Robotic Surgery Techniques to Improve Traditional Laparoscopy.

Introduction: Laparoscopic instruments and techniques are constantly improving, as the ability to perform minimally invasive surgery is crucial in modern medicine. The progression from open surgery to minimally invasive surgery over the years eventually led to the use of robotic devices to either assist or completely replace patient-side surgery with a separate console. Though robotic surgery has been praised for its surgical outcomes, certain situations limit its use, such as cost-effectiveness or physical space constraints.

Racial and Ethnic Differences in the Prevalence of Do-Not-Resuscitate Orders among Older Adults with Severe Traumatic Brain Injury.

Background: Older adults suffering from traumatic brain injury (TBI) are subject to higher injury burden and mortality. Do Not Resuscitate (DNR) orders are used to provide care aligned with patient wishes, but they may not be equitably distributed across racial/ethnic groups. We examined racial/ethnic differences in the prevalence of DNR orders at hospital admission in older patients with severe TBI.

Identifying risk factors for prevalent anal human papillomavirus type 16 infection in women living with HIV.

Background: Women living with HIV (WLHIV) have a high risk of anal cancer. Identifying risk factors for anal HPV 16 infection, the most significant risk factor for anal cancer, is essential for prevention and screening strategies.

Methods: In the EVVA Cohort study, 151 WLHIV had cervical and anal HPV testing with genotyping every 6 months for 2 years, while demographic and clinical data were collected via questionnaires and chart reviews.

Retinal toxicity secondary to subconjunctival cefuroxime following pars plana vitrectomy: A case report and literature review.

Purpose: To present a case of inadvertent retinal toxicity induced by a standard dose of subconjunctival cefuroxime after epiretinal membrane surgery. Narrative review of cefuroxime overdose or toxicity after intraocular surgery was carried out to describe characteristics of cefuroxime toxicity and their relationship to visual outcome.

Observations: A 64-year-old man underwent pars plana vitrectomy (PPV) with epiretinal membrane peel and received a standard dose of subconjunctival cefuroxime as endophthalmitis prophylaxis.

Reproductive Health and Coronavirus Disease 2019-Induced Economic Contracture: Lessons From the Great Recession.

The coronavirus disease 2019 (COVID-19) pandemic has magnified disparities in care, including within reproductive health. There has been limited research on the implications of the financial calamity COVID-19 has precipitated on reproductive health, including restricted access to contraception and prenatal care, as well as adverse perinatal outcomes resulting from economic contracture. We therefore examined the Great Recession (the period of economic downturn from 2007-2009 also referred to as the 2008 recession) to discuss how the current financial difficulties may influence reproductive health now and in the years to come.

"Reverse roussouly": cervicothoracic curvature ratios define characteristic shapes in adult cervical deformity.

Purpose: To investigate normal curvature ratios of the cervicothoracic spine and to establish radiographic thresholds for severe myelopathy and disability, within the context of shape.

Methods: Adult cervical deformity (CD) patients undergoing cervical fusion were included. C2-C7 Cobb angle (CL) and thoracic kyphosis (TK), using T2-T12 Cobb angle, were used as a ratio, ranging from -1 to + 1.

Sustainability of locally driven centres for those affected by dementia: a protocol for the get real with meeting centres realist evaluation.

Introduction: Improving support for people with early to moderate dementia to live at home in their communities is a global public health goal. Community adult social care is not robust in many parts of the UK, however, with the pandemic increasing pressure on services for this population. Community-led interventions can play a key role in supporting people postdiagnosis, helping delay decline, but many interventions struggle to sustain beyond 1-2 years.

The effect of age on phenotype of primary rhegmatogenous retinal detachment.

Background: To evaluate the influence of age on the clinical characteristics of primary rhegmatogenous retinal detachments (RRD).

Methods: We conducted a retrospective review of a prospectively collected dataset. Data regarding adult patients (aged 16-100 years) who had undergone primary RRD repair, were extracted from two online databases.

Do the newly proposed realignment targets for C2 and T1 slope bridge the gap between radiographic and clinical success in corrective surgery for adult cervical deformity?

