Neurosurgery
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Encouraging early time of discharge (TOD) for medical inpatients is commonplace and may potentially improve patient throughput. It is unclear, however, whether early TOD after elective spine surgery achieves this goal without a consequent increase in re-presentations to the hospital. ⋯ There does not appear to be an association between readmission or return to the emergency department and early TOD after elective spine surgery. Overuse of inpatient physical and occupational therapy consultations may contribute to decreased patient throughput in surgical admissions.
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Multicenter Study
Acute Implantation of a Bioresorbable Polymer Scaffold in Patients With Complete Thoracic Spinal Cord Injury: 24-Month Follow-up From the INSPIRE Study.
Based on 6-month data from the InVivo Study of Probable Benefit of the Neuro-Spinal Scaffold for Safety and Neurological Recovery in Patients with Complete Thoracic Spinal Cord Injury (INSPIRE) study (NCT02138110), acute implantation of an investigational bioresorbable polymer device (Neuro-Spinal Scaffold [NSS]) appeared to be safe in patients with complete thoracic spinal cord injury (SCI) and was associated with an ASIA Impairment Scale (AIS) conversion rate that exceeded historical controls. ⋯ In this small group of patients with complete thoracic SCI, acute NSS implantation within the spinal cord appeared to be safe with no long-term neurological issues identified during the 24-month follow-up. Patients remain stable, with additional AIS conversions observed in some patients at 12 months and beyond. These data further support the safety and probable benefit of NSS implantation in this patient population.
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Deep neural networks (DNNs) have not been proven to detect blood loss (BL) or predict surgeon performance from video. ⋯ BL and task outcome classification are important components of an automated assessment of surgical performance. DNNs can predict BL and outcome of hemorrhage control from video alone; their performance is improved with surgical instrument presence data. The generalizability of DNNs trained on hemorrhage control tasks should be investigated.
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Comment Letter Multicenter Study
Letter: Prospective, Multicenter Clinical Study of Microvascular Decompression for Hemifacial Spasm.
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Comment Letter Multicenter Study
In Reply: Prospective, Multicenter Clinical Study of Microvascular Decompression for Hemifacial Spasm.