Machine Learning-Assisted Decision Making in Orthopaedic Oncology.

» Artificial intelligence is an umbrella term for computational calculations that are designed to mimic human intelligence and problem-solving capabilities, although in the future, this may become an incomplete definition. Machine learning (ML) encompasses the development of algorithms or predictive models that generate outputs without explicit instructions, assisting in clinical predictions based on large data sets. Deep learning is a subset of ML that utilizes layers of networks that use various inter-relational connections to define and generalize data.

Radiographic parameters of pelvic and proximal femoral morphology do not predict outcomes for direct anterior total hip arthroplasty.

Background: Radiographic predictors of outcomes associated with direct anterior approach (DAA) total hip arthroplasty (THA) are largely unknown. Anecdotally, some surgeons limit surgery to patients with low body mass index (BMI) or "favorable" bony morphology. Objective data on the impact of these factors is limited.

Arthroscopic treatment for intra-articular fibroma of the tendon sheath in a teenager.

An adolescent female patient presented with atraumatic left knee pain and limited flexion. MRI demonstrated evidence of a soft tissue lesion abutting the posterior cruciate ligament. Differential diagnosis included pigmented villonodular synovitis (PVNS) and fibroma of the tendon sheath (FTS).

Complex Reconstruction for Acetabular Pathologic Fracture in Unusual Chondroblastoma With Aneurysmal Bone Cyst.

Treating bone loss with complex arthroplasty poses a significant challenge for the arthroplasty surgeon. When considering a reconstructive case after pathologic fracture and oncologic excision, a multidisciplinary approach with reliance on arthroplasty principles is critical. An 18-year-old patient presented with a complex acetabular pathologic fracture through a chondroblastoma with a secondary aneurysmal bone cyst.

Corrective Osteotomy and Physeal Bar Resection for Distal Radial Physeal Arrest After Flexible Nailing: A Case Report.

Case: A 9-year-old girl developed a physeal bar after flexible nailing for a proximal radius fracture. The patient presented 2 years after initial injury with gross deformity of the wrist with confirmed physeal bar. The patient underwent physeal bar resection, cement interposition, and corrective osteotomy with improvement of radial height, wrist deformity, and function.

Novel methods to enhance surgical sperm retrieval: a systematic review.

: To explore the use of novel technologies in sperm retrieval in men with azoospermia due to a production defect. : We performed a Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA)-compliant systemic literature review for manuscripts focussed on novel sperm-retrieval methods. We identified 30 studies suitable for qualitative analysis.

Shoulder arthroplasty in solid organ transplant patients: a retrospective, match paired analysis.

Background: Several studies have evaluated total hip and knee arthroplasty in solid organ transplant (SOT) patients; however, there are limited studies evaluating shoulder arthroplasty in SOT patients. This study compares the complications and functional outcomes of SOT patients undergoing shoulder arthroplasty with a matched control group.

Methods: The institution's database was retrospectively reviewed for patients with a history of SOT undergoing primary shoulder arthroplasty (with minimum 2-year follow-up) and compared with a control group matched for age, sex, preoperative diagnosis, and surgical procedure.

The Basic Physics of Waves, Soundwaves, and Shockwaves for Erectile Dysfunction.

Introduction: Over the past decade, low-intensity extracorporeal shockwave therapy (Li-ESWT) has emerged as a treatment modality for erectile dysfunction (ED). To better appreciate the differences between the various devices for the treatment of ED, it is imperative for physicians to understand the underlying physics of the different shockwave generators.

Aim: In this article, we explain the physics of shockwaves by establishing a foundation regarding the basics of waves, specifically soundwaves.

Shockwave Therapy in the Treatment of Peyronie's Disease.

Introduction: Peyronie's disease is an acquired condition of the connective tissue of the penis that affects 0.5-20.3% of the male population and is marked by fibrotic plaques in the tunica albuginea.

Prospective Analysis of Operating Room and Discharge Delays in a Burn Center.

Delays to the operating room (OR) or discharge (DC) lead to longer lengths of stay and increased costs. Surprisingly, little work has been done to quantify the number and cost of delays for inpatients to the OR, and to DC to outpatient status. They reviewed their burn admissions to determine how often a patient experiences delays in healthcare delivery.

Inability to predict subprophylactic anti-factor Xa levels in trauma patients receiving early low-molecular-weight heparin.

Background: Standard low-molecular-weight heparin dosing may be suboptimal for venous thromboembolism prophylaxis. We aimed to identify independent predictors of subprophylactic Xa (subXa) levels in trauma patients treated under a novel early chemoprophylaxis algorithm.

Methods: A retrospective analysis of trauma patients from July 2016 to June 2017 who received enoxaparin 40 mg twice daily and had peak Xa levels drawn was performed.

Low-Intensity Shockwave Therapy for Erectile Dysfunction.

Background: Vasculogenic erectile dysfunction (ED) is one of the leading causes of male sexual dysfunction. In the past decade, multiple studies have examined the use of low-intensity extracorporeal shockwave therapy (Li-ESWT) for the treatment of ED.

