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Harini Sriraman, Saleena Badarudeen, Saransh Vats, Prakash Balasubramanian School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, 600127, IndiaCorrespondence: Prakash Balasubramanian, School of Computer Science Engineering, Vellore Institute of Technology, Chennai, Tamil Nadu, India, Tel +91-044-39931228, Fax +91-044-39932555, Email Prakash.bala@vit.ac.inAbstract: Deep Learning (DL) drives academics to create models for cancer diagnosis using medical image processing because of its innate ability to recognize difficult-to-detect patterns in complex, noisy, and massive data. The use of deep learning algorithms for real-time cancer diagnosis is explored in depth in this work. Real-time medical diagnosis determines the illness or condition that accounts for a patient’s symptoms and outward physical manifestations within a predetermined time frame. With a waiting period of anywhere between 5 days and 30 days, there are currently several ways, including screening tests, biopsies, and other prospective methods, that can assist in discovering a problem, particularly cancer. This article conducts a thorough literature review to understand how DL affects the length of this waiting period. In addition, the accuracy and turnaround time of different imaging modalities is evaluated with DL-based cancer diagnosis. Convolutional neural networks are critical for real-time cancer diagnosis, with models achieving up to 99.3% accuracy. The effectiveness and cost of the infrastructure required for real-time image-based medical diagnostics are evaluated. According to the report, generalization problems, data variability, and explainable DL are some of the most significant barriers to using DL in clinical trials. Making DL applicable for cancer diagnosis will be made possible by explainable DL.Keywords: artificial intelligence, AI, machine learning, DL, CNN, healthcare, real-time diagnosis, classification, image processing, elastography, feedforward neural network

Obesity is a known risk factor for developing cardiovascular disease, including heart failure. However, the impact of obesity on patients with heart failure is unclear. Weight reduction is a recommended method of prevention of cardiovascular disease. However, the phenomenon of the "obesity paradox" (or "reverse epidemiology") revealed that overweight and mild to moderate obesity are associated with better outcomes in patients with heart failure compared with patients at normal or ideal weight. Even more, increases of weight in cachectic heart failure patients might improve survival, although patients with heart failure who are overweight or mildly to moderately obese have better outcomes than patients with heart failure who are at ideal or normal weight. In heart failure patients, weight reduction through diet regulation, moderate exercise, and bariatric surgery can improve quality of life and New York Heart Association functional class, but it is yet unclear if these measures will improve survival. [ABSTRACT FROM AUTHOR]

» Generative artificial intelligence (AI), a rapidly evolving field, has the potential to revolutionize orthopedic care by enhancing diagnostic accuracy, treatment planning, and patient management through data-driven insights and personalized strategies.» Unlike traditional AI, generative AI has the potential to generate relevant information for orthopaedic surgeons when instructed through prompts, automating tasks such as literature reviews, streamlining workflows, predicting health outcomes, and improving patient interactions.» Prompt engineering is essential for crafting effective prompts for large language models (LLMs), ensuring accurate and reliable AI-generated outputs, and promoting ethical decision-making in clinical settings.» Orthopaedic surgeons can choose between various prompt types-including open-ended, focused, and choice-based prompts-to tailor AI responses for specific clinical tasks to enhance the precision and utility of generated information.» Understanding the limitations of LLMs, such as token limits, context windows, and hallucinations, is crucial for orthopaedic surgeons to effectively use generative AI while addressing ethical concerns related to bias, privacy, and accountability., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/B163)., (Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.)

Prediction of the stock market is a challenging and time-consuming process. In recent times, various research analysts and organizations have used different tools and techniques to analyze and predict stock price movements. During the early days, investors mainly depend on technical indicators and fundamental parameters for short-term and long-term predictions, whereas nowadays many researchers started adopting artificial intelligence-based methodologies to predict stock price movements. In this article, an exhaustive literature study has been carried out to understand multiple techniques employed for prediction in the field of the financial market. As part of this study, more than hundreds of research articles focused on global indices and stock prices were collected and analyzed from multiple sources. Further, this study helps the researchers and investors to make a collective decision and choose the appropriate model for better profit and investment based on local and global market conditions., Competing Interests: The authors declare that they have no competing interests., (© 2024 Balasubramanian et al.)

Aim: Amidst COVID-19 pandemic, the health care delivery in India faces major challenges owing to the overwhelming hospitals, exhausted healthcare workers, and shortage of crucial medical supplies such as ventilators and oxygen. The study aims to propose a novel successful interventional home care model, the Virtual COVID In-Patient (VCIP) care for effective COVID management., Methods: The Covid-19 positive patients enrolled in VCIP were chosen for the study. A 24/7 active multidisciplinary WhatsApp group was created for each patient, for remote monitoring of temperature, blood pressure, blood glucose, respiratory and pulse rate along with the symptoms. Advice on sleep and exercises were given along with the medication via video-audio consultations. Lab facility was provided at the doorstep. Training on various devices, medications including steroids, delivering subcutaneous injections etc were given via video platforms., Results: Among the 220 patients who availed the VCIP facility, only two were hospitalized, yielding a 99.5 % success rate in preventing hospitalizations and patients enrolled have been immensely satisfied with their experience., Conclusions: With similar pandemics anticipated in near future, VCIP model may be considered for successful domiciliary treatment and overcoming the challenges., (Copyright © 2021 Diabetes India. All rights reserved.)

