Machine Learning and Statistical Analyses of Sensor Data Reveal Variability Between Repeated Trials in Parkinson's Disease Mobility Assessments.

Mobility tasks like the Timed Up and Go test (TUG), cognitive TUG (cogTUG), and walking with turns provide insights into the impact of Parkinson's disease (PD) on motor control, balance, and cognitive function. We assess the test-retest reliability of these tasks in 262 PD participants and 50 controls by evaluating machine learning models based on wearable-sensor-derived measures and statistical metrics. This evaluation examines total duration, subtask duration, and other quantitative measures across two trials.

POCUS-first in acute diverticulitis: Quantifying cost savings, length-of-stay reduction, and radiation risk mitigation in the ED.

Background: Recent studies have validated the efficacy of point-of-care ultrasound (POCUS) as an alternative diagnostic imaging approach to computed tomography (CT) for patients with suspected acute diverticulitis. This study aimed to quantify the national impact of this approach in cost savings, ED length-of-stay (LOS), and radiation risk mitigation using a POCUS-first approach for acute diverticulitis in the emergency department (ED).

Methods: Using published data, we constructed a Monte Carlo simulation model to compare two POCUS-first strategies (nonselective and selective approaches) for evaluating patients with suspected acute diverticulitis in the ED.

The Presence of a Trochlear Bump and Patella Alta May Predict the Risk of Recurrent Instability After Isolated Medial Patellofemoral Ligament Reconstruction: A Systematic Review and Meta-analysis.

Background: Medial patellofemoral ligament reconstruction (MPFLR) is an excellent surgical option for patients with recurrent patellar instability. This technique has demonstrated significant improvements in patient-reported outcomes, high rates of return to sport, and low rates of failure. However, there is debate regarding the use of isolated MPFLR in the setting of concomitant pathoanatomic features such as patella alta, trochlear dysplasia, or a lateralized tibial tubercle.

Catheter-Directed Aspiration for Right Atrial and Right Ventricular Masses: Trends in Use Over the Years and Comparison Between Percutaneous and Surgical Thrombectomy for Clot in Transit.

Background: Percutaneous mechanical aspiration thrombectomy is increasingly being employed as a less invasive alternative for managing right heart masses, including clot in transit.

Aims: We aimed to analyze trends in the use of catheter-directed aspiration (CDA) for right heart masses. Additionally, we analyzed in-hospital outcomes of percutaneous versus surgical approaches for patients with CIT and PE.

Surgical correction of a chin-on-abdomen deformity due to ankylosing spinal deformity and obesity: illustrative case.

Background: Kyphotic spinal deformity is a complication of ankylosing spondylitis (AS). In rare cases, particularly in obese patients, the deformity might extend to the cervicothoracic spine, resulting in a severe "chin-on-abdomen" deformity. This condition severely impairs quality of life by affecting gaze, swallowing, and causing chronic pain.

Genomic analysis of surgical patients to identify patients at risk for postoperative sepsis and surgical site infection.

Background: Early and accurate diagnosis of sepsis and the ensuing organ dysfunction remain a challenge in the postoperative setting. Susceptibility to infections, as well as the subsequent immunological response, are driven to some extent by the genetic predisposition of the patient. The purpose of this study was to identify novel genetic variants associated with postoperative sepsis (POS) and surgical site infections (SSIs).

Trends in Payments for Ambulatory Surgery Center Facility Fees and Surgeon Professional Fees for Hip and Knee Arthroplasty.

Background: Ambulatory Surgery Centers (ASCs) have been shown to deliver high-quality care to patients at major cost savings to the healthcare system. The objective of this investigation was to examine trends in the Medicare facility and surgeon professional fee payments for hip and knee arthroplasty.

Methods: Publicly available Medicare data was analyzed to determine professional and facility fee payments for unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), and total hip arthroplasty (THA) to ASCs and hospitals between 2018 and 2024.

No Association Between Donor Variables and Clinically Significant Outcomes, Reoperations, and Failure After Osteochondral Allograft Transplantation.

Background: Mismatch between osteochondral allograft (OCA) donor and recipient sex has been shown to negatively affect outcomes. This study accounts for additional donor variables and clinically relevant outcomes.

Purpose: To evaluate whether donor sex, age, donor-recipient sex mismatch, and duration of graft storage affect clinical outcomes and failure rates after knee OCA transplantation.

Exploring the Relationship Between Combined, Acetabular, and Femoral Version on Postoperative Outcomes 2 Years After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Background: Many studies have examined the prevalence of acetabular version (AV) and femoral version (FV) abnormalities and their effect on patient-reported outcomes (PROs) after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), but few have explored the prevalence and influence of combined version (CV) abnormalities.

Purpose: To (1) describe the distribution of AV, FV, and CV in the largest cohort to date and (2) determine the relationship between AV, FV, and CV and PROs after hip arthroscopy for FAIS.

Study Design: Cohort study; Level of evidence, 3.

Revision Unicompartmental Knee Arthroplasty: Worse Than a Primary, But Better Than a Revision Total Knee Arthroplasty.

