39-0.71); however, associations were stronger for Epps (Ps < .001). Receiver operating characteristics (ROC) revealed attributions from both measures predicted BPAQ scores (area under the ROC curves = 0.6-0.8); predictive validity did not statistically differ between the 2 measures. Both had comparable readability (fifth- to sixth-grade levels), but Epps required longer administration times. Conclusion: Negative attributions affect anger and aggression after TBI, making it important to identify suitable assessments for the TBI population. While psychometric properties of the AIHQ and Epps scenarios should be further explored, this study offers early support for the use of either instrument in persons with TBI. Advantages and disadvantages of the AIHQ and Epps scenarios are highlighted.Item Examination of Social Inferencing Skills in Men and Women After Traumatic Brain Injury(Elsevier, 2022-05) Neumann, Dawn; Mayfield, Ryan; Sander, Angelle M.; Jang, Jeong Hoon; Bhamidipalli, Surya Sruthi; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineObjective To examine sex differences in social inferencing deficits after traumatic brain injury (TBI) and to examine the odds of men and women being impaired while controlling for potential confounders. Design Cross-sectional survey. Setting Two TBI rehabilitation hospitals. Participants One hundred five participants with TBI (60 men, 45 women) and 105 controls without TBI (57 men, 48 women) (N=210). Interventions Not applicable. Main Outcome Measures The Awareness of Social Inference Test (TASIT), which includes (1) Emotion Evaluation Test (EET), (2) Social Inference-Minimal (SI-M) test, and (3) Social Inference-Enriched (SI-E) test. Results Within the control sample, men and women performed similarly on all 3 TASIT subtests. Within the group with TBI, men had significantly lower scores than women on EET (P=.03), SI-M (P=.01), and SI-E (P=.04). Using impairment cutoffs derived from the sample without TBI, we found significantly more men with TBI (30%) were impaired on the EET than women (16.7%); impairment was similar between men and women on SI-M and SI-E. When adjusting for executive functioning and education, the odds of being impaired on the EET did not significantly differ for men and women (odds ratio, 0.47; 95% CI, 0.16-1.40; P=.18). Conclusions Although more men with TBI have emotion perception deficits than women, the difference appears to be driven by education and executive functioning. Research is needed in larger samples with more definitive norms to better understand social inferencing impairments in men and women with TBI as well as translation to interpersonal behaviors.Item Hypermethylation of miRNA-17-92 cluster in peripheral blood mononuclear cells in diabetic retinopathy(Elsevier, 2022) Luo, Qianyi; Bhamidipalli, Surya Sruthi; Eckert, George J.; Bhatwadekar, Ashay D.; Ophthalmology, School of MedicineBackground and aims: Diabetic retinopathy (DR) is the most common complication of diabetes. The inflammatory milieu of diabetes results in changes throughout the body. This study asked whether epigenetic changes in peripheral blood mononuclear cells (PBMCs) reflect DR severity. Methods: PBMCs were separated from the whole blood of DR individuals using density gradient centrifugation. DNA was isolated, and methylation of micro-RNA (miR)-17-92 cluster was evaluated. Results: We observed that the miR-17-92 cluster was hypermethylated in DR individuals; specifically, this change was most remarkable with proliferative-DR (PDR). Conclusions: miR-17-92 methylation in PBMCs could help understand DR's pathogenesis and identify individuals at the risk of severe DR for early intervention.Item Intention to treat: obstetrical management at the threshold of viability(Elsevier, 2020) Tonismae, Tiffany R.; Edmonds, Brownsyne Tucker; Bhamidipalli, Surya Sruthi; Fadel, William F.; Carlos, Christine; Andrews, Bree; Fritz, Katie A.; Leuthner, Steven R.; Lawrence, Christin; Laventhal, Naomi; Hayslett, Drew; Coleman, Tasha; Famuyide, Mobolaji; Feltman, Dalia; Obstetrics and Gynecology, School of MedicineBackground Despite medical advances in the care of extremely preterm neonates and growing acceptance of resuscitation at 23 and even 22 weeks gestation, controversy remains concerning the use of antepartum obstetric intervention s that are intended to improve outcomes in the setting of anticipated extremely preterm birth. In the absence of demonstrated benefit at <23 weeks gestation and with uncertain benefit at 23 weeks