Anterior retropharyngeal approach (ARPA) for high cervical spine.

BACKGROUND: One of the major challenges in operating on the spine lies in taking an anterior approach for the high cervical spine. In patients with a short neck, Klippel-Fiel syndrome or when the C3 vertebra is high in relation to the hyoid bone, it will be difficult to access the C3 body. The transoral route is a highly contaminated zone, and therefore, no instrumentation or grafts can be placed through it. METHOD: The anterior retropharyngeal approach (ARPA) for the high cervical spine. CONCLUSION: The anterior retropharyngeal approach is an excellent approach for the high cervical spine where instrumentation is needed. This route provides wide exposure of the C1-C3 region, avoiding the contaminated of the oral cavity.

Differential Gene Expression Data Analysis of ASD Using Random Forest.

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain regions. Analysis of differential expression (DE) of transcriptomic data allows for genome-wide analysis of gene expression changes related to ASD. De-novo mutations may play a vital role in ASD, but the list of genes involved is still far from complete. Differentially expressed genes (DEGs) are treated as candidate biomarkers and a small set of DEGs might be identified as biomarkers using either biological knowledge or data-driven approaches like machine learning and statistical analysis. In this study, we employed a machine learning-based approach to identify the differential gene expression between ASD and Typical Development (TD). The gene expression data of 15 ASD and 15 TD were obtained from the NCBI GEO database. Initially, we extracted the data and used a standard pipeline to pre-process the data. Further, Random Forest (RF) was used to discriminate genes between ASD and TD. We identified the top 10 prominent differential genes and compared them with the statistical test results. Our results show that the proposed RF model yields 5-fold cross-validation accuracy, sensitivity and specificity of 96.67%. Further, we obtained precision and F-measure scores of 97.5% and 96.57%, respectively. Moreover, we found 34 unique DEG chromosomal locations having influential contributions in identifying ASD from TD. We have also identified chr3:113322718-113322659 as the most significant contributing chromosomal location in discriminating ASD and TD. Our machine learning-based method of refining DE analysis is promising for finding biomarkers from gene expression profiles and prioritizing DEGs. Moreover, our study reported top 10 gene signatures for ASD may facilitate the development of reliable diagnosis and prognosis biomarkers for screening ASD.