Background: The purpose of this study was to identify the incidence and types of complications after revision total hip arthroplasty (THA) within the first year, and determine the relative risk factors for these complications and of re-revision., Methods: The sample size of 5% Medicare claims data from 1998-2011 was studied. Primary THA patients who underwent subsequent revision were identified using ICD-9-CM codes. Outcomes and complications after revision THA were assessed. Multivariate Cox regression was used to evaluate the effect of patient demographic characteristics on the adjusted complication risk for revision THA patients., Results: Of the 64,260 primary THA patients identified between 1998 and 2011, 3555 patients (5.71%) underwent revision THA. Etiology of primary hip failure included mechanical complications such as loosening and wear (40.7%), dislocation (14.0%), and infection (11.3%). Complications after revision THA included infection and redo revision, 17.3% and 15.8% followed by venous thromboembolic disease (VTE) at 11.1%, dislocation at 5.43%, PE at 3.24%, and death at 2.11%. The rate of "new" infections after an aseptic revision was 8.13%. Patients in the 85+-year-old age group had a 100% greater adjusted risk of VTE (P < .001) and 406% higher adjusted risk of death (P < .001) than those in the 65-69 years-old age group. Patients with higher Charlson scores had higher adjusted risks of VTE (P < .001), infection (P < .001), death (P = .002), and re-revision THA (P = .011)., Conclusion: Advanced age is a clear risk factor for VTE and mortality, but not for dislocation, infection, or re-revision. Higher Charlson index was found to be a risk factor for every complication after revision except dislocation. Greater attention is required to address the high rate of infection and re-do revision after revision THA (17.3% and 15.8%)., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Primary total knee arthroplasty (TKA) for the treatment of knee arthritis has substantially increased over the past decade. Because of its success, the indications for primary TKA have expanded to include younger patients who are more active, elderly patients who have multiple comorbidities, and patients who have more complex issues, such as posttraumatic arthritis and severe deformity. TKA also has been used to salvage failed unicondylar arthroplasty and osteotomies about the knee. Exposure may be challenging and outcomes may not be as successful in patients with soft-tissue contractures, such as a stiff knee, who undergo TKA. Bone graft or augments may be required to correct deformity and attain proper knee alignment in patients who have a substantial varus or valgus deformity. TKA is somewhat challenging in patients who have deformity, bone loss, contracture, or multiple comorbidities, or have had prior surgery; therefore, it is necessary for surgeons to be aware of some general principles that may help minimize complications and improve outcomes.

Objectives: The purpose of this study was to compare the infection risk when internal fixation plates either overlap or did not overlap previous external fixator pin sites in patients with bicondylar tibial plateau fractures and pilon fractures treated with a 2-staged protocol of acute spanning external fixation and later definitive internal fixation., Design: Retrospective comparison study., Setting: Two level I trauma centers., Patients/participants: A total of 85 OTA 41C bicondylar tibial plateau fractures and 97 OTA 43C pilon fractures treated between 2005 and 2010. Radiographs were evaluated to determine the positions of definitive plates in relation to external fixator pin sites and patients were grouped into an "overlapping" group and a "nonoverlapping" group., Intervention: Fifty patients had overlapping pin sites and 132 did not., Main Outcome Measure: Presence of a deep wound infection., Results: Overall, 25 patients developed a deep wound infection. Of the 50 patients in the "overlapping" group, 12 (24%) developed a deep infection compared with 13 (10%) of the 132 patients in the "nonoverlapping" group (P = 0.033)., Conclusions: Placement of definitive plate fixation overlapping previous external fixator pin sites significantly increases the risk of deep infection in the 2-staged treatment of bicondylar tibial plateau and pilon fractures. Surgeons must make a conscious effort to place external fixator pins outside of future definitive fixation sites to reduce the overall incidence of deep wound infections. Additionally, consideration must be given to the relative benefit of a spanning external fixator in light of the potential for infection associated with their use., Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Introduction: The diagnosis of urinary tract infections includes microbiologic culture of urine to determine the etiology of the infection. However, interpretation of the results can be confounded by various factors including the accuracy of a patient's history of current antibiotic usage. , Methodology: In this report, we tested urine specimens for the presence of antibiotics and compared our results to the accuracy of antibiotic data entry on the accompanying request forms. In addition, the consequences of culturing urine specimens with incomplete antibiotic history received in the laboratory were investigated., Results: During the study period, 14,680 urines were obtained and tested with a modified urine antibacterial substance assay (UABA). There were (97.32%) true-negative, 6 (0.04%) false-negative, 222 (1.51%) true-positive and 166 (1.13%) false-positive results. The sensitivity and specificity of this test was 97.37% and 98.85% respectively., Conclusion: This internal audit practice demonstrates the importance of accurately completed request forms and how this information impacts the clinical interpretation of urine culture results.

