@misc{pettine_dont_2025,
	title = {Don't follow your gut when designing a medical {AI} product - ask these questions},
	url = {https://www.linkedin.com/pulse/dont-follow-your-gut-when-designing-medical-ai-product-warren-pettine-pdiqc/?trackingId=P2lAd4rhtSjgQJsbseEoMg%3D%3D},
	journal = {LinkedIn},
	author = {Pettine, Warren},
	month = jan,
	year = {2025},
}

@inproceedings{christenson_ai-enhanced_2024,
	title = {{AI}-{ENHANCED} {EMERGENCY} {SEVERITY} {INDEX} {FOR} {COMPREHENSIVE} {ED} {TRIAGE}},
	url = {https://figshare.com/articles/poster/AI-ENHANCED_EMERGENCY_SEVERITY_INDEX_FOR_COMPREHENSIVE_ED_TRIAGE/27755895/1},
	doi = {10.6084/m9.figshare.27755895.v1},
	abstract = {Background: Emergency Department (ED) triage systems, such as the Emergency Severity Index (ESI), are crucial for patient prioritization but have limitations in predicting outcomes and optimizing resource allocation. AI-enhanced triage systems offer potential improvements in accuracy, efficiency, and patient care.Objectives: To develop an optimized AI-enhanced ESI score using the MIMIC-IV ED dataset, integrating patient history, real-time vital signs, model predictions, and traditional nurse-assigned ESI to create a more comprehensive, dynamic, and accurate triage tool.Methods: We analyzed over 400,000 ED visits from the MIMIC-IV dataset. Using a customized autoML pipeline, we engineered features from triage variables, patient history, and temporal vital sign patterns. Multiple machine learning models, including XGBoost and MLPs, were trained to predict various outcomes. These predictions, along with the nurse-assigned ESI and real-time patient data, were then combined to create an optimized AI ESI score. Performance was evaluated using AUC, calibration metrics, and compared to traditional ESI scoring.Results: Individual models demonstrated high performance in predicting key outcomes: hospitalization (AUC: 0.85), critical outcomes (ICU admission/mortality within 12 hours, AUC: 0.88), and ED reattendance (AUC: 0.75). These models, triage variables, and vital sign patterns were combined into a single AI-enhanced ESI score, which showed stronger correlation with critical outcomes compared to the nurse-assigned ESI. This combined score allowed for more precise patient ranking than the traditional 5-level ESI system, effectively refining the nurse-assigned ESI.Conclusion: This AI-enhanced ESI system demonstrates significant improvements over traditional methods by integrating patient information with model predictions into a single, comprehensive, and dynamic triage score. It has the potential to optimize resource allocation, improve patient flow, and enhance overall patient care in EDs. Future work will focus on prospective validation, seamless integration into clinical workflows, and assessment of its impact on patient outcomes and ED efficiency.},
	language = {en},
	urldate = {2025-01-14},
	author = {Christenson, Matthias P. and Locke, Brian and Koirala, Pranav and Pettine, Warren Woodrich},
	month = nov,
	year = {2024},
	note = {Publisher: figshare},
}

Background: Emergency Department (ED) triage systems, such as the Emergency Severity Index (ESI), are crucial for patient prioritization but have limitations in predicting outcomes and optimizing resource allocation. AI-enhanced triage systems offer potential improvements in accuracy, efficiency, and patient care.Objectives: To develop an optimized AI-enhanced ESI score using the MIMIC-IV ED dataset, integrating patient history, real-time vital signs, model predictions, and traditional nurse-assigned ESI to create a more comprehensive, dynamic, and accurate triage tool.Methods: We analyzed over 400,000 ED visits from the MIMIC-IV dataset. Using a customized autoML pipeline, we engineered features from triage variables, patient history, and temporal vital sign patterns. Multiple machine learning models, including XGBoost and MLPs, were trained to predict various outcomes. These predictions, along with the nurse-assigned ESI and real-time patient data, were then combined to create an optimized AI ESI score. Performance was evaluated using AUC, calibration metrics, and compared to traditional ESI scoring.Results: Individual models demonstrated high performance in predicting key outcomes: hospitalization (AUC: 0.85), critical outcomes (ICU admission/mortality within 12 hours, AUC: 0.88), and ED reattendance (AUC: 0.75). These models, triage variables, and vital sign patterns were combined into a single AI-enhanced ESI score, which showed stronger correlation with critical outcomes compared to the nurse-assigned ESI. This combined score allowed for more precise patient ranking than the traditional 5-level ESI system, effectively refining the nurse-assigned ESI.Conclusion: This AI-enhanced ESI system demonstrates significant improvements over traditional methods by integrating patient information with model predictions into a single, comprehensive, and dynamic triage score. It has the potential to optimize resource allocation, improve patient flow, and enhance overall patient care in EDs. Future work will focus on prospective validation, seamless integration into clinical workflows, and assessment of its impact on patient outcomes and ED efficiency.

@article{locke_role_2024,
	title = {The {Role} of {Obstructive} {Sleep} {Apnea} in {Hypercapnic} {Respiratory} {Failure} {Identified} in {Critical} {Care}, {Inpatient}, and {Outpatient} {Settings}},
	volume = {19},
	issn = {1556-407X, 1556-4088},
	url = {https://www.sleep.theclinics.com/article/S1556-407X(24)00022-5/abstract},
	doi = {10.1016/j.jsmc.2024.02.012},
	language = {English},
	number = {2},
	urldate = {2024-12-13},
	journal = {Sleep Medicine Clinics},
	author = {Locke, Brian W. and Brown, Jeanette P. and Sundar, Krishna M.},
	month = jun,
	year = {2024},
	pmid = {38692757},
	note = {Publisher: Elsevier},
	keywords = {Hypercapnia, Hypercapnic respiratory failure, Hypoventilation, Non-invasive ventilation, Positive airway pressure, Respiratory insufficiency, Sleep apnea},
	pages = {339--356},
}

@inproceedings{locke_diagnostic_2024,
	address = {Cham},
	title = {Diagnostic {Modeling} to {Identify} {Unrecognized} {Inpatient} {Hypercapnia} {Using} {Health} {Record} {Data}},
	isbn = {978-3-031-66538-7},
	doi = {10.1007/978-3-031-66538-7_4},
	abstract = {Hypercapnic respiratory failure (an accumulation of carbon dioxide, CO2, in the blood) is often missed in clinical practice. Arterial blood gas is the standard diagnostic test, but it is painful and not routine. When clinicians fail to make the diagnosis, it is often because an arterial blood gas was not obtained. This ‘partial verification’ of CO2 levels presents a challenge for machine learning algorithms. We assessed the accuracy of two machine learning methods using demographics and routine lab work to estimate the likelihood that a patient has hypercapnic respiratory failure at hospital admission. Hospitalized patients who received an arterial blood gas sample constituted the training (n = 111,015) and geographic validation (n = 20,834) sets. Acceptance of “silver standard” diagnostic criteria and weighting observations by their modeled likelihood of receiving arterial blood gas sampling were used to assess the stability of findings in the presence of partial verification. Both regularized logistic regression and random-forest-based models resulted in acceptable performance (area under the curve: 0.763 and 0.758 respectively), with minimal changes in the auxiliary analyses. This work suggests that routinely available health record data can stratify the likelihood of hypercapnic respiratory failure among hospitalized adults, and findings may generalize to patients who have not received arterial blood gas sampling in clinical practice.},
	language = {en},
	booktitle = {Artificial {Intelligence} in {Medicine}},
	publisher = {Springer Nature Switzerland},
	author = {Locke, Brian W. and Richards, W. Wayne and Brown, Jeanette P. and Cui, Wanting and Finkelstein, Joseph and Sundar, Krishna M. and Gouripeddi, Ramkiran},
	editor = {Finkelstein, Joseph and Moskovitch, Robert and Parimbelli, Enea},
	year = {2024},
	pages = {36--45},
}

Hypercapnic respiratory failure (an accumulation of carbon dioxide, CO2, in the blood) is often missed in clinical practice. Arterial blood gas is the standard diagnostic test, but it is painful and not routine. When clinicians fail to make the diagnosis, it is often because an arterial blood gas was not obtained. This ‘partial verification’ of CO2 levels presents a challenge for machine learning algorithms. We assessed the accuracy of two machine learning methods using demographics and routine lab work to estimate the likelihood that a patient has hypercapnic respiratory failure at hospital admission. Hospitalized patients who received an arterial blood gas sample constituted the training (n = 111,015) and geographic validation (n = 20,834) sets. Acceptance of “silver standard” diagnostic criteria and weighting observations by their modeled likelihood of receiving arterial blood gas sampling were used to assess the stability of findings in the presence of partial verification. Both regularized logistic regression and random-forest-based models resulted in acceptable performance (area under the curve: 0.763 and 0.758 respectively), with minimal changes in the auxiliary analyses. This work suggests that routinely available health record data can stratify the likelihood of hypercapnic respiratory failure among hospitalized adults, and findings may generalize to patients who have not received arterial blood gas sampling in clinical practice.

@article{anderson-bell_hypercapnic_2024,
	title = {{HYPERCAPNIC} {RESPIRATORY} {FAILURE} {IS} {INFREQUENTLY} {REPORTED} {AS} {AN} {ADVERSE} {EVENT} {IN} {CLINICAL} {TRIALS}},
	volume = {166},
	issn = {0012-3692},
	url = {https://journal.chestnet.org/article/S0012-3692(24)04179-5/abstract},
	doi = {10.1016/j.chest.2024.06.3377},
	abstract = {SESSION TITLE: Pulmonary Physiology Abstracts Posters},
	language = {English},
	number = {4},
	urldate = {2024-12-13},
	journal = {CHEST},
	author = {Anderson-Bell, Dustin and Locke, Brian W.},
	month = oct,
	year = {2024},
	note = {Publisher: Elsevier},
	pages = {A5688},
}

SESSION TITLE: Pulmonary Physiology Abstracts Posters

@article{locke_low_2024,
	title = {A {LOW} {RESEARCH}-{BURDEN} {STUDY} {TO} {ASSESS} {FEASIBILITY} {AND} {INTEREST} {IN} {IMMERSIVE} {VIRTUAL} {REALITY} {IN} {THE} {INTENSIVE} {CARE} {UNIT}},
	volume = {166},
	url = {https://journal.chestnet.org/article/S0012-3692(24)00951-6/abstract},
	number = {4},
	urldate = {2024-12-13},
	journal = {CHEST},
	author = {LOCKE, BRIAN W. and RIVERA, CHRISTIAN REATEGUI and TSAI, TE-YI and GABRIEL, AILEEN and FINKELSTEIN, JOSEPH},
	year = {2024},
	note = {Publisher: Elsevier},
	pages = {A155--A156},
}

@article{aberegg_hickams_2024,
	title = {Hickam’s {Dictum}: {An} {Analysis} of {Multiple} {Diagnoses}},
	issn = {1525-1497},
	shorttitle = {Hickam’s {Dictum}},
	url = {https://doi.org/10.1007/s11606-024-09120-y},
	doi = {10.1007/s11606-024-09120-y},
	abstract = {Hickam’s dictum (“a patient can have as many diseases as he damn well pleases”) has been touted as a counterargument to Ockham’s razor, which enjoins clinicians to seek a single, simple, or unifying diagnosis. Yet the phenomenon of multiple diagnoses has not been formally analyzed.},
	language = {en},
	urldate = {2024-12-13},
	journal = {Journal of General Internal Medicine},
	author = {Aberegg, Scott K. and Poole, Brian R. and Locke, Brian W.},
	month = oct,
	year = {2024},
	keywords = {Ockham’s razor, Reichenbach’s common cause principle, causation, chief complaint, coincidence, incidence, incidentaloma, prevalence, probability, unifying diagnosis},
}

Hickam’s dictum (“a patient can have as many diseases as he damn well pleases”) has been touted as a counterargument to Ockham’s razor, which enjoins clinicians to seek a single, simple, or unifying diagnosis. Yet the phenomenon of multiple diagnoses has not been formally analyzed.

