Application of machine learning to identify risk factors for outpatient opioid prescriptions following spine surgery.

Introduction: Spine surgery is a common source of narcotic prescriptions and carries potential for long-term opioid dependence. As prescription opioids play a role in nearly 25 % of all opioid overdose deaths in the United States, mitigating risk for prolonged postoperative opioid utilization is crucial for spine surgeons.

Purpose: The aim of this study was to employ six ML algorithms to identify clinical variables predictive of increased opioid utilization across spinal surgeries, including anterior cervical discectomy and fusion (ACDF), posterior thoracolumbar fusion (PTLF), and lumbar laminectomy.

Sex differences in mitochondrial free-carnitine levels in subjects at-risk and with Alzheimer's disease in two independent study cohorts.

A major challenge in the development of more effective therapeutic strategies for Alzheimer's disease (AD) is the identification of molecular mechanisms linked to specific pathophysiological features of the disease. Importantly AD has a two-fold higher incidence in women than men and a protracted prodromal phase characterized by amnestic mild-cognitive impairment (aMCI) suggesting that biological processes occurring early can initiate vulnerability to AD. Here, we used a sample of 125 subjects from two independent study cohorts to determine the levels in plasma (the most accessible specimen) of two essential mitochondrial markers acetyl-L-carnitine (LAC) and its derivative free-carnitine motivated by a mechanistic model in rodents in which targeting mitochondrial metabolism of LAC leads to the amelioration of cognitive function and boosts epigenetic mechanisms of gene expression.

Development and Clinical Evaluation of a Contrast Optimizer for Contrast-Enhanced CT Imaging of the Liver.

Objective: Patient characteristics, iodine injection, and scanning parameters can impact the quality and consistency of contrast enhancement of hepatic parenchyma in CT imaging. Improving the consistency and adequacy of contrast enhancement can enhance diagnostic accuracy and reduce clinical practice variability, with added positive implications for safety and cost-effectiveness in the use of contrast medium. We developed a clinical tool that uses patient attributes (height, weight, sex, age) to predict hepatic enhancement and suggest alternative injection/scanning parameters to optimize the procedure.

Lumbar disc space height in relation to neural foraminal dimensions and patient characteristics: A morphometric analysis from L1-S1 using computed tomography.

Introduction: The normative relationship between lumbar intervertebral disc space height (DSH) and neuroforaminal dimensions (NFD) has yet to be defined.

Research Question: The purpose of this study was to investigate the relationship between lumbar DSH and NFD using computed tomography (CT), accounting for influences of patient demographic and anthropometric characteristics.

Materials And Methods: We analyzed CT imaging of 350 female and 350 male patients.

Total hip arthroplasty was found to be safe in Jehovah's Witness patients: a multi-centered matched study.

Background: Jehovah's Witness patients refuse blood transfusion because of their religious beliefs making total hip arthroplasty (THA) challenging. This study aims to determine the safety of THA in Jehovah's Witness patients using standard perioperative protocols as well as evaluate the effectiveness of tranexamic acid (TXA) in controlling blood loss.

Methods: Databases from two tertiary academic centers were queried from 2003 to 2021 to identify THA patients.

Patient Engagement with Radiology Report Content: A Retrospective Analysis of 60,572 Radiology Report Views.

Rationale And Objectives: To evaluate patient use of plain language radiology report content.

Methods: Webpage-style radiology reports delivering patient-centered content were made available to patients via an online patient portal. Simple language explanations of terms and phrases in the reports were accessible to patients via a clickable hyperlink.

Tunable Alginate-Polyvinyl Alcohol Bioinks for 3D Printing in Cartilage Tissue Engineering.

This study investigates 3D extrusion bioinks for cartilage tissue engineering by characterizing the physical properties of 3D-printed scaffolds containing varying alginate and polyvinyl alcohol (PVA) concentrations. We systematically investigated the effects of increasing PVA and alginate concentrations on swelling, degradation, and the elastic modulus of printed hydrogels. Swelling decreased significantly with increased PVA concentrations, while degradation rates rose with higher PVA concentrations, underscoring the role of PVA in modulating hydrogel matrix stability.

Functional Septorhinoplasty in Unilateral and Bilateral Nasal Obstruction: A Comparison of Patient-Reported Outcomes.

Purpose: Functional septorhinoplasty is an effective treatment for nasal airway obstruction. Little distinction exists between bilaterally and unilaterally obstructed patients in literature. Our study evaluates outcomes in patients with unilateral nasal airway obstruction compared to those with bilateral nasal airway obstruction as measured by nasal obstruction symptom evaluation scores following functional septorhinoplasty.

A phase 1 study of the CDK9 inhibitor voruciclib in relapsed/refractory acute myeloid leukemia and B-cell malignancies.

