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Rationale and objectivesRadiology turnaround time is an important quality measure that can impact hospital workflow and patient outcomes. We aimed to develop a machine learning model to predict delayed turnaround time during non-business hours and identify factors that contribute to this delay.Materials and methodsThis retrospective study consisted of 15,117 CT cases from May 2018 to May 2019 during non-business hours at two hospital campuses after applying exclusion criteria. Of these 15,177 cases, 7,532 were inpatient cases and 7,585 were emergency cases. Order time, scan time, first communication by radiologist, free-text indications, and other clinical metadata were extracted. A combined XGBoost classifier and Random Forest natural language processing model was trained with 85% of the data and tested with 15% of the data. The model predicted two measures of delay: when the exam was ordered to first communication (total time) and when the scan was completed to first communication (interpretation time). The model was analyzed with the area under the curve (AUC) of receiver operating characteristic (ROC) and feature importance. Source code: https://bit.ly/2UrLiVJ RESULTS: The algorithm reached an AUC of 0.85, with a 95% confidence interval [0.83, 0.87], when predicting delays greater than 245 minutes for "total time" and 0.71, with a 95% confidence interval [0.68, 0.73], when predicting delays greater than 57 minutes for "interpretation time". At our institution, CT scan description (e.g. "CTA chest pulmonary embolism protocol"), time of day, and year in training were more predictive features compared to body part, inpatient status, and hospital campus for both interpretation and total time delay.ConclusionThis algorithm can be applied clinically when a physician is ordering the scan to reasonably predict delayed turnaround time. Such a model can be leveraged to identify factors associated with delays and emphasize areas for improvement to patient outcomes.

Objective This study aims to explore and develop tools for early identification of depression concerns among cancer patients by leveraging the novel data source of messages sent through a secure patient portal. Materials and Methods We developed classifiers based on logistic regression (LR), support vector machines (SVMs), and 2 Bidirectional Encoder Representations from Transformers (BERT) models (original and Reddit-pretrained) on 6600 patient messages from a cancer center (2009-2022), annotated by a panel of healthcare professionals. Performance was compared using AUROC scores, and model fairness and explainability were examined. We also examined correlations between model predictions and depression diagnosis and treatment. Results BERT and RedditBERT attained AUROC scores of 0.88 and 0.86, respectively, compared to 0.79 for LR and 0.83 for SVM. BERT showed bigger differences in performance across sex, race, and ethnicity than RedditBERT. Patients who sent messages classified as concerning had a higher chance of receiving a depression diagnosis, a prescription for antidepressants, or a referral to the psycho-oncologist. Explanations from BERT and RedditBERT differed, with no clear preference from annotators. Discussion We show the potential of BERT and RedditBERT in identifying depression concerns in messages from cancer patients. Performance disparities across demographic groups highlight the need for careful consideration of potential biases. Further research is needed to address biases, evaluate real-world impacts, and ensure responsible integration into clinical settings. Conclusion This work represents a significant methodological advancement in the early identification of depression concerns among cancer patients. Our work contributes to a route to reduce clinical burden while enhancing overall patient care, leveraging BERT-based models. [ABSTRACT FROM AUTHOR]

The leading cause of ventricular shunt failure in pediatric patients is proximal catheter occlusion. Here, we evaluate various types of shunt catheters to assess in vitro cellular adhesion and obstruction. The following four types of catheters were tested: (1) antibiotic- and barium-impregnated, (2) polyvinylpyrrolidone, (3) barium stripe, and (4) barium impregnated. Catheters were either seeded superficially with astrocyte cells to test cellular adhesion or inoculated with cultured astrocytes into the catheters to test catheter performance under obstruction conditions. Ventricular catheters were placed into a three-dimensional printed phantom ventricular replicating system through which artificial CSF was pumped. Differential pressure sensors were used to measure catheter performance. Polyvinylpyrrolidone catheters had the lowest median cell attachment compared to antibiotic-impregnated (18 cells), barium stripe (17 cells), and barium-impregnated (21.5 cells) catheters after culture (p < 0.01). In addition, polyvinylpyrrolidone catheters had significantly higher flow in the phantom ventricular system (0.12 mL/min) compared to the antibiotic coated (0.10 mL/min), barium stripe (0.02 mL/min) and barium-impregnated (0.08 mL/min; p < 0.01) catheters. Polyvinylpyrrolidone catheters showed less cellular adhesion and were least likely to be occluded by astrocyte cells. Our findings can help suggest patient-appropriate proximal ventricular catheters for clinical use. [ABSTRACT FROM AUTHOR]