@inproceedings{locke_determinants_2024,
	title = {Determinants of the {Performance} of {Serum} {Bicarbonate} for {Identification} of {Hypercapnia} {From} {Health} {Record} {Data}},
	url = {https://www.atsjournals.org/doi/10.1164/ajrccm-conference.2024.209.1_MeetingAbstracts.A4916},
	doi = {10.1164/ajrccm-conference.2024.209.1_MeetingAbstracts.A4916},
	language = {en},
	urldate = {2024-12-13},
	booktitle = {B108. {BREATHE} {EASY}: {NAVIGATING} {THE} {WORLD} {OF} {VENTILATORY} {DISORDERS}},
	publisher = {American Thoracic Society},
	author = {Locke, B.W. and Richards, W. and Brown, J.P. and Gouripeddi, R. and Sundar, K.M.},
	month = may,
	year = {2024},
	pages = {A4916--A4916},
}

@article{locke_immersive_2024,
	title = {Immersive {Virtual} {Reality} {Use} in {Medical} {Intensive} {Care}: {Mixed} {Methods} {Feasibility} {Study}},
	volume = {12},
	copyright = {This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on https://games.jmir.org/, as well as this copyright and license information must be included.},
	shorttitle = {Immersive {Virtual} {Reality} {Use} in {Medical} {Intensive} {Care}},
	url = {https://games.jmir.org/2024/1/e62842},
	doi = {10.2196/62842},
	abstract = {Background: Immersive virtual reality (VR) is a promising therapy to improve the experience of patients with critical illness and may help avoid postdischarge functional impairments. However, the determinants of interest and usability may vary locally and reports of uptake in the literature are variable.
Objective: The aim of this mixed methods feasibility study was to assess the acceptability and potential utility of immersive VR in critically ill patients at a single institution.
Methods: Adults without delirium who were admitted to 1 of 2 intensive care units were offered the opportunity to participate in 5-15 minutes of immersive VR delivered by a VR headset. Patient vital signs, heart rate variability, mood, and pain were assessed before and after the VR experience. Pre-post comparisons were performed using paired 2-sided t tests. A semistructured interview was administered after the VR experience. Patient descriptions of the experience, issues, and potential uses were summarized with thematic analysis.
Results: Of the 35 patients offered the chance to participate, 20 (57\%) agreed to partake in the immersive VR experience, with no difference in participation rate by age. Improvements were observed in overall mood (mean difference 1.8 points, 95\% CI 0.6-3.0; P=.002), anxiety (difference of 1.7 points, 95\% CI 0.8-2.7; P=.001), and pain (difference of 1.3 points, 95\% CI 0.5-2.1; P=.003) assessed on 1-10 scales. The heart rate changed by a mean of –1.1 (95\% CI –0.3 to –1.9; P=.008) beats per minute (bpm) from a baseline of 86.1 (SD 11.8) bpm and heart rate variability, assessed by the stress index (SI), changed by a mean of –5.0 (95\% CI –1.5 to –8.5; P=.004) seconds–2 from a baseline SI of 40.0 (SD 23) seconds–2. Patients commented on the potential for the therapy to address pain, lessen anxiety, and facilitate calmness. Technical challenges were minimal and there were no adverse effects observed.
Conclusions: Patient acceptance of immersive VR was high in a mostly medical intensive care population with little prior VR experience. Patients commented on the potential of immersive VR to ameliorate cognitive and emotional symptoms. Investigators can consider integrating minimally modified commercial VR headsets into the existing intensive care unit workflow to further assess VR’s efficacy for a variety of endpoints.},
	language = {EN},
	number = {1},
	urldate = {2024-12-13},
	journal = {JMIR Serious Games},
	author = {Locke, Brian W. and Tsai, Te-yi and Reategui-Rivera, C. Mahony and Gabriel, Aileen S. and Smiley, Aref and Finkelstein, Joseph},
	month = aug,
	year = {2024},
	note = {Company: JMIR Serious Games
Distributor: JMIR Serious Games
Institution: JMIR Serious Games
Label: JMIR Serious Games
Publisher: JMIR Publications Inc., Toronto, Canada},
	pages = {e62842},
}

Background: Immersive virtual reality (VR) is a promising therapy to improve the experience of patients with critical illness and may help avoid postdischarge functional impairments. However, the determinants of interest and usability may vary locally and reports of uptake in the literature are variable. Objective: The aim of this mixed methods feasibility study was to assess the acceptability and potential utility of immersive VR in critically ill patients at a single institution. Methods: Adults without delirium who were admitted to 1 of 2 intensive care units were offered the opportunity to participate in 5-15 minutes of immersive VR delivered by a VR headset. Patient vital signs, heart rate variability, mood, and pain were assessed before and after the VR experience. Pre-post comparisons were performed using paired 2-sided t tests. A semistructured interview was administered after the VR experience. Patient descriptions of the experience, issues, and potential uses were summarized with thematic analysis. Results: Of the 35 patients offered the chance to participate, 20 (57%) agreed to partake in the immersive VR experience, with no difference in participation rate by age. Improvements were observed in overall mood (mean difference 1.8 points, 95% CI 0.6-3.0; P=.002), anxiety (difference of 1.7 points, 95% CI 0.8-2.7; P=.001), and pain (difference of 1.3 points, 95% CI 0.5-2.1; P=.003) assessed on 1-10 scales. The heart rate changed by a mean of –1.1 (95% CI –0.3 to –1.9; P=.008) beats per minute (bpm) from a baseline of 86.1 (SD 11.8) bpm and heart rate variability, assessed by the stress index (SI), changed by a mean of –5.0 (95% CI –1.5 to –8.5; P=.004) seconds–2 from a baseline SI of 40.0 (SD 23) seconds–2. Patients commented on the potential for the therapy to address pain, lessen anxiety, and facilitate calmness. Technical challenges were minimal and there were no adverse effects observed. Conclusions: Patient acceptance of immersive VR was high in a mostly medical intensive care population with little prior VR experience. Patients commented on the potential of immersive VR to ameliorate cognitive and emotional symptoms. Investigators can consider integrating minimally modified commercial VR headsets into the existing intensive care unit workflow to further assess VR’s efficacy for a variety of endpoints.

@article{locke_association_2024,
	title = {The association of weight loss from anti‐obesity medications or bariatric surgery and apnea‐hypopnea index in obstructive sleep apnea},
	volume = {25},
	issn = {1467-7881, 1467-789X},
	url = {https://onlinelibrary.wiley.com/doi/10.1111/obr.13697},
	doi = {10.1111/obr.13697},
	abstract = {Summary
            
              Introduction
              Weight loss is recommended for individuals with obstructive sleep apnea (OSA) and overweight or obesity, but there is limited evidence to guide the selection of weight management strategies for patients who do not lose sufficient weight with diet and lifestyle changes. We evaluated the relationship between weight loss caused by pharmacologic or surgical interventions and subsequent improvement in OSA by the apnea‐hypopnea index (AHI).
            
            
              Methods
              PubMed, Cochrane CENTRAL, and EMBASE were searched for randomized trials comparing pharmacologic or surgical obesity interventions to usual care, placebo, or no treatment in adults with OSA. The association between percentage weight loss and AHI change between randomization and last follow‐up was evaluated using meta‐regression. PROSPERO: CRD42022378853.
            
            
              Results
              
                Ten eligible trials (
                n
                 = 854 patients) were included. Four (
                n
                 = 211) assessed bariatric surgery, and 6 (
                n
                 = 643) assessed pharmacologic interventions over a median follow‐up of 13 months (interquartile range 6–26 months). The linear best estimate of the change in AHI is 0.45 events per hour (95\% Confidence Interval 0.18 to 0.73 events per hour) for every 1\% body weight lost.
              
            
            
              Conclusions
              Weight loss caused by medication or surgery caused a proportionate improvement of the AHI. Providers could consider extrapolating from this relationship when advising patients of the expected effects of other pharmacologic or surgical interventions without direct evidence in OSA.},
	language = {en},
	number = {4},
	urldate = {2024-12-13},
	journal = {Obesity Reviews},
	author = {Locke, Brian W. and Gomez‐Lumbreras, Ainhoa and Tan, Chia Jie and Nonthasawadsri, Teerawat and Veettil, Sajesh K. and Patikorn, Chanthawat and Chaiyakunapruk, Nathorn},
	month = apr,
	year = {2024},
	pages = {e13697},
}

Summary Introduction Weight loss is recommended for individuals with obstructive sleep apnea (OSA) and overweight or obesity, but there is limited evidence to guide the selection of weight management strategies for patients who do not lose sufficient weight with diet and lifestyle changes. We evaluated the relationship between weight loss caused by pharmacologic or surgical interventions and subsequent improvement in OSA by the apnea‐hypopnea index (AHI). Methods PubMed, Cochrane CENTRAL, and EMBASE were searched for randomized trials comparing pharmacologic or surgical obesity interventions to usual care, placebo, or no treatment in adults with OSA. The association between percentage weight loss and AHI change between randomization and last follow‐up was evaluated using meta‐regression. PROSPERO: CRD42022378853. Results Ten eligible trials ( n  = 854 patients) were included. Four ( n  = 211) assessed bariatric surgery, and 6 ( n  = 643) assessed pharmacologic interventions over a median follow‐up of 13 months (interquartile range 6–26 months). The linear best estimate of the change in AHI is 0.45 events per hour (95% Confidence Interval 0.18 to 0.73 events per hour) for every 1% body weight lost. Conclusions Weight loss caused by medication or surgery caused a proportionate improvement of the AHI. Providers could consider extrapolating from this relationship when advising patients of the expected effects of other pharmacologic or surgical interventions without direct evidence in OSA.

