Artificial Intelligence Helps Pathologists Increase Diagnostic Accuracy and Efficiency in the Detection of Breast Cancer Lymph Node Metastases.

The detection of lymph node metastases is essential for breast cancer staging, although it is a tedious and time-consuming task where the sensitivity of pathologists is suboptimal. Artificial intelligence (AI) can help pathologists detect lymph node metastases, which could help alleviate workload issues. We studied how pathologists' performance varied when aided by AI.

Impact of a machine learning algorithm on time to palliative care in a primary care population: protocol for a stepped-wedge pragmatic randomized trial.

Background: As primary care populations age, timely identification of palliative care need is becoming increasingly relevant. Previous studies have targeted particular patient populations with life-limiting disease, but few have focused on patients in a primary care setting. Toward this end, we propose a stepped-wedge pragmatic randomized trial whereby a machine learning algorithm identifies patients empaneled to primary care units at Mayo Clinic (Rochester, Minnesota, United States) with high likelihood of palliative care need.

Clinical Validation of Artificial Intelligence-Augmented Pathology Diagnosis Demonstrates Significant Gains in Diagnostic Accuracy in Prostate Cancer Detection.

Context.—: Prostate cancer diagnosis rests on accurate assessment of tissue by a pathologist. The application of artificial intelligence (AI) to digitized whole slide images (WSIs) can aid pathologists in cancer diagnosis, but robust, diverse evidence in a simulated clinical setting is lacking.

Assessment of Data Quality Variability across Two EHR Systems through a Case Study of Post-Surgical Complications.

Translation of predictive modeling algorithms into routine clinical care workflows faces challenges in the form of varying data quality-related issues caused by the heterogeneity of electronic health record (EHR) systems. To better understand these issues, we retrospectively assessed and compared the variability of data produced from two different EHR systems. We considered three dimensions of data quality in the context of EHR-based predictive modeling for three distinct translational stages: model development (data completeness), model deployment (data variability), and model implementation (data timeliness).

Early Post-Hospitalization Hemoglobin Recovery and Clinical Outcomes in Survivors of Critical Illness: A Population-Based Cohort Study.

Anemia is common during critical illness, is associated with adverse clinical outcomes, and often persists after hospitalization. The goal of this investigation is to assess the relationships between post-hospitalization hemoglobin recovery and clinical outcomes after survival of critical illness. This is a population-based observational study of adults (≥18 years) surviving hospitalization for critical illness between January 1, 2010 and December 31, 2016 in Olmsted County, Minnesota, United States with hemoglobin concentrations and clinical outcomes assessed through one-year post-hospitalization.

Early Detection of Post-Surgical Complications using Time-series Electronic Health Records.

Models predicting health complications are increasingly attempting to reflect the temporally changing nature of patient status. However, both the practice of medicine and electronic health records (EHR) have yet to provide a true longitudinal representation of a patient's medical history as relevant data is often asynchronous and highly missing. To match the stringent requirements of many static time models, time-series data has to be truncated, and missing values in samples have to be filled heuristically.

Quantifying the Importance of COVID-19 Vaccination to Our Future Outlook.

Predictive models have played a critical role in local, national, and international response to the COVID-19 pandemic. In the United States, health care systems and governmental agencies have relied on several models, such as the Institute for Health Metrics and Evaluation, Youyang Gu (YYG), Massachusetts Institute of Technology, and Centers for Disease Control and Prevention ensemble, to predict short- and long-term trends in disease activity. The Mayo Clinic Bayesian SIR model, recently made publicly available, has informed Mayo Clinic practice leadership at all sites across the United States and has been shared with Minnesota governmental leadership to help inform critical decisions during the past year.

Independent real-world application of a clinical-grade automated prostate cancer detection system.

Artificial intelligence (AI)-based systems applied to histopathology whole-slide images have the potential to improve patient care through mitigation of challenges posed by diagnostic variability, histopathology caseload, and shortage of pathologists. We sought to define the performance of an AI-based automated prostate cancer detection system, Paige Prostate, when applied to independent real-world data. The algorithm was employed to classify slides into two categories: benign (no further review needed) or suspicious (additional histologic and/or immunohistochemical analysis required).

Improving the delivery of palliative care through predictive modeling and healthcare informatics.

Objective: Access to palliative care (PC) is important for many patients with uncontrolled symptom burden from serious or complex illness. However, many patients who could benefit from PC do not receive it early enough or at all. We sought to address this problem by building a predictive model into a comprehensive clinical framework with the aims to (i) identify in-hospital patients likely to benefit from a PC consult, and (ii) intervene on such patients by contacting their care team.

Reelin depletion protects against autoimmune encephalomyelitis by decreasing vascular adhesion of leukocytes.

Neuroinflammation as a result of immune cell recruitment into the central nervous system (CNS) is a key pathogenic mechanism of multiple sclerosis (MS). However, current anti-inflammatory interventions depleting immune cells or directly targeting their trafficking into the CNS can have serious side effects, highlighting a need for better immunomodulatory strategies. We detected increased Reelin concentrations in the serum of patients with MS, resulting in increased endothelial permeability to leukocytes through increased nuclear factor κB-mediated expression of vascular adhesion molecules.

Validation of cell-cycle arrest biomarkers for acute kidney injury using clinical adjudication.

