An ensemble learning model for forecasting water-pipe leakage.

Based on the benefits of different ensemble methods, such as bagging and boosting, which have been studied and adopted extensively in research and practice, where bagging and boosting focus more on reducing variance and bias, this paper presented an optimization ensemble learning-based model for a large pipe failure dataset of water pipe leakage forecasting, something that was not previously considered by others. It is known that tuning the hyperparameters of each base learned inside the ensemble weight optimization process can produce better-performing ensembles, so it effectively improves the accuracy of water pipe leakage forecasting based on the pipeline failure rate. To evaluate the proposed model, the results are compared with the results of the bagging ensemble and boosting ensemble models using the root-mean-square error (RMSE), the mean square error (MSE), the mean absolute error (MAE), and the coefficient of determination (R2) of the bagging ensemble technique, the boosting ensemble technique and optimizable ensemble technique are higher than other models. The experimental result shows that the optimizable ensemble model has better prediction accuracy. The optimizable ensemble model has achieved the best prediction of water pipe failure rate at the 14th iteration, with the least RMSE = 0.00231 and MAE = 0.00071513 when building the model that predicts water pipe leakage forecasting via pipeline failure rate.

A Narrative Review of Osteoid Osteomas and an Audit on the Practice of CT-Guided Radiofrequency Ablation in the Northern Irish Population: A First in the Literature.

Introduction Osteoid osteoma is a benign condition of the bone, usually affecting young males. This retrospective study explores the demographics of osteoid osteomas in the Northern Irish population. It also aims to audit the practice of CT-guided radiofrequency ablation of osteoid osteomas at a major orthopaedic centre in Belfast, Northern Ireland, and to investigate the possible causes of treatment failure. Methods Forty-seven osteoid osteoma patients, diagnosed based on clinico-radiologic features and treated with CT-guided radiofrequency ablation, were found eligible for inclusion and analysis. We collected data from electronic health records (March 2011 to May 2022) and reviewed the radiological images and associated reports. Information about demographics, clinical indices, operative technique, clinical outcomes, biopsy results, and follow-up were also gathered. Data were then analysed using IBM SPSS Statistics for Mac, version 28.0.1.1 (14) (IBM Corp., Armonk, NY). Results The average age of patients was 19.3 years, with a male-to-female predilection of 2.1:1. The proximal and mid-tibial shafts were the most frequently involved sites. On average, patients had symptoms for 15.6 months, while the mean treatment delay period was 6.9 months. Primary clinical success was observed in 37 patients (78.7%), while ten patients had a clinical failure. Two out of the 10 patients with treatment failure underwent subsequent successful ablations, raising the secondary clinical success rate to (83.0%). Chi-Square association tests found no correlation between primary treatment outcomes and other qualitative variables (gender, bone type, lesion location, and Kayser classification). Moreover, binary logistic regression tests found no predictability of age and treatment delay on treatment outcomes. The overall observed complication rate was 4%, with only one significant side effect reported (third-degree skin burn). Conclusion We concluded that the demographics of osteoid osteomas in the Northern Irish population are comparable to what is previously established in the literature. Furthermore, we reasoned that CT-guided radiofrequency ablation is an efficient, safe, and effective minimally invasive technique in the management of osteoid osteomas.

A Retrospective Evaluation and Review of Radiographic Outcomes for Anterior Cervical Discectomy and Fusion (ACDF) Procedures: Northern Ireland's Experience.

Introduction Anterior Cervical Discectomy and Fusion (ACDF) is the gold standard treatment for symptomatic cervical spondylosis refractory to analgesic medical management. Currently, there are numerous approaches and devices used; however, there is no single implant that is preferred for this procedure. The aim of this study is to evaluate the radiological outcomes of ACDF procedures performed in the regional spinal surgery centre in Northern Ireland. The results of this study will aid surgical decision-making, specifically with regard to the choice of implant. The implants that will be assessed in this study are the stand-alone polyetheretherketone (PEEK) cage (Cage) and the Zero-profile augmented screw implant (Z-P). Methods A total of 420 ACDF cases were reviewed retrospectively. Following exclusion and inclusion criteria, 233 cases were reviewed. In the Z-P group, there were 117 patients, with 116 in the Cage group. Radiographic assessment was carried out at the pre-operative stage, day one post-operation, and follow-up (> three months). Measured parameters included segmental disc height, segmental Cobb angle, and spondylolisthesis displacement distance. Results Patient characteristic features showed no significant difference between the two groups (p>0.05) and no significant difference in mean follow-up time (p=0.146). The Z-P implant was superior in increasing and maintaining disc height post-operatively (+0.4±0.94mm, 5.20±0.66mm) compared to the Cage (+0.1±1.00mm, 4.40±0.95mm) (p<0.001). Z-P was also more successful in restoring and maintaining cervical lordosis in comparison to the Cage group, as it had a significantly smaller kyphosis incidence (0.85% vs. 34.5%) at follow-up (p<0.001). Conclusions Results of this study show a more advantageous outcome in the Zero-profile group as it restores and maintains both disc height and cervical lordosis; it is also more successful in treating spondylolisthesis. This study advocates cautious endorsement of the use of the Zero-profile implant in ACDF procedures for symptomatic cervical disc disease.

