Browsing by Author "Gonzales, Gabriel"
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Item Assessing the Reliability of Current AI Platforms in Delivering Health Information Related to Crohn Disease, Ulcerative Colitis, and Colorectal Cancer(2024-03-21) Isa, Salman; Elchehabi, Sahar; Jafri, Faraz; Hoang, Long; Sharma, Mukesh; Hapuarachchi, Menalee; Gonzales, Gabriel; Lewis, Trina; Richardson, Justin; Nguyen, Elizabeth; Hyman, CharlesPurpose In recent years, the advancements in artificial intelligence (AI) have revolutionized the way we seek and access health information. With more people turning towards AI for answers to their problems, it is important to question how safe it is to rely on AI for answers to health-related issues. We explored the accuracy of ChatGPT—a language model developed by OpenAI—and Gemini—Google’s AI platform—in providing health information related to Crohn disease, ulcerative colitis, and colorectal cancer. Methods We generated 10 questions relating to Crohn disease, ulcerative colitis, and colorectal cancer in relation to the social, psychological, economic, and physical aspects that patients with these diseases may face. Each query was remastered for each disease, resulting in 30 total questions which were posed to the two separate AI models. We then regenerated the responses for a total of three times ending up with 90 generated responses per AI model. We also measured the Flesch-Kincaid Readability scores for each response and analyzed the sentiment of the text using natural language processing and computational linguistics. The Centers of Disease Control and Prevention (CDC) recommend that medical information for the public be written at no higher than an eighth-grade reading level. Generated AI responses were evaluated by six gastroenterologist attendings and fellows for accuracy within the context of a patient seeking information. Sets were deemed inappropriate if any of the three responses contained inaccurate or misleading information, based on clinical judgment. Evaluators were blinded to model names and prices. Interrater agreement (94%) and reliability (κ score, 0.87) were ideal. The study was performed in July 2023. Results Of the 60 questions posed to the two different AI language models, 45% (n = 27) of the responses were found to be inaccurate. When the two AI models were compared, 43.33% (n = 13) of ChatGPT’s responses were accurate while 46.7% (n = 14) of Gemini’s responses were deemed accurate. ChatGPT also had a 13.20 average Flesch Kincaid Reading grade level and a 31.06 average Flesch Kincaid Readability score. Gemini’s responses received an average Flesch Kincaid Reading grade level of 8.34 and an average Flesch Kincaid Readability score of 56.92. ChatGPT’s average sentiment score was a 1.23 while Gemini’s average score was a 0.92. Conclusion While OpenAI’s ChatGPT and Google's Gemini platform can serve as valuable resources for information retrieval, they possess certain limitations when it comes to health-related information for Crohn disease, ulcerative colitis, and colorectal cancer. Importantly, both AI models in the study provided inappropriate responses to common patient questions regarding these conditions. Medical professionals should be aware of these limitations as they may lead to the spread of misinformation in populations with limited access to health care.Item Michels Type II Vessel Branching Pattern Variant of the Hepatic Pedicle(2016-03-23) Petree, Tyler; Kannappan, Anju; Gonzales, Gabriel; Vo, Steven; Doan, An; Pumphrey, KatherineMichels type II vessel branching pattern variant of the hepatic pedicle Gabriel Gonzales, Anju Kannappan, An Doan, Steven Vo, Tyler Petree, Katherine Pumphrey, Claire Kirchhoff UNT Health Science Center Introduction: In the branching of the celiac trunk, the left hepatic artery arises from the common hepatic in 89% of cases. However, in 11% of cases the vessel may instead arise from the left gastric artery, an alternate branching pattern known as Michels Type II variation of hepatic arteries. This study looks into the prevalence of this particular variation in a UNT Health Science Center cadaver subset and its correlation with the statistics stated in the most recent literature. Methods: The cadavers in this study (n = 39)were provided through the University of North Texas Health Science Center Willed Body program. For dissection protocol, dissections of the abdominal area included removal of overlying tissues to expose the celiac trunk. Literature review was performed utilizing PubMed. Results: Of the 39 cadavers observed, only 31 were examined due to 8 having undergone complete liver removal. The prevalence of the left hepatic artery branching off of the left gastric artery was 12.9%. The sample frequency of the Michels Type II variation correlated well with the previous findings, where 11% of people exhibited this variation. In addition, one of the cadavers with the variant branching pattern exhibited an additional variation where the cystic artery pierced the common bile duct. This was not observed in the other cadavers. Conclusion: Previous research has revealed a wide range of variations in the branching patterns of the liver vasculature. The Michels classification system was established to serve as a standard nomenclature. The variation of interest, with the left hepatic artery branching from the left gastric artery, is an example of a Michels Class II variant. Similar to prior results, a prevalence of approximately 12.9% was found within the sample of hepatic pedicles evaluated. In addition to this finding, a unique arterial branching pattern where the cystic artery pierces the common bile duct was noted. This finding was present in a single cadaver. Clinically, variants with persistently reported high prevalence such as these should be screened to help