Big Data in Neurosurgery: A Guideline on Data Structures, Machine Learning Models, and Ethical Considerations.

Artificial intelligence (AI) is reshaping neurosurgery, offering unprecedented opportunities to enhance diagnostics, personalize treatment, and predict outcomes. At the heart of this transformation is the ability to effectively harness big data (BD) within the electronic medical record. Understanding these data structures is essential for making sense of the vast volumes of information generated in modern neurosurgical practice.

Minimally Invasive Techniques for Intercostal Nerve Transfer: A Technical Note on Thoracoscopic and Robotic Approaches.

Background And Objectives: Brachial plexus injuries are a devastating and often life-altering event. For patients with flail limb and no intraplexal donors, intercostal (IC) to musculocutaneous nerve transfer allows for restoration of elbow flexion although the surgery can be long with a painful recovery. In this article, we demonstrate a minimal incision video-assisted thoracoscopic surgery (VATS) method and a robotic approach to IC harvesting for nerve to biceps brachii reanimation.

Sez6L2 autoimmunity induces cerebellar ataxia in mice.

Sez6L2 autoantibodies have been reported in patients with subacute cerebellar ataxia, presenting with gait disturbances, frequent falls, slurred speech, and repetitive eye movements. These case studies suggest that autoimmunity against Sez6L2 causes cerebellar damage leading to ataxia. Sez6L2 is a transmembrane protein expressed by most neurons, with the highest levels in the cerebellum.

The microglial response to inhibition of Colony-stimulating-factor-1 receptor by PLX3397 differs by sex in adult mice.

Microglia, the resident macrophages of the brain, are derived from the yolk sac and colonize the brain before the blood-brain barrier forms. Once established, they expand locally and require Colony-stimulating-factor-1 receptor (CSF1R) signaling for their development and maintenance. CSF1R inhibitors have been used extensively to deplete microglia in the healthy and diseased brain.

The Rochester Model for Spinal CSF Leak Repair Simulation and Scoring.

Background And Objective: Iatrogenic spinal durotomies occur at a rate of 1% to 17%. Surgical simulation for durotomy repair is needed to provide affordable, accessible, and validated practice. This study sought to design and validate a simple 3-dimensional printed model for spinal cerebrospinal fluid (CSF) leak repair and to introduce the Rochester original objective structured assessment of technical skills (OSATS) CSF leak (ROCL) repair criteria for assessment.

Noradrenergic signaling controls Alzheimer's disease pathology via activation of microglial β2 adrenergic receptors.

Norepinephrine (NE) is a potent anti-inflammatory agent in the brain. In Alzheimer's disease (AD), the loss of NE signaling heightens neuroinflammation and exacerbates amyloid pathology. NE inhibits surveillance activity of microglia, the brain's resident immune cells, via their β2 adrenergic receptors (β2ARs).

Neutrophilia with damage to the blood-brain barrier and neurovascular unit following acute lung injury.

Background: Links between acute lung injury (ALI), infectious disease, and neurological outcomes have been frequently discussed over the past few years, especially due to the COVID-19 pandemic. Yet, much of the cross-communication between organs, particularly the lung and the brain, has been understudied. Here, we have focused on the role of neutrophils in driving changes to the brain endothelium with ensuing microglial activation and neuronal loss in a model of ALI.

Neutrophilia with damage to the blood-brain barrier and neurovascular unit following acute lung injury.

Background: Links between acute lung injury (ALI), infectious disease, and neurological outcomes have been frequently discussed over the past few years, especially due to the COVID-19 pandemic. Yet, much of the cross-communication between organs, particularly the lung and the brain, has been understudied. Here, we have focused on the role of neutrophils in driving changes to the brain endothelium with ensuing microglial activation and neuronal loss in a model of ALI.

Quantum Dot Biomimetic for SARS-CoV-2 to Interrogate Blood-Brain Barrier Damage Relevant to NeuroCOVID Brain Inflammation.

Despite limited evidence for infection of SARS-CoV-2 in the central nervous system, cognitive impairment is a common complication reported in "recovered" COVID-19 patients. Identification of the origins of these neurological impairments is essential to inform therapeutic designs against them. However, such studies are limited, in part, by the current status of high-fidelity probes to visually investigate the effects of SARS-CoV-2 on the system of blood vessels and nerve cells in the brain, called the neurovascular unit.

URMC-099 prophylaxis prevents hippocampal vascular vulnerability and synaptic damage in an orthopedic model of delirium superimposed on dementia.

