PREDICTION OF TIME TO HEMODYNAMIC STABILIZATION OF UNSTABLE INJURED PATIENT ENCOUNTERS USING ELECTRONIC MEDICAL RECORD DATA.

Background : This study sought to predict time to patient hemodynamic stabilization during trauma resuscitations of hypotensive patient encounters using electronic medical record (EMR) data. Methods: This observational cohort study leveraged EMR data from a nine-hospital academic system composed of Level I, Level II, and nontrauma centers. Injured, hemodynamically unstable (initial systolic blood pressure, <90 mm Hg) emergency encounters from 2015 to 2020 were identified.

Prediction of intra-abdominal injury using natural language processing of electronic medical record data.

Background: This study aimed to use natural language processing to predict the presence of intra-abdominal injury using unstructured data from electronic medical records.

Methods: This was a random-sample retrospective observational cohort study leveraging unstructured data from injured patients taken to one of 9 acute care hospitals in an integrated health system between 2015 and 2021. Patients with International Classification of Diseases External Cause of Morbidity codes were identified.

Transoral Septoplasty before Le Fort I Downfracture: A Novel Functional Rhinoplasty Technique.

Individuals with maxillary dentofacial deformities commonly have preexisting nasal airway obstruction with associated nasal septal deviation. Combination bimaxillary procedures with intraoral septoplasty after maxillary downfracture have been demonstrated to address dentofacial deformities and nasal obstruction simultaneously. Although effective, current transoral septoplasty techniques offer limited visualization of the superior septum and are challenging to perform due to septal mobility after Le Fort I downfracture.

The Transoral Alar Batten Graft: A Functional Rhinoplasty Technique for the Orthognathic Jaw Surgery Patient.

Many patients seeking orthognathic jaw surgery also experience nasal obstruction. Current transoral functional rhinoplasty techniques include septoplasty and inferior turbinate reduction, which are performed through the mouth after maxillary downfracture. Although powerful, these interventions do not treat dynamic nasal sidewall collapse.

Use of topic modeling to assess research trends in the journal Gynecologic Oncology.

Study Objective: There is scant research identifying thematic trends within medical research. This work may provide insight into how a given field values certain topics. We assessed the feasibility of using a machine learning approach to determine the most common research themes published in Gynecologic Oncology over a thirty-year period and to subsequently evaluate how interest in these topics changed over time.

Genioglossus Advancement: Technique Modification for Improved Chin Contour.

Genioglossus advancement plays an important role in the armamentarium of the obstructive sleep apnea surgeon and has gone through many iterations over several decades. A recently described technique involves creating a box osteotomy, which is carried through the inferior border of the mandible in order to increase recruitment of the suprahyoid musculature. Here we introduce a further modification of the technique that uses virtual planning to improve the safety and accuracy of genial tubercle capture.

Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysis.

Unlabelled: Microsurgical advances have led to minimally invasive approaches for mandibular reconstruction. Currently, no resource compares all minimally invasive microvascular mandibular reconstruction (MIMMR) treatment options.

Methods: All known cases of MIMMR were identified following the Preferred Reporting Items for Systematic Reviews, Meta-Analyses guidelines, and our own surgical experience.

Vacuum rhexis - A novel capsulorhexis technique for white cataracts.

Capsulorhexis in white intumescent cataract is often associated with extension leading to radial tears or biradial extension "Argentinian flag sign" and associated complications. We describe a novel technique of managing this situation. Vacuum rhexis is performed with a 24 G bent cannula attached to a 10-ml syringe.

Adult Cleft Patients: An Exploration of Functional Needs and Treatment Barriers.

Background: Management of cleft lip and palate has been well characterized in pediatric patients, but limited data exist regarding the long-term functional outcomes of cleft patients once they reach adulthood.

Materials And Methods: An institutional, cross-sectional survey of adult patients with a history of cleft lip and/or palate was performed. The survey recorded patient characteristics, concerns, and barriers to care.

Risk of selection bias assessment in the NINDS rt-PA stroke study.

Objectives: The NINDS rt-PA Stroke Study is frequently cited in support of alteplase for acute ischemic stroke within 3 h of symptom onset. Multiple post-hoc reanalyses of this trial have been published to adjust for a baseline imbalance in stroke severity. We performed a risk of selection bias assessment and reanalyzed trial data to determine if the etiology of this baseline imbalance was more likely due to random chance or randomization errors.

Methodological survey of missing outcome data in an alteplase for ischemic stroke meta-analysis.

Objective: Recent national guidelines recommend alteplase treatment for ischemic stroke within 4.5 h of symptom-onset based on meta-analyses of randomized controlled clinical trials (RCT). A detailed description of missing outcome data (MOD) due to participant loss to follow-up has never been published.

Feasibility and Prediction of Adverse Events in a Postoperative Monitoring Program of Patient-Reported Outcomes and a Wearable Device Among Gynecologic Oncology Patients.

Purpose: The objective of this study was to test the feasibility of implementing a postoperative monitoring program for women with gynecologic cancers composed of patient-reported outcomes (PROs) and a wearable activity monitor.