@misc{pettine_need_2024,
	title = {The need for data harmonization, multimodal integration and multi-objective loss functions to identify longitudinal changes in aging},
	url = {https://preprints.jmir.org/preprint/68679},
	abstract = {Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet},
	language = {en},
	urldate = {2024-12-04},
	author = {Pettine, Warren and Christenson, Matthias},
	month = dec,
	year = {2024},
}

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

@article{christenson_hue_2024,
	title = {Hue selectivity from recurrent circuitry in {Drosophila}},
	volume = {27},
	copyright = {2024 The Author(s)},
	issn = {1546-1726},
	url = {https://www.nature.com/articles/s41593-024-01640-4},
	doi = {10.1038/s41593-024-01640-4},
	abstract = {In the perception of color, wavelengths of light reflected off objects are transformed into the derived quantities of brightness, saturation and hue. Neurons responding selectively to hue have been reported in primate cortex, but it is unknown how their narrow tuning in color space is produced by upstream circuit mechanisms. We report the discovery of neurons in the Drosophila optic lobe with hue-selective properties, which enables circuit-level analysis of color processing. From our analysis of an electron microscopy volume of a whole Drosophila brain, we construct a connectomics-constrained circuit model that accounts for this hue selectivity. Our model predicts that recurrent connections in the circuit are critical for generating hue selectivity. Experiments using genetic manipulations to perturb recurrence in adult flies confirm this prediction. Our findings reveal a circuit basis for hue selectivity in color vision.},
	language = {en},
	number = {6},
	urldate = {2024-12-11},
	journal = {Nature Neuroscience},
	author = {Christenson, Matthias P. and Sanz Diez, Alvaro and Heath, Sarah L. and Saavedra-Weisenhaus, Maia and Adachi, Atsuko and Nern, Aljoscha and Abbott, L. F. and Behnia, Rudy},
	month = jun,
	year = {2024},
	note = {Publisher: Nature Publishing Group},
	keywords = {Neural circuits, Sensory processing},
	pages = {1137--1147},
}

In the perception of color, wavelengths of light reflected off objects are transformed into the derived quantities of brightness, saturation and hue. Neurons responding selectively to hue have been reported in primate cortex, but it is unknown how their narrow tuning in color space is produced by upstream circuit mechanisms. We report the discovery of neurons in the Drosophila optic lobe with hue-selective properties, which enables circuit-level analysis of color processing. From our analysis of an electron microscopy volume of a whole Drosophila brain, we construct a connectomics-constrained circuit model that accounts for this hue selectivity. Our model predicts that recurrent connections in the circuit are critical for generating hue selectivity. Experiments using genetic manipulations to perturb recurrence in adult flies confirm this prediction. Our findings reveal a circuit basis for hue selectivity in color vision.

@misc{christenson_assessing_2024,
	title = {Assessing {Foundation} {Models}' {Transferability} to {Physiological} {Signals} in {Precision} {Medicine}},
	url = {http://arxiv.org/abs/2412.03427},
	doi = {10.48550/arXiv.2412.03427},
	abstract = {The success of precision medicine requires computational models that can effectively process and interpret diverse physiological signals across heterogeneous patient populations. While foundation models have demonstrated remarkable transfer capabilities across various domains, their effectiveness in handling individual-specific physiological signals - crucial for precision medicine - remains largely unexplored. This work introduces a systematic pipeline for rapidly and efficiently evaluating foundation models' transfer capabilities in medical contexts. Our pipeline employs a three-stage approach. First, it leverages physiological simulation software to generate diverse, clinically relevant scenarios, particularly focusing on data-scarce medical conditions. This simulation-based approach enables both targeted capability assessment and subsequent model fine-tuning. Second, the pipeline projects these simulated signals through the foundation model to obtain embeddings, which are then evaluated using linear methods. This evaluation quantifies the model's ability to capture three critical aspects: physiological feature independence, temporal dynamics preservation, and medical scenario differentiation. Finally, the pipeline validates these representations through specific downstream medical tasks. Initial testing of our pipeline on the Moirai time series foundation model revealed significant limitations in physiological signal processing, including feature entanglement, temporal dynamics distortion, and reduced scenario discrimination. These findings suggest that current foundation models may require substantial architectural modifications or targeted fine-tuning before deployment in clinical settings.},
	urldate = {2024-12-09},
	publisher = {arXiv},
	author = {Christenson, Matthias and Geary, Cove and Locke, Brian and Koirala, Pranav and Pettine, Warren Woodrich},
	month = dec,
	year = {2024},
	note = {arXiv:2412.03427},
	keywords = {Computer Science - Machine Learning},
}

The success of precision medicine requires computational models that can effectively process and interpret diverse physiological signals across heterogeneous patient populations. While foundation models have demonstrated remarkable transfer capabilities across various domains, their effectiveness in handling individual-specific physiological signals - crucial for precision medicine - remains largely unexplored. This work introduces a systematic pipeline for rapidly and efficiently evaluating foundation models' transfer capabilities in medical contexts. Our pipeline employs a three-stage approach. First, it leverages physiological simulation software to generate diverse, clinically relevant scenarios, particularly focusing on data-scarce medical conditions. This simulation-based approach enables both targeted capability assessment and subsequent model fine-tuning. Second, the pipeline projects these simulated signals through the foundation model to obtain embeddings, which are then evaluated using linear methods. This evaluation quantifies the model's ability to capture three critical aspects: physiological feature independence, temporal dynamics preservation, and medical scenario differentiation. Finally, the pipeline validates these representations through specific downstream medical tasks. Initial testing of our pipeline on the Moirai time series foundation model revealed significant limitations in physiological signal processing, including feature entanglement, temporal dynamics distortion, and reduced scenario discrimination. These findings suggest that current foundation models may require substantial architectural modifications or targeted fine-tuning before deployment in clinical settings.

@techreport{pettine_attention_2024,
	title = {Attention and learning strategies reveal distinct profiles of psychiatric traits},
	url = {https://osf.io/preprints/psyarxiv/52mkw},
	language = {en-us},
	institution = {PsyArXiv},
	author = {Pettine, Warren Woodrich and Tseng, Angela and Yang, Amy and Docherty, Anna R. and Redish, A. David and Murray, John D. and Jacob, Suma},
	year = {2024},
	keywords = {Cognitive Psychology, Concepts and Categories, Learning, Social and Behavioral Sciences, category learning, computational model, reinforcement learning},
}

@article{pettine_tool_2024,
	title = {A tool for longitudinal assessment of individual differences in judgment calibration during category learning},
	url = {https://osf.io/n32gy},
	doi = {10.31234/osf.io/n32gy},
	abstract = {Accurately judging the quality of one’s estimates is a critical psychological process that varies across individuals, fluctuates over time, and is highly domain specific. While there are many methods for assessing judgment calibration during basic sensory tasks and tests of general knowledge, the field lacks a rigorous, controlled tool for assessing this form of metacognitive monitoring during category learning or goal-directed attention. This is especially important given the applicability of category learning and goal-directed attention to both high-level functioning and psychiatric disease. We therefore developed and tested a tool that pairs an established category learning paradigm with a standard metacognitive report, and validated the tool through longitudinal testing. A total of 80 adult subjects completed three sequential sessions online and answered a set of personality and psychiatric trait questionnaires. Test-retest results suggested that our tool provides fair reliability in assessing judgment calibration. We found aloofness and introversion are associated with improved metacognitive resolution. Furthermore, the best calibrated subjects were more likely to report narrowing their attention to a subset of goal-directed stimulus features. Our results suggested specific ways to improve the tools retest stability, while validating its use for longitudinal assessment of individual differences in judgment calibration during category learning.},
	language = {en-us},
	urldate = {2024-01-02},
	author = {Pettine, Warren Woodrich and Winters, Drew E. and Murray, John D. and Anticevic, Alan and Jacob, Suma},
	month = jan,
	year = {2024},
	note = {Publisher: OSF},
}

Accurately judging the quality of one’s estimates is a critical psychological process that varies across individuals, fluctuates over time, and is highly domain specific. While there are many methods for assessing judgment calibration during basic sensory tasks and tests of general knowledge, the field lacks a rigorous, controlled tool for assessing this form of metacognitive monitoring during category learning or goal-directed attention. This is especially important given the applicability of category learning and goal-directed attention to both high-level functioning and psychiatric disease. We therefore developed and tested a tool that pairs an established category learning paradigm with a standard metacognitive report, and validated the tool through longitudinal testing. A total of 80 adult subjects completed three sequential sessions online and answered a set of personality and psychiatric trait questionnaires. Test-retest results suggested that our tool provides fair reliability in assessing judgment calibration. We found aloofness and introversion are associated with improved metacognitive resolution. Furthermore, the best calibrated subjects were more likely to report narrowing their attention to a subset of goal-directed stimulus features. Our results suggested specific ways to improve the tools retest stability, while validating its use for longitudinal assessment of individual differences in judgment calibration during category learning.

@article{locke_uncomfortable_2023,
	title = {Uncomfortable {Truths} {About} {Data}, {Justice}, and {Idiopathic} {Pulmonary} {Fibrosis} in the {Veterans} {Health} {Administration}},
	volume = {164},
	issn = {0012-3692},
	url = {https://journal.chestnet.org/article/S0012-3692(23)00465-8/abstract},
	doi = {10.1016/j.chest.2023.03.037},
	abstract = {The 2014 approvals of pirfenidone and nintedanib for use in idiopathic pulmonary fibrosis
(IPF) by the US Food and Drug Administration were notable in the acceptance of an
unproven surrogate end point: decrease in the rate of FVC decline. They offered the
following rationale1: (1) IPF carries a dire prognosis, with a current mean survival
of 4 years2 and no disease-modifying treatments; (2) the preferred clinical efficacy
end point (death) would require a prohibitively large, slow, and expensive trial;
and (3) both the natural disease course and cumulative trial data suggest that reduced
spirometric decline ultimately would translate to improvements in mortality rates
and other patient-important end points.},
	language = {English},
	number = {2},
	urldate = {2024-12-13},
	journal = {CHEST},
	author = {Locke, Brian W. and Callahan, Sean J.},
	month = aug,
	year = {2023},
	pmid = {37558321},
	note = {Publisher: Elsevier},
	pages = {280--282},
}

The 2014 approvals of pirfenidone and nintedanib for use in idiopathic pulmonary fibrosis (IPF) by the US Food and Drug Administration were notable in the acceptance of an unproven surrogate end point: decrease in the rate of FVC decline. They offered the following rationale1: (1) IPF carries a dire prognosis, with a current mean survival of 4 years2 and no disease-modifying treatments; (2) the preferred clinical efficacy end point (death) would require a prohibitively large, slow, and expensive trial; and (3) both the natural disease course and cumulative trial data suggest that reduced spirometric decline ultimately would translate to improvements in mortality rates and other patient-important end points.