Systemic perturbations can drive a neuroimmune cascade after surgical trauma, including affecting the blood-brain barrier (BBB), activating microglia, and contributing to cognitive deficits such as delirium. Delirium superimposed on dementia (DSD) is a particularly debilitating complication that renders the brain further vulnerable to neuroinflammation and neurodegeneration, albeit these molecular mechanisms remain poorly understood. Here, we have used an orthopedic model of tibial fracture/fixation in APPSwDI/mNos2 AD (CVN-AD) mice to investigate relevant pathogenetic mechanisms underlying DSD.

The Sez6 Family Inhibits Complement by Facilitating Factor I Cleavage of C3b and Accelerating the Decay of C3 Convertases.

The Sez6 family consists of Sez6, Sez6L, and Sez6L2. Its members are expressed throughout the brain and have been shown to influence synapse numbers and dendritic morphology. They are also linked to various neurological and psychiatric disorders.

Survival and Motor Phenotypes in FVB C9-500 ALS/FTD BAC Transgenic Mice Reproduced by Multiple Labs.

Mordes et al. (2020) did not detect the survival or motor phenotypes in C9orf72 BAC transgenic mice originally described by Liu et al. (2016).

The Mixed-Lineage Kinase Inhibitor URMC-099 Protects Hippocampal Synapses in Experimental Autoimmune Encephalomyelitis.

Treatments to stop gray matter degeneration are needed to prevent progressive disability in multiple sclerosis (MS). We tested whether inhibiting mixed-lineage kinases (MLKs), which can drive inflammatory microglial activation and neuronal degeneration, could protect hippocampal synapses in C57BL/6 mice with experimental autoimmune encephalomyelitis (EAE), a disease model that recapitulates the excitatory synaptic injury that occurs widely within the gray matter in MS. URMC-099, a broad spectrum MLK inhibitor with additional activity against leucine-rich repeat kinase 2 (LRRK2) and other kinases, prevented loss of PSD95-positive postsynaptic structures, shifted activated microglia toward a less inflammatory phenotype, and reversed deficits in hippocampal-dependent contextual fear conditioning in EAE mice when administered after the onset of motor symptoms.

Making meaning of cancer: A qualitative analysis of oral-digestive cancer survivors' reflections.

This qualitative study aimed to confirm and extend research on meaning making after cancer. In all, 119 adults aged 41 to 88 years ( = 65.50 years and standard deviation = 9.

User-centered design of discharge warnings tool for colorectal surgery patients.

Objectives: Readmission following colorectal surgery, typically due to surgery-related complications, is common. Patient-centered discharge warnings may guide recognition of early complication signs after colorectal surgery.

Materials And Methods: User-centered design of a discharge warnings tool consisted of iterative health literacy review and a heuristic evaluation with human factors and clinical experts as well as patient end users to establish content validity and usability.

Patient experience with discharge instructions in postdischarge recovery: a qualitative study.

Objectives: We examined the role of discharge instructions in postoperative recovery for patients undergoing colorectal surgery and report themes related to patient perceptions of discharge instructions and postdischarge experience.

Design: Semistructured interviews were conducted as part of a formative evaluation of a Project Re-Engineered Discharge intervention adapted for surgical patients.

Setting: Michael E.

Testosterone treatment and MMPI-2 improvement in transgender men: a prospective controlled study.

Objective: Most transgender men desire to receive testosterone treatment in order to masculinize their bodies. In this study, we aimed to investigate the short-term effects of testosterone treatment on psychological functioning in transgender men. This is the 1st controlled prospective follow-up study to examine such effects.

Pain is prevalent and persisting in cancer survivors: differential factors across age groups.

Objective: The Institute of Medicine documents a significant gap in care for long term side effects of cancer treatment, including pain. This paper characterizes age differences in the prevalence and predictive characteristics of pain to guide clinicians in identification and treatment.

Materials And Methods: A sample of 170 adults with head and neck, esophageal, gastric, or colorectal cancers were recruited from two regional Veterans Administration Medical Centers.

Cancer survivor rehabilitation and recovery: protocol for the Veterans Cancer Rehabilitation Study (Vet-CaRes).

Background: Cancer survivors are a rapidly growing and aging population in the U.S., but there are many challenges associated with the survivorship experience such as functional disabilities and psychosocial distress.

A patient-centered early warning system to prevent readmission after colorectal surgery: a national consensus using the Delphi method.

Background: Warnings of deteriorating condition provided to patients at hospital discharge are highly subjective, based on conventional wisdom, and lack systematic implementation. We conducted a standardized Delphi process to achieve national consensus on warning indicators and recommended action plans for patients after colorectal surgery.

Study Design: Expert panel eligibility was determined by pre-established criteria.