Spine-Abductor Syndrome: Novel Associations Between Lumbar Spine Disease and Hip Gluteal Muscle Pathology.

Background: Risk factors for gluteal tears include age-related deterioration, female sex, and increased body mass index. As the literature that supports the sagittal relationship between the lumbar spine and the hip is increasing, there may be a parallel relationship between the perturbations in spinopelvic alignment caused by lumbar spine disease and gluteal muscle tears. Because no prior studies other than single-institution series have reported on this phenomenon, we investigated spine-abductor syndrome at the population level.

The Impact of Contemporary Glucagon-like Peptide-1 Receptor Agonists on the Onset, Severity, and Conversion to Arthroplasty in Hip and Knee Osteoarthritis.

Background: The growing popularity of glucagon-like peptide-1 receptor agonists (GLP-1-RAs) for weight loss could significantly impact joint preservation and arthroplasty. While this will in part be driven by the association between obesity, osteoarthritis (OA), and total joint arthroplasty (TJA), recent evidence also indicates that GLP-1-RAs may have direct joint-protective, anti-inflammatory effects.

Purpose: To evaluate the association between GLP-1-RA use and the onset and progression of hip and knee OA in an obese population.

With big data comes big responsibility: Strategies for utilizing aggregated, standardized, de-identified electronic health record data for research.

Electronic health records (EHRs), though they are maintained and utilized for clinical and billing purposes, may provide a wealth of information for research. Currently, sources are available that offer insight into the health histories of well over a quarter of a billion people. Their use, however, is fraught with hazards, including introduction or reinforcement of biases, clarity of disease definitions, protection of patient privacy, definitions of covariates or confounders, accuracy of medication usage compared with prescriptions, the need to introduce other data sources such as vaccination or death records and the ensuing potential for inaccuracy, duplicative records, and understanding and interpreting the outcomes of data queries.

Atrial Fibrillation after RSV Vaccination Among Older Adults.

RSV vaccine clinical trials reported higher frequencies of atrial fibrillation in intervention groups compared to control. In this large, population-based, propensity-matched study, we found RSV vaccine was not associated with increased risk of new-onset or recurrent atrial fibrillation within 1-42 days compared to influenza or Tdap vaccines.

System-Based Intervention for Medical Providers to Improve Dental Attendance in Adult Primary Care.

Introduction: There are minimal evidence-based outcomes from clinical trials for medical-dental integration. This formative work and pilot study is a precursor to a larger cluster-randomized clinical trial in adult primary care practices to test an electronic health record (EHR) structured workflow for primary care providers (physicians/nurse practitioners [NPs]) and medical staff (medical assistants [MAs] and nurses) with oral health (OH) screening and referral for Medicaid-enrolled adults ≥55 years.

Methods: This study was conducted in 2 practices with providers, medical staff, and older adults.

Intrapartum and 30-Day Postpartum Complications in Patients With Antenatal COVID-19 Infection: A Retrospective Cohort Study.

The study was aimed at comparing intrapartum and postpartum outcomes between pregnant patients with and without antenatal COVID-19 infection using aggregated, deidentified electronic health record (EHR) data. This retrospective cohort study included data from over 80 health care organizations within the TriNetX Analytics Research Network. Individuals admitted for delivery from Jan 2020 to May 2023 were studied.

Association between selective serotonin reuptake inhibitors and mortality following COVID-19 among patients with Alzheimer's disease.

Background: Recent research suggests that selective serotonin reuptake inhibitors (SSRIs) may reduce mortality in COVID-19 patients; however, research into their benefits for elderly Alzheimer's disease (AD) patients remains limited.

Objective: To investigate the relationship between SSRIs therapy and the mortality risk after COVID-19 infection in elderly patients with and without AD.

Methods: This retrospective cohort study leveraged a large database containing over 100 million electronic health records in the US from the TriNetX platform to compare the hazard rates of mortality after COVID-19 infection in elderly AD patients prescribed SSRIs versus propensity-score matched individuals prescribed other antidepressants.

Sociodemographic Disparities in 1-Year Outcomes of Children With Community-Acquired Acute Kidney Injury.

Importance: Racial disparities have been identified in pediatric community-acquired acute kidney injury (CA-AKI), and they are associated with increased risk of child mortality, morbidity, and progression of kidney disease.

Objective: To assess clinical outcomes at 1 year among children with CA-AKI, stratified by age, race, and ethnicity.

Design, Setting, And Participants: This retrospective cohort study is a population-based analysis of deidentified, aggregated electronic health record data collected by 61 large health care organizations from 2003 to 2023 and accessed through the TriNetX platform.

The Epidemiology of Pediatric Shoulder Dislocations in the United States.

Background: Shoulder dislocations are the most common of all major joint dislocations and are a frequent cause of emergency department (ED) presentations. While the epidemiology of shoulder dislocations has been characterized in adults, it has not yet been done for children in the United States. The primary goal of this study was to calculate the incidence rate of pediatric shoulder dislocations in the United States.

Associations of semaglutide with first-time diagnosis of Alzheimer's disease in patients with type 2 diabetes: Target trial emulation using nationwide real-world data in the US.

Introduction: Emerging preclinical evidence suggests that semaglutide, a glucagon-like peptide receptor agonist (GLP-1RA) for type 2 diabetes mellitus (T2DM) and obesity, protects against neurodegeneration and neuroinflammation. However, real-world evidence for its ability to protect against Alzheimer's disease (AD) is lacking.

Methods: We conducted emulation target trials based on a nationwide database of electronic health records (EHRs) of 116 million US patients.

Gut-derived PPAR-γ signaling and risk of bacterial enteric infection: insight from thiazolidinedione users in a US population-based study.

Background And Aims: The ongoing antimicrobial resistant crisis heralds the need for new therapeutics against enteric infection. In mouse models, colon epithelial peroxisome proliferator-activated receptor-γ (PPAR-γ) signaling limits oxygen and nitrate luminal bioavailability, thereby preventing bacterial pathogen colonization. However, whether this mechanism operates similarly in humans remains uncertain.

Machine learning interpretability methods to characterize the importance of hematologic biomarkers in prognosticating patients with suspected infection.

Objective: To evaluate the effectiveness of Monocyte Distribution Width (MDW) in predicting sepsis outcomes in emergency department (ED) patients compared to other hematologic parameters and vital signs, and to determine whether routine parameters could substitute MDW in machine learning models.

Methods: We conducted a retrospective analysis of data from 10,229 ED patients admitted to a large regional safety-net hospital in Cleveland, Ohio who had suspected infections and developed sepsis-associated poor outcomes. We developed a new analytical framework consisting of seven data models and an ensemble of high accuracy machine learning (ML) algorithms (accuracy values ranging from 0.