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1.
J Pers Med ; 14(9)2024 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-39338211

RESUMO

BACKGROUND: The early detection of mental health crises is crucial for timely interventions and improved outcomes. This study explores the potential of artificial intelligence (AI) in analyzing social media data to identify early signs of mental health crises. METHODS: We developed a multimodal deep learning model integrating natural language processing and temporal analysis techniques. The model was trained on a diverse dataset of 996,452 social media posts in multiple languages (English, Spanish, Mandarin, and Arabic) collected from Twitter, Reddit, and Facebook over 12 months. Its performance was evaluated using standard metrics and validated against expert psychiatric assessments. RESULTS: The AI model demonstrated a high level of accuracy (89.3%) in detecting early signs of mental health crises, with an average lead time of 7.2 days before human expert identification. Performance was consistent across languages (F1 scores: 0.827-0.872) and platforms (F1 scores: 0.839-0.863). Key digital markers included linguistic patterns, behavioral changes, and temporal trends. The model showed varying levels of accuracy for different crisis types: depressive episodes (91.2%), manic episodes (88.7%), suicidal ideation (93.5%), and anxiety crises (87.3%). CONCLUSIONS: AI-powered analysis of social media data shows promise for the early detection of mental health crises across diverse linguistic and cultural contexts. However, ethical challenges, including privacy concerns, potential stigmatization, and cultural biases, need careful consideration. Future research should focus on longitudinal outcome studies, ethical integration of the method with existing mental health services, and developing personalized, culturally sensitive models.

2.
EFORT Open Rev ; 9(7): 676-684, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38949156

RESUMO

Adolescent idiopathic scoliosis (AIS) is an abnormal coronal curvature of the spine that most commonly presents in adolescence. While it may be asymptomatic, AIS can cause pain, cosmetic deformity, and physical and psychological disability with curve progression. As adolescents with AIS enter adulthood, condition outcomes vary with some experiencing curve stabilization and others noting further curve progression, chronic pain, osteoporosis/fractures, declines in pulmonary and functional capacity, among others. Regular monitoring and individualized management by healthcare professionals are crucial to address the diverse challenges and provide appropriate support for a fulfilling adult life with AIS. This review examines the prevalence, risk factors, presenting symptoms, diagnosis, management, and complications of AIS in the adult population, informing targeted interventions by clinicians caring for adult patients with AIS.

3.
Cureus ; 16(3): e56584, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38646218

RESUMO

INTRODUCTION:  Hydrocele of the canal of Nuck is a condition that arises due to incomplete obliteration of the processus vaginalis or an abnormal outpouching from the round ligament during fetal development. It usually presents as a painless, rarely painful, groin swelling. The definitive diagnosis for this condition is magnetic resonance imaging. Various management options have been proposed for this condition, including open surgery, transabdominal preperitoneal approach, totally extraperitoneal approach, and a combination of laparoscopic and open surgery. The present study highlights the benefits of the transabdominal preperitoneal approach when compared with the open anterior approach and addresses the intraoperative challenges faced during laparoscopic surgery. MATERIALS AND METHODS:  The study is a retrospective study inclusive of 20 patients who underwent surgery for the hydrocele of the canal of Nuck from June 2019 to December 2023. Case records of patients were studied for information such as demographic features, type of pathology, the surgery performed, intraoperative challenges encountered, operative time, duration of hospital stay, scores from the visual analog scale pain assessment chart at various intervals, and time taken to return to work. The variables were documented and statistically analyzed. RESULTS:  The average age group of the study population was 27.8 ± 8.34 years. Of the 20 patients, 10 had undergone a transabdominal preperitoneal approach (Group A), and 10 had undergone an open anterior approach (Group B). Eleven out of 20 patients had an associated inguinal hernia, of which three were identified preoperatively and eight were identified incidentally during surgery. The mean operative time of Group A cases was 97.95 ± 7.54 minutes, while it was 66.3 ± 6.20 minutes for Group B cases. The Mann-Whitney U test showed a statistically significantly lesser operative time for Group B than for Group A (p-value < 0.001). The duration of hospital stays was comparable for the two groups with no significant difference (two days versus 3.8 ± 3.08 days, respectively). When the difference in the means of time taken to return to normal work was compared using the Mann-Whitney U test between Group A and B (6.1 ± 0.87 days and 11.2 ± 1.81 days, respectively), a statistically significant early return to normal work in the former group (p-value = 0.001) was revealed. Similarly, the Mann-Whitney U test when used to compare the median postoperative pain score of both groups at 12-24 hours, 48-72 hours, seven days, and three months showed a significantly lesser pain score among patients of Group A at all intervals (p-value < 0.001, p-value = 0.005, p-value = 0.005, p-value < 0.001, respectively). The incidence of intraoperative challenges, sero-hematoma, and surgical site infection were insignificant in comparison. CONCLUSION: The transabdominal preperitoneal approach for the hydrocele of the canal of Nuck is ideal as it offers excellent intraoperative delineation of pathology and postoperative outcomes. Prophylactic placement of a mesh in all cases can help prevent a future occurrence of inguinal hernia in these cases.