Recent studies have identified a growing diversity of splice variants of auxiliary [Ca.sub.2+] channel [Ca.sub.v][beta] subunits. The [Ca.sub.v][[beta].sub.1d] isoform encodes a putative protein composed of the amino-terminal half of the full-length [Ca.sub.v][[beta].sub.1] isoform and thus lacks the known high-affinity binding site that recognizes the [Ca.sub.2+] channel [[alpha].sub.1]-subunit, the [alpha]-binding pocket. The present study investigated whether the [Ca.sub.v][[beta].sub.1d] subunit is expressed at the protein level in heart, and whether it exhibits any of the functional properties typical of full-length [Ca.sub.v][beta] subunits. On Western blots, an antibody directed against the unique carboxyl terminus of [Ca.sub.v][[beta].sub.1d] identified a protein of the predicted molecular mass of 23 kDa from canine and human hearts. Immunocytochemistry and surface-membrane biotinylation experiments in transfected HEK-293 cells revealed that the full-length [Ca.sub.v][[beta].sub.1b] subunit promoted membrane trafficking of the pore-forming [[alpha].sub.1c] ([Ca.sub.v]1.2)-subunit to the surface membrane, whereas the [Ca.sub.v][[beta].sub.1d] subunit did not. Whole cell patch-clamp analysis of transfected HEK-293 cells demonstrated no effect of coexpression of the [Ca.sub.v][[beta].sub.1d] with the [[alpha].sub.1c]-subunit compared with the 15-fold larger currents and leftward shift in voltage-dependent activation induced by full-length [Ca.sub.v][[beta].sub.1b] coexpression. In contrast, cell-attached patch single-channel studies demonstrated that coexpression of either [Ca.sub.v][[beta].sub.1b] or [Ca.sub.v][[beta].sub.1d] significantly increased mean open probability four- to fivefold relative to the [[alpha].sub.1c]-channels alone, but only [Ca.sub.v][[beta].sub.1b] coexpression increased the number of channels observed per patch. In conclusion, the [Ca.sub.v][[beta].sub.1d] isoform is expressed in heart and can modulate the gating of L-type [Ca.sup.2+] channels, but it does not promote membrane trafficking of the channel complex. electrophysiology; ion; heart; splice variant

Recent studies have identified a growing diversity of splice variants of auxiliary Ca2+ channel Cavβ subunits. The Cavβ1d isoform encodes a putative protein composed of the amino-terminal half of the full-length Cavβ1d isoform and thus lacks the known high-affinity binding site that recognizes the Ca2+ channel α1-subunit, the α-binding pocket. The present study investigated whether the Cavβ1d subunit is expressed at the protein level in heart, and whether it exhibits any of the functional properties typical of full-length Cavβ subunits. On Western blots, an antibody directed against the unique carboxyl terminus of Cavβ1d identified a protein of the predicted molecular mass of 23 kDa from canine and human hearts. Immunocytochemistry and surface-membrane biotinylation experiments in transfected HEK-293 cells revealed that the full-length Cavβ1d subunit promoted membrane trafficking of the pore-forming α1c (Cav1.2)-subunit to the surface membrane, whereas the Cavβ1d subunit did not. Whole cell patch-clamp analysis of transfected HEK-293 cells demonstrated no effect of coexpression of the Cavβ1d with the α1c-subunit compared with the 15-fold larger currents and leftward shift in voltage-dependent activation induced by full-length Cavβ1b coexpression. In contrast, cell-attached patch single-channel studies demonstrated that coexpression of either Cavβ1b or Cavβ1d significantly increased mean open probability four- to fivefold relative to the α1c-channels alone, but only Cavβ1b coexpression increased the number of channels observed per patch. In conclusion, the Cavβ1d isoform is expressed in heart and can modulate the gating of L-type Ca2+ channels, but it does not promote membrane trafficking of the channel complex. