Practical applications of three-dimensional printing for process improvement in the cytopathology laboratory.

With the increased availability of three-dimensional (3D) printers, innovative teaching and training materials have been created in medical fields. For pathology, the use of 3D printing has been largely limited to anatomic representations of disease processes or the development of supplies during the coronavirus disease 2019 pandemic. Herein, an institution's 3D printing laboratory and staff with expertise in additive manufacturing illustrate how this can address design issues in cytopathology specimen collection and processing.

Patient Perspectives on Artificial Intelligence in Healthcare Decision Making: A Multi-Center Comparative Study.

Objective: Investigate the patient opinion on the use of Artificial Intelligence (AI) in Orthopaedics.

Methods: 397 orthopaedic patients from a large urban academic center and a rural health system completed a 37-component survey querying patient demographics and perspectives on clinical scenarios involving AI. An average comfort score was calculated from thirteen Likert-scale questions (1, not comfortable; 10, very comfortable).

The State of Machine Learning in Spine Surgery: A Systematic Review.

Study Design: This was a systematic review of existing literature.

Objective: The objective of this study was to evaluate the current state-of-the-art trends and utilization of machine learning in the field of spine surgery.

Summary Of Background Data: The past decade has seen a rise in the clinical use of machine learning in many fields including diagnostic radiology and oncology.

Deep-learning-assisted analysis of echocardiographic videos improves predictions of all-cause mortality.

Machine learning promises to assist physicians with predictions of mortality and of other future clinical events by learning complex patterns from historical data, such as longitudinal electronic health records. Here we show that a convolutional neural network trained on raw pixel data in 812,278 echocardiographic videos from 34,362 individuals provides superior predictions of one-year all-cause mortality. The model's predictions outperformed the widely used pooled cohort equations, the Seattle Heart Failure score (measured in an independent dataset of 2,404 patients with heart failure who underwent 3,384 echocardiograms), and a machine learning model involving 58 human-derived variables from echocardiograms and 100 clinical variables derived from electronic health records.

Computational simulation to assess patient safety of uncompensated COVID-19 two-patient ventilator sharing using the Pulse Physiology Engine.

Background: The COVID-19 pandemic is stretching medical resources internationally, sometimes creating ventilator shortages that complicate clinical and ethical situations. The possibility of needing to ventilate multiple patients with a single ventilator raises patient health and safety concerns in addition to clinical conditions needing treatment. Wherever ventilators are employed, additional tubing and splitting adaptors may be available.

Feasibility of blood testing combined with PET-CT to screen for cancer and guide intervention.

Cancer treatments are often more successful when the disease is detected early. We evaluated the feasibility and safety of multicancer blood testing coupled with positron emission tomography-computed tomography (PET-CT) imaging to detect cancer in a prospective, interventional study of 10,006 women not previously known to have cancer. Positive blood tests were independently confirmed by a diagnostic PET-CT, which also localized the cancer.

Using Adipose Measures from Health Care Provider-Based Imaging Data for Discovery.

The location and type of adipose tissue is an important factor in metabolic syndrome. A database of picture archiving and communication system (PACS) derived abdominal computerized tomography (CT) images from a large health care provider, Geisinger, was used for large-scale research of the relationship of volume of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) with obesity-related diseases and clinical laboratory measures. Using a "greedy snake" algorithm and 2,545 CT images from the Geisinger PACS, we measured levels of VAT, SAT, total adipose tissue (TAT), and adipose ratio volumes.

Advanced machine learning in action: identification of intracranial hemorrhage on computed tomography scans of the head with clinical workflow integration.

Intracranial hemorrhage (ICH) requires prompt diagnosis to optimize patient outcomes. We hypothesized that machine learning algorithms could automatically analyze computed tomography (CT) of the head, prioritize radiology worklists and reduce time to diagnosis of ICH. 46,583 head CTs (~2 million images) acquired from 2007-2017 were collected from several facilities across Geisinger.

Bariatric Left Gastric Artery Embolization for the Treatment of Obesity: A Review of Gut Hormone Involvement in Energy Homeostasis.

Objective: The global population is becoming more overweight and obese, leading to increases in associated morbidity and mortality rates. Advances in catheter-directed embolotherapy offer the potential for the interventional radiologist to make a contribution to weight loss. Left gastric artery embolization reduces the supply of blood to the gastric fundus and decreases serum levels of ghrelin.