4.
World Neurosurg ; 181: e1001-e1011, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37956902

RESUMO

OBJECTIVE: The aim of this study, a retrospective database analysis, was to assess the impact of baseline cannabis use disorder (CUD) on perioperative complication outcomes in patients undergoing primary 1- to 2-level anterior cervical diskectomy and fusion (ACDF) surgery. METHODS: The PearlDiver Database was queried from January 2010 to December 2021 for patients who underwent primary 1- to 2-level ACDF surgery for degenerative spine disease. Patients with CUD diagnosis 6 months before the index ACDF surgery (i.e., CUD) were propensity matched with patients without CUD (i.e., control in a ratio of 1:1, employing age, gender, and Charlson Comorbidity Index as matching covariates). Univariate and multivariable analysis models with adjustment of confounding variables were used to evaluate the risk of CUD on perioperative complications between the propensity-matched cohorts. RESULTS: The 1:1 matched cohort included 838 patients in each group. Following multivariate analysis, CUD was demonstrated to be associated with an increased incidence of hospital readmission at 90 days (odds ratio [OR] = 2.64, 95% confidence interval: [1.19 to 6.78], [P = 0.027]) and revision surgery at 1 year postoperative (OR = 3.36, 95% confidence interval: [1.17 to 14.18], [P = 0.049]). CUD was additionally associated with reduced risk of overall medical complications at both 6 months and 1 year postoperative (OR = 0.55, [P = 0.021], and OR = 0.54, [P = 0.015], respectively). CONCLUSIONS: These findings indicate that isolated baseline CUD is associated with an increased risk of hospital readmission at 90 days postoperative and cervical spine reoperation at 1 year after primary 1- to 2-level ACDF surgery with a decrease in overall medical complications, cardiac arrhythmias, and acute renal failure.


Assuntos
Abuso de Maconha , Fusão Vertebral , Transtornos Relacionados ao Uso de Substâncias , Humanos , Estudos Retrospectivos , Fusão Vertebral/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Vértebras Cervicais/cirurgia , Discotomia/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/complicações , Abuso de Maconha/complicações , Abuso de Maconha/cirurgia
5.
Updates Surg ; 76(1): 279-288, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37436542

RESUMO

Diaphragmatic eventration is one of the rarest conditions characterized by elevation of the hemidiaphragm while maintaining its normal attachments. In recent years, video-assisted thoracoscopic surgery (VATS) has gained popularity for diaphragmatic surgery. In this study, we share our experience over six years with VATS plication of diaphragmatic eventration. We conducted a prospective study at our institute for six years from April 2016 to March 2021, which included 37 symptomatic patients with diaphragmatic eventration. The sample size reported in this study is one of the largest to date for VATS diaphragmatic plication. Of these, 18 patients underwent combined stapler and suture plication, and 19 patients underwent single modality approach (10-stapled resection, 9-suture alone plication). All patients were followed-up for a minimum of 2 years. Comparative analysis of the combined approach and the single modality approach was performed. The mean operative time was significantly longer with the combined approach (p value < 0.01). However, there was no difference in postoperative pain (p value = 0.50), analgesia requirement (p value = 0.72), or pleural drainage (p value = 0.32) between the two approaches. Although not statistically significant, the combined approach had fewer post-operative complications (p value = 0.32). Besides, the Single modality approach resulted in one recurrence (p value = 0.32) and one mortality (p value = 0.32). VATS diaphragmatic plication using staplers and/or sutures is safe and efficacious in the management of diaphragmatic eventration. Surgeons should consider using both staplers and sutures whenever possible, rather than selecting one over the other.


