Rheumatic Heart Disease and Endomyocardial Fibrosis: A Complex Novel Case of Heart Failure.

Rheumatic heart disease (RHD) and endomyocardial fibrosis (EMF) are major causes of cardiac disease in low-income countries. We present a case of a patient with mitral stenosis and restrictive cardiomyopathy, initially attributed to severe RHD, but with disease progression despite valve replacement, likely secondary to previously undiagnosed EMF.

Understanding the Composition of a Comprehensive Otolaryngologist's Practice Through Medicare Reimbursements.

Objective: With a rising number of otolaryngology (ORL) graduates completing a fellowship, the number of generalists (also known as comprehensive ORLs [c-ORLs]), arguably the group of ORLs most needed, is likely to decrease. However, the practice and reimbursement patterns of c-ORLs have yet to be examined.

Study Design: Cross-sectional retrospective analysis.

Prospective, multi-site evaluation of the Cepheid Xpert Xpress CoV-2 test on nasal and nasopharyngeal swabs.

Unlabelled: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues its largely aseasonal spread with millions of cases per year. Highly sensitive, point-of-care testing is critical for rapid detection of coronavirus disease 2019 (COVID-19) cases and initiation of antiviral therapy to avert adverse health outcomes and reduce onward transmission of the virus. While hundreds of COVID-19 diagnostics received emergency use authorization from the FDA during the pandemic, significantly fewer have navigated the course to FDA clearance or approval.

Trends in Medicare Utilization and Reimbursement of Tracheostomy From 2000 to 2022.

Objective: To analyze the utilization and reimbursement for tracheostomy.

Study Design: Retrospective Cross-Sectional Study.

Setting: Centers for Medicare & Medicaid Services (CMS) Medicare Provider Utilization and Payment Data (2013 and 2021) and Part B Medicare Fee-For-Service National Summary Data (2000-2022).

Software-driven chronic disease management: Algorithm design and implementation in a community-based blood pressure control pilot.

Background: Optimal guideline-directed medical therapy is rarely attained in practice, resulting in inadequate control of diseases such as hypertension, with poorer results in under-resourced communities. Technology, including artificial intelligence-driven decision support and software-driven workflow transformation, can potentially improve disease outcomes at a reduced cost, although it must be integrated with a holistic approach.

Methods: We describe the design of a software platform that enables rapid iterative remote management of >20 conditions across cardiac-kidney-metabolic disease.

Developing an automated algorithm for identification of children and adolescents with diabetes using electronic health records from the OneFlorida+ clinical research network.

Aim: To develop an automated computable phenotype (CP) algorithm for identifying diabetes cases in children and adolescents using electronic health records (EHRs) from the UF Health System.

Materials And Methods: The CP algorithm was iteratively derived based on structured data from EHRs (UF Health System 2012-2020). We randomly selected 536 presumed cases among individuals aged <18 years who had (1) glycated haemoglobin levels ≥ 6.

Acute Liver Failure Induced by Provitalize: A Menopause Supplement Concocted From Herbs & Probiotics.

Drug-induced liver injury is one of the most common causes of acute liver failure in the Western world. Despite discontinuation of the offending agent, it can still tax a grim prognosis. We describe a case of a menopausal woman taking a herbal supplement called "Provitalize" to relieve hot flashes and bloating.

Economic evaluation of extended panel analysis in cancer patients with historical NHS diagnostic germline genetic testing - A modeling study based on real-world data.

Background: The South West Thames Centre for Genomics implemented a wider diagnostic Next Generation Sequencing (NGS) gene panel for eligible cancer patients undergoing diagnostic testing whilst restricting data analysis and reporting for BRCA1/BRCA2/PALB2/CHEK2 1100delC only as per contemporaneous guidelines. This study investigated the cost-utility of reanalyzing existing diagnostic grade extended panel data for truncating germline pathogenic variants (GPVs) in known moderate risk cancer susceptibility genes (CSGs) and performing follow-up genetic testing for first-degree relatives if patients have an identified CSG allele.

Methods: Reanalysis of existing NGS data was undertaken in 889 samples from cancer patients contemporaneously eligible through the NHS England National Genomic Test Directory (NGTD) codes R207 (ovarian) or R208 (breast) who had tested negative for BRCA1/BRCA2/PALB2 and CHEK2 1100delC founder variant.

3D-printed neck phantoms with detailed anatomy for ultrasound-guided procedure and device testing.

Objectives: With rapid advances in ultrasound-guided procedures, there is an unmet need for echogenic phantoms with sufficient anatomical details for artificial intelligence and ultrasound-guided device testing. We developed a method for creating neck phantoms for novel otolaryngology-related device testing. To achieve accurate representation of the anatomy, we utilized CT scans and 3D printing technology to create customized agar molds, thus providing high-fidelity yet cost-effective tools.

Tracheal Anastomosis Leaks Across Suture Techniques and Tensions: A Biomechanical Ex Vivo Study.

Background: Anastomotic leak after tracheal resection may occur while coughing in the early postoperative period. We investigated the varying effects of suturing technique, stretch, and tension on anastomotic leaks during simulated coughs.

Methods: End-to-end anastomoses were performed using continuous or interrupted sutures on excised porcine larynges.

Development of PainFace software to simplify, standardize, and scale up mouse grimace analyses.

Facial grimacing is used to quantify spontaneous pain in mice and other mammals, but scoring relies on humans with different levels of proficiency. Here, we developed a cloud-based software platform called PainFace ( http://painface.net ) that uses machine learning to detect 4 facial action units of the mouse grimace scale (orbitals, nose, ears, whiskers) and score facial grimaces of black-coated C57BL/6 male and female mice on a 0 to 8 scale.