@article{locke_pulmonary_2023,
	title = {{PULMONARY} {ARTERY} {SIZE} {ON} {CT} {AND} {MORTALITY} {RISK}: {A} {DOSE}-{RESPONSE} {ANALYSIS}},
	volume = {164},
	issn = {0012-3692},
	shorttitle = {{PULMONARY} {ARTERY} {SIZE} {ON} {CT} {AND} {MORTALITY} {RISK}},
	url = {https://journal.chestnet.org/article/S0012-3692(23)04909-7/abstract},
	doi = {10.1016/j.chest.2023.07.3871},
	abstract = {SESSION TITLE: Pulmonary Vascular Disease Posters 5},
	language = {English},
	number = {4},
	urldate = {2024-12-13},
	journal = {CHEST},
	author = {Locke, Brian W. and Scarpato, Brittany and Bledsoe, Joseph and Knox, Daniel and Conner, Karen and Stoddard, Gregory and Cirulis, Meghan M. and Elliott, C. Gre and Dodson, Mark W.},
	month = oct,
	year = {2023},
	note = {Publisher: Elsevier},
	pages = {A6004--A6005},
}

SESSION TITLE: Pulmonary Vascular Disease Posters 5

@article{fenger_just_2023,
	title = {{JUST} {KEEP} {TRYING}: {PRIOR} {ATTEMPTS} {AT} {WEANING} {DO} {NOT} {DETERMINE} {EVENTUAL} {LIBERATION} {FROM} {TRACHESOTOMY} {AND} {MECHANICAL} {VENTILATION} {IN} {HIGH}-{LEVEL} {SPINAL} {CORD} {PATIENTS}},
	volume = {164},
	issn = {0012-3692},
	shorttitle = {{JUST} {KEEP} {TRYING}},
	url = {https://journal.chestnet.org/article/S0012-3692(23)05014-6/abstract},
	doi = {10.1016/j.chest.2023.07.3976},
	abstract = {SESSION TITLE: Respiratory Care Posters},
	language = {English},
	number = {4},
	urldate = {2024-12-13},
	journal = {CHEST},
	author = {Fenger, Casey and Barker, James and Creveling, Polly and Tang, William and Flis, Alexandra and Park, Kevin and Rosenbluth, Jeffrey and Locke, Brian W. and Brown, Jeanette P.},
	month = oct,
	year = {2023},
	note = {Publisher: Elsevier},
	pages = {A6180--A6181},
}

SESSION TITLE: Respiratory Care Posters

@article{locke_what_2023,
	title = {What {Are} {We} {Aiming} for in {Chronic} {Hypercapnic} {Respiratory} {Failure}?},
	volume = {68},
	copyright = {Copyright © 2023 by Daedalus Enterprises},
	issn = {0020-1324, 1943-3654},
	url = {https://rc.rcjournal.com/content/68/12/1775},
	doi = {10.4187/respcare.11573},
	abstract = {The wisdom of organizing illness into clinical syndromes—sepsis, ARDS, and the like—has been debated for at least 50 years, perhaps longer.1,2 The utility comes from a syndrome’s ability to facilitate the recognition or understanding of an important common element among the people who receive the label.3 The “lumpers,” being in favor of syndromes as a paradigm, note the promise of more reliable clinical recognition, efficient enrollment into studies, and optimization of care processes. The “splitters,” taking the opposite position, emphasize the peril of grouping patients with different pathophysiology, different natural histories of disease, and differing responses to treatment. If the average outcome poorly represents how individuals will respond, both individual care and the efficiency of trials suffer.

Hypercapnic respiratory failure is the syndrome that occurs when alveolar ventilation is insufficient to match metabolic demand. Is the “syndrome paradigm” the right way for us to improve how we treat these patients? Or would efforts be better spent focusing on individual diseases? Comparison to where other syndrome-based research has excelled or struggled might provide guidance.

The heterogeneity of patients labeled as having ARDS or sepsis is one proposal for why few trials studying therapies for those conditions have shown replicable benefits.4 A diverse range of pathologies can lead to hypercapnia. Permutations of physiologic derangements limiting the maximal sustainable ventilation (unfavorable respiratory system loads, muscle weakness, mechanical disadvantage, unstable ventilatory control) and those leading to a large ventilation requirement (ventilatory inefficiency, elevated metabolic rate) contribute to hypercapnia in differing degrees in different diseases.5 Will most patients with hypercapnic respiratory failure respond similarly to a proposed management strategy? The demonstrated benefit of noninvasive ventilation (NIV) in COPD is contingent on selecting only specific patients (that remain hypercapnic after 2–4 weeks of stability) and applying a specific strategy (high … 

Correspondence: Brian W Locke MD. E-mail: brian.locke\{at\}hsc.utah.edu},
	language = {en},
	number = {12},
	urldate = {2024-12-13},
	journal = {Respiratory Care},
	author = {Locke, Brian W. and Brown, Jeanette},
	month = dec,
	year = {2023},
	pmid = {38007234},
	note = {Publisher: Respiratory Care
Section: Editorial},
	pages = {1775--1778},
}

The wisdom of organizing illness into clinical syndromes—sepsis, ARDS, and the like—has been debated for at least 50 years, perhaps longer.1,2 The utility comes from a syndrome’s ability to facilitate the recognition or understanding of an important common element among the people who receive the label.3 The “lumpers,” being in favor of syndromes as a paradigm, note the promise of more reliable clinical recognition, efficient enrollment into studies, and optimization of care processes. The “splitters,” taking the opposite position, emphasize the peril of grouping patients with different pathophysiology, different natural histories of disease, and differing responses to treatment. If the average outcome poorly represents how individuals will respond, both individual care and the efficiency of trials suffer. Hypercapnic respiratory failure is the syndrome that occurs when alveolar ventilation is insufficient to match metabolic demand. Is the “syndrome paradigm” the right way for us to improve how we treat these patients? Or would efforts be better spent focusing on individual diseases? Comparison to where other syndrome-based research has excelled or struggled might provide guidance. The heterogeneity of patients labeled as having ARDS or sepsis is one proposal for why few trials studying therapies for those conditions have shown replicable benefits.4 A diverse range of pathologies can lead to hypercapnia. Permutations of physiologic derangements limiting the maximal sustainable ventilation (unfavorable respiratory system loads, muscle weakness, mechanical disadvantage, unstable ventilatory control) and those leading to a large ventilation requirement (ventilatory inefficiency, elevated metabolic rate) contribute to hypercapnia in differing degrees in different diseases.5 Will most patients with hypercapnic respiratory failure respond similarly to a proposed management strategy? The demonstrated benefit of noninvasive ventilation (NIV) in COPD is contingent on selecting only specific patients (that remain hypercapnic after 2–4 weeks of stability) and applying a specific strategy (high … Correspondence: Brian W Locke MD. E-mail: brian.locke\at\hsc.utah.edu

@inproceedings{locke_test_2023,
	title = {Test {Performance} of {Serum} {Bicarbonate} in {Identifying} {Hypercapnia} {Across} {Settings} and {Diseases}},
	url = {https://www.atsjournals.org/doi/10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A6495},
	doi = {10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A6495},
	language = {en},
	urldate = {2024-12-13},
	booktitle = {D30. {INTEGRATING} {OSA} {AND} {COMORBIDITIES} {FOR} {EFFECTIVE} {THERAPIES}},
	publisher = {American Thoracic Society},
	author = {Locke, B.W. and Gouripeddi, R. and Richards, W. and Brown, J.P. and Sundar, K.M.},
	month = may,
	year = {2023},
	pages = {A6495--A6495},
}

@inproceedings{taylor_trajectory_2023,
	title = {Trajectory of {Bicarbonate} {With} {CPAP} {Usage} {Across} the {Spectrum} of {Obesity} {Related} {Hypoventilation}},
	url = {https://www.atsjournals.org/doi/10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A1424},
	doi = {10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A1424},
	language = {en},
	urldate = {2024-12-13},
	booktitle = {A36. {SLEEP}-{RELATED} {HEALTH} {SERVICES} {RESEARCH}},
	publisher = {American Thoracic Society},
	author = {Taylor, A. and Locke, B.W. and Howe, H. and Workman, K. and Sundar, K.M.},
	month = may,
	year = {2023},
	pages = {A1424--A1424},
}

@article{locke_predictors_2023,
	title = {Predictors of {Initial} {CPAP} {Prescription} and {Subsequent} {Course} with {CPAP} in {Patients} with {Central} {Sleep} {Apneas} at a {Single} {Center}},
	volume = {201},
	issn = {1432-1750},
	url = {https://doi.org/10.1007/s00408-023-00657-z},
	doi = {10.1007/s00408-023-00657-z},
	abstract = {Guidelines recommend considering an initial trial of continuous positive airway pressure (CPAP) to treat central sleep apnea (CSA). However, practice patterns vary widely. This study investigated predictors for an initial trial of CPAP in patients with central apneas and whether those factors predict adequate treatment response in patients receiving an initial CPAP trial.},
	language = {en},
	number = {6},
	urldate = {2024-12-13},
	journal = {Lung},
	author = {Locke, Brian W. and Sellman, Jeffrey and McFarland, Jonathan and Uribe, Francisco and Workman, Kimberly and Sundar, Krishna M.},
	month = dec,
	year = {2023},
	keywords = {Clinical decision-making, Continuous positive airway pressure, Sleep apnea syndromes, Sleep apnea, central},
	pages = {625--634},
}

Guidelines recommend considering an initial trial of continuous positive airway pressure (CPAP) to treat central sleep apnea (CSA). However, practice patterns vary widely. This study investigated predictors for an initial trial of CPAP in patients with central apneas and whether those factors predict adequate treatment response in patients receiving an initial CPAP trial.

