Using machine learning to predict internal rotation after anatomic and reverse total shoulder arthroplasty.

Background: Improvement in internal rotation (IR) after anatomic (aTSA) and reverse (rTSA) total shoulder arthroplasty is difficult to predict, with rTSA patients experiencing greater variability and more limited IR improvements than aTSA patients. The purpose of this study is to quantify and compare the IR score for aTSA and rTSA patients and create supervised machine learning that predicts IR after aTSA and rTSA at multiple postoperative time points.

Methods: Clinical data from 2270 aTSA and 4198 rTSA patients were analyzed using 3 supervised machine learning techniques to create predictive models for internal rotation as measured by the IR score at 6 postoperative time points.

Validation of a machine learning-derived clinical metric to quantify outcomes after total shoulder arthroplasty.

Background: We propose a new clinical assessment tool constructed using machine learning, called the Shoulder Arthroplasty Smart (SAS) score to quantify outcomes following total shoulder arthroplasty (TSA).

Methods: Clinical data from 3667 TSA patients with 8104 postoperative follow-up reports were used to quantify the psychometric properties of validity, responsiveness, and clinical interpretability for the proposed SAS score and each of the Simple Shoulder Test (SST), Constant, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), University of California Los Angeles (UCLA), and Shoulder Pain and Disability Index (SPADI) scores.

Results: Convergent construct validity was demonstrated, with all 6 outcome measures being moderately to highly correlated preoperatively and highly correlated postoperatively when quantifying TSA outcomes.

Using machine learning to predict clinical outcomes after shoulder arthroplasty with a minimal feature set.

Background: A machine learning analysis was conducted on 5774 shoulder arthroplasty patients to create predictive models for multiple clinical outcome measures after anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA). The goal of this study was to compare the accuracy associated with a full-feature set predictive model (ie, full model, comprising 291 parameters) and a minimal-feature set model (ie, abbreviated model, comprising 19 input parameters) to predict clinical outcomes to assess the efficacy of using a minimal feature set of inputs as a shoulder arthroplasty clinical decision-support tool.

Methods: Clinical data from 2153 primary aTSA patients and 3621 primary rTSA patients were analyzed using the XGBoost machine learning technique to create and test predictive models for multiple outcome measures at different postoperative time points via the full and abbreviated models.

A Multidimensional Reputation Barometer for Public Agencies: A Validated Instrument.

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What Is the Accuracy of Three Different Machine Learning Techniques to Predict Clinical Outcomes After Shoulder Arthroplasty?

Background: Machine learning techniques can identify complex relationships in large healthcare datasets and build prediction models that better inform physicians in ways that can assist in patient treatment decision-making. In the domain of shoulder arthroplasty, machine learning appears to have the potential to anticipate patients' results after surgery, but this has not been well explored.

Questions/purposes: (1) What is the accuracy of machine learning to predict the American Shoulder and Elbow Surgery (ASES), University of California Los Angeles (UCLA), Constant, global shoulder function, and VAS pain scores, as well as active abduction, forward flexion, and external rotation at 1 year, 2 to 3 years, 3 to 5 years, and more than 5 years after anatomic total shoulder arthroplasty (aTSA) or reverse total shoulder arthroplasty (rTSA)? (2) What is the accuracy of machine learning to identify whether a patient will achieve clinical improvement that exceeds the minimum clinically important difference (MCID) threshold for each outcome measure? (3) What is the accuracy of machine learning to identify whether a patient will achieve clinical improvement that exceeds the substantial clinical benefit threshold for each outcome measure?

Methods: A machine learning analysis was conducted on a database of 7811 patients undergoing shoulder arthroplasty of one prosthesis design to create predictive models for multiple clinical outcome measures.

Unfolding thermodynamics of the Delta-domain in the prohead I subunit of phage HK97: determination by factor analysis of Raman spectra.

An early step in the morphogenesis of the double-stranded DNA (dsDNA) bacteriophage HK97 is the assembly of a precursor shell (prohead I) from 420 copies of a 384-residue subunit (gp5). Although formation of prohead I requires direct participation of gp5 residues 2-103 (Delta-domain), this domain is eliminated by viral protease prior to subsequent shell maturation and DNA packaging. The prohead I Delta-domain is thought to resemble a phage scaffolding protein, by virtue of its highly alpha-helical secondary structure and a tertiary fold that projects inward from the interior surface of the shell.

Raman spectroscopy of proteins.

A protein Raman spectrum comprises discrete bands representing vibrational modes of the peptide backbone and its side chains. The spectral positions, intensities, and polarizations of the Raman bands are sensitive to protein secondary, tertiary, and quaternary structures and to side -chain orientations and local environments. In favorable cases, the Raman spectrum serves as an empirical signature of protein three-dimensional structure, intramolecular dynamics, and intermolecular interactions.

Characterization of community-acquired Staphylococcus aureus infections in children.

Background: Limited data exist concerning characteristics of community-acquired Staphylococcus aureus infections (CA-SAI) in central and eastern Kentucky.

Objective: To describe the incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections from January 1, 2004 through December 31, 2005, compare the number of CA-MRSA infections between years, and contrast treatment interventions and antibiotic susceptibility patterns of CA-SAI.

Methods: A concurrent and retrospective study was conducted in 125 patients less than 18 years of age with CA-SAI admitted to the hospital/clinic based on criteria from the Centers for Disease Control and Prevention.

Impact of in vitro assembly defects on in vivo function of the phage P22 portal.

