Patricia Goedecke | University of Tennessee (original) (raw)

Papers by Patricia Goedecke

Research paper thumbnail of Long-Term Patiromer Use and Outcomes Among US Veterans With Hyperkalemia and CKD: A Propensity-Matched Cohort Study

Kidney Medicine, Dec 31, 2023

Research paper thumbnail of Social Determinants of Health as Primary Risk Factors of Hypertensive Disorders of Pregnancy: A Retrospective Cohort Study

Research Square (Research Square), Jun 25, 2024

Research paper thumbnail of Telehealth Utilization in High-Risk Pregnancies During COVID-19

Telemedicine reports, May 1, 2023

Research paper thumbnail of Racial differences in healthcare expenditures for prevalent multimorbidity combinations in the USA: a cross-sectional study

BMC Medicine

Background We aimed to model total charges for the most prevalent multimorbidity combinations in ... more Background We aimed to model total charges for the most prevalent multimorbidity combinations in the USA and assess model accuracy across Asian/Pacific Islander, African American, Biracial, Caucasian, Hispanic, and Native American populations. Methods We used Cerner HealthFacts data from 2016 to 2017 to model the cost of previously identified prevalent multimorbidity combinations among 38 major diagnostic categories for cohorts stratified by age (45–64 and 65 +). Examples of prevalent multimorbidity combinations include lipedema with hypertension or hypertension with diabetes. We applied generalized linear models (GLM) with gamma distribution and log link function to total charges for all cohorts and assessed model accuracy using residual analysis. In addition to 38 major diagnostic categories, our adjusted model incorporated demographic, BMI, hospital, and census division information. Results The mean ages were 55 (45–64 cohort, N = 333,094) and 75 (65 + cohort, N = 327,260), respe...

Research paper thumbnail of Does the transfusion rate following reverse total shoulder arthroplasty warrant aggressive peri-operative blood management? An indications-based analysis

Seminars in Arthroplasty: JSES

Research paper thumbnail of Comparison of Methods for Choosing an Appropriate Number of Topics in an LDA Model

Topic modeling is a technique for reducing dimensionality of large corpuses of text. Latent Diric... more Topic modeling is a technique for reducing dimensionality of large corpuses of text. Latent Dirichlet allocation (LDA), the most prevalent form of topic modeling, improved upon earlier methods by introducing Bayesian iterative updates, providing a sound theoretical basis for modeling by iteration. Yet a piece of the modeling puzzle remains unsolved; the number of topics to model, K, is an as yet unanswered question. This number of topics may also be called the dimensionality of the model. With this is an integrally related puzzle; how to determine when a model has been best fit. Presented here are a brief history of the development of topic modeling from its inception preceding LDA to the present; and a comparison of methods for determining what is a best-fit topic model, in pursuit of the most appropriate K

Research paper thumbnail of Fetal growth restriction phenotypes according to growth trajectory analysis

American Journal of Obstetrics and Gynecology, 2022

Research paper thumbnail of Early pregnancy ultrasound measurements and prediction of first trimester pregnancy loss: A logistic model

Scientific Reports, 2020

Our objective was to prospectively validate the use of gestational sac (GS), yolk sac (YS) diamet... more Our objective was to prospectively validate the use of gestational sac (GS), yolk sac (YS) diameter, crown-rump length (CRL), and embryonal heart rate (HR) dimensions to identify early pregnancy loss. This was a prospective cohort study of first trimester pregnancies. GS and YS diameter, CRL, and HR measurements were serially obtained in singleton and twin pregnancies from 6 through 10 weeks’ gestation. Non-parametric tests and logistic regression models were used for comparisons of distributions and testing of associations. A total of 252 patients were included, of which 199 were singleton pregnancies, 51 were twins, and 2 were triplets (304 total fetuses). Fifty-two patients had 61 losses. We built nomograms with the changes of the parameters evaluated in ongoing, as well as in pregnancy loss. In the pregnancies which failed, all the parameters showed significant changes, with different temporal onsets: GS and YS were the first to become abnormal, deviating from normality as early...