Rationale: We recently reported two novel biomarkers for acute kidney injury (AKI), tissue inhibitor of metalloproteinases (TIMP)-2 and insulin-like growth factor binding protein 7 (IGFBP7), both related to G1 cell cycle arrest.

Objectives: We now validate a clinical test for urinary [TIMP-2]·[IGFBP7] at a high-sensitivity cutoff greater than 0.3 for AKI risk stratification in a diverse population of critically ill patients.

Clinical outcomes with selectively constrained SECURE-C cervical disc arthroplasty: two-year results from a prospective, randomized, controlled, multicenter investigational device exemption study.

Study Design: Prospective, multicenter, randomized, and controlled Investigational Device Exemption clinical trial.

Objective: To compare the clinical safety and effectiveness of the selectively constrained SECURE-C (Globus Medical, Audubon, PA) Cervical Artificial Disc to anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Cervical total disc replacement has been developed as an alternative to ACDF by allowing segmental motion.

Effects of the combination of metyrapone and oxazepam on cocaine craving and cocaine taking: a double-blind, randomized, placebo-controlled pilot study.

Although cocaine dependence affects an estimated 1.6 million people in the USA, there are currently no medications approved for the treatment of this disorder. Experiments performed in animal models have demonstrated that inhibitors of the stress response effectively reduce intravenous cocaine self-administration.

Psychopathology and sexual trauma in childhood and adulthood.

This study evaluates the occurrence of psychopathology among 97 women who (1) experienced sexual abuse in childhood only, (2) were raped in adulthood only, (3) experienced both childhood sexual abuse and rape in adulthood, or (4) experienced no sexual trauma. Women were recruited from advertisements and assessed using the Structured Clinical Interview for DSM-IV (SCID-I/P) and the Modified PTSD Symptom Scale Self-Report. Women who reported sexual trauma were significantly more likely to exhibit psychopathology than controls.

Eating disturbance and sexual trauma in childhood and adulthood.

Objective: This study examined the relationship between sexual trauma and eating disorder behavior, taking into account the effects of developmental stage of the victim and the effects of multiple sexual assaults.

Method: Four groups of adult women took part in this study. Subjects were either victims of childhood sexual abuse, victims of rape in adulthood, victims of both childhood sexual abuse and rape, and controls who were not traumatized sexually.

Pathways mediating sexual abuse and eating disturbance in children.

Objective: To examine the relationship between childhood maltreatment and eating disorders in a sample of children.

Method: Twenty 10-15-year-old female children who were receiving treatment following reported childhood sexual abuse and 20 age-matched controls were compared on a series of measures assessing eating disorder behaviors, body image concerns, substance use, mood, impulsive behavior, and self-concept.

Results: Sexually abused children reported higher levels of eating disorder behaviors, impulsive behaviors, and drug abuse than controls.

Development of a dye ingress method to assess container-closure integrity: correlation to microbial ingress.

To demonstrate maintenance of parenteral product sterility, container-closure integrity over the shelf life of the product is critical. In the past, sterility testing has been used to ensure closure integrity. However, because of the limitations associated with sterility testing, there is a need for an improved method for evaluating container-closure integrity.

Relationship of childhood sexual abuse and eating disturbance in children.

Objective: To test the hypothesis that childhood sexual abuse increases the risk of eating disturbance in children.

Method: Data obtained from 20 sexually abused children were compared with data obtained from 20 nonabused control children. All subjects were female and between the ages of 10 and 15 years.

Academic difficulty of women, minority, and older medical student subgroups: a study of incidence and recovery.

Despite many retention studies, little is known about the performance of students in academic difficulty (SDs) who recover and graduate. In this study (1973-1982), the authors tracked 213 women, minorities, and older students in academic difficulty, those with three or more failures. Improvement measures were retention, National Board scores, and class rank at graduation.

The elicitation of a movement disorder by trazodone: case report.

A 65-year-old woman with bipolar disorder and complicated cardiovascular disease who was on maintenance lithium therapy developed a movement disorder following high doses of trazodone for treatment of an acute depression. When the trazodone was reduced, the involuntary movements promptly ceased. Although the movement disorder could not with certainty be attributed to trazodone alone, the drug at least acted as an eliciting agent.

Lithium incorporation in the fibroblasts of manic-depressives.

Lithium incorporation in cultured human skin fibroblasts was measured in a group of 10 manic-depressives and 10 controls. This system was believed to eliminate many of the sources of variability to which measurement of the lithium ratio in erythrocytes (RBCs) is subject. A fibroblast lithium ratio calculated from 1-hr lithium incorporation studies correlated highly with an in vitro RBC lithium ratio in medication-free controls.

alpha-Methyldopa and depression: a clinical study and review of the literature.

A review of the literature showed that a high incidence or prevalence of depression in patients being treated with alpha-methyldopa has never been documented. In their study of hypertensive patients in a general medical clinic the authors found that symptoms of depression were no more common in 42 patients treated with alpha-methyldopa than in 38 patients treated with other antihypertensive agents. As with other centrally active agents, alpha-methyldopa appears able to produce many different behavioral symptoms, including mood changes, in predisposed individuals.

Self-amputation and restitution.

This paper reports two cases of psychotically induced self-amputation of the hand, and discusses the psychological issues for the patient and staff involved in replantation and adaptation. The psychiatrist's role in facilitating patients' and staffs' utilization of restorative innovative techniques is also addressed.