Bijan Najafi

Bijan Najafi
Baylor College of Medicine | BCM · Michael E. DeBakey Department of Surgery

PhD

About

335
Publications
55,903
Reads
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7,715
Citations
Additional affiliations
December 2015 - January 2016
Baylor College of Medicine
Position
  • Professor (Tenure), Director iCAMP, Director of Clinical Research
April 2012 - present
The University of Arizona
Position
  • Professor (Associate)
January 2008 - April 2012

Publications

Publications (335)
Article
Introduction: The technology-driven solution can reduce the caregiving burden; however, the needs of dementia caregiving are unique, and attitudes towards adopting technology from the perspectives of all the stakeholders involved in dementia caregiving are unclear. This study aims to assess the acceptability and feasibility of a technology-driven...
Preprint
Full-text available
People with diabetic foot frequently exhibit poor gait and balance. However, there is no review to inform digital biomarkers of poor gait and balance related to diabetic foot, measurable by wearables outside traditional gait laboratories. Such information could assist in designing remote patient monitoring platform to track changes in gait and bala...
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Assessment of instrumental activities of daily living (IADL) is essential for the diagnosis and staging of dementia. However, current IADL assessments are subjective and cannot be administered remotely. We proposed a smart-home design, called IADLSys, for remote monitoring of IADL. IADLSys consists of three major components: (1) wireless physical t...
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Maintaining function in older adults is key to the quality of life and longevity. This study examined the potential impact of falls on accelerating further deterioration over time in gait, balance, physical activity, depression, fear of falling, and motor capacity in older adults. 163 ambulatory older adults (age = 76.5 ± 7.7 years) participated an...
Article
Objective: We investigated the association between the complexity of diabetic foot ulcers (DFUs) and frailty. Research Design and Methods: Individuals (n = 38) with Grade 2 Wagner DFU were classified into 3 groups based on the Society for Vascular Surgery risk-stratification for major limb amputation as Stage 1 at very low risk (n = 19), Stage 2 a...
Preprint
UNSTRUCTURED Digital transformation is the adoption of digital technologies by an entity in an effort to increase operational efficiency. In mental health care, digital transformation entails technology implementation to improve the quality of care and clinical outcomes; however, the process of digital transformation is in its infancy, and to our k...
Article
Outcomes 1. Recognize the acceptability, safety, and effectiveness of home-based telerehabilitation to improve daytime sleepiness among veterans with end-stage pulmonary disease (ESPD) 2. Recognize acceptability, safety, and effectiveness of home-based telerehabilitation to improve quality of life of veterans with ESPD Importance Palliative care (...
Article
BACKGROUND AND AIMS Reduced physical activity in daily life is a persistent problem in patients undergoing hemodialysis (HD). Although exercise could be beneficial, factors such as post-dialysis fatigue, time limitation and severe frailty may result in poor compliance. We are exploring an alternative therapy using intradialytic plantar electrical n...
Preprint
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We conducted a field study using multiple wearable devices on 231 federal office workers to assess the impact of the indoor environment on individual wellbeing. Past research has established that the workplace environment is closely tied to an individual’s wellbeing. Since sound is the most-reported environmental factor causing stress and discomfor...
Article
Background A critical factor in healing diabetic foot ulcers is patient adherence to offloading devices. We tested a smart offloading boot (SmartBoot) combined with a smartwatch app and cloud dashboard to remotely monitor patient adherence and activity. In addition, the impact of SmartBoot on balance, gait, and user experience was investigated. Me...
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The emerging literature suggests that implantable functional electrical stimulation may improve gait performance in stroke survivors. However, there is no review providing the possible therapeutic effects of implanted functional electrical stimulation on gait performance in stroke survivors. We performed a web-based, systematic paper search using P...
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Background Dressing materials are known to influence post-operative surgical wound healing and scar formation (SF). A particular dressing that could promote wound hydration is essential to ensure quick epithelialization and reduce SF. This study examined the effectiveness of a novel Continuous Diffusion of Oxygen (CDO) dressing to reduce scar lengt...
Article
Introduction: An early detection of impaired functional performance is critical to enhance symptom management for patients with chronic obstructive pulmonary disease (COPD). However, conventional functional measures based on walking assessments are often impractical for small clinics where the available space to administrate gait-based test is lim...