Research paper thumbnail of Conditional loss of Engrailed1/2 in Atoh1 ‐derived excitatory cerebellar nuclear neurons impairs eupneic respiration in mice

Genes, Brain and Behavior

Evidence for a cerebellar role during cardiopulmonary challenges has long been established, but s... more Evidence for a cerebellar role during cardiopulmonary challenges has long been established, but studies of cerebellar involvement in eupneic breathing have been inconclusive. Here we investigated temporal aspects of eupneic respiration in the Atoh1‐En1/2 mouse model of cerebellar neuropathology. Atoh1‐En1/2 conditional knockout mice have conditional loss of the developmental patterning genes Engrailed1 and 2 in excitatory cerebellar nuclear neurons, which leads to loss of a subset of medial and intermediate excitatory cerebellar nuclear neurons. A sample of three Atoh1‐derived extracerebellar nuclei showed no cell loss in the conditional knockout compared to control mice. We measured eupneic respiration in mutant animals and control littermates using whole‐body unrestrained plethysmography and compared the average respiratory rate, coefficient of variation, and the CV2, a measure of intrinsic rhythmicity. Linear regression analyses revealed that Atoh1‐En1/2 conditional knockouts have decreased overall variability (p = 0.021; b = −0.045) and increased intrinsic rhythmicity compared to their control littermates (p < 0.001; b = −0.037), but we found no effect of genotype on average respiratory rate (p = 0.064). Analysis also revealed modestly decreased respiratory rates (p = 0.025; b = −0.82), increased coefficient of variation (p = 0.0036; b = 0.060), and increased CV2 in female animals, independent of genotype (p = 0.024; b = 0.026). These results suggest a cerebellar involvement in eupneic breathing by controlling rhythmicity. We argue that the cerebellar involvement in controlling the CV2 of respiration is indicative of an involvement of coordinating respiration with other orofacial rhythms, such as swallowing.

Research paper thumbnail of MP23-17 Socioeconomic Factors Predict Delay in Prostate Cancer Treatment Decision and Initiation

The Journal of Urology, 2021

INTRODUCTION AND OBJECTIVE:Although prostate cancer is typically a slow-growing malignancy, patho... more INTRODUCTION AND OBJECTIVE:Although prostate cancer is typically a slow-growing malignancy, pathology and risk stratification can progress in as quick as 3 months. Socioeconomic status (SES) and he...

Research paper thumbnail of Breaking off Engagement: Readers' Disengagement as a Function of Reader and Text Characteristics

Engagement during reading can be measured by the amount of time readers invest in the reading pro... more Engagement during reading can be measured by the amount of time readers invest in the reading process. It is hypothesized that disengagement is marked by a decrease in time investment as compared with the demands made on the reader by the text. In this study, self-paced reading times for screens of text were predicted by a text complexity score called formality; formality scores increase with cohesion, informational content/genre, syntactic complexity, and word abstractness as measured by the Coh-Metrix text-analysis program. Cognitive decoupling is defined as the difference between actual reading times and reading times predicted by text formality. Decoupling patterns were found to differ as a function of the serial position of the screens of text and the text genre (i.e., informational, persuasive, and narrative) but surprisingly not as a function of reader characteristics (reading speed and comprehension). This underscores the importance of mining text characteristics in addition...

Research paper thumbnail of Pregnancy Ultrasound Measurements and Early Pregnancy Loss: Validation of a Predictive Model

Fertility and Sterility, 2020

Research paper thumbnail of Relationship Between Standardized Test Scores and Board Certification Exams in a Combined Internal Medicine/Pediatrics Residency Program

Cureus, 2021

Background Combined Internal Medicine/Pediatrics (Med/Peds) residencies rely on categorical progr... more Background Combined Internal Medicine/Pediatrics (Med/Peds) residencies rely on categorical program data to predict pass rates for the American Board of Internal Medicine Certifying Exam (ABIM-CE) and the American Board of Pediatrics Certifying Exam (ABP-CE). There is insufficient literature describing what best predicts a Med/Peds resident passing board exams. In this study, we aimed to determine how standardized test scores predict performance on ABIM-CE and ABP-CE for Med/Peds residents. Methodology We analyzed prior exam scores for 91/96 (95%) residents in a Med/Peds program from 2008 to 2017. Scores from the United States Medical Licensing Examination (USMLE) Steps 1 and 2 Clinical Knowledge (CK) and In-Training Exams in Internal Medicine (ITE-IM) and Pediatrics (ITE-P) were analyzed with the corresponding ABIM-CE and ABP-CE first-time scores. Linear and logistic regression were applied to predict board scores/passage. Results USMLE 1 and 2 CK, ITE-IM, and ITE-P scores had a li...