@article{scarpato_association_2023,
	title = {The association between pulmonary artery enlargement and mortality in an {Emergency} {Department} population undergoing computed tomography pulmonary angiography},
	volume = {13},
	copyright = {© 2023 The Authors. Pulmonary Circulation published by John Wiley \& Sons Ltd on behalf of Pulmonary Vascular Research Institute.},
	issn = {2045-8940},
	url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/pul2.12225},
	doi = {10.1002/pul2.12225},
	abstract = {Findings of an enlarged pulmonary artery diameter (PAd) and increased pulmonary artery to ascending aorta ratio (PA:AA) on contrast-enhanced computed tomography pulmonary angiography (CTPA) are associated with increased mortality in particular groups of patients with cardiopulmonary disease. However, the frequency and prognostic significance of these incidental findings has not been studied in unselected patients evaluated in the Emergency Department (ED). This study aims to determine the prevalence and associated prognosis of enlarged pulmonary artery measurements in an ED cohort. We measured PA and AA diameters on 990 CTPA studies performed in the ED. An enlarged PA diameter was defined as {\textgreater}27 mm in females and {\textgreater}29 mm in males, while an increased PA:AA was defined as {\textgreater}0.9. Poisson regression was performed to calculate prevalence ratios for relevant comorbidities, and multivariable Cox regression was performed to calculate hazard ratios (HR) for mortality of patients with enlarged pulmonary artery measurements. An enlarged PAd was observed in 27.9\% of 990 patients and was more commonly observed in older patients and in patients with obesity or heart failure. Conversely, PA:AA was increased in 34.2\% of subjects, and was more common in younger patients and those with peripheral vascular disease or obesity. After controlling for age, sex, and comorbidities, both enlarged PAd (HR 1.29, 95\% CI 1.00–1.68, p = 0.05) and PA:AA (HR 1.70, 95\% CI 1.31–2.22 p {\textless} 0.01) were independently associated with mortality. In sum, enlarged PAd and increased PA:AA are common in patients undergoing CTPAs in the ED setting and both are independently associated with mortality.},
	language = {en},
	number = {2},
	urldate = {2024-12-13},
	journal = {Pulmonary Circulation},
	author = {Scarpato, Brittany M. and Locke, Brian W. and Bledsoe, Joseph and Knox, Daniel B. and Conner, Karen and Stoddard, Gregory J. and Cirulis, Meghan M. and Elliott, Charles Gregory and Dodson, Mark W.},
	year = {2023},
	note = {\_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/pul2.12225},
	keywords = {contrast media, diagnostic techniques and monitoring, epidemiology, imaging, mortality},
	pages = {e12225},
}

Findings of an enlarged pulmonary artery diameter (PAd) and increased pulmonary artery to ascending aorta ratio (PA:AA) on contrast-enhanced computed tomography pulmonary angiography (CTPA) are associated with increased mortality in particular groups of patients with cardiopulmonary disease. However, the frequency and prognostic significance of these incidental findings has not been studied in unselected patients evaluated in the Emergency Department (ED). This study aims to determine the prevalence and associated prognosis of enlarged pulmonary artery measurements in an ED cohort. We measured PA and AA diameters on 990 CTPA studies performed in the ED. An enlarged PA diameter was defined as \textgreater27 mm in females and \textgreater29 mm in males, while an increased PA:AA was defined as \textgreater0.9. Poisson regression was performed to calculate prevalence ratios for relevant comorbidities, and multivariable Cox regression was performed to calculate hazard ratios (HR) for mortality of patients with enlarged pulmonary artery measurements. An enlarged PAd was observed in 27.9% of 990 patients and was more commonly observed in older patients and in patients with obesity or heart failure. Conversely, PA:AA was increased in 34.2% of subjects, and was more common in younger patients and those with peripheral vascular disease or obesity. After controlling for age, sex, and comorbidities, both enlarged PAd (HR 1.29, 95% CI 1.00–1.68, p = 0.05) and PA:AA (HR 1.70, 95% CI 1.31–2.22 p \textless 0.01) were independently associated with mortality. In sum, enlarged PAd and increased PA:AA are common in patients undergoing CTPAs in the ED setting and both are independently associated with mortality.

@article{locke_verity_2023,
	title = {The {Verity} of a {Unifying} {Diagnosis}},
	volume = {43},
	issn = {0272-989X},
	url = {https://doi.org/10.1177/0272989X231192521},
	doi = {10.1177/0272989X231192521},
	language = {en},
	number = {7-8},
	urldate = {2024-12-13},
	journal = {Medical Decision Making},
	author = {Locke, Brian W. and Aberegg, Scott K.},
	month = oct,
	year = {2023},
	note = {Publisher: SAGE Publications Inc STM},
	pages = {755--757},
}

@misc{pettine_altered_2023,
	address = {Tampa, Florida},
	title = {Altered goal-directed attention and test-retest performance adults typed for autism, {ADHD} and depression},
	author = {Pettine, Warren W. and Redish, A. David and Tseng, Angela and Murray, John D. and Jacob, Suma},
	year = {2023},
}

@article{winters_cognitive_2023,
	title = {Cognitive {Mechanisms} {Underlying} {Prosocial} {Decision} {Making} in {Callous}-{Unemotional} {Traits}},
	volume = {45},
	issn = {1573-3505},
	url = {https://doi.org/10.1007/s10862-023-10043-x},
	doi = {10.1007/s10862-023-10043-x},
	abstract = {Callous-unemotional (CU) traits are characterized by a lack of prosocial emotions, which has been demonstrated with prosocial behavior paradigms. While shaping our understanding of prosocial behavior in youth with CU traits, most of this work relies on outcomes that don’t reliably capture cognitive processes during prosocial behavior. Examining prosocial cognitive processes can cue researchers into cognitive mechanisms underlying core impairments of CU traits. Drift diffusion modeling is a valuable tool for elucidating more precise outcomes of latent cognitive processes during forced choice tasks such as drift rate (information accumulation toward a decision boundary) and threshold separation (amount of information considered) as well as metrics outside of the decision-making processing including bias (starting point in decision process) and non-decision time (cognitive processes outside of choice). In a sample of 87 adolescents (12–14, 49\% female) we applied diffusion modeling to a prosocial behavior task in which participants either accepted or rejected trials where a real monetary value was given to them and taken away from a charity (self-serving trial) or money was given to a charity and taken from them (donation trial). Results revealed that CU traits associated with information accumulation toward accepting self-serving trials. Exploratory sex differences suggested males trended toward rejecting donation trials and females considered more information during self-serving trials. CU trait associations were independent of conduct problems. Results suggest a unique cognitive profile that are differentiated by sex at higher CU traits when making prosocial decisions involving knowledge accumulation toward self-serving decisions.},
	language = {en},
	number = {2},
	urldate = {2023-09-11},
	journal = {Journal of Psychopathology and Behavioral Assessment},
	author = {Winters, Drew E. and Pettine, Warren W. and Sakai, Joseph T.},
	month = jun,
	year = {2023},
	keywords = {Callous-unemotional traits, Drift diffusion modeling, Early adolescents, Prosocial},
	pages = {308--321},
}

Callous-unemotional (CU) traits are characterized by a lack of prosocial emotions, which has been demonstrated with prosocial behavior paradigms. While shaping our understanding of prosocial behavior in youth with CU traits, most of this work relies on outcomes that don’t reliably capture cognitive processes during prosocial behavior. Examining prosocial cognitive processes can cue researchers into cognitive mechanisms underlying core impairments of CU traits. Drift diffusion modeling is a valuable tool for elucidating more precise outcomes of latent cognitive processes during forced choice tasks such as drift rate (information accumulation toward a decision boundary) and threshold separation (amount of information considered) as well as metrics outside of the decision-making processing including bias (starting point in decision process) and non-decision time (cognitive processes outside of choice). In a sample of 87 adolescents (12–14, 49% female) we applied diffusion modeling to a prosocial behavior task in which participants either accepted or rejected trials where a real monetary value was given to them and taken away from a charity (self-serving trial) or money was given to a charity and taken from them (donation trial). Results revealed that CU traits associated with information accumulation toward accepting self-serving trials. Exploratory sex differences suggested males trended toward rejecting donation trials and females considered more information during self-serving trials. CU trait associations were independent of conduct problems. Results suggest a unique cognitive profile that are differentiated by sex at higher CU traits when making prosocial decisions involving knowledge accumulation toward self-serving decisions.

@article{pettine_human_2023,
	title = {Human generalization of internal representations through prototype learning with goal-directed attention},
	volume = {7},
	copyright = {2023 The Author(s), under exclusive licence to Springer Nature Limited},
	issn = {2397-3374},
	url = {https://www.nature.com/articles/s41562-023-01543-7},
	doi = {10.1038/s41562-023-01543-7},
	abstract = {The world is overabundant with feature-rich information obscuring the latent causes of experience. How do people approximate the complexities of the external world with simplified internal representations that generalize to novel examples or situations? Theories suggest that internal representations could be determined by decision boundaries that discriminate between alternatives, or by distance measurements against prototypes and individual exemplars. Each provide advantages and drawbacks for generalization. We therefore developed theoretical models that leverage both discriminative and distance components to form internal representations via action-reward feedback. We then developed three latent-state learning tasks to test how humans use goal-oriented discrimination attention and prototypes/exemplar representations. The majority of participants attended to both goal-relevant discriminative features and the covariance of features within a prototype. A minority of participants relied only on the discriminative feature. Behaviour of all participants could be captured by parameterizing a model combining prototype representations with goal-oriented discriminative attention.},
	language = {en},
	number = {3},
	urldate = {2023-04-11},
	journal = {Nature Human Behaviour},
	author = {Pettine, Warren Woodrich and Raman, Dhruva Venkita and Redish, A. David and Murray, John D.},
	month = mar,
	year = {2023},
	note = {Number: 3
Publisher: Nature Publishing Group},
	keywords = {Human behaviour, Learning algorithms},
	pages = {442--463},
}

The world is overabundant with feature-rich information obscuring the latent causes of experience. How do people approximate the complexities of the external world with simplified internal representations that generalize to novel examples or situations? Theories suggest that internal representations could be determined by decision boundaries that discriminate between alternatives, or by distance measurements against prototypes and individual exemplars. Each provide advantages and drawbacks for generalization. We therefore developed theoretical models that leverage both discriminative and distance components to form internal representations via action-reward feedback. We then developed three latent-state learning tasks to test how humans use goal-oriented discrimination attention and prototypes/exemplar representations. The majority of participants attended to both goal-relevant discriminative features and the covariance of features within a prototype. A minority of participants relied only on the discriminative feature. Behaviour of all participants could be captured by parameterizing a model combining prototype representations with goal-oriented discriminative attention.

