Pushing the Limits of Minimally Invasive Spine Surgery-From Preoperative to Intraoperative to Postoperative Management.

The introduction of minimally invasive surgery ushered in a new era of spine surgery by minimizing the undue iatrogenic injury, recovery time, and blood loss, among other complications, of traditional open procedures. Over time, technological advancements have further refined the care of the operative minimally invasive spine patient. Moreover, pre-, and postoperative care have also undergone significant change by way of artificial intelligence risk stratification, advanced imaging for surgical planning and patient selection, postoperative recovery pathways, and digital health solutions. Despite these advancements, challenges persist necessitating ongoing research and collaboration to further optimize patient care in minimally invasive spine surgery.

Surveillance of pathogenic bacteria on a food matrix using machine-learning-enabled paper chromogenic arrays.

Global food systems can benefit significantly from continuous monitoring of microbial food safety, a task for which tedious operations, destructive sampling, and the inability to monitor multiple pathogens remain challenging. This study reports significant improvements to a paper chromogenic array sensor - machine learning (PCA-ML) methodology sensing concentrations of volatile organic compounds (VOCs) emitted on a species-specific basis by pathogens by streamlining dye selection, sensor fabrication, database construction, and machine learning and validation. This approach enables noncontact, time-dependent, simultaneous monitoring of multiple pathogens (Listeria monocytogenes, Salmonella, and E. coli O157:H7) at levels as low as 1 log CFU/g with over 90% accuracy. The report provides theoretical and practical frameworks demonstrating that chromogenic response, including limits of detection, depends on time integrals of VOC concentrations. The paper also discusses the potential for implementing PCA-ML in the food supply chain for different food matrices and pathogens, with species- and strain-specific identification.

Nondestructive and multiplex differentiation of pathogenic microorganisms from spoilage microflora on seafood using paper chromogenic array and neural network.

Non-destructive detection of human foodborne pathogens is critical to ensuring food safety and public health. Here, we report a new method using a paper chromogenic array coupled with a machine learning neural network (PCA-NN) to detect viable pathogens in the presence of background microflora and spoilage microbe in seafood via volatile organic compounds sensing. Morganella morganii and Shewanella putrefaciens were used as the model pathogen and spoilage bacteria. The study evaluated microbial detection in monoculture and cocktail multiplex detection. The accuracy of PCA-NN detection was first assessed on standard media and later validated on cod and salmon as real seafood models with pathogenic and spoilage bacteria, as well as background microflora. In this study PCA-NN method successfully identified pathogenic microorganisms from microflora with or without the prevalent spoilage microbe, Shewanella putrefaciens in seafood, with accuracies ranging from 90% to 99%. This approach has the potential to advance smart packaging by achieving nondestructive pathogen surveillance on food without enrichment, incubation, or other sample preparation.

Nondestructive multiplex detection of foodborne pathogens with background microflora and symbiosis using a paper chromogenic array and advanced neural network.

We have developed an inexpensive, standardized paper chromogenic array (PCA) integrated with a machine learning approach to accurately identify single pathogens (Listeria monocytogenes, Salmonella Enteritidis, or Escherichia coli O157:H7) or multiple pathogens (either in multiple monocultures, or in a single cocktail culture), in the presence of background microflora on food. Cantaloupe, a commodity with significant volatile organic compound (VOC) emission and large diverse populations of background microflora, was used as the model food. The PCA was fabricated from a paper microarray via photolithography and paper microfluidics, into which 22 chromogenic dye spots were infused and to which three red/green/blue color-standard dots were taped. When exposed to VOCs emitted by pathogens of interest, dye spots exhibited distinguishable color changes and pattern shifts, which were automatically segmented and digitized into a ΔR/ΔG/ΔB database. We developed an advanced deep feedforward neural network with a learning rate scheduler, L2 regularization, and shortcut connections. After training on the ΔR/ΔG/ΔB database, the network demonstrated excellent performance in identifying pathogens in single monocultures, multiple monocultures, and in cocktail culture, and in distinguishing them from the background signal on cantaloupe, providing accuracy of up to 93% and 91% under ambient and refrigerated conditions, respectively. With its combination of speed, reliability, portability, and low cost, this nondestructive approach holds great potential to significantly advance culture-free pathogen detection and identification on food, and is readily extendable to other food commodities with complex microflora.

Machine learning-enabled non-destructive paper chromogenic array detection of multiplexed viable pathogens on food.

Fast and simultaneous identification of multiple viable pathogens on food is critical to public health. Here we report a pathogen identification system using a paper chromogenic array (PCA) enabled by machine learning. The PCA consists of a paper substrate impregnated with 23 chromogenic dyes and dye combinations, which undergo colour changes on exposure to volatile organic compounds emitted by pathogens of interest. These colour changes are digitized and used to train a multi-layer neural network (NN), endowing it with high-accuracy (91-95%) strain-specific pathogen identification and quantification capabilities. The trained PCA-NN system can distinguish between viable Escherichia coli, E. coli O157:H7 and other viable pathogens, and can simultaneously identify both E. coli O157:H7 and Listeria monocytogenes on fresh-cut romaine lettuce, which represents a realistic and complex environment. This approach has the potential to advance non-destructive pathogen detection and identification on food, without enrichment, culturing, incubation or other sample preparation steps.