Aim: Investigate the efficacy of Li-ESWT for the treatment of ED.

Can CT imaging of the chest, abdomen, and pelvis identify all vertebral injuries of the thoracolumbar spine without dedicated reformatting?

Background: The main objective of this study was to compare detection rates of clinically significant thoracolumbar spine (TLS) fracture between computed tomography (CT) imaging of the chest, abdomen, and spine (CT CAP) and CT for the thoracolumbar spine (CT TL).

Methods: We retrospectively identified patients at our institution with a TLS fracture over a two-year period that had both CT CAP and reformatted CT TL imaging. The sensitivity of CT CAP to identify fracture was calculated for each fracture type.

Testosterone therapy improves erectile function and libido in hypogonadal men.

Purpose Of Review: Erectile dysfunction and decreased libido are common complaints in the older male population. Recent studies have elucidated the role testosterone therapy (TTh) can play in men with low testosterone levels. The aim of this review is to provide an overview of these findings and the utility of TTh.

Interplay of buried histidine protonation and protein stability in prion misfolding.

Misofolding of mammalian prion proteins (PrP) is believed to be the cause of a group of rare and fatal neurodegenerative diseases. Despite intense scrutiny however, the mechanism of the misfolding reaction remains unclear. We perform nuclear Magnetic Resonance and thermodynamic stability measurements on the C-terminal domains (residues 90-231) of two PrP variants exhibiting different pH-induced susceptibilities to aggregation: the susceptible hamster prion (GHaPrP) and its less susceptible rabbit homolog (RaPrP).

Review of Postoperative Delirium in Geriatric Patients Undergoing Hip Surgery.

Postoperative delirium is a serious complication following hip surgery in elderly patients that can adversely affect outcomes in both hip fracture and arthroplasty surgery. Recently, the incidence of hip fracture in the Medicare population was estimated at approximately 500 000 patients per year, with the majority treated surgically. The annual volume of total hip arthroplasty is nearly 450 000 patients and is projected to increase over the next 15 to 20 years.

Developing a Web Site: A Strategy for Employment Integration of Internationally Educated Nurses.

In Canada and elsewhere, the case for hiring internationally educated nurses (IENs) has not been adequately made and guidance for employers is lacking. The Web site Internationally Educated Nurses: An Employer's Guide, launched in 2012, is intended to provide healthcare employers in Ontario with comprehensive information on the hiring and integration of IENs. An evaluation framework and mixed methods design were used to determine the usability of the site in relation to its goal.

The effect of inflammatory cell-derived MCP-1 loss on neuronal survival during chronic neuroinflammation.

Intracranial implants elicit neurodegeneration via the foreign body response (FBR) that includes BBB leakage, macrophage/microglia accumulation, and reactive astrogliosis, in addition to neuronal degradation that limit their useful lifespan. Previously, monocyte chemoattractant protein 1 (MCP-1, also CCL2), which plays an important role in monocyte recruitment and propagation of inflammation, was shown to be critical for various aspects of the FBR in a tissue-specific manner. However, participation of MCP-1 in the brain FBR has not been evaluated.

Evaluating the late career nurse initiative: a cross-sectional survey of senior nurses in Ontario.

Aim: This study evaluated the impact of the late career nurse initiative on nurse perceptions of their work environment, workplace burnout, job satisfaction, organisational commitment and intention to remain.

Background: The Ontario Ministry of Health and Long-Term Care introduced the late career nurse initiative with the goal of improving the retention of front-line nurses aged 55 and over by implementing a 0.20 full-time equivalent reduction of physically or psychologically demanding duties, enabling nurses to engage in special projects for the improvement of their organisations and patient care.

A descriptive study of employment patterns and work environment outcomes of specialist nurses in Canada.

Purpose/objectives: The purpose was to describe the number, demographic characteristics, work patterns, exit rates, and work perceptions of nurses in Ontario, Canada, in 4 specialty classifications: advanced practice nurse (APN)-clinical nurse specialist (CNS), APN-other, primary healthcare nurse practitioner [RN(extended class [EC])], and registered nurse (RN) with specialty certification. The objectives were to (1) describe how many qualified nurses are available by specialty class; (2) create a demographic profile of specialist nurses; (3) determine the proportions of specialist and nonspecialist nurses who leave (a) direct patient care and (b) nursing practice annually; (4) determine whether specialist and nonspecialist nurses differ in their self-ratings of work environment, job satisfaction, and intention to remain in nursing. Employment patterns refer to nurses' employment status (eg, full-time, part-time, casual), work duration (ie, length of employment in nurses and in current role), and work transitions (ie, movement in and out of the nursing workforce, and movement out of current role).

Lebanese guidelines for osteoporosis assessment and treatment: who to test? What measures to use? When to treat?

With the demographic explosion of the population worldwide, the human, social, and economic costs of osteoporosis will continue to rise. It is estimated that the magnitude of the problem might be even larger in developing countries, including those in the Middle East. Although several organizations and countries have developed or adapted guidelines to their local needs, as of today there are no guidelines for osteoporosis assessment in the Middle East.