Assuntos
Eventração Diafragmática , Humanos , Eventração Diafragmática/cirurgia , Eventração Diafragmática/etiologia , Estudos Prospectivos , Cirurgia Torácica Vídeoassistida/efeitos adversos , Cirurgia Torácica Vídeoassistida/métodos , Diafragma/cirurgia , Dor Pós-Operatória
6.
Am J Med ; 136(7): 645-651, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37072094

RESUMO

Lumbar disc herniations are common causes of lower back pain, neurological dysfunction, and buttock/leg pain. Herniation refers to the displacement of the nucleus pulposus of the intervertebral disc through the annulus fibrosus, thereby causing pressure on the neural elements. The sequalae of lumbar disc herniations range in severity from mild low back and buttock pain to severe cases of inability to ambulate and cauda equina syndrome. Diagnosis is achieved with a thorough history and physical examination along with advanced imaging. Treatment plans are dictated by corresponding patient symptoms and examination findings with their imaging. Most patients can experience relief with nonsurgical measures. However, if symptoms persist or worsen, surgery may be appropriate.


Assuntos
Síndrome da Cauda Equina , Deslocamento do Disco Intervertebral , Dor Lombar , Humanos , Deslocamento do Disco Intervertebral/diagnóstico , Deslocamento do Disco Intervertebral/terapia , Síndrome da Cauda Equina/etiologia , Dor Lombar/etiologia , Imageamento por Ressonância Magnética , Exame Físico , Vértebras Lombares
7.
J Clin Med ; 12(5)2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36902730

RESUMO

Understanding global body balance can optimize the postoperative course for patients undergoing spinal or lower limb surgical realignment. This observational cohort study aimed to characterize patients with reported imbalance and identify predictors. The CDC establishes a representative sample annually via the NHANES. All participants who said "yes" (Imbalanced) or "no" (Balanced) to the following question were identified from 1999-2004: "During the past 12 months, have you had dizziness, difficulty with balance or difficulty with falling?" Univariate analyses compared Imbalanced versus Balanced subjects and binary logistic regression modeling predicted for Imbalance. Of 9964 patients, imbalanced (26.5%) were older (65.4 vs. 60.6 years), with more females (60% vs. 48%). Imbalanced subjects reported higher rates of comorbidities, including osteoporosis (14.4% vs. 6.6%), arthritis (51.6% vs. 31.9%), and low back pain (54.4% vs 32.7%). Imbalanced patients had more difficulty with activities, including climbing 10 steps (43.8% vs. 21%) and stooping/crouching/kneeling (74.3% vs. 44.7%), and they needed greater time to walk 20 feet (9.5 vs. 7.1 s). Imbalanced subjects had significantly lower caloric and dietary intake. Regression revealed that difficulties using fingers to grasp small objects (OR: 1.73), female gender (OR: 1.43), difficulties with prolonged standing (OR: 1.29), difficulties stooping/crouching/kneeling (OR: 1.28), and increased time to walk 20 feet (OR: 1.06) were independent predictors of Imbalance (all p < 0.05). Imbalanced patients were found to have identifiable comorbidities and were detectable using simple functional assessments. Structured tests that assess dynamic functional status may be useful for preoperative optimization and risk-stratification for patients undergoing spinal or lower limb surgical realignment.

8.
J Nanosci Nanotechnol ; 21(6): 3256-3268, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34739780

RESUMO

Polyethyleneimine functionalized graphene oxide (PEI-GO) was prepared and characterized for its molecular structure and morphology. The PEI-GO is, for the first time, reported as an inhibitor against copper (Cu) corrosion in 0.5 M HCl using electrochemical studies. PEI-GO acts as a promising corrosion inhibitor for Cu with 92.24% efficiency at 100 mgL-1. The PDP studies reveal a mixed type of inhibitor behavior of PEI-GO with cathodic prevalence. Cyclic voltammetry revealed the inhibition influence of PEI-GO on the redox process of Cu corrosion. SEM and FTIR-ATR studies showed the creation of a protective layer on the Cu substrate. DFT studies revealed that the PEIGO exhibits better reactivity compared to parent PEI, and Monte Carlo simulations showed higher adsorption energy for PEI-GO on the Cu surface compared to the PEI.


Assuntos
Cobre , Polietilenoimina , Corrosão , Grafite , Ácido Clorídrico
9.
Materials (Basel) ; 12(1)2018 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-30577577

RESUMO

Benzimidazole derivatives were synthesized, characterized, and tested as a corrosion inhibitor for J55 steel in a 3.5 wt % NaCl solution saturated with carbon dioxide. The experimental results revealed that inhibitors are effective for steel protection, with an inhibition efficiency of 94% in the presence of 400 mg/L of inhibitor. The adsorption of the benzimidazole derivatives on J55 steel was found to obey Langmuir's adsorption isotherm. The addition of inhibitors decreases the cathodic as well anodic current densities and significantly strengthens impedance parameters. X-ray photoelectron spectroscopy (XPS) was used for steel surface characterization. Density functional theory (DFT) and molecular dynamic simulation (MD) were applied for theoretical studies.

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