Ryan Jarrah

Radiofrequency ablation (RFA) of the basivertebral and sinuvertebral nerve is a relatively new intervention for patients with chronic discogenic low back pain. It aims to ablate the irritated nerve endings to improve pain control and disability. This meta-analysis includes prospective single and double-arm studies that determine if RFA is effective in improving chronic low back pain and disability for patients with degenerative spinal discs who have not yet required surgical decompression. The outcomes of interest were comprised of commonly used patient-reported outcomes, which included the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. Forest plots were generated to report associations as well as funnel plots to report the risk of publication bias. The meta-analysis included 429 patients from five eligible studies, comprising two randomized controlled trials and three prospective single-arm trials. A total of 280 patients underwent RFA whereas 149 served as controls. The baseline scores in the single-arm trials served as the outcomes of their control group. The RFA group (n = 280) had significantly lower ODI scores (mean difference = - 28.08; 95% CI: [- 43.53, - 12.63]) than the control group (n = 240). Similarly, the RFA group (n = 279) had significantly lower VAS scores (mean difference = - 3.16; 95% CI: [- 5.02, - 1.31]) than the control group (n = 238). Our study demonstrates RFA as a promising intervention for chronic discogenic low back pain, noting significant improvements in pain control and disability. Although not intended to substitute surgical decompression, it can serve as a better alternative to other non-operative therapies in patients who do not require surgical management. Clinical trial number: not applicable.

Among the greatest general challenges in bioengineering is to mimic human physiology. Advanced efforts in tissue engineering have led to sophisticated ‘brain-on-chip’ (BoC) microfluidic devices tha... Plain language summary In this paper, the authors describe the role of microfluidic ‘brain-on-chip’ systems as a tool to model and study the human brain. While animal studies have provided signific... Tweetable abstract Microfluidic brain on chip (BoC) technology offers the precision needed to model minute changes in biochemical cues with the critical opportunity for real-time data acquisition.

Introduction: The Kosovo War is widely remembered as one of the most brutal conflicts in the modern era. With over 13,000 deaths and 90% of the population displaced as refugees, the impact of the war has led to everlasting levels of trauma that impacts the lives of thousands of Kosovar-Albanians today. Objectives: To characterize the psychosocial impact of the Kosovo war by comprehensively assessing the literature to date. We also provide recommendations to improve outcomes for Kosovar-Albanian patients in the post-war era. Methods: A systematic review was conducted using post-war clinical psychological articles on the Kosovo War. Our search involved utilizing full-text English articles from PubMed, OVID Medline, and EMBASE journals. Keywords used were “Kosovo War”, “Psychosocial”, and “Post Traumatic Stress Disorder”. Results: Our post-traumatic stress disorder (PTSD) analysis yielded a total of 10,134 responses from participants ranging from refugees to the general public. Our results showed 2,997 subjects (30%) who reported or met the criteria for post-traumatic stress disorder. When analyzing refugee participants, there was 1,133 with 60% of them meeting the PTSD criteria. In a filtered cohort of 5,117 subjects measured for adverse events, 3,180 subjects (64%) of subjects had experienced combat, while 3,664 (74%) were exiled from their homes. Conclusion: The psychosocial impact of the Kosovo war is likely under-reported by patients due to cultural stigmas, language barriers, and trust barriers with clinicians. Factors such as age, employment, displacement status, number of traumatic events, socioeconomic vulnerability, and health literacy are associated with poor psychiatric morbidity.

Study Design: Bibliometric literature review. Objective: Total disc arthroplasty (TDA) is an evolving technique used by surgeons to preserve neural elements and range of motion in patients with degenerative disc disease, spondylosis and more. In comparison to discectomy, disc arthroplasty has been shown to decrease morbidity, reduce adjacent-level disease, and preserve pre-operative range of motion. The objective of this manuscript is to provide a bibliometric analysis of the use of disc arthroplasty in scientific literature and highlight the main contributing authors and their publication characteristics. Methods: The Scopus database was used to perform a title-specific, keyword-based search for all publications until June 2022. The keyword “total disc arthroplasty” was used. The most-cited 100 articles were selected for analysis. Parameters included the following: title, citation count, citations per year, authors, specialty first author, institution, country of origin, publishing journal, Source Normalized, Impact Per Paper (SNIP), and Hirsch index. Results: Our search on disc arthroplasty yielded 580 articles that were published, with the first publication on the topic found in 1966. The most cited 100 articles received a total of 8694 citations, with an average of 86.94 citations per article. After assessing countries with the greatest contributions, United States, China, and Germany were top 3 with 54, 14, and 7 articles, respectively. Conclusion: The bibliometric analysis provides an overview of how medical research is analyzed in academic medicine. In the present study, we evaluated the global trends in disc arthroplasty for the treatment of degenerative disc disease.