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore and develop tools for early identification of depression concerns among cancer patients by leveraging the novel data source of messages sent through a secure patient portal., Materials and Methods: We developed classifiers based on logistic regression (LR), support vector machines (SVMs), and 2 Bidirectional Encoder Representations from Transformers (BERT) models (original and Reddit-pretrained) on 6600 patient messages from a cancer center (2009-2022), annotated by a panel of healthcare professionals. Performance was compared using AUROC scores, and model fairness and explainability were examined. We also examined correlations between model predictions and depression diagnosis and treatment., Results: BERT and RedditBERT attained AUROC scores of 0.88 and 0.86, respectively, compared to 0.79 for LR and 0.83 for SVM. BERT showed bigger differences in performance across sex, race, and ethnicity than RedditBERT. Patients who sent messages classified as concerning had a higher chance of receiving a depression diagnosis, a prescription for antidepressants, or a referral to the psycho-oncologist. Explanations from BERT and RedditBERT differed, with no clear preference from annotators., Discussion: We show the potential of BERT and RedditBERT in identifying depression concerns in messages from cancer patients. Performance disparities across demographic groups highlight the need for careful consideration of potential biases. Further research is needed to address biases, evaluate real-world impacts, and ensure responsible integration into clinical settings., Conclusion: This work represents a significant methodological advancement in the early identification of depression concerns among cancer patients. Our work contributes to a route to reduce clinical burden while enhancing overall patient care, leveraging BERT-based models., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: We characterized the quality of statistical methods for studies of racial and ethnic disparities in the surgical-relevant literature during 2021-2022., Background: Hundreds of scientific papers are published each year describing racial and ethnic disparities in surgical access, quality, and outcomes. The content and design quality of this literature has never been systematically reviewed., Methods: We searched for 2021-2022 studies focused on describing racial and/or ethnic disparities in surgical or perioperative access, process quality, or outcomes. Identified studies were characterized in terms of three methodological criteria: 1) adjustment for variables related to both race/ethnicity and outcomes, including social determinants of health (SDOH); 2) accounting for clustering of patients within hospitals or other subunits ("providers") and; 3) distinguishing within- and between-provider effects., Results: We identified 224 papers describing racial and/or ethnic differences. Of the 38 single institution studies, 24 (63.2%) adjusted for at least one SDOH variable. Of the 186 multisite studies, 113 (60.8%) adjusted for at least one SDOH variable, and 43 (23.1%) accounted for clustering of patients within providers using appropriate statistical methods. Only 10 (5.4%) of multi-institution studies made efforts to examine how much of overall disparities were driven by within versus between provider effects., Conclusions: Most recently published papers on racial and ethnic disparities in the surgical literature do not meet these important statistical design criteria and therefore may risk inaccuracy in the estimation of group differences in surgical access, quality, and outcomes. The most potent leverage points for these improvements are changes to journal publication guidelines and policies., Competing Interests: None of the authors have relevant conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The multifunctional Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) is activated by elevated intracellular Ca(2+) (Ca(2+)(i)), and mice with chronic myocardial CaMKII inhibition (Inh) resulting from transgenic expression of a CaMKII inhibitory peptide (AC3-I) unexpectedly showed action potential duration (APD) shortening. Inh mice exhibit increased L-type Ca(2+) current (I(Ca)), because of upregulation of protein kinase A (PKA) activity, and decreased CaMKII-dependent phosphorylation of phospholamban (PLN). We hypothesized that CaMKII is a molecular signal linking Ca(2+)(i) to repolarization. Whole cell voltage-clamp recordings revealed that the fast transient outward current (I(to,f)) and the inward rectifier current (I(K1)) were selectively upregulated in Inh, compared with wild-type (WT) and transgenic control, mice. Breeding Inh mice with mice lacking PLN returned I(to,f) and I(K1) to control levels and equalized the APD and QT intervals in Inh mice to control and WT levels. Dialysis of AC3-I into WT cells did not result in increased I(to,f) or I(K1), suggesting that enhanced cardiac repolarization in Inh mice is an adaptive response to chronic CaMKII inhibition rather than an acute effect of reduced CaMKII activity. Increasing PKA activity, by cell dialysis with cAMP, or inhibition of PKA did not affect I(K1) in WT cells. Dialysis of WT cells with cAMP also reduced I(to,f), suggesting that PKA upregulation does not increase repolarizing K(+) currents in Inh mice. These findings provide novel in vivo and cellular evidence that CaMKII links Ca(2+)(i) to cardiac repolarization and suggest that PLN may be a critical CaMKII target for feedback regulation of APD in ventricular myocytes.