Neurosurgery
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Physician rating websites (PRWs) are increasingly used by patients to find health care providers. This study explores spine neurosurgeon PRW ratings and their relationship with academic productivity. ⋯ Overall, spine neurosurgeon ratings on PRWs were favorable. Ratings were found to decrease with increasing surgeon age, and academic productivity was not correlated with better ratings.
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Currently, the management for pituitary apoplexy (PA) has been promoted toward a more conservative approach, particularly for patients with low-grade PA scores. Our aim was to investigate trends in PA management and compare clinical presentation, therapeutic approaches, and outcomes before and after 2017, additionally to evaluate long-term outcomes in conservatively treated patients. ⋯ Although conservative management increased in the last years, surgery remains the predominant option. Patients managed conservatively experience a lower risk of permanent arginine vasopressin deficiency, and a high proportion exhibit clinically significant tumor shrinkage over time.
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Classical biomedical data science models are trained on a single modality and aimed at one specific task. However, the exponential increase in the size and capabilities of the foundation models inside and outside medicine shows a shift toward task-agnostic models using large-scale, often internet-based, data. Recent research into smaller foundation models trained on specific literature, such as programming textbooks, demonstrated that they can display capabilities similar to or superior to large generalist models, suggesting a potential middle ground between small task-specific and large foundation models. This study attempts to introduce a domain-specific multimodal model, Congress of Neurological Surgeons (CNS)-Contrastive Language-Image Pretraining (CLIP), developed for neurosurgical applications, leveraging data exclusively from Neurosurgery Publications. ⋯ This study presents a pioneering effort in building a domain-specific multimodal model using data from a medical society publication. The results indicate that domain-specific models, while less globally versatile, can offer advantages in specialized contexts. This emphasizes the importance of using tailored data and domain-focused development in training foundation models in neurosurgery and general medicine.