Objective: Surgical correction of cervical deformity (CD) has been associated with superior alignment and functional outcomes. It has not yet been determined whether baseline or postoperative T1 slope (T1S) and C2 slope (C2S) correlate with health-related quality-of-life (HRQoL) metrics and radiographic complications, such as distal junctional kyphosis (DJK) and distal junctional failure (DJF). The objective of this study was to determine the impact of T1S and C2S deformity severity on HRQoL metrics and DJF development in patients with CD who underwent a cervical fusion procedure.

Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery.

Background: Recent studies have evaluated the correlation of health-related quality of life (HRQL) scores with radiographic parameters. This relationship may provide insight into the connection of patient-reported disability and disease burden caused by cervical diagnoses.

Purpose: To evaluate the association between spinopelvic sagittal parameters and HRQLs in patients with primary cervical diagnoses.

The potential long-term comparative effectiveness of larotrectinib vs standard of care for treatment of metastatic TRK fusion thyroid cancer, colorectal cancer, and soft tissue sarcoma.

Larotrectinib is approved for patients with metastatic TRK fusion cancers, including differentiated thyroid (DTC), colorectal cancer (CRC), and soft tissue sarcoma (STS). Given the basket clinical trial design of larotrectinib, direct comparisons against standard of care in each of the mentioned cancers have not been assessed. Also, owing to the limited duration of follow-up in clinical trials, long-term outcomes for treatments are generally not known or estimated.

The Prevalence of Hip Pathologies in Adolescent Idiopathic Scoliosis.

Background: Adolescent idiopathic scoliosis (AIS) is the most common form of abnormal spine curvature observed in patients age 10 to 18. Typically characterized by shoulder height and waistline asymmetry, AIS may drive uneven distribution of force in the hips, leading to increased rates of concurrent hip diagnoses. The relationship between AIS and concurrent hip diagnoses is underexplored in the literature, and to date, there has been little research comparing rates of hip diagnoses between patients with AIS and those unaffected.

Brawn before brains in placental mammals after the end-Cretaceous extinction.

Mammals are the most encephalized vertebrates, with the largest brains relative to body size. Placental mammals have particularly enlarged brains, with expanded neocortices for sensory integration, the origins of which are unclear. We used computed tomography scans of newly discovered Paleocene fossils to show that contrary to the convention that mammal brains have steadily enlarged over time, early placentals initially decreased their relative brain sizes because body mass increased at a faster rate.

Facets of stigma, self-compassion, and health-related adjustment to lung cancer: A longitudinal study.

Objective: The aim of this study was to investigate whether three facets of lung cancer stigma (internalized stigma, constrained disclosure, and perceived subtle discrimination) uniquely predicted psychological and physical health-related adjustment to lung cancer across 12 weeks. Additionally, self-compassion was tested as a moderator of the stigma-health relationship.

Method: Adults receiving oncologic treatment for lung cancer (N = 108) completed measures of lung cancer stigma, self-compassion, depressive symptoms, cancer-related stress, and physical symptom bother.

Assessment of Postoperative Outcomes of Spine Fusion Patients With History of Cardiac Disease.

Introduction: There is paucity on the effect of different cardiac diagnoses on outcomes in elective spine fusion patients.

Methods: Patients undergoing elective spine fusion surgery were isolated in the PearlDiver database. Patients were stratified by having a previous history of coronary artery disease (CAD), congestive heart failure (CHF), valve disorder (valve), dysrhythmia, and no heart disease (control).

Primary Care: The Actual Intelligence Required for Artificial Intelligence to Advance Health Care and Improve Health.

With conversational agents triaging symptoms, cameras aiding diagnoses, and remote sensors monitoring vital signs, the use of artificial intelligence (AI) outside of hospitals has the potential to improve health, according to a recently released report from the National Academy of Medicine. Despite this promise, the success of AI is not guaranteed, and stakeholders need to be involved with its development to ensure that the resulting tools can be easily used by clinicians, protect patient privacy, and enhance the value of the care delivered. A crucial stakeholder group missing from the conversation is primary care.