@inproceedings{locke_changes_2022,
	title = {Changes in {Bicarbonate} in {Patients} at {Risk} for {Obesity} {Hypoventilation} {Undergoing} {Bariatric} {Surgery}},
	url = {https://www.atsjournals.org/doi/10.1164/ajrccm-conference.2022.205.1_MeetingAbstracts.A4996},
	doi = {10.1164/ajrccm-conference.2022.205.1_MeetingAbstracts.A4996},
	language = {en},
	urldate = {2024-12-13},
	booktitle = {C110. {BRIDGING} {THE} {GAPS}: {SLEEP}, {NIV}, {PULMONARY} {DISEASE}, {AND} {COMORBIDITIES}},
	publisher = {American Thoracic Society},
	author = {Locke, B.W. and Addison, C. and Mishra, S. and Sundar, K.M.},
	month = may,
	year = {2022},
	pages = {A4996--A4996},
}

@inproceedings{locke_common_2022,
	title = {Common {Methods} of {Identifying} {Hypercapnic} {Respiratory} {Failure} {Produce} {Meaningfully} {Different} {Cohorts}},
	url = {https://www.atsjournals.org/doi/10.1164/ajrccm-conference.2022.205.1_MeetingAbstracts.A2889},
	doi = {10.1164/ajrccm-conference.2022.205.1_MeetingAbstracts.A2889},
	language = {en},
	urldate = {2024-12-13},
	booktitle = {B43. {ICU} {MANAGEMENT}},
	publisher = {American Thoracic Society},
	author = {Locke, B.W. and Sundar, K.M. and Brown, J.P. and Gouripeddi, R.},
	month = may,
	year = {2022},
	pages = {A2889--A2889},
}

@article{locke_osa_2022,
	title = {{OSA} and {Chronic} {Respiratory} {Disease}: {Mechanisms} and {Epidemiology}},
	volume = {19},
	copyright = {http://creativecommons.org/licenses/by/3.0/},
	issn = {1660-4601},
	shorttitle = {{OSA} and {Chronic} {Respiratory} {Disease}},
	url = {https://www.mdpi.com/1660-4601/19/9/5473},
	doi = {10.3390/ijerph19095473},
	abstract = {Obstructive sleep apnea (OSA) is a highly prevalent disorder that has profound implications on the outcomes of patients with chronic lung disease. The hallmark of OSA is a collapse of the oropharynx resulting in a transient reduction in airflow, large intrathoracic pressure swings, and intermittent hypoxia and hypercapnia. The subsequent cytokine-mediated inflammatory cascade, coupled with tractional lung injury, damages the lungs and may worsen several conditions, including chronic obstructive pulmonary disease, asthma, interstitial lung disease, and pulmonary hypertension. Further complicating this is the sleep fragmentation and deterioration of sleep quality that occurs because of OSA, which can compound the fatigue and physical exhaustion often experienced by patients due to their chronic lung disease. For patients with many pulmonary disorders, the available evidence suggests that the prompt recognition and treatment of sleep-disordered breathing improves their quality of life and may also alter the course of their illness. However, more robust studies are needed to truly understand this relationship and the impacts of confounding comorbidities such as obesity and gastroesophageal reflux disease. Clinicians taking care of patients with chronic pulmonary disease should screen and treat patients for OSA, given the complex bidirectional relationship OSA has with chronic lung disease.},
	language = {en},
	number = {9},
	urldate = {2024-12-13},
	journal = {International Journal of Environmental Research and Public Health},
	author = {Locke, Brian W. and Lee, Janet J. and Sundar, Krishna M.},
	month = jan,
	year = {2022},
	note = {Number: 9
Publisher: Multidisciplinary Digital Publishing Institute},
	keywords = {hypoventilation, hypoxia, lung inflammation, obstructive, obstructive pulmonary disease, outcomes assessments, sleep apnea},
	pages = {5473},
}

Obstructive sleep apnea (OSA) is a highly prevalent disorder that has profound implications on the outcomes of patients with chronic lung disease. The hallmark of OSA is a collapse of the oropharynx resulting in a transient reduction in airflow, large intrathoracic pressure swings, and intermittent hypoxia and hypercapnia. The subsequent cytokine-mediated inflammatory cascade, coupled with tractional lung injury, damages the lungs and may worsen several conditions, including chronic obstructive pulmonary disease, asthma, interstitial lung disease, and pulmonary hypertension. Further complicating this is the sleep fragmentation and deterioration of sleep quality that occurs because of OSA, which can compound the fatigue and physical exhaustion often experienced by patients due to their chronic lung disease. For patients with many pulmonary disorders, the available evidence suggests that the prompt recognition and treatment of sleep-disordered breathing improves their quality of life and may also alter the course of their illness. However, more robust studies are needed to truly understand this relationship and the impacts of confounding comorbidities such as obesity and gastroesophageal reflux disease. Clinicians taking care of patients with chronic pulmonary disease should screen and treat patients for OSA, given the complex bidirectional relationship OSA has with chronic lung disease.

@article{christenson_exploiting_2022,
	title = {Exploiting colour space geometry for visual stimulus design across animals},
	volume = {377},
	url = {https://royalsocietypublishing.org/doi/full/10.1098/rstb.2021.0280},
	doi = {10.1098/rstb.2021.0280},
	abstract = {Colour vision represents a vital aspect of perception that ultimately enables a wide variety of species to thrive in the natural world. However, unified methods for constructing chromatic visual stimuli in a laboratory setting are lacking. Here, we present stimulus design methods and an accompanying programming package to efficiently probe the colour space of any species in which the photoreceptor spectral sensitivities are known. Our hardware-agnostic approach incorporates photoreceptor models within the framework of the principle of univariance. This enables experimenters to identify the most effective way to combine multiple light sources to create desired distributions of light, and thus easily construct relevant stimuli for mapping the colour space of an organism. We include methodology to handle uncertainty of photoreceptor spectral sensitivity as well as to optimally reconstruct hyperspectral images given recent hardware advances. Our methods support broad applications in colour vision science and provide a framework for uniform stimulus designs across experimental systems.
This article is part of the theme issue ‘Understanding colour vision: molecular, physiological, neuronal and behavioural studies in arthropods’.},
	number = {1862},
	urldate = {2024-12-11},
	journal = {Philosophical Transactions of the Royal Society B: Biological Sciences},
	author = {Christenson, Matthias P. and Mousavi, S. Navid and Oriol, Elie and Heath, Sarah L. and Behnia, Rudy},
	month = sep,
	year = {2022},
	note = {Publisher: Royal Society},
	keywords = {Python, colour management, colour space, colour vision, nonlinear optimization, univariance},
	pages = {20210280},
}

Colour vision represents a vital aspect of perception that ultimately enables a wide variety of species to thrive in the natural world. However, unified methods for constructing chromatic visual stimuli in a laboratory setting are lacking. Here, we present stimulus design methods and an accompanying programming package to efficiently probe the colour space of any species in which the photoreceptor spectral sensitivities are known. Our hardware-agnostic approach incorporates photoreceptor models within the framework of the principle of univariance. This enables experimenters to identify the most effective way to combine multiple light sources to create desired distributions of light, and thus easily construct relevant stimuli for mapping the colour space of an organism. We include methodology to handle uncertainty of photoreceptor spectral sensitivity as well as to optimally reconstruct hyperspectral images given recent hardware advances. Our methods support broad applications in colour vision science and provide a framework for uniform stimulus designs across experimental systems. This article is part of the theme issue ‘Understanding colour vision: molecular, physiological, neuronal and behavioural studies in arthropods’.

@misc{kohn_state_2021,
	title = {State and stimulus dependence reconcile motion computation and the {Drosophila} connectome},
	copyright = {© 2021, Posted by Cold Spring Harbor Laboratory. The copyright holder for this pre-print is the author. All rights reserved. The material may not be redistributed, re-used or adapted without the author's permission.},
	url = {https://www.biorxiv.org/content/10.1101/2021.04.17.440267v1},
	doi = {10.1101/2021.04.17.440267},
	abstract = {Sensory systems dynamically optimize their processing properties in order to process a wide range of environmental and behavioral conditions. However, attempts to infer the function of these systems via modeling often treat system components as having static processing properties. This is particularly evident in the Drosophila motion detection circuit, where the core algorithm for motion detection is still debated, and where inputs to motion detecting neurons remain underdescribed. Using whole-cell patch clamp electrophysiology, we measured the state- and stimulus-dependent filtering properties of inputs to the OFF motion-detecting T5 cell in Drosophila. Simply summing these inputs within the framework of a connectomic-constrained model of the circuit demonstrates that changes in the shape of input temporal filters are sufficient to explain conflicting theories of T5 function. Therefore, with our measurements and our model, we reconcile motion computation with the anatomy of the circuit.},
	language = {en},
	urldate = {2024-12-11},
	publisher = {bioRxiv},
	author = {Kohn, Jessica R. and Portes, Jacob P. and Christenson, Matthias P. and Abbott, L. F. and Behnia, Rudy},
	month = apr,
	year = {2021},
	note = {Pages: 2021.04.17.440267
Section: New Results},
}

Sensory systems dynamically optimize their processing properties in order to process a wide range of environmental and behavioral conditions. However, attempts to infer the function of these systems via modeling often treat system components as having static processing properties. This is particularly evident in the Drosophila motion detection circuit, where the core algorithm for motion detection is still debated, and where inputs to motion detecting neurons remain underdescribed. Using whole-cell patch clamp electrophysiology, we measured the state- and stimulus-dependent filtering properties of inputs to the OFF motion-detecting T5 cell in Drosophila. Simply summing these inputs within the framework of a connectomic-constrained model of the circuit demonstrates that changes in the shape of input temporal filters are sufficient to explain conflicting theories of T5 function. Therefore, with our measurements and our model, we reconcile motion computation with the anatomy of the circuit.

