Miracle-dz/UniFAR-FTUs huggingface dataset:
Natural History of Serviceable Hearing During Active Surveillance of Nongrowing Sporadic Vestibular Schwannoma Supports Consideration of Initial Wait-and-Scan Management

Objective The treatment paradigm of vestibular schwannoma (VS) focuses on preservation of neurologic function, with small tumors increasingly managed with active surveillance. Often, tumor size and hearing outcomes are poorly correlated. The aim of the current work was to describe the natural history of hearing among patients with nongrowing VS during observational management. Study Design Historical cohort study. Patients Adults with sporadic VS. Intervention Wait-and-scan management. Main Outcome Measure Maintenance of serviceable hearing (SH) after diagnosis. Results Among 228 patients with nongrowing VS, 157 patients had SH at diagnosis. Rates of maintaining SH (95% CI; number still at risk) at 1, 3, and 5 years after diagnosis were 94% (89–98; 118), 81% (74–89; 65), and 78% (71–87; 42), respectively. Poorer hearing at diagnosis (hazard ratio [HR] per 10 dB hearing level increase in pure-tone average of 2.51, p < 0.001; HR per 10% decrease in word recognition score of 1.70, p = 0.001) was associated with increased likelihood of developing non-SH during observation. When controlling for baseline hearing status, tumors measuring 5 mm or greater in the internal auditory canal or with cerebellopontine angle extension were associated with significantly increased risk of developing non-SH (HR, 4.87; p = 0.03). At 5 years after diagnosis, 95% of patients with nongrowing intracanalicular VS measuring less than 5 mm maintained SH. Conclusions Hearing worsens during periods of nongrowth in sporadic VS. Patients with small (<5 mm) intracanalicular tumors demonstrate robust maintenance of SH over time, reinforcing the consideration of initial observation in this patient subset.
Effect of Various Lengths of Respiration on Heart Rate Variability during Simple Bhramari (Humming)

Background: Heart rate varies during breathing and the heart rate variability (HRV) facilitates the autonomic homeostatic capacity. The maximum HRV was observed at around 10 s of prolonged respiration as per HRV biofeedback literature. However, there is a gap in understanding the variations in HRV by different respiration lengths during simple Bhramari practice. Objective: To assess the effect of various respiration lengths (8, 10, 12, and 14 s) on HRV during the simple Bhramari (humming) practice. Methodology: A total of 118 individuals (67 males, 51 females) signed up for the study based on convenience sampling at a wellness center. A randomized (simple permutation) within-subject crossover design with repeated measures was used to measure their HRV during the simple Bhramari practice. The results were analyzed with one-way ANOVA and paired samples t-test. Results: The results indicate that, unlike the 10 s of respiration during HRV biofeedback breathing, maximum HRV during humming happens between 12 and 14 s of long breathing. Conclusions: The unique findings of the study demonstrate the maximization of HRV between the respiration lengths of 12 and 14 s. Future work should explore expanding the research to a broader group of participants, including individuals with chronic conditions and other demographic variables and mantra chanting.
Women Veterans’ Barriers to Care-Seeking for Cardiovascular Disease Prevention

Background Women veterans have a high prevalence of traditional and nontraditional risks for cardiovascular disease (CVD) including obesity and posttraumatic stress disorder. Experts from the U.S. Department of Veterans Affairs have called for actions to improve the cardiovascular health of this population. One approach is to assess women veterans’ barriers to care-seeking for CVD prevention, to inform future intervention research. Objective The objective of this study was to describe women veterans’ barriers to care-seeking for CVD prevention, guided by the theory of care-seeking behavior and concept awareness. Methods Using a cross-sectional, descriptive design, a national sample of 245 women veterans participated in an online survey about barriers to care-seeking. Participants provided narrative responses to open-ended items, endorsements to closed-ended items, and rankings of their top five barriers. Researchers conducted poststratification weighting of numerical data to reflect the women veteran population. Results Narrative responses described unaffordable and inaccessible services, feeling harassed or not respected in healthcare settings, and lack of awareness of risks for CVD. Frequently endorsed barriers were unaffordable and inaccessible services. Frequently ranked barriers were feeling not respected in healthcare settings and clinicians not recommending CVD prevention. Discussion Findings support concepts in theory of care-seeking behavior and concept awareness. Understanding women veterans’ barriers to care-seeking for CVD prevention can inform clinicians and researchers as they address these barriers.
Looking behind the scenes of Grubbs catalysis with the Uniﬁed Reaction Valley Approach

