Multi-institutional development and testing of attention-enhanced deep learning segmentation of thyroid nodules on ultrasound.

Purpose: Thyroid nodules are common, and ultrasound-based risk stratification using ACR's TIRADS classification is a key step in predicting nodule pathology. Determining thyroid nodule contours is necessary for the calculation of TIRADS scores and can also be used in the development of machine learning nodule diagnosis systems. This paper presents the development, validation, and multi-institutional independent testing of a machine learning system for the automatic segmentation of thyroid nodules on ultrasound.

Renal denervation for hypertension.

Innovative therapies for hypertension are desperately needed given the rising prevalence and falling rates of control of hypertension despite an abundance of available medical therapies. Procedural interventions lower blood pressure without depending on adherence to medications, and endovascular renal denervation (RDN) is the interventional procedure with the best evidence base for the treatment of hypertension. After nearly two decades of study, with major refinements to devices, technique and trial design, two different systems for RDN received approval from the FDA in late 2023 for the treatment of hypertension.

The efficacy of revascularization in ischemic cardiomyopathy.

Ischemic cardiomyopathy (ICM) is characterized by myocardial dysfunction due to myocardial ischemia, associated with the presence of significant coronary artery disease (CAD). We provide a comprehensive review of the current evidence for coronary revascularization in ICM, including consideration of the different modalities of coronary artery bypass grafting and percutaneous coronary intervention. In addition to a contemporary assessment of the literature, we aim to provide real-world insights and perspectives to guide clinical decision-making in this heterogeneous and complex patient population.

Physician inpatient handoffs-Patient and physician outcomes: A systematic review.

Background: Prior reviews have shown that interventions to improve inpatient handoffs are inconsistently associated with improvement in patient outcomes. This systematic review examines the effectiveness of inpatient handoff interventions on outcomes affecting patients and physicians, including objective measures when reported (PROSPERO ID: CRD42022309326).

Methods: Pubmed, Embase, and Cochrane Central Register of Controlled Trials were searched on January 13th, 2022.

Endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy in the diagnosis of gastrointestinal lymphomas.

Introduction: The role of endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy (EUS-FNA/B) in the clinical management of gastrointestinal lymphoma has not been extensively studied. This study investigates the use of EUS-FNA/B in the diagnosis of first-time and recurrent gastrointestinal lymphomas at a large academic institution.

Materials And Methods: A total of 40 patients who had final diagnosis of lymphoma according to the World Health Organization (WHO) classification of tumors of hematopoietic lymphoid tissues who underwent EUS-FNA/B were included in the study.

Minimizing for Maximum Benefit: An Illustrative Case-Series of Atrial Only Leadless Pacing.

Leadless pacing technology now includesdedicated atrial helix-fixation leadless pacemakers (LPs), expanding theapplication of leadless devices for patients with sinus node dysfunction andatrioventricular block during sinus rhythm. This first reportedcase-series of atrial LPs describes and discusses the potential use-casescenarios of recently approved helix-fixation atrial LPs. The article highlights important concepts regarding their use, including implantationtechniques, programming, battery conservation, and the low rate of progressionof AV block in patients implanted with AAI(R) pacemakers.

The Use of Robotics in Implant Dentistry.

The integration of robotics in medicine and surgery marks a pivotal shift in the way modern health care delivers care. Robotics technology is not only capable of augmenting human capabilities but also improving the quality of surgical interventions. Initially designed to enhance precision in complex surgeries, robotics has made significant advancements in orthopedics, soft tissue surgery, and, more recently, implant dentistry.

Current approaches to optimize the donor heart for transplantation.

Heart transplantation remains a critical therapy for patients with end-stage heart failure, offering incremental survival and improved quality of life. One of the key components behind the success of heart transplantation is the condition and preservation of the donor's heart. In this review, we provide a comprehensive overview of ischemic reperfusion injury, risk factors associated with primary graft dysfunction, current use of various preservation solutions for organ procurement, and recent advancements in donor heart procurement technologies.

Immediate postpartum contraceptive implant placement and breastfeeding success in postpartum people at risk for low milk supply: A randomized non-inferiority trial.

Objectives: Our goal was to measure the impact of postpartum contraceptive implant insertion timing on breastfeeding success and duration in a population at high-risk for low milk supply.

Study Design: We conducted a three-armed randomized non-inferiority study of postpartum people who plan to breastfeed and have known risk factors for low milk supply. Participants were randomized to one of three groups for the timing of implant placement: within 30 minutes of placental delivery, 24-72 hours postpartum, or 6+ weeks postpartum.

Impact of hospital lead extraction volume on management of cardiac implantable electronic device-associated infective endocarditis.

Aims: Utilization of transvenous lead extraction/removal (TLE) for the management of cardiac implantable electronic device (CIED)-associated infective endocarditis (IE) remains low. The aim of this study was to examine the impact of hospital TLE procedural volume on TLE utilization and outcomes for patients with CIED-associated IE.