gestation, previous obstetric committee opinions have advised against their use at these gestational ages. Objective The purpose of this study was to review the use of obstetric intervention s at the threshold of viability based on neonatal resuscitation plan and to review the odds of survival to neonatal intensive care unit discharge based on use of obstetric intervention s with adjustment for neonatal factors. Study Design This retrospective study of 6 study centers reviewed pregnant patients who were admitted between 22+0/7 and 24+6/7 weeks gestation facing delivery from 2011–2015. Patients with known anomalies or missing data were excluded. Records were reviewed for demographics, resuscitation plan, and obstetric intervention s. Mode of delivery, delivery room care, and final infant dispositions were recorded. Multiple gestations were included as 1 pregnancy in regard to the use of obstetric intervention s and were excluded from survival analysis. Results Four hundred seventy-eight mothers met the inclusion criteria. When resuscitation was planned, mothers were more likely to receive all conventional obstetric intervention s (antenatal steroids, magnesium sulfate for neuroprotection, tocolytics, and Group Beta Streptococcus prophylaxis), regardless of gestational age at admission, and were more likely to be delivered by cesarean section (P<.05). Analyzed as a group, when antenatal steroids, magnesium sulfate, tocolytics and Group Beta Streptococcus prophylaxis were administered, the odds of survival to neonatal intensive care unit discharge increased for newborn infants who were born at 22 (odds ratio, 11.33; 95% confidence interval, 1.405–91.4) and 23 weeks gestation (odds ratio, 15.5; 95% confidence interval, 3.747-64.11; P<.05). In singletons, the odds of survival to neonatal intensive care unit discharge was not improved by cesarean delivery vs vaginal delivery, even after adjustment for the use of additional interventions, weight, gender, and gestational age (odds ratio, 1.0; 95% confidence interval, 0.59–1.8; P=.912). Conclusion In this study, when postnatal resuscitation was planned at 22 and 23 weeks gestation, women were more likely to receive antenatal steroids, magnesium sulfate, and antibiotics; provision of this bundle imparted survival benefit at 23 weeks gestation but could not be demonstrated at 22 weeks gestation because of the small sample size. These findings support of neonate-oriented obstetric interventions in the setting of delivery at 23 weeks gestation when resuscitation is planned and further exploration of optimal obstetric care when resuscitation of infants who were born at 22 weeks gestation is anticipated.Item Negative Attribution Bias and Related Risk Factors after Brain Injury(Wolters Kluwer, 2021) Neumann, Dawn; Sander, Angelle M.; Perkins, Susan M.; Bhamidipalli, Surya Sruthi; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineObjective: In participants with traumatic brain injury (TBI) and peer controls, examine (1) differences in negative attributions (interpret ambiguous behaviors negatively); (2) cognitive and emotional factors associated with negative attributions; and (3) negative attribution associations with anger responses, life satisfaction, and participation. Setting: Two TBI outpatient rehabilitation centers. Participants: Participants with complicated mild to severe TBI (n = 105) and peer controls (n = 105). Design: Cross-sectional survey study. Main measures: Hypothetical scenarios describing ambiguous behaviors were used to assess situational anger and attributions of intent, hostility, and blame. Executive functioning, perspective taking, emotion perception and social inference, alexithymia, aggression, anxiety, depression, participation, and life satisfaction were also assessed. Results: Compared with peer controls, participants with TBI rated behaviors significantly more intentional, hostile, and blameworthy. Regression models explained a significant amount of attribution variance (25%-43%). Aggression was a significant predictor in all models; social inference was also a significant predictor of intent and hostility attributions. Negative attributions were associated with anger responses and lower life satisfaction. Conclusion: People with TBI who have higher trait aggression and poor social inferencing skills may be prone to negative interpretations of people's ambiguous actions. Negative attributions and social inferencing skills should be considered when treating anger problems after TBI.