Novel force feedback technology improves suturing in robotic-assisted surgery: a pre-clinical study.

Introduction: The inability to sense force applied to tissue is suggested as a limitation to robotic-assisted surgery (RAS). This pre-clinical study evaluated the impact of a novel force feedback (FFB) technology, integrated on a next-generation robotic system that allows surgeons to sense forces exerted at the instrument tips, on suturing performance by novice surgeons during RAS.

Methods: Twenty-nine novice surgeons (< 50 RAS cases in the last 5 years) were randomized into two groups with (n = 15) or without (n = 14) FFB sensing.

Artificial Intelligence (AI) and Men's Health Clinic Efficiency and Clinic Billing.

Purpose Of Review: Artificial Intelligence (AI) has produced a significant impact across various industries, including healthcare. In the outpatient clinic setting, AI offers promising improvements in efficiency through Chatbots, streamlined medical documentation, and personalized patient education materials. On the billing side, AI technologies hold potential for optimizing the selection of appropriate billing codes, automating prior authorizations, and enhancing healthcare fraud detection.

Atrial Fibrillation in Patients with Breast Cancer: A Literature Review.

In addition to traditional risk factors, patients with breast cancer are at an increased risk of atrial fibrillation due to cancer itself and certain cancer therapies. Atrial fibrillation in these patients adds to their morbidity and mortality. The precise mechanisms leading to the increased atrial fibrillation in patients with breast cancer are not well understood.

Endpoint Selection in Randomized Clinical Trials for Hypertrophic Cardiomyopathy.

Randomized clinical trials (RCTs) for hypertrophic cardiomyopathy (HCM) have long been challenging caused by the condition's rarity, low event rates, and diverse clinical presentations. However, recent advances in targeted therapies have sparked increased interest in HCM research. Despite this, designing effective RCTs remains complex, particularly in identifying clinically meaningful endpoints.

The Society of Thoracic Surgeons Expert Consensus Statements on a Framework for a Standardized National Robotic Curriculum for Thoracic Surgery Trainees.

Objective: With robotic technology's rapid growth and integration, an urgent need to bridge the educational gap in thoracic surgical training has emerged. This document, a result of consensus among a group of experts in the practice and training of robotic surgery from the Society of Thoracic Surgeons (STS), aims to provide a framework for a standardized national robotic curriculum for thoracic surgery trainees.

Methods: The STS Task Force on Robotic Thoracic Surgery and Workforce on E-learning and Educational Innovation assembled an expert group with the input of the Thoracic Surgery Director's Association (TSDA).

Association of Palliative Care Consultation in Patients With Heart Failure With Preserved Ejection Fraction With Symptom Burden and Health Care Use.

Background: Guidelines recommend palliative care (PC) for patients with heart failure. However, little research has been performed assessing the effect of PC consultation in patients with heart failure with preserved ejection fraction (HFpEF).

Objectives: The purpose of this study was to investigate the impact of PC consultation on symptom burden and health care utilization among individuals with HFpEF during the last 3 years of their lives.

Standardizing social determinants of health data: a proposal for a comprehensive screening tool to address health equity a systematic review.

Social determinants of health (SDoH) significantly impacts health outcomes and disparities. While the Centers for Medicare and Medicaid Services has mandated hospitals to collect standardized SDoH data, existing tools lack key elements. This systematic review identified 78 studies and 20 screening tools addressing various SDoH domains.

Processes of obstetrical care and outcomes among Ontario physicians versus non-physicians: a population-based study.

Objective: We compared processes of antepartum, intrapartum and postpartum care and obstetrical outcomes between physicians and non-physicians.

Design: This is a population-based retrospective matched cohort study.

Setting: The study was conducted in Ontario, Canada.

Common Variable Immunodeficiency Clinical Manifestations Are Shaped by Presence and Type of Heterozygous NFKB1 Variants.

Background: NFKB1 encodes p105, which is processed to p50 to mediate canonical nuclear factor-κB (NF-κB) signaling. Although NF-κB is a central driver of inflammation and heterozygous NFKB1 variants are considered the most common monogenic etiologies of common variable immunodeficiency (CVID), few studies have explored how NFKB1 variants shape clinical course or inflammation in CVID.

Objective: We leveraged a regional cohort of patients with CVID with and without heterozygous NFKB1 variants to assess how clinical and inflammatory features of CVID are shaped by the presence of these variants.

GLP-1 Receptor Agonist in Nonobese Patients with Type 2 Diabetes Mellitus and Heart Failure with Preserved Ejection Fraction.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) promote weight loss and improve heart failure-related symptoms, quality of life, and functional capacity in patients with obesity and heart failure with preserved ejection fraction (HFpEF). However, their clinical effectiveness in nonobese patients with diabetes and HFpEF is understudied.

Methods: The TriNetX research network was used to identify adult patients (≥18 years) with type 2 diabetes mellitus (T2DM), heart failure with preserved ejection fraction (left ventricular ejection fraction ≥45%), elevated brain natriuretic peptide (≥ 150 pg/mL) or N-terminal pro-B-type natriuretic peptide(≥ 450 pg/mL) and a body mass index (BMI) <30 kg/m2 on or before August 31, 2022.

Health-Related Quality of Life Across the Spectrum of Bladder Cancer: A Current Review.