Comparative evaluation of alkaline ionized water and normal water on oral microbial flora: An study.

Background: Various artificial chemical agents have been evaluated over many years with respect to their antimicrobial effect in oral cavity. The gold standard for removal of plaque is usage of chlorhexidine, but it can cause alteration in taste sensation and staining of teeth. Electrolytes and oxidizing water may be useful against microbes, but its clinical application has still not been evaluated.

Effects of Surgeon-Preferred Staff and Staff Turnover on Operating Time and Complication Rates in Reverse and Anatomic Total Shoulder Arthroplasty.

Background: This study focuses on investigating the risk factors of increased operating room time and patient complication rates after total shoulder arthroplasty cases (both reverse and anatomic). We hypothesize that the use of surgeon-preferred staff will improve operating room efficiency and reduce complication rates while increased staff turnover will decrease efficiency and increase complications.

Methods: This is a single-center, retrospective study focused on determining the effects of staffing on operating room time and efficiency in total shoulder arthroplasty.

How Variable are Patient Comorbidity Profiles Among Practicing Otolaryngologists?

Objective: To determine whether certain groups of otolaryngologists (ORLs) are treating cohorts of patients with more comorbidities.

Study Design: Cross-sectional population-based analysis.

Setting: 2019 Medicare Provider Utilization and Payment Dataset.

Medicare volume and reimbursement trends in lingual and hyoid procedures for obstructive sleep apnea.

Objectives: This study aims to analyze utilization and reimbursement trends in lingual and hyoid surgery for obstructive sleep apnea (OSA).

Methods: Annual retrospective data on lingual and hyoid OSA surgeries was obtained from the 2000-2021 Medicare Part B National Summary Datafiles. Current Procedural Terminology (CPT) codes utilized included 21,685 (hyoid myotomy and suspension [HMS]), 41,512 (tongue base suspension [TBS]), 41,530 (radiofrequency ablation of the tongue [RFT]) and 42,870 (lingual tonsillectomy [LT]).

Fabrication of a wearable and foldable photodetector based on a WSe-MXene 2D-2D heterostructure using a scalable handprint technique.

Several studies on semiconductor material-based single-band, high-performance photosensitive, and chemically stable photodetectors are available; however, the lack of broad spectral response, device flexibility, and biodegradability prevents them from being used in wearable and flexible electronics. Apart from that, the selection of the device fabrication technique is a very crucial factor nowadays in terms of equipment utilization and environmental friendliness. This report presents a study demonstrating a straightforward solvent- and equipment-free handprint technique for the fabrication of WSe-TiCT flexible, biodegradable, robust, and broadband (Vis-NIR) photodetectors.

An Endoscopic Ultrasound Diagnosis of a Rare Cause of Pancreatic Body Mass Demonstrating the Transformation to Large B-Cell Lymphoma.

The presence of lymphoma in the gastrointestinal tract is most frequently manifested in the stomach and intestines. Pancreatic lymphomas consist of only 0.5% of all pancreatic neoplasms.

A Pilot Randomized Trial of Combined Cognitive-Behavioral Therapy and Exercise Training Versus Exercise Training Alone for the Management of Chronic Insomnia in Obstructive Sleep Apnea.

Insomnia treatment among individuals with comorbid insomnia and obstructive sleep apnea is suboptimal. In a pilot randomized controlled trial, 19 individuals with comorbid insomnia and obstructive sleep apnea were allocated to one of two arms: EX + EX, consisting of two 8-week phases of exercise training (EX), or RE + CBTiEX, encompassing 8 weeks of relaxation training (RE) followed by 8 weeks of combined cognitive-behavioral therapy and exercise (CBTiEX). Outcomes included Insomnia Severity Index (ISI), polysomnography, and cardiorespiratory fitness measures.

Radioembolization plus Immune Checkpoint Inhibitor Therapy Compared with Radioembolization plus Tyrosine Kinase Inhibitor Therapy for the Treatment of Hepatocellular Carcinoma.

Purpose: To investigate if combination therapy with immune checkpoint inhibitor (ICI) and yttrium-90 (Y) radioembolization results in superior outcomes than those yielded by tyrosine kinase inhibitor (TKI) therapy and Y for the treatment of intermediate- to advanced-stage hepatocellular carcinoma (HCC).

Methods: A retrospective review of patients presented at an institutional multidisciplinary liver tumor board between January 1, 2012 and August 1, 2023 was conducted. In total, 44 patients with HCC who underwent Y 4 weeks within initiation of ICI or TKI therapy were included.

Predicting disease onset from electronic health records for population health management: a scalable and explainable Deep Learning approach.

Introduction: The move from a reactive model of care which treats conditions when they arise to a proactive model which intervenes early to prevent adverse healthcare events will benefit from advances in the predictive capabilities of Artificial Intelligence and Machine Learning. This paper investigates the ability of a Deep Learning (DL) approach to predict future disease diagnosis from Electronic Health Records (EHR) for the purposes of Population Health Management.

Methods: In this study, embeddings were created using a Word2Vec algorithm from structured vocabulary commonly used in EHRs e.

Trends in Medicare Reimbursements for Commonly Performed Laryngeal Procedures from 2000 to 2021.

Objective: Numerous studies among different specialties have suggested that inflation-adjusted Medicare reimbursements have steadily declined in the last few decades. The objective of this study is to investigate whether this is true within the field of laryngology.

Study Design: Retrospective Cross-Sectional Study.