Background: Antibiograms must use a standard format to present microbiologic data., Objective: When antibacterials are selected for the treatment of infections, knowledge of the locally most likely causative organisms and the prevalence of resistant pathogens to antibacterial agents are essential. This involves generating a cumulative antibiogram. We designed an in-house novel software to prepare our antibiogram, validate data, and analyze results and assessed the performance of this technology. It should be noted that analysis of specific antibiotic resistance patterns were not a focus of this study., Setting: The study was conducted at Al Khor Hospital, Hamad Medical Corporation, a 110-bed acute care hospital that serves patients in the northern area of Qatar. Positive microbiology cultures excluding surveillance samples, isolated in the microbiology laboratory from January 2008 to December 2008, were entered into an in-house software, ABSOFT, designed by one of the authors., Results: The software produced the antibiogram in a fixed format. Epidemiologic data and comparison of our data to the National Nosocomial Infection Surveillance benchmark for multidrug-resistant organism distribution were also presented real time. Automatic color-coded results in tabular format were printed instantaneously without errors, thus eliminating the need to be reviewed., Conclusion: The paper highlights real-time validation and presentation of the cumulative antibiogram, additionally suggesting the format for reporting using a novel in-house software ABSOFT. This technology provided us an accurate, simple, cost-effective solution to present validated data real-time in a transparent and consistent manner. To our knowledge to date, no uniform format has been recommended for the presentation of cumulative antibiograms., (Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)

Background: Health literacy is the single best predictor of an individual's health status. It is important to customize health-related education material to the individual patient's level of reading skills. Readability of a given text is the objective measurement of the reading skills one should possess to understand the written material., Questions/purposes: In this article, some of the commonly used readability assessment tools are discussed and guidelines to improve the comprehension of patient education handouts are provided. Where are we now? Several healthcare organizations have recommended the readability of patient education materials be no higher than sixth- to eighth-grade level. However, most of the patient education materials currently available on major orthopaedic Web sites are written at a reading level that may be too advanced for comprehension by a substantial proportion of the population. WHERE DO WE NEED TO GO?: There are several readily available and validated tools for assessing the readability of written materials. While use of audiovisual aids such as video clips, line drawings, models, and charts can enhance the comprehension of a health-related topic, standard readability tools cannot construe such enhancements. HOW DO WE GET THERE?: Given the variability in the capacity to comprehend health-related materials among individuals seeking orthopaedic care, stratifying the contents of patient education materials at different levels of complexity will likely improve health literacy and enhance patient-centered communication.

One of the goals of the American Academy of Orthopaedic Surgeons (AAOS) is to disseminate patient education materials that suit the readability skills of the patient population. According to standard guidelines from healthcare organizations, the readability of patient education materials should be no higher than the sixth-grade level. We hypothesized the readability level of patient education materials available on the AAOS Web site would be higher than the recommended grade level, regardless when the material was available online. Readability scores of all articles from the AAOS Internet-based patient information Web site, "Your Orthopaedic Connection," were determined using the Flesch-Kincaid grade formula. The mean Flesch-Kincaid grade level of the 426 unique articles was 10.43. Only 10 (2%) of the articles had the recommended readability level of sixth grade or lower. The readability of the articles did not change with time. Our findings suggest the majority of the patient education materials available on the AAOS Web site had readability scores that may be too difficult for comprehension by a substantial portion of the patient population.

Background: While experts recommend that the readability of patient education materials should be less than the sixth grade level, the available information pertaining to orthopaedic diseases may be excessively complex for some to read and comprehend. The Flesch-Kincaid grade level is the most widely used tool to evaluate the readability score of a given text, with a lower grade level suggesting easier readability. The goal of our study was to assess the readability of pediatric orthopaedic patient education materials that were developed by the American Academy of Orthopaedic Surgeons (AAOS) and the Pediatric Orthopaedic Society of North America (POSNA) and were accessible to the general public through the Internet., Materials and Methods: All articles from the "Children" section of the patient education library, "Your Orthopaedic Connection," on the AAOS web site and the "Parent/Patient" section on the POSNA web site were identified. The Flesch-Kincaid grade level of each article was determined with use of Microsoft Office Word software. The mean grade levels of articles that were available in 2001 were compared with those accessible in 2007., Results: Fifty-seven unique articles were available in 2007 on both web sites compared with twenty-five articles available in 2001. The readability score of only one (2%) of the currently available articles was less than sixth grade level. The mean Flesch-Kincaid grade level of the currently available articles was 8.9 compared with 8.7 for the articles available in 2001 (p = 0.71)., Conclusions: Our findings suggest that most of the pediatric orthopaedic patient education materials available on the AAOS and POSNA web sites have readability scores that may be too high, making comprehension difficult for a substantial portion of the United States population.