@article{kohn_flexible_2021,
	title = {Flexible filtering by neural inputs supports motion computation across states and stimuli},
	volume = {31},
	issn = {0960-9822},
	url = {https://www.cell.com/current-biology/abstract/S0960-9822(21)01317-8},
	doi = {10.1016/j.cub.2021.09.061},
	language = {English},
	number = {23},
	urldate = {2024-12-11},
	journal = {Current Biology},
	author = {Kohn, Jessica R. and Portes, Jacob P. and Christenson, Matthias P. and Abbott, L. F. and Behnia, Rudy},
	month = dec,
	year = {2021},
	pmid = {34670114},
	note = {Publisher: Elsevier},
	keywords = {Drosophila melanogaster, ON/OFF pathways, connectome, direction selectivity, motion vision, neuromodulation, octopamine, state dependence, temporal filter},
	pages = {5249--5260.e5},
}

@article{pettine_excitatory-inhibitory_2021,
	title = {Excitatory-inhibitory tone shapes decision strategies in a hierarchical neural network model of multi-attribute choice},
	volume = {17},
	issn = {1553-7358},
	url = {https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1008791},
	doi = {10.1371/journal.pcbi.1008791},
	abstract = {We are constantly faced with decisions between alternatives defined by multiple attributes, necessitating an evaluation and integration of different information sources. Time-varying signals in multiple brain areas are implicated in decision-making; but we lack a rigorous biophysical description of how basic circuit properties, such as excitatory-inhibitory (E/I) tone and cascading nonlinearities, shape attribute processing and choice behavior. Furthermore, how such properties govern choice performance under varying levels of environmental uncertainty is unknown. We investigated two-attribute, two-alternative decision-making in a dynamical, cascading nonlinear neural network with three layers: an input layer encoding choice alternative attribute values; an intermediate layer of modules processing separate attributes; and a final layer producing the decision. Depending on intermediate layer E/I tone, the network displays distinct regimes characterized by linear (I), convex (II) or concave (III) choice indifference curves. In regimes I and II, each option’s attribute information is additively integrated. In regime III, time-varying nonlinear operations amplify the separation between offer distributions by selectively attending to the attribute with the larger differences in input values. At low environmental uncertainty, a linear combination most consistently selects higher valued alternatives. However, at high environmental uncertainty, regime III is more likely than a linear operation to select alternatives with higher value. Furthermore, there are conditions where readout from the intermediate layer could be experimentally indistinguishable from the final layer. Finally, these principles are used to examine multi-attribute decisions in systems with reduced inhibitory tone, leading to predictions of different choice patterns and overall performance between those with restrictions on inhibitory tone and neurotypicals.},
	language = {en},
	number = {3},
	urldate = {2021-03-29},
	journal = {PLOS Computational Biology},
	author = {Pettine, Warren Woodrich and Louie, Kenway and Murray, John D. and Wang, Xiao-Jing},
	month = mar,
	year = {2021},
	keywords = {Behavior, Cognitive science, Decision making, Electrophysiology, Neural networks, Neurons, Nonlinear dynamics, Working memory},
	pages = {e1008791},
}

We are constantly faced with decisions between alternatives defined by multiple attributes, necessitating an evaluation and integration of different information sources. Time-varying signals in multiple brain areas are implicated in decision-making; but we lack a rigorous biophysical description of how basic circuit properties, such as excitatory-inhibitory (E/I) tone and cascading nonlinearities, shape attribute processing and choice behavior. Furthermore, how such properties govern choice performance under varying levels of environmental uncertainty is unknown. We investigated two-attribute, two-alternative decision-making in a dynamical, cascading nonlinear neural network with three layers: an input layer encoding choice alternative attribute values; an intermediate layer of modules processing separate attributes; and a final layer producing the decision. Depending on intermediate layer E/I tone, the network displays distinct regimes characterized by linear (I), convex (II) or concave (III) choice indifference curves. In regimes I and II, each option’s attribute information is additively integrated. In regime III, time-varying nonlinear operations amplify the separation between offer distributions by selectively attending to the attribute with the larger differences in input values. At low environmental uncertainty, a linear combination most consistently selects higher valued alternatives. However, at high environmental uncertainty, regime III is more likely than a linear operation to select alternatives with higher value. Furthermore, there are conditions where readout from the intermediate layer could be experimentally indistinguishable from the final layer. Finally, these principles are used to examine multi-attribute decisions in systems with reduced inhibitory tone, leading to predictions of different choice patterns and overall performance between those with restrictions on inhibitory tone and neurotypicals.

@incollection{locke_effect_2020,
	series = {American {Thoracic} {Society} {International} {Conference} {Abstracts}},
	title = {The {Effect} of {OSA} {Severity} and {CPAP} {Adherence} on {Weight} {Regain} {After} {Bariatric} {Surgery}},
	url = {https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A2439},
	urldate = {2024-12-13},
	booktitle = {A69. {SRN}: {CLINICAL} {AND} {PHYSIOLOGICAL} {INSIGHTS} {INTO} {THE} {MANAGEMENT} {OF} {SDB}},
	publisher = {American Thoracic Society},
	author = {Locke, B.w. and Kim, J. and Bennion, J. and Prasad, C. and Volckmann, E. and Sundar, K.},
	month = may,
	year = {2020},
	doi = {10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A2439},
	pages = {A2439--A2439},
}

@incollection{sellman_spectrum_2020,
	series = {American {Thoracic} {Society} {International} {Conference} {Abstracts}},
	title = {Spectrum of {Central} {Sleep} {Apnea} at an {Academic} {Sleep} {Center} {Between} 2016-2018 and {Treatment} {Responses} to {CPAP} vs. {Adaptive} {Servo} {Ventilation}},
	url = {https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A2430},
	urldate = {2024-12-13},
	booktitle = {A69. {SRN}: {CLINICAL} {AND} {PHYSIOLOGICAL} {INSIGHTS} {INTO} {THE} {MANAGEMENT} {OF} {SDB}},
	publisher = {American Thoracic Society},
	author = {Sellman, J. and Locke, B.w. and McFarland, J. and Uribe, F. and Sundar, K.},
	month = may,
	year = {2020},
	doi = {10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A2430},
	pages = {A2430--A2430},
}

@article{anton_creating_2020,
	title = {Creating a {COVID}-19 {Action} {Plan} for {GME} {Programs}},
	volume = {12},
	issn = {1949-8349},
	url = {https://doi.org/10.4300/JGME-D-20-00206.1},
	doi = {10.4300/JGME-D-20-00206.1},
	number = {4},
	urldate = {2024-12-13},
	journal = {Journal of Graduate Medical Education},
	author = {Anton, Marja and Wright, Josephine and Braithwaite, Matthew and Sturgeon, Greg and Locke, Brian and Milne, Caroline and Crosby, Aaron},
	month = aug,
	year = {2020},
	pages = {399--402},
}

@article{heath_circuit_2020,
	title = {Circuit {Mechanisms} {Underlying} {Chromatic} {Encoding} in {Drosophila} {Photoreceptors}},
	volume = {30},
	issn = {0960-9822},
	url = {https://www.cell.com/current-biology/abstract/S0960-9822(19)31577-5},
	doi = {10.1016/j.cub.2019.11.075},
	language = {English},
	number = {2},
	urldate = {2024-12-11},
	journal = {Current Biology},
	author = {Heath, Sarah L. and Christenson, Matthias P. and Oriol, Elie and Saavedra-Weisenhaus, Maia and Kohn, Jessica R. and Behnia, Rudy},
	month = jan,
	year = {2020},
	pmid = {31928878},
	note = {Publisher: Elsevier},
	keywords = {Drosophila melanogaster, color model, color opponency, color vision, convergent evolution, horizontal cell, medulla, neural circuit, photon capture, photoreceptor},
	pages = {264--275.e8},
}

@article{moore_role_2020,
	title = {A {Role} for {Gaze} {Control} {Circuitry} in the {Selection} and {Maintenance} of {Visual} {Spatial} {Information}},
	url = {https://direct.mit.edu/books/edited-volume/5456/chapter/3966982/A-Role-for-Gaze-Control-Circuitry-in-the-Selection},
	doi = {10.7551/mitpress/11442.003.0039},
	language = {en},
	urldate = {2023-10-04},
	author = {Moore, Tirin and Jonikaitis, Donatas and Pettine, Warren},
	month = may,
	year = {2020},
}

@article{pettine_laminar_2019,
	title = {Laminar segregation of sensory coding and behavioral readout in macaque {V4}},
	copyright = {© 2019 . https://www.pnas.org/site/aboutpnas/licenses.xhtmlPublished under the PNAS license.},
	issn = {0027-8424, 1091-6490},
	url = {https://www.pnas.org/content/early/2019/06/26/1819398116},
	doi = {10.1073/pnas.1819398116},
	abstract = {Neurons in sensory areas of the neocortex are known to represent information both about sensory stimuli and behavioral state, but how these 2 disparate signals are integrated across cortical layers is poorly understood. To study this issue, we measured the coding of visual stimulus orientation and of behavioral state by neurons within superficial and deep layers of area V4 in monkeys while they covertly attended or prepared eye movements to visual stimuli. We show that whereas single neurons and neuronal populations in the superficial layers conveyed more information about the orientation of visual stimuli than neurons in deep layers, the opposite was true of information about the behavioral relevance of those stimuli. In particular, deep layer neurons encoded greater information about the direction of planned eye movements than superficial neurons. These results suggest a division of labor between cortical layers in the coding of visual input and visually guided behavior.},
	language = {en},
	urldate = {2019-06-28},
	journal = {Proceedings of the National Academy of Sciences},
	author = {Pettine, Warren W. and Steinmetz, Nicholas A. and Moore, Tirin},
	month = jun,
	year = {2019},
	pmid = {31249141},
	keywords = {attention, neural coding, visual cortex},
	pages = {201819398},
}

Neurons in sensory areas of the neocortex are known to represent information both about sensory stimuli and behavioral state, but how these 2 disparate signals are integrated across cortical layers is poorly understood. To study this issue, we measured the coding of visual stimulus orientation and of behavioral state by neurons within superficial and deep layers of area V4 in monkeys while they covertly attended or prepared eye movements to visual stimuli. We show that whereas single neurons and neuronal populations in the superficial layers conveyed more information about the orientation of visual stimuli than neurons in deep layers, the opposite was true of information about the behavioral relevance of those stimuli. In particular, deep layer neurons encoded greater information about the direction of planned eye movements than superficial neurons. These results suggest a division of labor between cortical layers in the coding of visual input and visually guided behavior.

@article{bahmani_prefrontal_2018,
	title = {Prefrontal {Contributions} to {Attention} and {Working} {Memory}},
	url = {https://link.springer.com/chapter/10.1007/7854_2018_74},
	doi = {10.1007/7854_2018_74},
	abstract = {The processes of attention and working memory are conspicuously interlinked, suggesting that they may involve overlapping neural mechanisms. Working memory (WM) is the ability to maintain information...},
	language = {en},
	urldate = {2019-03-05},
	author = {Bahmani, Zahra and Clark, Kelsey and Merrikhi, Yaser and Mueller, Adrienne and Pettine, Warren and Vanegas, M. Isabel and Moore, Tirin and Noudoost, Behrad},
	year = {2018},
	pages = {1--25},
}

The processes of attention and working memory are conspicuously interlinked, suggesting that they may involve overlapping neural mechanisms. Working memory (WM) is the ability to maintain information...

