Evaluating an ICD-10 Based Proxy for Date of Birth in Electronic Health Record Data.

Purpose: To comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, many real-world data providers mask a patient's date of birth by supplying only year of birth to data users. The lack of granularity around patient age is a challenge when using RWD, especially for pediatric research studies. In this study, a proxy for patient date of birth is evaluated using electronic health record (EHR) data.

Evaluating factors impacting National Institutes of Health funding in pain medicine.

Background: While many medical specialties have established links between bibliometric indices, academic rank, leadership roles, and National Institutes of Health (NIH) funding, there exists a gap within the field of pain medicine. The purpose of our study is to examine the impact of research productivity (h-index, m-index, publications, citations), professional degrees (PhD, MPH, MBA), leadership positions (program director, division chief, chairman), and faculty demographics (gender, nationality of training) on attaining NIH grant funding among pain medicine faculty.

Methods: A complete list of 98 civilian pain medicine programs was included in the study.

Daily automated prediction of delirium risk in hospitalized patients: Model development and validation.

Background: Delirium is common in hospitalized patients and correlated with increased morbidity and mortality. Despite this, delirium is underdiagnosed, and many institutions do not have sufficient resources to consistently apply effective screening and prevention.

Objective: To develop a machine learning algorithm to identify patients at highest risk of delirium in the hospital each day in an automated fashion based on data available in the electronic medical record, reducing the barrier to large-scale delirium screening.

The Role of Processed Electroencephalogram in Adult Surgical Procedures: A Retrospective Cohort Study.

The use of depth of anesthesia monitoring, such as a processed electroencephalogram (pEEG), can decrease the risk of awareness with recall, yet the current standards for monitoring during the administration of anesthesia do not include the use of brain monitoring for anesthetic depth. This retrospective cohort study describes the frequency of use and explores the characteristics of utilization of pEEG monitoring by anesthesia professionals during the administration of general anesthesia in the adult patient population at a large academic medical center. Descriptive associations with pEEG monitoring were confirmed in both univariate and multivariable analyses with multiple patient, anesthetic, and surgical characteristics.

Intraoperative Non-Opiate Anesthesia for Patients Undergoing Arthroscopic Temporomandibular Joint Surgery: A Randomized Controlled Trial.

Background: Pain intensity after temporomandibular joint (TMJ) surgery is often underestimated, and inadequate pain control may relate to poor recovery quality, increased opioid consumption, and longer hospital stay. This trial aims to evaluate whether non-opiate anesthesia provides a promising option of pain management for patients undergoing TMJ surgery.

Methods: Sixty patients receiving TMJ surgery were randomly assigned to either the control group or the non-opiate group.

Startle sign events induced by mechanical manipulation during surgery for neuroma localization: a retrospective cohort study.

Background: Chronic pain from peripheral neuromas is difficult to manage and often requires surgical excision, though intraoperative identification of neuromas can be challenging due to anatomical ambiguity. Mechanical manipulation of the neuroma during surgery can elicit a characteristic "startle sign", which can help guide surgical management. However, it is unknown how anesthetic management affects detection of the startle sign.

Cardiac index as a surrogate marker for anxiety in pediatric patients undergoing ambulatory endoscopy: a prospective cohort study.

Pediatric patients undergoing medical procedures often grapple with preoperative anxiety, which can impact postoperative outcomes. While healthcare providers subjectively assess anxiety, objective quantification tools remain limited. This study aimed to evaluate two objective measures-cardiac index (CI) and heart rate (HR) in comparison with validated subjective assessments, the modified Yale Preoperative Anxiety Scale (mYPAS) and the numeric rating scale (NRS).

Development and validation of a score for prediction of postoperative respiratory complications in infants and children (SPORC-C).

Background: In infants and children, postoperative respiratory complications are leading causes of perioperative morbidity, mortality, and increased healthcare utilisation. We aimed to develop a novel score for prediction of postoperative respiratory complications in paediatric patients (SPORC for children).

Methods: We analysed data from paediatric patients (≤12 yr) undergoing surgery in New York and Boston, USA for score development and external validation.

A Multiresolution Approach with Method-Informed Statistical Analysis for Quantifying Lymphatic Pumping Dynamics.

Despite significant strides in lymphatic system imaging, the timely diagnosis of lymphatic disorders remains elusive. One main cause for this is the absence of standardized, quantitative methods for real-time analysis of lymphatic contractility. Here, we address this unmet need by combining near-infrared lymphangiography imaging with an innovative analytical workflow.

Pain medication beliefs in individuals with headache.

Objective: To evaluate pain medication beliefs in a community sample of individuals with headache.

Background: Previous studies of medication adherence for individuals with headache have identified a high rate of prescription nonfulfillment, frequent medication discontinuation, and widely varying levels of medication-related satisfaction. Still, there is a limited understanding of how these individuals view their medications and their relationships with health-care providers.

Effects of Intra-operative Cardiopulmonary Variability On Post-operative Pulmonary Complications in Major Non-cardiac Surgery: A Retrospective Cohort Study.

Intraoperative cardiopulmonary variables are well-known predictors of postoperative pulmonary complications (PPC), traditionally quantified by median values over the duration of surgery. However, it is unknown whether cardiopulmonary instability, or wider intra-operative variability of the same metrics, is distinctly associated with PPC risk and severity. We leveraged a retrospective cohort of adults (n = 1202) undergoing major non-cardiothoracic surgery.