Methods: We prospectively enrolled patients undergoing gynecologic cancer surgery to this single-arm study. Enrolled patients completed PROs (Patient-Reported Outcomes Measurement Information System physical function, sleep disturbance, anxiety, fatigue, and pain intensity) at baseline and one-week intervals for 4 weeks.

Le Fort I maxillary osteotomy in a Jehovah's Witness patient: strategies for minimizing blood loss and maximizing safety.

Background: The Watch Tower Society, the main governing organization of the Jehovah's Witness (JW) faith, introduced the doctrine to refuse blood in 1945 and has been enforcing it since 1961. A member can be expelled for accepting prohibited blood components. Many reconstructive surgeries place patients at an increased risk for blood loss.

Management of a Highly Vascular Low-grade Myofibroblastic Sarcoma of the Mandible.

An 11-year-old male patient presented with a large, highly vascular, destructive mandibular mass. An intraoral biopsy showed pleomorphic spindle cells arranged in intersecting fascicles, with scattered atypia. A diagnosis of low-grade myofibroblastic sarcoma was made.

Pediatric Odontogenic and Maxillofacial Bone Pathology: A Global Analysis.

Background: Although pathology in the maxillary and mandibular bones is rare in young patients, the differential diagnosis is broad. The World Health Organization (WHO) updated its classification of maxillofacial bone pathology in 2017. Using these updated guidelines, a systematic review of common maxillofacial bone lesions in the pediatric population was performed.

Improved Visual Localization via Graph Filtering.

Vision-based localization is the problem of inferring the pose of the camera given a single image. One commonly used approach relies on image retrieval where the query input is compared against a database of localized support examples and its pose is inferred with the help of the retrieved items. This assumes that images taken from the same places consist of the same landmarks and thus would have similar feature representations.

Machine learning models improve prediction of large vessel occlusion and mechanical thrombectomy candidacy in acute ischemic stroke.

Background And Purpose: Early identification of large vessel occlusions (LVO) and timely recanalization are paramount to improved clinical outcomes in acute ischemic stroke. A stroke assessment that maximizes sensitivity and specificity for LVOs is needed to identify these cases and not overburden the health system with unnecessary transfers. Machine learning techniques are being used for predictive modeling in many aspects of stroke care and may have potential in predicting LVO presence and mechanical thrombectomy (MT) candidacy.

Prediction of 30-Day Readmission After Stroke Using Machine Learning and Natural Language Processing.

This study aims to determine whether machine learning (ML) and natural language processing (NLP) from electronic health records (EHR) improve the prediction of 30-day readmission after stroke. Among index stroke admissions between 2011 and 2016 at an academic medical center, we abstracted discrete data from the EHR on demographics, risk factors, medications, hospital complications, and discharge destination and unstructured textual data from clinician notes. Readmission was defined as any unplanned hospital admission within 30 days of discharge.

Unique Techniques Utilizing Rib Grafts for Mandibular Reconstruction in the Pediatric Population.

Introduction: Pediatric mandibular reconstruction requires a grafted segment of sufficient height and stability to support dental implant placement. Double barreling and mandibular distraction osteogenesis (MDO) after reconstruction are two techniques to achieve this, but they have only been reported with fibular grafts. Rib grafts not only have a lower donor site morbidity than fibular grafts, but they also provide adequate defect coverage in children.

Simultaneous LeFort III and LeFort I Osteotomies in Craniometaphyseal Dysplasia.

Craniometaphyseal dysplasia (CMD) is a rare genetic disease affecting bone metabolism with sclerosis of craniofacial bones. Orthognathic surgery has rarely been described in this patient population due to the bony thickness, making osteotomies challenging. We present a 19-year-old male with CMD with malocclusion, severe midface hypoplasia, and obstructive sleep apnea.

Natural language processing with machine learning to predict outcomes after ovarian cancer surgery.

Objective: To determine if natural language processing (NLP) with machine learning of unstructured full text documents (a preoperative CT scan) improves the ability to predict postoperative complication and hospital readmission among women with ovarian cancer undergoing surgery when compared with discrete data predictors alone.

Methods: Medical records from two institutions were queried to identify women with ovarian cancer and available preoperative CT scan reports who underwent debulking surgery. Machine learning methods using both discrete data predictors (age, comorbidities, preoperative laboratory values) and natural language processing of full text reports (preoperative CT scans) were used to predict postoperative complication and hospital readmission within 30 days of surgery.

The Atherogenic Index of Plasma is Independently Associated with Symptomatic Carotid Artery Stenosis.

Introduction: Small, dense low-density lipoprotein (sdLDL) is strongly associated with symptomatic carotid artery stenosis, but is not routinely evaluated in ischemic stroke patients. A method using the logarithmic transformation of the ratio of the plasma concentration of triglycerides (TGY) to HDL-cholesterol (HDL-C)[(Log[TGY/HDL-C])] has been described as a surrogate marker for sdLDL termed the atherogenic index of plasma (AIP).

Objective: To determine if the AIP is independently associated with symptomatic carotid artery stenosis.