In this study we analyzed the mechanism of [2+2] cycloaddition and cycloreversion reactions between trichlorovinylsilane and one ﬁrst–generation Grubbs model catalyst M1 with a P(Me) 3 ligand and two second– generation Grubbs model catalysts M2 with an N–heterocyclic carbene (NHC) ligand and M3 with a 2,5-di–methyl–NHC ligand. As a mechanistic tool we applied the Uniﬁed Reaction Valley Approach (URVA), based on reaction path calculations performed at the B3LYP/6–31G(d,p)/SDD(Ru) level of theory. In addition, for all stationary points of these reactions we performed a Local Mode Analysis (LMA) and QTAIM analysis of the electron density attheB3LYP/6–31G(d,p)/NESC/Jorge–TZP(Ru)andDLPNO–CCSD(T)/def2–TZVP/ECP(Ru) levelsoftheory.Inallreactionsinvestigatedinthisworkfourtargetbondsplayakeyrole,eitherbeingformedand/orbrokenorchangingfromdoubletosinglebondsandviceversaduringthe catalyticprocess.AsrevealedbytheURVAanalysisinthecycloadditionreactionsthebondformingeventsleadingtotheintermediatemetallacyclobutaneoccurinaconcertedfashionaf-terthetransitionstate(TS),i.e.thisprocessdoesnotcontributetotheenergybarrier.Thebondbreakingeventsofthefollowingcycloreversionreactionstransformingtheintermediateintoto ﬁnalproductarealsoconcerted,howevertheyoccurbeforetheTS,i.e.thisprocesscontributestothebarrierheight.InthiswayURVArationalizeswhyallcycloadditionreactionshavealower activationenergiesthantheircycloreversioncounterparts.Accordingtoourresults, M3 is the most e � ective model catalyst. Its activity is related to a strong stabilization of the metallacy-clobutane intermediate and speciﬁc interactions between the reacting species and the methyl hydrogen atoms of the 2,5–di–methyl-NHC ligand of the catalyst . Based on LMA, we could also quantify the important role of a 4–center–2–electron ↵ , � –(CCC) agostic interaction in the metallacyclobutane intermediate donating electron density to the Ru coordination center and facilitating the CC bond cleavage of the ring-opening cycloreversion step, lowering in this way the energy barrier. Overall, the new mechanistic details obtained with the URVA and LMA analysis can serve as a roadmap for the optimization of current and the future design of the next generations of Grubbs catalysts and beyond.
Comparison of Transcutaneous and Percutaneous Implantable Hearing Devices for the Management of Congenital Aural Atresia: A Systematic Review and Meta-Analysis

Objective To compare audiometric outcomes, complications, and revisions required for percutaneous (pBCD) versus transcutaneous (tBCD) implantable bone-conduction devices for the treatment of hearing loss associated with congenital aural atresia (CAA). Databases Reviewed. PubMed, Scopus, CINAHL. Methods A systematic review was performed searching for English language articles from inception to December 14, 2022. Studies reporting audiometric outcomes or complications for either pBCDs or tBCDs for the treatment of CAA were selected for inclusion. A meta-analysis of single means and meta-analysis of proportions with comparison (Δ) of weighted proportions was conducted. Results A total of 56 articles with 756 patients were selected for inclusion. One hundred ninety patients were implanted with pBCDs, whereas the remaining 566 were implanted with tBCDs. Mean pure-tone audiometry improvement in the pBCD group (39.1 ± 1.1 dB) was significantly higher than in the tBCD group (34.6 ± 1.6 dB; Δ4.5 dB; 95% confidence interval, 4.2–4.7 dB; p < 0.0001). The average improvement in speech reception threshold was 38.6 ± 2.5 dB in the percutaneous group as compared with 32.7 ± 1.6 dB in the transcutaneous group (Δ5.9 dB [5.3–6.5 dB], p < 0.0001). Overall complication rates for patients implanted with pBCDs and tBCDs were 29.0% (15.7–44.4%) and 9.4% (6.5%–13.0%), respectively (Δ19.6% [12.0–27.7%], p < 0.0001). Conclusions Patients with CAA implanted with pBCDs had significantly better audiometric outcomes than those implanted with tBCDs. However, complication rates were significantly higher among the pBCD group.
COVID-19-induced Stress in Health-care Workers: Effect of 8-week Common Yoga Protocol on Autonomic Function and Inflammatory and Oxidative Stress Markers