prevent serious complications during surgical procedures involving these vessels, such as left gastric artery ligation and liver removal. The persistently reported high prevalence for the Michels type II variant exemplifies the need for such pre-operative screening.Item Rotational Alignment in the Coronal Plane During Tibial Tubercle Osteotomy Background & Significance(2017-03-14) Webb, Brian; Gonzales, GabrielSignificance & Hypothesis: Prior literature has demonstrated the effects of translation of the tibial tubercle during tibial tubercle osteotomy (TTO) procedures in both the sagittal and transverse planes but there has not been much investigation into the effects of adjustment of the rotation alignment of the tibial tubercle in the coronal plane. Since changes in the positioning of the tibial tubercle in all three planes has the opportunity to yield significant physiological changes in range of motion, the results of this study would possibly provide insight on how to optimize this procedure. Specifically, a margin of error determination may be made from the data to guide surgeon fixation of the tubercle post osteotomy. This study is aimed at the effects of variations to the tibial tubercle in the TTO procedure, specifically investigating effects of rotational alignment of the tibial tubercle in the coronal plane. The hypothesis of this study is that coronal plane rotation during TTO must be within 5 degrees of native orientation to prevent poor patellofemoral kinematic effects. Materials & Methods: At least 10 frozen, fresh, prepared specimens would have the musculature of the thigh exposed with specific muscles sutured to accommodate loads of weight specific to each muscle type to achieve standardized range of motion. The specimens would be secured into a knee-rig structure allowing full flexion and extension. Each specimen would be initially range of motion tested and used as control for comparison to the resulting range of motion after the TTO is performed. A tracking system will be utilized, recording patellar range of motion data with 6 degrees of freedom during leg range of motion testing cycles. For each specimen, initial native patellar motion would be documented, and then compared against resultant patellar motion as the degree of tibial tubercle rotational alignment in the coronal plane is incrementally adjusted. Comparison will involve evaluation of the Euler angle changes of the native patella against measurements as the rotational alignment is adjusted. A repeated one-way ANOVA will be used with a post hoc tukey test to find statistical significance. Results: Pathologic rotational motion of the tibia on femur has been noted grossly with alterations of coronal alignment of the tibial tubercle, especially at the end range of extension. Detailed statistical analysis is currently pending on gathered data. Conclusions: Rotational alignment modification of the patellar tendon insertion, the tibial tubercle, causes unilateral unloading and loading of the quadriceps musculature. This change in force vectors results in gross change to lower extremity flexion and extension mechanics. Further data analysis is required to make specific comments on the details of this change.Item Safety and Efficacy of Ledipasvir plus Sofosbuvir with or without ribavirin in hepatitis C genotype 1 patients who failed previous treatment with Simeprevir plus Sofosbuvir(2016-03-23) Modi, Apurva; Gonzales, GabrielCombination therapy with Simeprevir (SIM), NS3/4 protease inhibitor, with Sofosbuvir (SOF), NS5b polymerase inhibitor is an FDA approved treatment option for chronic hepatitis C genotype 1 patients with an over all SVR 12 rate of 85-95%. Single tablet fixed dose combination of Ledipasvir (LDV), NS5a inhibitor, with SOF is also FDA approved for treatment of hepatitis C genotype 1 with SVR 12 rates of ≥ 95%. However, there is no data on the efficacy of retreatment with LDV+SOF in patients who failed initial treatment with SIM+SOF. Methods: Data was collected from treatment cohorts at 2 large hepatology referral centers in Dallas-Fort Worth area. Patients included in the analysis were previously treated with SIM+SOF with or without RBV for 12 weeks but failed to achieve SVR 12 and then undergone re-treatment with LDV+SOF with or without RBV for 12-24 weeks. Patients with cirrhosis, including decompensated Child’s class B or C were included. Decompensation was defined by the presence of fluid overload, hepatic encephalopathy or variceal bleeding. Patients with HCC as the only event that defined decompensation were excluded.. Patients received singlet tablet fixed-dose combination of Ledipasvir 90 mg with Sofosbuvir 400 mg PO +/- wt based ribavirin (RBV) daily for 12-24 weeks at the discretion of the treating hepatologist. Baseline and end of treatment (EOT) laboratory tests & viral load were obtained on all patients. SVR 12 defined as undetectable viral load 12 weeks after EOT was collected on all patients who had reached that time point by Nov 10, 2015. Adverse effects during treatment were obtained on all patients. Data was analyzed using 2 sided t test for continuous variables and chi-quare test for categorical variables. Results: SVR 12 was achieved for 11/13 of all patients and 10/11 for patients who were cirrhotic. 100% (29/29) had achieved EOT response. 10/29 had no side effects on treatments. Of those who had side effects, none were considered severe enough to warrant discontinuation. Conclusions: Ledipasvir + Sofosbuvir is a viable treatment option with high SVR 12 rate in patients who have failed 12 weeks of treatment with SIM + SOF. High SVR 12 rates of 100% (4/4) & 86% (6/7) were achieved in patients with compensated and decompensated cirrhosis respectively •Treatment was generally well tolerated requiring no discontinuations including in those with cirrhosis