Tumors of the craniocervical junction (CCJ) are complicated pathologies with high patient mortality or low quality of life. In the pediatric population, these tumors are less prevalent, with various symptomatic presentations that include motor and neurological manifestations. Three of the most common neoplasms at the CCJ in children are meningiomas, schwannomas, and chordomas. In this review, we will characterize the tissue biomarkers, clinical presentation, treatment methods, and surgical outcomes for these pediatric tumors at the CCJ. A comprehensive literature review was used using the PubMed Database. Keywords used were “craniocervical junction”, “pediatric”, “meningiomas”, schwannomas”, and “meningiomas”. Articles that were not related to the CCJ, included only adult cases, and non-English studies were filtered. Our search yielded a total of 11 studies, with a total of 239 pediatric patients with tumors at the CCJ. These studies were broken down as five for meningiomas, one for schwannomas, and eight for chordomas. In conclusion, resection of pediatric neoplasms at the CCJ is challenging due to anatomical limitations and the size of the patient. Within the CCJ, chordomas were the most prevalent tumor type, with schwannomas being the least prevalent. Literature findings indicate that genetic mutations of the NF2 gene associated with neurofibromatosis type II, as well as incomplete tumor resection, are predictors of poor outcomes. Further developments of monoclonal antibody chemotherapy and endoscopic approaches could expand treatment options for aggressive pediatric neoplasms at the skull base.

Objective: To comprehensively characterize the utilization of alginate hydrogels as an alternative treatment modality for spinal cord injury (SCI).Methods: An extensive review of the published literature on studies using alginate hydrogels to treat SCI was performed. The review of the literature was performed using electronic databases such as PubMed, EMBASE, and OVID MEDLINE electronic databases. The keywords used were “alginate,” “spinal cord injury,” “biomaterial,” and “hydrogel.”Results: In the literature, we identified a total of 555 rat models that were treated with alginate scaffolds for regenerative biomarkers. Alginate hydrogels were found to be efficient and promising substrates for tissue engineering, drug delivery, neural regeneration, and cellbased therapies for SCI repair. With its ability to act as a pro-regenerative and antidegenerative agent, the alginate hydrogel has the potential to improve clinical outcomes.Conclusion: The emerging developments of alginate hydrogels as treatment modalities may support current and future tissue regenerative strategies for SCI.

Tweetable abstract Proper wound healing, including internal and surface tissue regeneration with the minimization of scar formation, is one of the most significant topics in surgical discussions an...

Acute transverse myelitis (ATM) is a rare, immune-mediated pathology that is defined as an adverse inflammatory response in the spinal cord leading to neurologic injury. The pathophysiology of ATM is poorly understood, with no apparent differences in age, ethnicities, or race, along with variable radiographic and clinical presentation. Therefore, in this review, we will characterize what is known about ATM's etiology and diagnostic criteria, and relate it to properties of neuroimmunology. Moreover, we will further discuss current treatment options, along with potential novel methods, to provide a comprehensive overview of the status of ATM's research development. Among these novel treatments, potassium blockers reveal exciting early outcomes in restoring neurologic motor function. In addition, human glial progenitor cell transportations have been described as a potential treatment through integrating and remyelinating lesion sites. Nevertheless, despite these novel methods, there is a paucity of clinical trials establishing ATM's immunopathology and the therapeutic role of potential treatment methods. Therefore, we will highlight the importance of larger well-designed clinical trials in revealing significant biomarkers of injury and recovery.

LIDAR (from “light detection and ranging” or “laser imaging, detection, and ranging”) is an evolving three-dimensional scanning technology with historical applications in various fields. However, the applicability of LIDAR in the field of medicine has mostly not been examined thus far. Here, we review the basic principles governing LIDAR and its potential to be used in three notable use cases in the context of remote patient monitoring: geriatric fall prevention, postoperative recovery monitoring, and home safety assessment. For assisting geriatric populations, LIDAR can create 3D renderings of their home environments and classify which objects may be associated with risk for falls. These risk factors can then be forwarded to both patients and providers in order for them to discuss how to make the patient’s environment safer. LIDAR is also capable of mapping the range of extremity motion in patients undergoing postoperative recovery. Such LIDAR data is simple to acquire and record for these patients and could enable unique metrics to be developed to assess patient outcomes in postoperative recovery. Finally, LIDAR can also reproduce 3D home models to identify attributes of their environments that could be harmful to infants. Given the recent momentum in telehealth following the events of the coronavirus 2019 disease (COVID-19) pandemic, LIDAR may also be a powerful tool in driving new insights from quality improvement initiatives through remote patient monitoring.