Background: COVID-19 pandemic posed a huge stress on health-care givers affecting their physical and mental health. Wellness strategies like yoga can improve flexibility, resilience, and outlook. Aim: The present study explored the effect of 8-week standard common yoga protocol (CYP) intervention on autonomic functions, emotional stress, oxidative stress, and inflammation markers in the nurse group of health-care givers. Materials and Methods: It is a randomized controlled trial where 50 nurses underwent CYP and 50 participated as controls. Anthropometric parameters, cardiovascular parameters, autonomic function including time and frequency domain parameters, biochemical parameters, and psychological stress using the questionnaire were assessed before and after 8-week CYP. Results: Total 88 nurses completed the study with 42 and 46 participants, respectively, in the CYP and control groups. CYP intervention resulted in a significant reduction in cardiovascular parameters systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, and rate pressure product (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.002, respectively), perceived stress score and Depression, Anxiety, and Stress Scale psychological variables of depression, anxiety, and stress, and serum lipid parameters compared to the control group. CYP significantly increased total power, low frequency, high frequency, root mean square of successive differences between adjacent NN intervals, change in successive normal sinus (NN) intervals exceeds 50 ms, and pNN50% (P < 0.001, P = 0.006, P = 0.006, P = 0.039, P < 0.001, and P = 0.013, respectively) suggesting improved resting autonomic modulation and parasympathodominance due to higher vagal efferent activity. There were significant reductions in serum cortisol, tumor necrosis factor-alpha, interleukin (IL)-1, and IL-6 in both the groups. Serum telomerase significantly reduced (P = 0.024) and total antioxidant capacity (P = 0.036) increased in the CYP group post intervention. Conclusion: CYP intervention was beneficial in improving psychophysiological, autonomic, and biochemical profile of the nurse group of health-care workers.
The PRIMARY Score

Purpose Multiparametric MRI is the current standard for detecting clinically significant prostate cancer (csPCa). However, men with negative or equivocal MRI often undergo unnecessary biopsies due to concerns about false-negative results. The recently proposed 68Ga-PSMA PET/CT-based PRIMARY score exhibited good diagnostic performance for csPCa. This study aimed to externally validate the performance of the PRIMARY score and evaluate its added diagnostic value to MRI triage in detecting csPCa. Patients and Methods This retrospective cohort study included 431 men who underwent both 68Ga-PSMA PET/CT and MRI before biopsy. Performance was assessed using the area under the receiver operating characteristic curve and the decision curve analysis. The PRIMARY score + MRI was considered positive for either PRIMARY score 3–5 or Prostate Imaging Reporting and Data System (PI-RADS) 4/5. Results The prevalence of csPCa was 51.7% (223/431). The area under the receiver operating characteristic curve of the 5-level PRIMARY score for csPCa was significantly higher than that of MRI (0.873 vs 0.786, P < 0.001). For the entire group, sensitivity, specificity, positive predictive value, and negative predictive value of the PRIMARY score were 90.6%, 61.1%, 71.4%, and 85.8%, respectively, which outperformed 87.9%, 49.0%, 64.9%, and 79.1% of PI-RADS on MRI. The PRIAMRY score + MRI improved sensitivity (96.0% vs 87.9%, P < 0.001) and negative predictive value (91.5% vs 79.1%, P < 0.001) without compromising specificity and positive predictive value compared with MRI alone. This combined approach avoided 24.6% (106/431) of unnecessary biopsies, while missing 4.0% (9/223) of csPCa cases. The addition of the PRIMARY score in men with PI-RADS 1–3 showed a net benefit, but not in men with PI-RADS 4/5. Conclusions The PRIMARY score was superior to MRI in detecting csPCa, and its added diagnostic value was in men with negative or equivocal MRI results. The PRIMARY score + MRI improved negative predictive value and sensitivity for csPCa compared with MRI alone. Further prospective trials will validate whether men with clinical suspicion of csPCa but negative PRIMARY score + MRI can safely avoid unnecessary biopsies.
Percutaneous gastrostomies in advanced cancer