Research paper thumbnail of Breaking Off Engagement: Readers' Cognitive Decoupling as a Function of Reader and Text Characteristics

Engagement during reading can be measured by the amount of time readers invest in the reading pro... more Engagement during reading can be measured by the amount of time readers invest in the reading process. It is hypothesized that disengagement is marked by a decrease in time investment as compared with the demands made on the reader by the text. In this study, self-paced reading times for screens of text were predicted by a text complexity score called formality; formality scores increase with cohesion, informational content/genre, syntactic complexity, and word abstractness as measured by the Coh-Metrix text-analysis program. Cognitive decoupling is defined as the difference between actual reading times and reading times predicted by text formality. Decoupling patterns were found to differ as a function of the serial position of the screens of text and the text genre (i.e., informational, persuasive, and narrative) but surprisingly not as a function of reader characteristics (reading speed and comprehension). This underscores the importance of mining text characteristics in addition...

Research paper thumbnail of Author Correction: Early pregnancy ultrasound measurements and prediction of first trimester pregnancy loss: A logistic model

Research paper thumbnail of 593: Is maternal magnesium sulfate administration prior to delivery an independent predictor of survival in neonates who weigh fewer than five hundred grams?

American Journal of Obstetrics and Gynecology, 2018

Among women receiving steroids or tocolysis for an episode of TPTL, those delivering at term are ... more Among women receiving steroids or tocolysis for an episode of TPTL, those delivering at term are more likely to have an infant SGA <10% and <5%, compared with those delivering preterm. This effect is as large as the effect of smoking on SGA. An episode of TPTL requiring steroids or tocolysis may represent an insult on the uteroplacental unit that if not delivered may result in subsequent SGA. Characteristics and outcomes of women delivering at term after TPTL, compared with preterm delivery. Women receiving steroids or tocolysis Characteristics/Outcome TPTL Term Delivery N=320 TPTL Preterm Delivery N=389

Research paper thumbnail of Prediction of first trimester miscarriage by ultrasound

Fertility and Sterility

3.0 (95% CI 1.2-7.2) times higher when the change in hCG levels was <5% between day-7 vs. day of ... more 3.0 (95% CI 1.2-7.2) times higher when the change in hCG levels was <5% between day-7 vs. day of MTX, day-7 vs. day-4, and day-4 vs. day of MTX, respectively. Kaplan-Meier plots demonstrated that EP rupture and EP resolution occurred 7-13 days and 20-36 days after MTX treatment. CONCLUSIONS: Patient with ruptured tubal EPs despite MTX present more frequently with vaginal spotting and have <5% change in hCG levels between the day of MTX and day-4 or day-7 after MTX.

Research paper thumbnail of 594: Cesarean section reduces the odds of morbidity and mortality among very low birthweight infants

American Journal of Obstetrics and Gynecology, 2018

exposure. Magnesium sulfate did not appear to protect from severe IVH (OR¼ 0.20; 95% CI 0.01-2.4;... more exposure. Magnesium sulfate did not appear to protect from severe IVH (OR¼ 0.20; 95% CI 0.01-2.4; p¼0.21). CONCLUSION: Maternal magnesium appears to be an independent predictor of survival from 12 hours after birth until discharge among neonates who are born weighing less than 500g. This is the first study that has found a survival benefit in these periviable birth weights.