The anti-apoptotic protein myeloid cell leukemia-1 (Mcl-1) contributes to the pathophysiology of acute myeloid leukemia (AML) and certain B-cell malignancies. Tumor dependence on Mcl-1 is associated with resistance to venetoclax. Voruciclib, an oral cyclin-dependent kinase (CDK) inhibitor targeting CDK9, indirectly decreases Mcl-1 protein expression and synergizes with venetoclax in preclinical models.

A Prospective, Randomized, Noninferiority Study to Evaluate the Safety and Effectiveness of Steerable Ureteroscopic Renal Evacuation Compared with Standard Ureteroscopy: 30-Day Results of the ASPIRE Study.

We report the first multicenter, prospective, randomized noninferiority controlled trial of steerable ureteroscopic renal evacuation (SURE) for nephrolithiasis treatment. Candidates for laser lithotripsy ≥18 years with ≥1 renal stone ≥7 mm and 7-20 mm stone burden were randomized 1:1 SURE ureteroscopy (URS). SURE was performed using the CVAC Aspiration System, a novel steerable irrigation-aspiration catheter.

Increased risk of adverse events following the treatment of associated versus elementary acetabular fractures: a matched analysis of short-term complications.

Purpose: This retrospective cohort study aims to compare short-term complication rates between patients receiving open reduction and internal fixation (ORIF) for associated versus elementary acetabular fractures, with a secondary objective of identifying independent risk factors for adverse outcomes.

Methods: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried using current procedural terminology (CPT) codes to identify patients that underwent ORIF for associated acetabular (CPT 27228) or elementary acetabular fractures (CPT 27226, 27227) from 2010 to 2021. Propensity score matching was employed to account for baseline differences and the short-term complication rates were compared between the cohorts.

What can we learn from machine learning studies on flow diverter aneurysm embolization? A systematic review.

Background: As the use of flow diverters has expanded in recent years, predicting successful outcomes has become more challenging for certain aneurysms.

Objective: To provide neurointerventionalists with an understanding of the available machine learning algorithms for predicting the success of flow diverters in occluding aneurysms.

Methods: This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the four major medical databases (PubMed, Embase, Scopus, Web of Science) were screened.

Towards Clinical Application: Calcium Waves for In Vitro Qualitative Assessment of Propagated Primary Human Corneal Endothelial Cells.

Corneal endothelium cells (CECs) regulate corneal hydration between the leaky barrier of the corneal endothelium and the ionic pumps on the surface of CECs. As CECs do not regenerate, loss of CECs leads to poor vision and corneal blindness. Corneal transplant is the only treatment option; however, there is a severe shortage of donor corneas globally.

A US-Based Consensus on Diagnostic Overlap and Distinction for Pediatric Feeding Disorder and Avoidant/Restrictive Food Intake Disorder.

Objective: As diagnoses covering dysfunctional feeding and eating in pediatrics, avoidant/restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD) contain inherent areas of overlap in their diagnostic criteria. Areas of overlap include criteria regarding nutritional consequences associated with feeding/eating dysfunction and shared emphasis on possible psychosocial impairment associated with restricted food intake. Complicating the differential diagnosis process is a lack of guidance regarding when the two conditions occur independently, co-qualify, and/or transition into the other.

Initial Evaluation of the Safety and Performance of Single-Port Robotic-Assisted Thymectomy Via Subxiphoid Incision.

Background: Sternotomy is the traditional approach for thymectomy. However, over the last 2 decades minimally invasive surgical approaches (multiport thoracoscopic and robotic-assisted surgery) have proven feasible, offering similar survival, lower morbidity and shorter length of stay. Single-port (SP), subxiphoid thymectomy potentially offers less pain and allows bilateral visualization of the mediastinum.

Current and emerging strategies for the prevention of hepatocellular carcinoma.

Liver cancer is the third leading cause of cancer-related deaths globally, with incident cases expected to rise from 905,700 in 2020 to 1.4 million by 2040. Hepatocellular carcinoma (HCC) accounts for about 80% of all primary liver cancers.

A Pathological Diagnosis Method for Fever of Unknown Origin Based on Multipath Hierarchical Classification: Model Design and Validation.

Background: Fever of unknown origin (FUO) is a significant challenge for the medical community due to its association with a wide range of diseases, the complexity of diagnosis, and the likelihood of misdiagnosis. Machine learning can extract valuable information from the extensive data of patient indicators, aiding doctors in diagnosing the underlying cause of FUO.

Objective: The study aims to design a multipath hierarchical classification algorithm to diagnose FUO due to the hierarchical structure of the etiology of FUO.

Experts Speak Forum: Implementation of the FAIR Principles in Biobanking Needs Fair Incentives.

While the FAIR (Findable, Accessible, Interoperable, and Reusable) principles are primarily concerned with data, samples can also be considered a distinct category of data. In light of these considerations, the FAIR principles represent a major challenge for biobanks, as discussed in detail in two recently published studies. We invited seven experts with diverse backgrounds to share their views on these studies and the FAIR principles in general.