Hispanic/Latino Ethnicity and Loss of Post-Surgery Independent Living: A Retrospective Cohort Study from a Bronx Hospital Network.

Background: Black race is associated with postoperative adverse discharge to a nursing facility, but the effects of Hispanic/Latino ethnicity are unclear. We explored the Hispanic paradox , described as improved health outcomes among Hispanic/Latino patients on postoperative adverse discharge to nursing facility.

Methods: A total of 93,356 adults who underwent surgery and were admitted from home to Montefiore Medical Center in the Bronx, New York, between January 2016 and June 2021 were included.

Narrow band green light effects on headache, photophobia, sleep, and anxiety among migraine patients: an open-label study conducted online using daily headache diary.

Background: Narrow band green light (NbGL) has been shown to relieve headache in small numbers of subjects but large-scale real-world assessments are lacking. The goal of this prospective, observational, open-label, real world study was to determine whether treatment with NbGL during the ictal phase of migraine, improves patients' perception of their headache, photophobia, anxiety and same-night sleep.

Methods: The study was conducted in purchasers of the NbGL Lamp in two phases.

The impact of residency training level on early postoperative desaturation: A retrospective multicenter cohort study.

Objective: We studied the primary hypothesis that the training level of anesthesiology residents (first clinical anesthesia year, CA1 vs CA2/3 residents) is associated with early postoperative desaturation (oxygen saturation < 90%). We also analyzed the change in the rate (trajectory) of desaturation during the resident's development from CA1 to CA2/3 resident, and its effects on postoperative respiratory complications.

Design: Retrospective hospital registry study.

Information theory and headache triggers.

Objectives: This secondary analysis evaluated the information content exhibited by various measurement strategies of commonly perceived causes, or "triggers," of headache attacks.

Background: When evaluating triggers of primary headache attacks, the variation observed in trigger candidates must be measured to compare against the covariation in headache activity. Given the numerous strategies that could be used to measure and record headache trigger variables, it is useful to consider the information contained in these measurements.

Association of Intraoperative Opioid Administration With Postoperative Pain and Opioid Use.

Importance: Opioids administered to treat postsurgical pain are a major contributor to the opioid crisis, leading to chronic use in a considerable proportion of patients. Initiatives promoting opioid-free or opioid-sparing modalities of perioperative pain management have led to reduced opioid administration in the operating room, but this reduction could have unforeseen detrimental effects in terms of postoperative pain outcomes, as the relationship between intraoperative opioid usage and later opioid requirements is not well understood.

Objective: To characterize the association between intraoperative opioid usage and postoperative pain and opioid requirements.

Association Between Postoperative Delirium and Long-Term Subjective Cognitive Decline in Older Patients Undergoing Cardiac Surgery: A Secondary Analysis of the Minimizing Intensive Care Unit Neurological Dysfunction with Dexmedetomidine-Induced Sleep Trial.

Objectives: This study aimed to evaluate whether a measure of subjective cognitive decline (SCD), the Patient-Reported Outcomes Measurement Information System (PROMIS) Applied Cognition-Abilities questionnaire, was associated with postoperative delirium. It was hypothesized that delirium during the surgical hospitalization would be associated with a decrease in subjective cognition up to 6 months after cardiac surgery.

Design: This was a secondary analysis of data from the Minimizing Intensive Care Unit Neurological Dysfunction with Dexmedetomidine-induced Sleep randomized, placebo-controlled, parallel-arm superiority trial.

Indole-3-Propionic Acid, a Gut Microbiota Metabolite, Protects Against the Development of Postoperative Delirium.

Objective: The aim was to determine preoperative gut microbiota metabolites that may be associated with postoperative delirium (POD) development in patients and further study in rodents.

Summary Background Data: POD occurs in 9% to 50% of older patients undergoing anesthesia/surgery but lacks effective treatments or prevention. High-throughput metabolomics using liquid chromatography with tandem mass spectrometry has accelerated disease-related biomarkers discovery.

The association between gut microbiota and postoperative delirium in patients.

Postoperative delirium is a common postoperative complication in older patients, and its pathogenesis and biomarkers remain largely undetermined. The gut microbiota has been shown to regulate brain function, and therefore, it is vital to explore the association between gut microbiota and postoperative delirium. Of 220 patients (65 years old or older) who had a knee replacement, hip replacement, or laminectomy under general or spinal anesthesia, 86 participants were included in the data analysis.

Sound and light levels in intensive care units in a large urban hospital in the United States.

Intensive care units (ICUs) may disrupt sleep. Quantitative ICU studies of concurrent and continuous sound and light levels and timings remain sparse in part due to the lack of ICU equipment that monitors sound and light. Here, we describe sound and light levels across three adult ICUs in a large urban United States tertiary care hospital using a novel sensor.

Learning headache triggers through experience: A laboratory study.

Objective: To examine how individuals may learn headache trigger beliefs through sequential symbolic pairings of trigger candidates and headache attacks.

Background: Learning from experience may be a major source of information about headache triggers. Little is known about learning-based influences on the establishment of trigger beliefs.