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Neurogenic thoracic outlet syndrome (nTOS) is a musculoskeletal disorder in which compression of the brachial plexus between the scalene muscles of the neck and the first rib results in disabling upper extremity pain and paresthesia. Currently there are no objective metrics for assessing the disability of nTOS or for monitoring response to its ther...
Article
Background: Leukocyte-rich platelet-rich plasma (LR-PRP) has demonstrated to be beneficial for patient with knee osteoarthritis (KOA); however, reliable objective end points to accurately assess its therapeutic effects is lacking. Aim: To investigate the efficacy of LR-PRP as assessed by functional and patient-reported outcomes at early time-points...
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Remote monitoring of physical frailty is important to personalize care for slowing down the frailty process and/or for the healthy recovery of older adults following acute or chronic stressors. Taking the Fried frailty criteria as a reference to determine physical frailty and frailty phenotypes (slowness, weakness, exhaustion, inactivity), this stu...
Article
Background Robotic transthoracic first rib resection (R-FRR) has advantages over traditional approaches however its impact on post-operative nTOS outcomes is unknown. Our primary objective was to determine improvement of patient-reported outcome measures (PROMs) of pain and disability following R-FRR in neurogenic thoracic outlet syndrome (nTOS). O...
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Background Electrical stimulation (E-Stim) may offer a unique adjunctive treatment to heal complicated diabetic foot ulcers (DFU). Our primary goal is to examine the effectiveness of daily home-based E-Stim therapy to speed-up wound healing. Methods Patients with chronic DFUs and mild to severe peripheral arterial disease (PAD) were recruited and...
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Objectives and background Social demands of the school-year and summer environment may affect children’s sleep patterns and circadian rhythms during these periods. The current study examined differences in children’s sleep and circadian-related behaviors during the school-year and summer and explored the association between sleep and circadian para...
Article
Background Traditional physical frailty (PF) screening tools are resource intensive and unsuitable for remote assessment. In this study, we used five times sit-to-stand test (5×STS) with wearable sensors to determine PF and three key frailty phenotypes (slowness, weakness, and exhaustion) objectively. Materials and methods Older adults (n = 102, a...
Article
Background Traditional assessment (e.g., checklists, videotaping) for surgical proficiency may lead to subjectivity and does not predict performance in the clinical setting. Hand motion analysis is evolving as an objective tool for grading technical dexterity; however, most devices accompany with technical limitations or discomfort. We purpose the...
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Background and Aims Assessing and monitoring cognitive frailty (CF; coexistence of physical frailty and cognitive impairment) are critical for hemodialysis patients. For administering physical frailty and cognitive assessments, however, clinical settings need to address challenges (e.g., cost, human and technical resources, patient’s fatigue, etc.)...
Article
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Background Physical inactivity among patients undergoing hemodialysis (HD) is a long-standing clinical problem. While exercise could be beneficial, post-dialysis fatigue, limited time availability, and severe frailty to travel often lead to poor adherence to conventional exercise programs. To address this gap, we proposed testing an alternative the...
Article
Background: Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF. Methods: Of 121...
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Since conventional screening tools for assessing frailty phenotypes are resource intensive and unsuitable for routine application, efforts are underway to simplify and shorten the frailty screening protocol by using sensor-based technologies. This study explores whether machine learning combined with frailty modeling could determine the least senso...
Article
Introduction: Parkinson's disease (PD) progressively impairs motor and cognitive performance. The current tools to detect decline in motor and cognitive functioning are often impractical for busy clinics and home settings. To address the gap, we designed an instrumented trail-making task (iTMT) based on a wearable sensor (worn on the shin) with in...
Article
Background Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) are at increased risk of falls and developing fear of falling (FoF). Although FoF may continue to impair motor performance and increase the risk of falling even further, this association remains unexplored in CIPN. Research question Does high FoF in patients with CIP...
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Background: Social isolation during COVID-19 may negatively impact older adults' wellbeing. To assess its impact, we measured changes in physical activity and sleep among community-dwelling older adults, from pre-to post-pandemic declaration. Method: Physical activity and sleep in older adults (n = 10, age = 77.3 ± 1.9 years, female = 40%) were...