3D Visualisation of the Spine.

The 3D visualisation of the spine is thought of from multiple viewpoints. Firstly, radiological imaging is considered, with plain radiography, CT and MRI imaging discussed in detail with relevant applications to spinal surgery.3D printing can be used in spinal surgery with multiple applications including education, pre-operative planning for complex cases and making patient-specific guides and implants. The rapidly growing field of intraoperative navigation and robotics have been discussed, in addition to their benefits and limitations within spinal surgery, as well as some technical tips.An understanding of relevant anatomy and biomechanics is necessary for any surgeon, and so this chapter describes the key concepts to be familiar with, particularly the spinal motion segment and the different methods for classifying spinal injuries and how that relates to stability. The concepts discussed have been brought together by applying this knowledge to some interesting clinical cases. They highlight the importance of 3D visualisation of the spine, which must be considered throughout the decision-making process when managing patients. Spinal surgeons use multiple imaging modalities, knowledge of anatomy and biomechanics, as well as considering the need for navigation in more complex cases, all on a daily basis. With the advancement of technology available for 3D visualisation of the spine, we will be able to improve patient outcomes even further in the future.

Ten techniques for improving navigated spinal surgery.

With the identification of literature shortfalls on the techniques employed in intraoperative navigated (ION) spinal surgery, we outline a number of measures which have been synthesised into a coherent operative technique. These include positioning, dissection, management of the reference frame, the grip, the angle of attack, the drill, the template, the pedicle screw, the wire, and navigated intrathecal analgesia. Optimizing techniques to improve accuracy allow an overall reduction of the repetition of the surgical steps with its associated productivity benefits including time, cost, radiation, and safety. Cite this article: Bone Joint J 2020;102-B(3):371-375.

A novel surgical technique aiding the reduction of lumbar spondylolisthesis using the Jazz™ Band.

Posterior reduction and fusion of spondylolisthesis has a number of recognized and accepted procedural difficulties dependent on its severity. The Jazz™ Band is a novel system designed primarily for posterior fixation of the spine; however, its uses can be applied to a breadth of spinal conditions. Its benefits include that one size will fit all spinal levels; the connector is designed for multiple union rod diameters and reduced comorbidity when compared with other surgical methods. We present a case of a 26-year-old female with an L5/S1 spondylolisthesis slip angle of 117.4°. A 25° improvement in the spondylolisthesis slip angle was achieved with the use of the Jazz™ Band. The Jazz™ Band demonstrates excellent short-term results, and in order to determine the clinical outcomes and efficacy of the Jazz™ Band system, long-term results and analysis should be performed.

Influence of timing of surgery on Cauda equina syndrome: Outcomes at a national spinal centre.

PURPOSE: There is no doubt that the best outcome achieved in Cauda equina syndrome (CES) involves surgical decompression. The controversy regarding outcome lies with timing of surgery. This study reports outcomes on a large population based series. Timing of surgery, Cauda Equina syndrome classification based on British Association of Spine Surgeons (BASS) guidelines and co-morbid illness will be assessed to evaluate influence on outcome. MATERIALS AND METHODS: A retrospective review of all patients surgically decompressed for CES between 01/01/2008 to 01/08/2014 was conducted. Patients with ongoing symptoms were followed up for a minimum of 2 years. Cauda Equina Syndrome (CES) was classified according to the BASS criteria: CES suspicious (CESS), incomplete (CESI) and painless urinary retention (CESR). Time and symptom resolution were assessed. RESULTS: A total of 136 patients were treated for CES; 69 CESR, 22 CESI and 45 CESS. There was no statistical difference in age, sex, smoking status and alcohol status with regards to timing of surgery. No correlation between increasing co-morbidity score and poor outcome was demonstrated in any subgroupAll CESR/I patients demonstrated some improvement in bowel and bladder dysfunction post-operatively. No significant difference in improved autonomic dysfunction was demonstrated in relation to timing of surgery. CES subclassification may predict outcome of non-autonomic symptoms. Statistically better outcomes were found in CESS groups with regards to post-operative lower back pain (P 0.049) and saddle paraesthesia (P 0.02). CONCLUSION: Surgical Decompression for CES is an effective treatment that significantly improves patient symptoms including bowel and bladder dysfunction Early surgical decompression <24 h from symptom onset does not appear to significantly improve resolution of bowel or bladder dysfunction.