@article{locke_enhancing_2017,
	title = {Enhancing medical student quality improvement education through immersion},
	volume = {51},
	issn = {1365-2923},
	doi = {10.1111/medu.13313},
	language = {eng},
	number = {5},
	journal = {Medical Education},
	author = {Locke, Brian and Kneeland, Patrick},
	month = may,
	year = {2017},
	pmid = {28394060},
	keywords = {Clinical Competence, Competency-Based Education, Curriculum, Education, Medical, Undergraduate, Humans, Quality Improvement, Students, Medical},
	pages = {549--550},
}

@article{brandenburg_mountain_2017,
	title = {Mountain medical kits: epidemiology-based recommendations and analysis of medical supplies carried by mountain climbers in {Colorado}},
	volume = {24},
	shorttitle = {Mountain medical kits},
	url = {https://academic.oup.com/jtm/article-abstract/24/2/taw088/2930765},
	number = {2},
	urldate = {2024-12-13},
	journal = {Journal of travel medicine},
	author = {Brandenburg, William E. and Locke, Brian W.},
	year = {2017},
	note = {Publisher: Oxford University Press},
	pages = {taw088},
}

@article{livingstone_symbol_2014,
	title = {Symbol addition by monkeys provides evidence for normalized quantity coding},
	volume = {111},
	url = {http://www.pnas.org/content/111/18/6822.short},
	doi = {10.1073/pnas.1404208111},
	number = {18},
	urldate = {2015-01-07},
	journal = {Proceedings of the National Academy of Sciences},
	author = {Livingstone, Margaret S. and Pettine, Warren W. and Srihasam, Krishna and Moore, Brandon and Morocz, Istvan A. and Lee, Daeyeol},
	year = {2014},
	keywords = {macaque, normalization, number sense, value coding},
	pages = {6822--6827},
}

@article{pettine_characterization_2012,
	title = {Characterization of novel microelectrode geometries for detection of neurotransmitters},
	volume = {12},
	url = {http://ieeexplore.ieee.org/xpls/abs_all.jsp?arnumber=5976363},
	number = {5},
	urldate = {2015-01-07},
	journal = {Sensors Journal, IEEE},
	author = {Pettine, Warren and Jibson, Matthew and Chen, Tom and Tobet, Stuart and Nikkel, Phil and Henry, Charles S.},
	year = {2012},
	keywords = {Amperometry, Arrays, DPV, Electric potential, Geometry, Microelectrodes, Neurotransmitters, Platinum, amperometric sensors, amperometry, cyclic voltammetry, differential pulse voltammetry, electrochemical electrodes, electrode geometry, electrode response, fast scan cyclic voltammetry, microelectrode array, microelectrode geometry, microelectrodes, neurophysiology, neurotransmitter detection, norepinephrine, onboard platinum pseudoreference electrode, optimal electrode configuration, platinum pseudo-reference electrode, reliability, voltammetry (chemical analysis)},
	pages = {1187--1192},
}

@article{aberegg_full_nodate,
	title = {Full title: {Hickam}’s {Dictum}: {An} {Analysis} of {Multiple} {Diagnoses} {Running} title: {Analysis} of {Multiple} {Diagnoses}},
	shorttitle = {Full title},
	url = {https://www.newswise.com/pdf_docs/17293520117628_Hickam_9-19_R1_final-clean.pdf},
	urldate = {2024-12-13},
	author = {Aberegg, Scott K. and Poole, Brian R. and Locke, Brian W.},
}

@article{locke_electronic_nodate,
	title = {Electronic health record–derived outcomes in obstructive sleep apnea managed with positive airway pressure tracking systems},
	volume = {18},
	url = {https://jcsm.aasm.org/doi/full/10.5664/jcsm.9750},
	doi = {10.5664/jcsm.9750},
	abstract = {Study Objectives:To assess the effectiveness of continuous positive airway pressure (CPAP) management guided by CPAP machine downloads in newly diagnosed patients with obstructive sleep apnea (OSA) using electronic health record–derived health care utilization, biometric variables, and laboratory data.Methods:Electronic health record data of patients seen at the University of Utah Sleep Program from 2012–2015 were reviewed to identify patients with new diagnosis of OSA in whom CPAP adherence and residual apnea-hypopnea index as measured by a positive airway pressure adherence tracking device data for ≥ 1 year were available. Biometric data, laboratory data, and system-wide charges were compared in the 1 year before and after CPAP therapy. Subgroups were divided by whether patients met tracking criteria, mean nightly usage, and OSA severity.Results:976 consecutive, newly diagnosed participants with OSA (median age 55 years, 56.6\% male) met inclusion criteria. There was a mean decrease of systolic blood pressure (BP) of 1.2 mm Hg and diastolic BP of 1.0 mm Hg within a year of initiation of CPAP therapy. BP improvements in the subgroup meeting CPAP tracking targets were 1.36 mmHg (systolic) and 1.37 mmHg (diastolic). No significant change was noted in body mass index, glycated hemoglobin, or serum creatinine values within a year of starting CPAP therapy, and health care utilization increased (mean acute care visits 0.22 per year to 0.53 per year; mean charges of \$3,997 per year to \$8,986 per year).Conclusions:An improvement in BP was noted within a year of CPAP therapy in newly diagnosed patients with OSA, with no difference in the magnitude of improvement between those meeting tracking system adherence targets.Citation:Locke BW, Neill SE, Howe HE, Crotty MC, Kim J, Sundar KM. Electronic health record–derived outcomes in obstructive sleep apnea managed with positive airway pressure tracking systems. J Clin Sleep Med. 2022;18(3):885–894.},
	number = {3},
	urldate = {2024-12-13},
	journal = {Journal of Clinical Sleep Medicine},
	author = {Locke, Brian W. and Neill, Sarah E. and Howe, Heather E. and Crotty, Michael C. and Kim, Jaewhan and Sundar, Krishna M.},
	note = {Publisher: American Academy of Sleep Medicine},
	keywords = {continuous positive airway pressure, obstructive sleep apnea, treatment outcome},
	pages = {885--894},
}

Study Objectives:To assess the effectiveness of continuous positive airway pressure (CPAP) management guided by CPAP machine downloads in newly diagnosed patients with obstructive sleep apnea (OSA) using electronic health record–derived health care utilization, biometric variables, and laboratory data.Methods:Electronic health record data of patients seen at the University of Utah Sleep Program from 2012–2015 were reviewed to identify patients with new diagnosis of OSA in whom CPAP adherence and residual apnea-hypopnea index as measured by a positive airway pressure adherence tracking device data for ≥ 1 year were available. Biometric data, laboratory data, and system-wide charges were compared in the 1 year before and after CPAP therapy. Subgroups were divided by whether patients met tracking criteria, mean nightly usage, and OSA severity.Results:976 consecutive, newly diagnosed participants with OSA (median age 55 years, 56.6% male) met inclusion criteria. There was a mean decrease of systolic blood pressure (BP) of 1.2 mm Hg and diastolic BP of 1.0 mm Hg within a year of initiation of CPAP therapy. BP improvements in the subgroup meeting CPAP tracking targets were 1.36 mmHg (systolic) and 1.37 mmHg (diastolic). No significant change was noted in body mass index, glycated hemoglobin, or serum creatinine values within a year of starting CPAP therapy, and health care utilization increased (mean acute care visits 0.22 per year to 0.53 per year; mean charges of $3,997 per year to $8,986 per year).Conclusions:An improvement in BP was noted within a year of CPAP therapy in newly diagnosed patients with OSA, with no difference in the magnitude of improvement between those meeting tracking system adherence targets.Citation:Locke BW, Neill SE, Howe HE, Crotty MC, Kim J, Sundar KM. Electronic health record–derived outcomes in obstructive sleep apnea managed with positive airway pressure tracking systems. J Clin Sleep Med. 2022;18(3):885–894.

@article{locke_severity_nodate,
	title = {Severity, comorbidities, and adherence to therapy in {Native} {Hawaiians}/{Pacific} {Islanders} with obstructive sleep apnea},
	volume = {19},
	url = {https://jcsm.aasm.org/doi/full/10.5664/jcsm.10472},
	doi = {10.5664/jcsm.10472},
	abstract = {Study Objectives:Considerable disparities in the prevalence, diagnosis, and management of obstructive sleep apnea (OSA) exist for minority groups in the United States. However, the impact of OSA on Native Hawaiian/Pacific Islanders (NHPIs) has not been evaluated.Methods:We performed a retrospective review of patient records of NHPIs who underwent sleep apnea testing between 2014 and 2021 at a single center in Utah to characterize the distribution of comorbidities, disease severity, and treatment adherence.Results:140 of 141 NHPI patients who underwent sleep testing had OSA. High rates of obesity (94\%) and other relevant comorbidities were found. OSA was mostly severe (57\%), particularly in males with higher obesity. Adherence to continuous positive airway pressure was low (41\% using for 4 or more hours on 70\% of nights), and medical factors predicted whether adherence targets were met with modest accuracy (area under the curve 0.699).Conclusions:NHPIs at a single sleep center had a high prevalence of comorbidities in association with OSA, a skewed distribution toward severe disease suggestive of barriers to care or unique disease characteristics, and low adherence to continuous positive airway pressure. These findings suggest a high burden of OSA in this population, and further work to characterize barriers to identifying and treating OSA in NHPIs can improve chronic disease outcomes in NHPIs.Citation:Locke BW, Sundar DJ, Ryujin D. Severity, comorbidities, and adherence to therapy in Native Hawaiians/Pacific Islanders with obstructive sleep apnea. J Clin Sleep Med. 2023;19(5):967–974.},
	number = {5},
	urldate = {2024-12-13},
	journal = {Journal of Clinical Sleep Medicine},
	author = {Locke, Brian W. and Sundar, Divya J. and Ryujin, Darin},
	note = {Publisher: American Academy of Sleep Medicine},
	keywords = {Native Hawaiian/Pacific Islander (NHPI), continuous positive airway pressure, obstructive sleep apnea, racial disparity},
	pages = {967--974},
}

Study Objectives:Considerable disparities in the prevalence, diagnosis, and management of obstructive sleep apnea (OSA) exist for minority groups in the United States. However, the impact of OSA on Native Hawaiian/Pacific Islanders (NHPIs) has not been evaluated.Methods:We performed a retrospective review of patient records of NHPIs who underwent sleep apnea testing between 2014 and 2021 at a single center in Utah to characterize the distribution of comorbidities, disease severity, and treatment adherence.Results:140 of 141 NHPI patients who underwent sleep testing had OSA. High rates of obesity (94%) and other relevant comorbidities were found. OSA was mostly severe (57%), particularly in males with higher obesity. Adherence to continuous positive airway pressure was low (41% using for 4 or more hours on 70% of nights), and medical factors predicted whether adherence targets were met with modest accuracy (area under the curve 0.699).Conclusions:NHPIs at a single sleep center had a high prevalence of comorbidities in association with OSA, a skewed distribution toward severe disease suggestive of barriers to care or unique disease characteristics, and low adherence to continuous positive airway pressure. These findings suggest a high burden of OSA in this population, and further work to characterize barriers to identifying and treating OSA in NHPIs can improve chronic disease outcomes in NHPIs.Citation:Locke BW, Sundar DJ, Ryujin D. Severity, comorbidities, and adherence to therapy in Native Hawaiians/Pacific Islanders with obstructive sleep apnea. J Clin Sleep Med. 2023;19(5):967–974.