Research paper thumbnail of Neonatal blood pressure before and after delayed umbilical cord clamping

The Journal of Maternal-Fetal & Neonatal Medicine

Research paper thumbnail of Estimated fetal weight accuracy in pregnancies with preterm prelabor rupture of membranes by the Hadlock method

The Journal of Maternal-Fetal & Neonatal Medicine

Research paper thumbnail of Long-Term Patiromer Use and Outcomes Among US Veterans With Hyperkalemia and CKD: A Propensity-Matched Cohort Study

Kidney Medicine, Dec 31, 2023

Research paper thumbnail of Social Determinants of Health as Primary Risk Factors of Hypertensive Disorders of Pregnancy: A Retrospective Cohort Study

Research Square (Research Square), Jun 25, 2024

Research paper thumbnail of Telehealth Utilization in High-Risk Pregnancies During COVID-19

Telemedicine reports, May 1, 2023

Research paper thumbnail of Racial differences in healthcare expenditures for prevalent multimorbidity combinations in the USA: a cross-sectional study

BMC Medicine

Background We aimed to model total charges for the most prevalent multimorbidity combinations in ... more Background We aimed to model total charges for the most prevalent multimorbidity combinations in the USA and assess model accuracy across Asian/Pacific Islander, African American, Biracial, Caucasian, Hispanic, and Native American populations. Methods We used Cerner HealthFacts data from 2016 to 2017 to model the cost of previously identified prevalent multimorbidity combinations among 38 major diagnostic categories for cohorts stratified by age (45–64 and 65 +). Examples of prevalent multimorbidity combinations include lipedema with hypertension or hypertension with diabetes. We applied generalized linear models (GLM) with gamma distribution and log link function to total charges for all cohorts and assessed model accuracy using residual analysis. In addition to 38 major diagnostic categories, our adjusted model incorporated demographic, BMI, hospital, and census division information. Results The mean ages were 55 (45–64 cohort, N = 333,094) and 75 (65 + cohort, N = 327,260), respe...

Research paper thumbnail of Does the transfusion rate following reverse total shoulder arthroplasty warrant aggressive peri-operative blood management? An indications-based analysis

Seminars in Arthroplasty: JSES

Research paper thumbnail of Comparison of Methods for Choosing an Appropriate Number of Topics in an LDA Model

Topic modeling is a technique for reducing dimensionality of large corpuses of text. Latent Diric... more Topic modeling is a technique for reducing dimensionality of large corpuses of text. Latent Dirichlet allocation (LDA), the most prevalent form of topic modeling, improved upon earlier methods by introducing Bayesian iterative updates, providing a sound theoretical basis for modeling by iteration. Yet a piece of the modeling puzzle remains unsolved; the number of topics to model, K, is an as yet unanswered question. This number of topics may also be called the dimensionality of the model. With this is an integrally related puzzle; how to determine when a model has been best fit. Presented here are a brief history of the development of topic modeling from its inception preceding LDA to the present; and a comparison of methods for determining what is a best-fit topic model, in pursuit of the most appropriate K

Research paper thumbnail of Fetal growth restriction phenotypes according to growth trajectory analysis

American Journal of Obstetrics and Gynecology, 2022

Research paper thumbnail of Early pregnancy ultrasound measurements and prediction of first trimester pregnancy loss: A logistic model

Scientific Reports, 2020

Our objective was to prospectively validate the use of gestational sac (GS), yolk sac (YS) diamet... more Our objective was to prospectively validate the use of gestational sac (GS), yolk sac (YS) diameter, crown-rump length (CRL), and embryonal heart rate (HR) dimensions to identify early pregnancy loss. This was a prospective cohort study of first trimester pregnancies. GS and YS diameter, CRL, and HR measurements were serially obtained in singleton and twin pregnancies from 6 through 10 weeks’ gestation. Non-parametric tests and logistic regression models were used for comparisons of distributions and testing of associations. A total of 252 patients were included, of which 199 were singleton pregnancies, 51 were twins, and 2 were triplets (304 total fetuses). Fifty-two patients had 61 losses. We built nomograms with the changes of the parameters evaluated in ongoing, as well as in pregnancy loss. In the pregnancies which failed, all the parameters showed significant changes, with different temporal onsets: GS and YS were the first to become abnormal, deviating from normality as early...