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About 422 million people worldwide have diabetes and approximately one-third of them have a major risk factor for diabetic foot ulcers, including poor sensation in their feet from peripheral neuropathy and/or poor perfusion to their feet from peripheral artery disease. The current healthcare ecosystem, which is centered on the treatment of establis...
Article
Introduction: Preoperative frailty is an independent risk factor for postoperative complications across surgical specialties. Functional mobility such as gait, timed up and go (TUG), and 5 times sit-to-stand (5-STS) are popular preoperative frailty measurements but are not suitable for patients with severe mobility impairment. A wrist-worn sensor-...
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Full-text available
Every 20 seconds a limb is amputated somewhere in the world due to diabetes. This is a global health problem that requires a global solution. The International Conference on Medical Image Computing and Computer Assisted Intervention challenge, which concerns the automated detection of diabetic foot ulcers (DFUs) using machine learning techniques, w...
Article
Diabetes-related foot ulcers are a leading cause of global morbidity, mortality, and health-care costs. People with a history of foot ulcers have a diminished quality of life attributed to limited walking and mobility. One of the largest concerns is ulceration recurrence. Approximately 40% of patients with ulcerations will have a recurrent ulcer in...
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Full-text available
Background: Although numerous studies suggest the benefit of electrical stimulation (E-Stim) therapy to accelerate wound healing, the underlying mechanism of action is still debated. In this pilot study, we examined the potential effectiveness of lower-extremity E-Stim therapy to improve tissue perfusion in patients with diabetic foot ulcers. Met...
Article
Objective: This study examined office workstation types' impact on the relationship between fatigue and three health metrics: physical activity, stress, and sleep quality. Methods: Data from 225 office workers were collected for perceived fatigue, perceived sleep quality (Pittsburgh Sleep Quality Index [PSQI]), physiological stress response (sta...
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Physical activity is an essential part of general health and diabetes management. However, recommending weight-bearing physical activity for people with plantar diabetic foot ulcers is controversial, even when gold standard offloading devices are used, as it is commonly thought to delay healing. We aimed to narratively review relevant studies inves...
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Objective Cancer-related fatigue (CRF) is highly prevalent among cancer survivors, which may have long-term effects on physical activity and quality of life. CRF is assessed by self-report or clinical observation, which may limit timely diagnosis and management. In this study, we examined the effect of CRF on mobility performance measured by a wear...
Article
Introduction: Concern about falling is a prevalent worry among community-dwelling older adults and may contribute to a decline in physical and mental health. This study aimed to examine the association between mobility performance and concern about falling. Methods: Older adults aged 65 years and older, with Mini-Mental State Examination score ≥...
Article
Background Survivors of childhood cancer (CCS) are at risk for early aging and frailty. Frailty in CCS has been assessed with established clinical criteria, a time-intensive approach requiring specialized training. There is an unmet need for cost-effective, rapid methods for assessing frailty in at-risk adolescent and young adult (AYA) CCS, which a...
Article
Background : Dual-task gait training may improve dual-task gait speed after stroke, but the effects on the relative amount of dual-task interference are unclear. Objective : To compare the efficacy of dual-task gait training (DTGT) and single-task gait training (STGT) on cognitive-motor dual-task interference after stroke. Methods : 36 adults withi...
Chapter
Almost half of people with diabetes have peripheral nerve dysfunction (neuropathy; PN) or poor blood supply to the lower limb caused by diabetes or peripheral artery disease (PAD). They are at a high risk of developing foot complications, such as ulcers, gangrene, and infection. Recent efforts to reduce the burden of foot disease and its associated...
Article
Full-text available
Every 20 seconds a limb is amputated somewhere in the world due to diabetes. This is a global health problem that requires a global solution. The International Conference on Medical Image Computing and Computer Assisted Intervention challenge, which concerns the automated detection of diabetic foot ulcers (DFUs) using machine learning techniques, w...
Article
Full-text available
Importance Physical frailty is a key risk factor associated with higher rates of major adverse events (MAEs) after surgery. Assessing physical frailty is often challenging among patients with chronic limb-threatening ischemia (CLTI) who are often unable to perform gait-based assessments because of the presence of plantar wounds. Objective To test...
Article
Objectives: Robotic first rib resection (R-FRR) is an emerging approach in the field of thoracic outlet syndrome (TOS) that has technical advantages over traditional open approaches, including superior exposure of the first rib and freedom from retracting neurovascular structures. We set out to define the safety of R-FRR and compare it with that of...