Methods And Results: Using the Nationwide Readmissions Database, we evaluated 21 545 admissions for patients (mean age 70 years, 39% female) with CIEDs hospitalized with IE at TLE centres.

Primary Versus Secondary Immune Thrombocytopenia (ITP): A Meeting Report from the 2023 McMaster ITP Summit.

The McMaster Immune Thrombocytopenia (ITP) Summit was an educational seminar from leading experts in immune thrombocytopenia and related disorders geared towards hematologists, internists, immunologists, and clinical and translational scientists. The focus of the Summit was to review the mechanisms, diagnosis and treatment of primary versus secondary ITP. Specific objectives were to describe the unique features of secondary ITP, and to review its mechanisms in the context of autoimmune disease and infection.

Heightened cholesterol 25-hydroxylase expression in aged lung during .

Introduction: Alveolar macrophages (AM) are critical effectors of the immune response and are essential for host responses to . Changes in lipid metabolism in AM can alter cellular function and biology. Impaired metabolism can contribute to excessive lipid accumulation and pro-inflammatory signaling.

Cervical spine considerations in Goldenhar syndrome: a clinical perspective.

Background: Goldenhar syndrome is a clinically heterogeneous disorder defined by a rare combination of congenital anomalies-an eye abnormality, in addition to two of the following three: ear anomalies, mandibular malformations, and vertebral defects. Notably, children with Goldenhar syndrome present with a high incidence of cervical spine malformations.

Clinical Case: In this report, we present an unusual case of a 15-year-old child with Goldenhar syndrome, who additionally presents with some clinical features of VACTERL syndrome.

Risk Stratification of Miscellaneous Uterine Mesenchymal Neoplasms: The Role of Morphology, Immunohistochemistry, and Molecular Testing.

Uterine mesenchymal tumors are a diverse group of tumors that can display a broad range of morphologic, immunohistochemical, and molecular profiles and are associated with varied clinical behaviors. In recent years, they have increasingly been classified by their underlying molecular alterations, leading to a more precise separation of diagnostic entities. As their diagnostic criteria have been refined, so too have the features that can be used to predict clinical outcomes.

Left Ventricular Dimensions and Clinical Outcomes With a Fully Magnetically Levitated Left Ventricular Assist Device.

Background: Prior analyses have suggested that a smaller left ventricular end-diastolic diameter (LVEDD) is associated with reduced survival following HeartMate 3 left ventricular assist device implantation.

Objectives: In this trial-based comprehensive analysis, the authors sought to examine clinical characteristics and association with the outcome of this specific relationship.

Methods: The authors analyzed the presence of LVEDD <55 mm among 1,921 analyzable HeartMate 3 patients within the MOMENTUM 3 (Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3) trial portfolio, on endpoints of overall survival and adverse events at 2 years.

Human AI collaboration for unsupervised categorization of live surgical feedback.

Formative verbal feedback during live surgery is essential for adjusting trainee behavior and accelerating skill acquisition. Despite its importance, understanding optimal feedback is challenging due to the difficulty of capturing and categorizing feedback at scale. We propose a Human-AI Collaborative Refinement Process that uses unsupervised machine learning (Topic Modeling) with human refinement to discover feedback categories from surgical transcripts.

Safety of prolonged bilateral antegrade cerebral perfusion in aortic arch surgery with moderate hypothermia.

Objectives: This study investigates the impact of bilateral antegrade cerebral perfusion (ACP) time on outcomes in aortic arch surgery.

Methods: In total, 961 patients underwent either hemiarch (n = 385) or total arch replacement (n = 576) with bilateral ACP and moderate hypothermia management between 2006 and 2020 across 2 aortic centres. ACP time was categorized into 4 groups (≤30 min: n = 169, 30-60 min: n = 298, 60-90 min: n = 261, >90 min: n = 233).

Cost and Inpatient Burden of Mandible Fracture Management: A 14-Year Analysis.

Objective: To evaluate characteristics associated with increased cost and length of hospitalization of mandible fracture management.

Study Design: Retrospective chart review.

Methods: Demographics, injury mechanism, associated injuries, treatment information, and associated costs were collected for all patients treated for mandible fracture treated at a single institution over a 14-year period.

Trends in Urology Residency Applications: Results From The Society of Academic Urologists Program Director Survey From 2022 to 2024.

Objective: To provide a cross-sectional view of the current opinions surrounding the urology match by analyzing data from the annual Society of Academic Urologists Program Director Surveys conducted between 2022 and 2024.

Methods: Data collected through surveys distributed to all urology program directors (PD) consisting of questions covering program demographics, applicant selection criteria, preference signals (PS), virtual interviews (VI), and other relevant topics.

Results: 89, 90, and 89 PD participated in the surveys for the years 2022, 2023, and 2024, respectively.

Five Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.

Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.