10-Year Trends in Healthcare Spending among Patients with Schizophrenia in Alberta, Canada.

Objectives: Schizophrenia is characterized by high levels of disability often resulting in increased healthcare utilization and spending. With expanding healthcare costs across all healthcare sectors, there is a need to understand how healthcare spending has changed over time. We conducted a population-based study using administrative health data from Alberta, Canada, to describe changes in medical complexity and direct healthcare spending among patients with schizophrenia over a 10-year period.

Reporting of Model Performance and Statistical Methods in Studies That Use Machine Learning to Develop Clinical Prediction Models: Protocol for a Systematic Review.

Background: With the growing excitement of the potential benefits of using machine learning and artificial intelligence in medicine, the number of published clinical prediction models that use these approaches has increased. However, there is evidence (albeit limited) that suggests that the reporting of machine learning-specific aspects in these studies is poor. Further, there are no reviews assessing the reporting quality or broadly accepted reporting guidelines for these aspects.

Stringency of containment and closures on the growth of SARS-CoV-2 in Canada prior to accelerated vaccine roll-out.

Background: Many studies have examined the effectiveness of non-pharmaceutical interventions (NPIs) on SARS-CoV-2 transmission worldwide. However, less attention has been devoted to understanding the limits of NPIs across the course of the pandemic and along a continuum of their stringency. In this study, we explore the relationship between the growth of SARS-CoV-2 cases and an NPI stringency index across Canada before the accelerated vaccine roll-out.

Healthy food prescription incentive programme for adults with type 2 diabetes who are experiencing food insecurity: protocol for a randomised controlled trial, modelling and implementation studies.

Introduction: The high cost of many healthy foods poses a challenge to maintaining optimal blood glucose levels for adults with type 2 diabetes mellitus who are experiencing food insecurity, leading to diabetes complications and excess acute care usage and costs. Healthy food prescription programmes may reduce food insecurity and support patients to improve their diet quality, prevent diabetes complications and avoid acute care use. We will use a type 2 hybrid-effectiveness design to examine the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of a healthy food prescription incentive programme for adults experiencing food insecurity and persistent hyperglycaemia.

Geographic concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: a cross-sectional study.

Background: Understanding inequalities in SARS-CoV-2 transmission associated with the social determinants of health could help the development of effective mitigation strategies that are responsive to local transmission dynamics. This study aims to quantify social determinants of geographic concentration of SARS-CoV-2 cases across 16 census metropolitan areas (hereafter, cities) in 4 Canadian provinces, British Columbia, Manitoba, Ontario and Quebec.

Methods: We used surveillance data on confirmed SARS-CoV-2 cases and census data for social determinants at the level of the dissemination area (DA).

Developing an ACT-based intervention to address lung cancer stigma: Stakeholder recommendations and feasibility testing in two NCI-designated cancer centers.

Few psychosocial interventions have been tailored to meet the unique needs of patients diagnosed with lung cancer. This pilot study developed and tested a six-week intervention for reducing lung cancer stigma. Guided by qualitative interviews conducted with 9 lung cancer patients and 5 thoracic oncology care providers, Acceptance and Commitment Therapy was adapted for treatment of lung cancer stigma (ACT-LCS).

Temporal trends in methane emissions from a small eutrophic reservoir: the key role of a spring burst.

Waters impounded behind dams (i.e., reservoirs) are important sources of greenhouses gases (GHGs), especially methane (CH), but emission estimates are not well constrained due to high spatial and temporal variability, limitations in monitoring methods to characterize hot spot and hot moment emissions, and the limited number of studies that investigate diurnal, seasonal, and interannual patterns in emissions.

The Clinical Impact of Failing to Achieve Ideal Proportional Realignment in Adult Spinal Deformity Patients.

Summary Of Background Data: The impact of not achieving ideal realignment in the global alignment and proportion (GAP) score in adult spinal deformity (ASD) correction on clinical outcomes is understudied at present.

Objective: To identify the clinical impact of failing to achieve GAP proportionality in ASD surgery.

Study Design: Retrospective cohort.