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Full-text available
Objective: Evidence assessing endovascular therapy (EVT) versus re-do open revascularization for chronically occluded bypasses is suboptimal. Comparative outcomes to EVT first-line procedures also remain uncertain. The present study evaluated EVT as a first-line approach for chronic limb-threatening ischemia (CLTI) due to a chronically occluded byp...
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Full-text available
Diabetes-related foot disease (DFD), which includes foot ulcers, infection and gangrene, is a leading cause of the global disability burden. About half of people who develop DFD experience a recurrence within one year. Long-term medical management to reduce the risk of recurrence is therefore important to reduce the global DFD burden. This review d...
Article
e14104 Background: Accurate performance status (PS) assessment is important for chemotherapy decisions, but current tools such as the Eastern Cooperative Oncology Group (ECOG) PS assessment are subjective, static, and prone to inter-observer and recall biases. Continuous patient monitoring technology can enhance PS assessment by providing an object...
Article
Background Emerging literature suggests that the arousal and regulatory systems as measured by sleep-wakefulness, heart rate (HR) and heart rate variability (HRV) may be powerful objective warning signs of suicidality. However, there is no systematic literature review examining the association between objective measurements of these variables with...
Preprint
Full-text available
Every 20 seconds, a limb is amputated somewhere in the world due to diabetes. This is a global health problem that requires a global solution. The MICCAI challenge discussed in this paper, which concerns the detection of diabetic foot ulcers, will accelerate the development of innovative healthcare technology to address this unmet medical need. In...
Chapter
The lifetime incidence of diabetic foot ulcers (DFU) has been estimated to be between 19 and 34 percent amongst people with diabetes. Thanks to new ‘smart’ sensors and communications technology, new opportunities have opened to smartly manage DFUs with personalized screening and timely intervention. With the help of automation, patients can even be...
Article
Full-text available
Cognitive impairment is prevalent but still poorly diagnosed in hemodialysis adults, mainly because of the impracticality of current tools. This study examined whether remotely monitoring mobility performance can help identifying digital measures of cognitive impairment in hemodialysis patients. Sixty-nine diabetes mellitus hemodialysis patients (a...
Article
Full-text available
Physical frailty together with cognitive impairment (Cog), known as cognitive frailty, is emerging as a strong and independent predictor of cognitive decline over time. We examined whether remote physical activity (PA) monitoring could be used to identify those with cognitive frailty. A validated algorithm was used to quantify PA behaviors, PA patt...
Article
Background The impact of high distraction, real-world environments on dual-task interference and flexibility of attentional prioritization during dual-task walking in people with stroke is unknown. Research question How does a real-world environment affect dual-task performance and flexible task prioritization during dual-task walking in adults wi...
Article
Full-text available
Regular exercise can reduce depression. However, the uptake of exercise is limited in patients with end-stage renal disease undergoing hemodialysis. To address the gap, we designed a gamified non-weight-bearing intradialytic exercise program (exergame). The intradialytic exergame is virtually supervised based on its interactive feedback via wearabl...
Article
Purpose To describe the applicability of the Society for Vascular Surgery (SVS) Objective Performance Goals (OPGs) as a tool to evaluate results in the context of endovascular management of non-complex and complex patients (i.e., end stage renal disease/history of prosthetic conduit) with chronic limb-threatening ischemia (CLTI). Methods Patients...
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Full-text available
People with peripheral neuropathy (PN) are at risk of falling. Many people with PN have comorbid cognitive impairment, an independent risk factor of falls, which may further increase the risk of falling in people with PN. However, the negative synergic effect of those factors is yet to be reported. We investigated whether the presence of cognitive...
Article
Background: Gait is deteriorated in older adults with diabetic peripheral neuropathy; however, too little is known about the gait initiation phase. We aimed to determine if gait initiation variables are more sensitive in identifying the extent to which diabetic peripheral neuropathy impacts gait. Methods: We examined steps, distance, speed and dyna...
Preprint
Regular exercise can reduce depression. However, the uptake of exercise is limited in patients with end-stage renal disease undergoing hemodialysis. To address the gap, we designed a gamified non-weight-bearing exercise program (Exergame), which can be executed during hemodialysis treatment. The Exergame is virtually supervised based on its interac...