Contemporary comparison of surgical and interventional arteriography management of blunt renal injury.

Purpose: High-grade renal injuries have traditionally been treated operatively. Alternatively, embolotherapy is used to control hemorrhage, but there are few studies that validate this practice after renal injury. Embolotherapy may offer an effective and safe means to arrest hemorrhage after high-grade blunt renal injury.

Triple-lumen peripherally inserted central catheter in patients in the critical care unit: prospective evaluation.

Purpose: To prospectively evaluate outcomes associated with use of a triple-lumen (TL) peripherally inserted central catheter (PICC) in the intensive care unit (ICU) setting.

Materials And Methods: Patients were prospectively enrolled in this HIPAA-compliant, institutional review board-approved study. Informed consent was obtained.

Drainage of collections associated with hernia mesh: is it worthwhile?

Purpose: Synthetic mesh has revolutionized abdominal wall hernia repair. However, mesh infections present a clinical problem because the standard practice of surgical excision is fraught with increased morbidity. Here, single-institutional outcomes in managing mesh-related collections via percutaneous drainage are retrospectively reviewed to assess its effectiveness.

Short-term infection in cuffed versus noncuffed small bore central catheters: a randomized trial.

Purpose: To determine if a polyester cuff offered benefit in jugular small-bore central catheters (SBCCs).

Materials And Methods: Eighty-four patients were randomly assigned to receive a 5-F single- or 6-F dual-lumen SBCC with (n = 42) or without (n = 42) a polyester cuff. Follow-up was performed at 2 weeks, 1 month, and 3 months or at catheter removal, whichever came first.

The case for primary placement of tunneled hemodialysis catheters in acute kidney injury.

Purpose: Nontunneled hemodialysis catheters (NTDCs) are widely used for initial hemodialysis access in new-onset renal failure. The National Kidney Foundation recommends NTDC use for hemodialysis duration of less than 1 week in acute kidney injury because of the increased infection risk compared with tunneled hemodialysis catheters (TDCs) with longer use. The present study was performed to determine whether primary placement of TDCs in this setting is more appropriate, and whether there are predictors of recovery of renal function in less than 1 week.

MRI of TIPS with covered stent-grafts: In vitro analysis using a flow phantom and initial clinical experience.

Objective: The use of the Viatorr stent-graft for transjugular intrahepatic portosystemic shunt (TIPS) creation is thought to improve patency rates. This study was designed to show the feasibility and pitfalls of imaging Viatorr TIPS using MRI.

Conclusion: MRI of the Viatorr stent-graft is feasible for the initial assessment of the TIPS.

Incidence and management of percutaneous transluminal angioplasty-induced venous rupture in the "fistula first" era.

Purpose: Percutaneous transluminal angioplasty (PTA)-induced venous rupture is a common complication of hemodialysis access interventions. The authors sought to determine if venous rupture rates and management differed between grafts and fistulas, and in the fistula subset, between transposed and nontransposed fistulas.

Materials And Methods: Patients experiencing venous rupture during hemodialysis PTA over a 5-year period were identified.

Angiographic changes following the use of a purse-string suture hemostasis device in hemodialysis access interventions.

Purpose: To evaluate late angiographic changes at the puncture site with use of a suture lock device for hemostasis after hemodialysis access interventions.

Materials And Methods: Thirty-five patients who underwent percutaneous intervention of a failing or thrombosed access had 76 puncture sites (58 grafts, 15 fistulas, three composite) managed with a purse-string suture lock device. All patients had follow-up fistulograms available for analysis.

Preoperative mapping venography in patients who require hemodialysis access: imaging findings and contribution to management.

Purpose: To analyze the use of preoperative venographic mapping in patients who require permanent hemodialysis access.

Materials And Methods: Ninety-one patients underwent 108 preoperative studies. Sixty-eight (75%) were documented to have ongoing or previous hemodialysis at the time of the study.

Large or small bore, push or pull: a comparison of three classes of percutaneous fluoroscopic gastrostomy catheters.

Purpose: To compare the tube performance and complication rates of small-bore, large-bore push-type, and large-bore pull-type gastrostomy catheters.

Materials And Methods: A total of 160 patients (74 men, 86 women; mean age, 66.9 years, range, 22-95 y) underwent percutaneous fluoroscopic gastrostomy placement between January 2004 and March 2006.