Research paper thumbnail of Conditional loss of Engrailed1/2 in Atoh1 ‐derived excitatory cerebellar nuclear neurons impairs eupneic respiration in mice

Genes, Brain and Behavior

Evidence for a cerebellar role during cardiopulmonary challenges has long been established, but s... more Evidence for a cerebellar role during cardiopulmonary challenges has long been established, but studies of cerebellar involvement in eupneic breathing have been inconclusive. Here we investigated temporal aspects of eupneic respiration in the Atoh1‐En1/2 mouse model of cerebellar neuropathology. Atoh1‐En1/2 conditional knockout mice have conditional loss of the developmental patterning genes Engrailed1 and 2 in excitatory cerebellar nuclear neurons, which leads to loss of a subset of medial and intermediate excitatory cerebellar nuclear neurons. A sample of three Atoh1‐derived extracerebellar nuclei showed no cell loss in the conditional knockout compared to control mice. We measured eupneic respiration in mutant animals and control littermates using whole‐body unrestrained plethysmography and compared the average respiratory rate, coefficient of variation, and the CV2, a measure of intrinsic rhythmicity. Linear regression analyses revealed that Atoh1‐En1/2 conditional knockouts have decreased overall variability (p = 0.021; b = −0.045) and increased intrinsic rhythmicity compared to their control littermates (p < 0.001; b = −0.037), but we found no effect of genotype on average respiratory rate (p = 0.064). Analysis also revealed modestly decreased respiratory rates (p = 0.025; b = −0.82), increased coefficient of variation (p = 0.0036; b = 0.060), and increased CV2 in female animals, independent of genotype (p = 0.024; b = 0.026). These results suggest a cerebellar involvement in eupneic breathing by controlling rhythmicity. We argue that the cerebellar involvement in controlling the CV2 of respiration is indicative of an involvement of coordinating respiration with other orofacial rhythms, such as swallowing.

Research paper thumbnail of MP23-17 Socioeconomic Factors Predict Delay in Prostate Cancer Treatment Decision and Initiation

The Journal of Urology, 2021

INTRODUCTION AND OBJECTIVE:Although prostate cancer is typically a slow-growing malignancy, patho... more INTRODUCTION AND OBJECTIVE:Although prostate cancer is typically a slow-growing malignancy, pathology and risk stratification can progress in as quick as 3 months. Socioeconomic status (SES) and he...

Research paper thumbnail of Breaking off Engagement: Readers' Disengagement as a Function of Reader and Text Characteristics

Engagement during reading can be measured by the amount of time readers invest in the reading pro... more Engagement during reading can be measured by the amount of time readers invest in the reading process. It is hypothesized that disengagement is marked by a decrease in time investment as compared with the demands made on the reader by the text. In this study, self-paced reading times for screens of text were predicted by a text complexity score called formality; formality scores increase with cohesion, informational content/genre, syntactic complexity, and word abstractness as measured by the Coh-Metrix text-analysis program. Cognitive decoupling is defined as the difference between actual reading times and reading times predicted by text formality. Decoupling patterns were found to differ as a function of the serial position of the screens of text and the text genre (i.e., informational, persuasive, and narrative) but surprisingly not as a function of reader characteristics (reading speed and comprehension). This underscores the importance of mining text characteristics in addition...

Research paper thumbnail of Pregnancy Ultrasound Measurements and Early Pregnancy Loss: Validation of a Predictive Model

Fertility and Sterility, 2020

Research paper thumbnail of Relationship Between Standardized Test Scores and Board Certification Exams in a Combined Internal Medicine/Pediatrics Residency Program

Cureus, 2021

Background Combined Internal Medicine/Pediatrics (Med/Peds) residencies rely on categorical progr... more Background Combined Internal Medicine/Pediatrics (Med/Peds) residencies rely on categorical program data to predict pass rates for the American Board of Internal Medicine Certifying Exam (ABIM-CE) and the American Board of Pediatrics Certifying Exam (ABP-CE). There is insufficient literature describing what best predicts a Med/Peds resident passing board exams. In this study, we aimed to determine how standardized test scores predict performance on ABIM-CE and ABP-CE for Med/Peds residents. Methodology We analyzed prior exam scores for 91/96 (95%) residents in a Med/Peds program from 2008 to 2017. Scores from the United States Medical Licensing Examination (USMLE) Steps 1 and 2 Clinical Knowledge (CK) and In-Training Exams in Internal Medicine (ITE-IM) and Pediatrics (ITE-P) were analyzed with the corresponding ABIM-CE and ABP-CE first-time scores. Linear and logistic regression were applied to predict board scores/passage. Results USMLE 1 and 2 CK, ITE-IM, and ITE-P scores had a li...