Purpose Of Review: The purpose of this review is to highlight the health-related quality of life (HRQOL) burden of bladder cancer due to the disease itself and its treatments.

Recent Findings: Large database studies have provided evidence that patients with bladder cancer have worse HRQOL than the general population. While transurethral resections and intravesical therapy are known to cause urinary symptoms, a large impact on HRQOL otherwise has not been demonstrated.

Evaluation of the Incidence of Nocardia Infection in Solid Organ Transplant Recipients on Trimethoprim-Sulfamethoxazole for Opportunistic Infection Prophylaxis.

Background: Trimethoprim-sulfamethoxazole (TMP-SMX) is the preferred prophylactic agent for pneumonia (PJP) and toxoplasmosis after solid organ transplant (SOT). Compared with other agents, it has additional activity against species.

Objective: The purpose of this study was to evaluate the incidence of infection in SOT patients receiving TMP-SMX or an alternative agent for opportunistic infection (OI) prophylaxis.

Development and Validation of the Length, Segment, and Etiology Anterior Urethral Stricture Disease Staging System Using Longitudinal Urethroplasty Outcomes Data From the Trauma and Urologic Reconstruction Network of Surgeons.

Purpose: The purpose of this study was to create and validate an anterior urethral stricture disease (aUSD) staging system based on the previously validated Length (L), Urethral Segment (S), and Etiology (E, LSE) classification system.

Materials And Methods: The Trauma and Urologic Reconstruction Network of Surgeons (TURNS) prospective database was used to create and validate the staging system. A novel Urethroplasty Triad Score was created to aid in ranking the stagings into stricture severity based on (1) functional outcomes, (2) location of urethral meatus (eg, orthotopic, perineal), and (3) number of surgeries required for repair.

Efficacy and safety of sotatercept across ranges of cardiac index in patients with pulmonary arterial hypertension: A pooled analysis of PULSAR and STELLAR.

Background: This analysis examined the effects of the activin signaling inhibitor, sotatercept, in pulmonary arterial hypertension (PAH) subgroups stratified by baseline cardiac index (CI).

Methods: Pooled data from PULSAR (N = 106; NCT03496207) and STELLAR (N = 323; NCT04576988) were analyzed using 2 different CI thresholds, <2.0 and ≥2.

Detecting and Mitigating the Clever Hans Effect in Medical Imaging: A Scoping Review.

The Clever Hans effect occurs when machine learning models rely on spurious correlations instead of clinically relevant features and poses significant challenges to the development of reliable artificial intelligence (AI) systems in medical imaging. This scoping review provides an overview of methods for identifying and addressing the Clever Hans effect in medical imaging AI algorithms. A total of 173 papers published between 2010 and 2024 were reviewed, and 37 articles were selected for detailed analysis, with classification into two categories: detection and mitigation approaches.

How Reliable is the Assessment of Fusion Status Following ACDF Using Dynamic Flexion-Extension Radiographs?

Study Design: Reliability study.

Objectives: The radiographic diagnosis of non-union is not standardized. Prior authors have suggested using a cutoff of <1 mm interspinous process motion (ISPM) on flexion-extension radiographs, but the ability of practicing surgeons to make these measurements reliably is not clear.

Congenital T cell activation impairs transitional to follicular B cell maturation in humans.

CTLA4-deficient patients exhibit profound humoral immune dysfunction, yet the basis for the B cell defect is not known. We observed a marked reduction in transitional to follicular B cell development in CTLA4-deficient patients, correlating with decreased CTLA4 function in regulatory T cells, increased CD40L levels in effector CD4+ T cells, and increased mTORC1 signaling in transitional B cells. Treatment of transitional B cells with CD40L was sufficient to induce mTORC1 signaling and inhibit follicular B cell maturation in vitro.

Gender disparity in morbidity and mortality among patients with ST-elevation myocardial infarction due to spontaneous coronary artery dissection complicated by cardiogenic shock.

Background: There is limited data on gender differences among patients with spontaneous coronary artery dissection (SCAD) who present as ST-elevation myocardial infarction (STEMI) and develop cardiogenic shock (CS).

Objectives: To describe outcomes of SCAD patients presenting with STEMI and CS and outline the differences between men and women.

Methods: We queried the US Nationwide Readmissions Database (NRD) from January 2016 to December 2020 to identify patients with SCAD presenting with STEMI who developed CS.

The impact of the pandemic on female physicians: "I just don't think I will ever feel the same".

Background: TheCOVID-19 pandemic profoundly affected female physicians, exacerbating existing gender disparities both at home and in the workplace. We aimed to understand how the effects of the pandemic continued to impact female physicians.

Methods: We conducted a qualitative study of 24 female physicians through focus groups consisting of 4 to 6 participants.

Disparities in Genetic Testing for Inborn Errors of Immunity.

Background: Inequities in genetic testing have been documented in a range of diseases, and no-charge genetic testing programs have been proposed as a means to enhance access. However, no studies have examined disparities in genetic testing for inborn errors of immunity (IEI) and the impact of no-charge programs on testing equity.

Objective: To examine socioeconomic, geographic, and racial disparities in the uptake of genetic testing for IEI in the United States and the impact of a no-charge sponsored program on testing equity.