Background: Revision of a unicompartmental to a total knee arthroplasty (TKA) is often compared to primary TKA with regard to its technical difficulty and complication rates. We sought to compare medical and surgical complications following revision unicompartmental knee arthroplasty (UKA) to those following primary TKA and aseptic revision TKA.

Methods: A national administrative claims database was queried for patients undergoing revision UKA between 2010 and 2019.

Lower ACLR Failure Rates in Bone-Soft Tissue Versus Soft Tissue-Only Allografts in Adults: A Systematic Review and Meta-analysis.

Background: While allografts are commonly used for anterior cruciate ligament reconstruction (ACLR), evidence to guide specific allograft selection is lacking.

Purpose: To compare clinical and graft failure rates after ACLR using soft tissue-only allografts and bone-soft tissue allografts in adults.

Study Design: Systematic review and meta-analysis; Level of evidence, 4.

Vascular endothelial growth factor receptor-1 (FLT1) interactions with amyloid-beta in Alzheimer's disease: A putative biomarker of amyloid-induced vascular damage.

We have identified FLT1 as a protein that changes during Alzheimer's disease (AD) whereby higher brain protein levels are associated with more amyloid, more tau, and faster longitudinal cognitive decline. Given FLT1's role in angiogenesis and immune activation, we hypothesized that FLT1 is upregulated in response to amyloid pathology, driving a vascular-immune cascade resulting in neurodegeneration and cognitive decline. We sought to determine (1) if in vivo FLT1 levels (CSF and plasma) associate with biomarkers of AD neuropathology or differ between diagnostic staging in an aged cohort enriched for early disease, and (2) whether FLT1 expression interacts with amyloid on downstream outcomes, such as phosphorylated tau levels and cognitive performance.

The economic burden of diabetes in spinal fusion surgery: a systematic review and meta-analysis.

Purpose: This study aimed at comparing the costs of spinal fusion surgery between patients with and without diabetes.

Methods: Following PRISMA guidelines, a systematic search of four databases was conducted. A meta-analysis was performed on comparative studies examining diabetic versus non-diabetic adults undergoing cervical/lumbar fusion in terms of cost.

Adaptive measurement of cognitive function based on multidimensional item response theory.

Introduction: Up to 20% of older adults in the United States have mild cognitive impairment (MCI), and about one-third of people with MCI are predicted to transition to Alzheimer's disease (AD) within 5 years. Standard cognitive assessments are long and require a trained technician to administer. We developed the first computerized adaptive test (CAT) based on multidimensional item response theory (MIRT) to more precisely, rapidly, and repeatedly assesses cognitive abilities across the adult lifespan.

Association of binge alcohol use with functional outcomes among individuals with COVID-19 infection.

Aims: Alcohol consumption along with negative sequelae from excess alcohol intake increased during the COVID-19 pandemic. We evaluated the association between binge alcohol use and long-term functional outcomes among COVID-19-positive individuals.

Methods: Using a prospective, longitudinal, multisite cohort study design, we evaluated the association between binge alcohol use and mental and physical functional outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores three and six months postinfection.

Physicians-in-training and advanced practice providers perceptions in managing perioperative obstructive sleep apnea: a multi-institutional survey.

Study Objectives: Physicians-in-training (residents, fellows) and Advanced Practice Providers (APPs) receive limited education on sleep disorders, including obstructive sleep apnea (OSA). They often assess patients first. We aimed to understand their views on OSA and screening for OSA in the perioperative period.

Dedifferentiation of a Chondrosarcoma of the Larynx: A Case Report.

Background: Chondrosarcomas of the larynx, relatively rare tumors with low grade pathology in approximately 95% of cases, can most often be managed with conservation laryngeal procedures. Dedifferentiated chondrosarcomas are much more rare and aggressive requiring more aggressive surgical extirpation.

Methods: A patient underwent three debulking procedures for a laryngeal chondrosarcoma Grade I/II histologically over a 2.

Sex-Based Differences in Endovascular Thrombectomy Outcomes for Large Ischemic Stroke: A SELECT2 Subanalysis.

Background: Several social and biological factors are shown to differentially affect stroke outcomes between men and women. We evaluated whether clinical outcomes and endovascular thrombectomy (EVT) treatment effects differed between the sexes in patients presenting with large ischemic stroke.

Methods: The SELECT2 trial (A Randomized Controlled Trial to Optimize Patient's Selection for Endovascular Treatment in Acute Ischemic Stroke) was a randomized controlled trial assessing the efficacy and safety of EVT in patients with large strokes across the United States, Canada, Europe, Australia, and New Zealand between October 2019 and September 2022.

Growing empathy through art therapy, life story, and relationships: experiential learning in adult day services.

Introduction: Empathy is a fundamental element of high-quality healthcare, though it has been shown to be in decline among medical students and residents. Appeals have therefore been made for the development of evidence-based empathy-enhancing experiential learning and training models. Bringing Art to Life (BATL) is a service-learning program designed within experiential learning pedagogy for psychology and pre-healthcare students.