Research paper thumbnail of Breaking Off Engagement: Readers' Cognitive Decoupling as a Function of Reader and Text Characteristics

Engagement during reading can be measured by the amount of time readers invest in the reading pro... more Engagement during reading can be measured by the amount of time readers invest in the reading process. It is hypothesized that disengagement is marked by a decrease in time investment as compared with the demands made on the reader by the text. In this study, self-paced reading times for screens of text were predicted by a text complexity score called formality; formality scores increase with cohesion, informational content/genre, syntactic complexity, and word abstractness as measured by the Coh-Metrix text-analysis program. Cognitive decoupling is defined as the difference between actual reading times and reading times predicted by text formality. Decoupling patterns were found to differ as a function of the serial position of the screens of text and the text genre (i.e., informational, persuasive, and narrative) but surprisingly not as a function of reader characteristics (reading speed and comprehension). This underscores the importance of mining text characteristics in addition...

Research paper thumbnail of Author Correction: Early pregnancy ultrasound measurements and prediction of first trimester pregnancy loss: A logistic model

Research paper thumbnail of 593: Is maternal magnesium sulfate administration prior to delivery an independent predictor of survival in neonates who weigh fewer than five hundred grams?

American Journal of Obstetrics and Gynecology, 2018

Among women receiving steroids or tocolysis for an episode of TPTL, those delivering at term are ... more Among women receiving steroids or tocolysis for an episode of TPTL, those delivering at term are more likely to have an infant SGA <10% and <5%, compared with those delivering preterm. This effect is as large as the effect of smoking on SGA. An episode of TPTL requiring steroids or tocolysis may represent an insult on the uteroplacental unit that if not delivered may result in subsequent SGA. Characteristics and outcomes of women delivering at term after TPTL, compared with preterm delivery. Women receiving steroids or tocolysis Characteristics/Outcome TPTL Term Delivery N=320 TPTL Preterm Delivery N=389

Research paper thumbnail of Prediction of first trimester miscarriage by ultrasound

Fertility and Sterility

3.0 (95% CI 1.2-7.2) times higher when the change in hCG levels was <5% between day-7 vs. day of ... more 3.0 (95% CI 1.2-7.2) times higher when the change in hCG levels was <5% between day-7 vs. day of MTX, day-7 vs. day-4, and day-4 vs. day of MTX, respectively. Kaplan-Meier plots demonstrated that EP rupture and EP resolution occurred 7-13 days and 20-36 days after MTX treatment. CONCLUSIONS: Patient with ruptured tubal EPs despite MTX present more frequently with vaginal spotting and have <5% change in hCG levels between the day of MTX and day-4 or day-7 after MTX.

Research paper thumbnail of 594: Cesarean section reduces the odds of morbidity and mortality among very low birthweight infants

American Journal of Obstetrics and Gynecology, 2018

exposure. Magnesium sulfate did not appear to protect from severe IVH (OR¼ 0.20; 95% CI 0.01-2.4;... more exposure. Magnesium sulfate did not appear to protect from severe IVH (OR¼ 0.20; 95% CI 0.01-2.4; p¼0.21). CONCLUSION: Maternal magnesium appears to be an independent predictor of survival from 12 hours after birth until discharge among neonates who are born weighing less than 500g. This is the first study that has found a survival benefit in these periviable birth weights.

Research paper thumbnail of Neonatal blood pressure before and after delayed umbilical cord clamping

The Journal of Maternal-Fetal & Neonatal Medicine

Research paper thumbnail of Estimated fetal weight accuracy in pregnancies with preterm prelabor rupture of membranes by the Hadlock method

The Journal of Maternal-Fetal & Neonatal Medicine