The podovirus P22, which infects O-antigen strains of Salmonella, incorporates a dsDNA translocating channel (portal dodecamer) at a unique vertex of the icosahedral capsid. The portal subunit (gp1, 82.7 kDa) exhibits multiple S-Hcdots, three dots, centeredX hydrogen bonding states for cysteines 153, 173, 283 and 516 and these interactions are strongly perturbed by portal ring formation.

Utilizing Pharmacy Records to Assess Antibiotic Prescribing Patterns on the Incidence of Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections in Children.

Objective: To assess the effect of prior antibiotic therapy on the incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in children.

Methods: This was a concurrent and retrospective review of antibiotic records for children < 18 years of age with documented CA-MRSA infection identified between January 1, 2004, and December 31, 2005. Antibiotic records were compared against a control group.

The structure of a filamentous bacteriophage.

Many thin helical polymers, including bacterial pili and filamentous bacteriophage, have been seen as refractory to high-resolution studies by electron microscopy. Studies of the quaternary structure of such filaments have depended upon techniques such as modeling or X-ray fiber diffraction, given that direct visualization of the subunit organization has not been possible. We report the first image reconstruction of a filamentous virus, bacteriophage fd, by cryoelectron microscopy.

Structural characterization of the filamentous bacteriophage PH75 from Thermus thermophilus by Raman and UV-resonance Raman spectroscopy.

The filamentous bacteriophage PH75, which infects the thermophile T. thermophilus, assembles in vivo at 70 degrees C and is stable to at least 90 degrees C. Although a high-resolution structure of PH75 is not available, the virion is known to comprise a closed single-stranded (ss) DNA circle of 6500 nucleotides sheathed by a capsid comprising 2700 copies of a 46-residue subunit (pVIII).

Effects of virion and salt concentrations on the Raman signatures of filamentous phages fd, Pf1, Pf3, and PH75.

Filamentous phages consist of a single-stranded DNA genome encapsidated by several thousand copies of a small alpha-helical coat protein subunit plus several copies of four minor proteins at the filament ends. The filamentous phages are important as cloning vectors, vehicles for peptide display, and substrates for macromolecular alignment. Effective use of a filamentous phage in such applications requires an understanding of experimental factors that may influence the propensity of viral filaments to laterally aggregate in solution.

The cognitive effects of opioids.

Successful opioid therapy often depends on achieving a balance between analgesic effectiveness and side effects. The risk of opioid-induced cognitive impairment often hinders clinicians and patients from initiating or optimizing opioid therapy. Despite subjective experiences of mental dullness and sedation, objective tests of cognitive functioning do not always demonstrate marked changes following opioid administration.

Point prevalence of Cryptosporidium, Cyclospora, and Isospora infections in patients being evaluated for diarrhea.

From March to September 2001, 315 specimens from "nonrepeat" patients that were submitted for ova and parasite examination were stained using the Kinyoun modified acid-fast stain to detect the intestinal coccidians. Four patients (1.3%) were infected with coccidians, 2 with Cryptosporidium parvum and 2 with Cyclospora cayetanensis.

Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial.

Context: Faster magnetic resonance imaging (MRI) scanning has made MRI a potential cost-effective replacement for radiographs for patients with low back pain. However, whether rapid MRI scanning results in better patient outcomes than radiographic evaluation or a cost-effective alternative is unknown.

Objective: To determine the clinical and economic consequences of replacing spine radiographs with rapid MRI for primary care patients.

Orientation and interactions of an essential tryptophan (Trp-38) in the capsid subunit of Pf3 filamentous virus.

The filamentous bacteriophage Pf3 consists of a covalently closed DNA single strand of 5833 nucleotides sheathed by approximately 2500 copies of a 44-residue capsid subunit. The capsid subunit contains a single tryptophan residue (Trp-38), which is located within the basic C-terminal sequence (-RWIKAQFF) and is essential for virion assembly in vivo. Polarized Raman microspectroscopy has been employed to determine the orientation of the Trp-38 side chain in the native virus structure.

Protein and DNA residue orientations in the filamentous virus Pf1 determined by polarized Raman and polarized FTIR spectroscopy.

The Pseudomonas bacteriophage Pf1 is a long ( approximately 2000 nm) and thin ( approximately 6.5 nm) filament consisting of a covalently closed, single-stranded DNA genome of 7349 nucleotides coated by 7350 copies of a 46-residue alpha-helical subunit. The coat subunits are arranged as a superhelix of C(1)()S(5.

Evaluation of methods to increase the sensitivity and timeliness of detection of Streptococcus agalactiae in pregnant women.

Direct culture of rectovaginal specimens on Granada agar was compared to culture on sheep blood agar plate (SBAP) and AccuProbe detection of group B streptococcus from overnight LIM broth enhancement cultures (LIM-SBAP). Both broth-enhanced methods demonstrated excellent sensitivity (97.5% for LIM-SBAP and 93.

Etanercept in the treatment of adult patients with Still's disease.

Objective: To evaluate the safety and efficacy of etanercept in the treatment of adult patients with Still's disease.

Methods: Twelve adult patients who met criteria for Still's disease and had active arthritis were enrolled in a 6-month open-label trial of etanercept given in biweekly doses of 25 mg. The mean disease duration at study entry was 10.

Performance characteristics of VIDAS and directigen respiratory syncytial virus (RSV) antigen detection assays and culture for the identification of RSV in respiratory specimens.

In a comparison of the Directigen and VIDAS respiratory syncytial virus antigen detection assays with viral culture, the sensitivity, specificity, positive and negative predictive values, and testing efficiency were 86, 93.1, 82.7, 94.