Abstract Introduction: Gastrostomies can be performed percutaneously by interventional radiology (PRG) or endoscopy (PEG). Methods: Retrospective analysis of patients with advanced cancer who underwent a gastrostomy in 2017 in an oncology center. Results: In 2017, 164 patients underwent gastrostomies, and 137 (84%) were male. The median age was 60 years (range: 38–91). The predominant Eastern Cooperative Oncology Group (ECOG) performance status stage was 1, with 73 (45%) patients. Head and neck cancer was the most common diagnosis, with 127 (77%) cases. The most frequent reason for performing a gastrostomy was dysphagia, 132 (81%). Most gastrostomies were PEG, 121 (74%), followed by PRG, 41 (25%), and surgery, 2 (1%). Early complications occurred in 86 (52%) patients, and the most frequent of them were local pain in 69 (80%) patients and minor local bleeding in 13 (15%). Late complications occurred in 90 (55%) patients, and the most frequent was also local pain in 57 (63%) patients, followed by local infection in 8 (9%), tube extrusion in 7 (8%), and stomal leakage in 7 (8%). In the multivariable analysis, the factors associated with survival were lymph node metastases and the ECOG performance status. Until June 30th, 2022, 123 (75%) patients had died, and 41 (25%) were still alive. Conclusion: Gastrostomies were performed predominantly in ECOG performance stage 1 patients with head and neck cancer and symptoms of dysphagia, and PEG was the most common procedure.
Diagnosis and management of acute lower gastrointestinal bleeding

Purpose of review We review and summarize the most recent literature, including evidence-based guidelines, on the evaluation and management of acute lower gastrointestinal bleeding (LGIB). Recent findings LGIB primarily presents in the elderly, often on the background of comorbidities, and constitutes a significant healthcare and economic burden worldwide. Therefore, acute LGIB requires rapid evaluation, informed decision-making, and evidence-based management decisions. LGIB management involves withholding and possibly reversing precipitating medications and concurrently addressing risk factors, with definitive diagnosis and therapy for the source of bleeding usually performed by endoscopic or radiological means. Recent advancements in LGIB diagnosis and management, including risk stratification tools and novel endoscopic therapeutic techniques have improved LGIB management and patient outcomes. In recent years, the various society guidelines on acute lower gastrointestinal bleeding have been revised and updated accordingly. Summary By integrating the most recently published high-quality clinical studies and society guidelines, we provide clinicians with an up-to-date and comprehensive overview on acute LGIB diagnosis and management.
Differences in Approach and Avoidance Motivation Sensitivities Predicting Participation and Performance in Strength Sport

Abstract Cusimano, K, Freeman, P, Moran, J, and Yamaguchi, M. Differences in approach and avoidance motivation sensitivities predicting participation and performance in strength sport. J Strength Cond Res 38(1): 180–184, 2024—Gray's Reinforcement Sensitivity Theory proposes that individual differences in behavior are due to the sensitivity to 2 brain systems: the behavioral inhibition system (BIS), which regulates aversive emotions to threatening stimuli, and the behavioral approach system (BAS), which regulates positive emotions toward rewarding or nonpunishing stimuli. The current study investigated whether BIS and BAS sensitivity predicts participation and performance in strength sports. A sample of 177 competitive strength athletes (male = 148; female = 29; mean age = 28.68; SD = 6.24 years) and 178 control participants (male = 89; female = 89; mean age = 29.39; SD = 7.42) completed the BIS/BAS scale, with strength athletes also providing their Wilks scores as a measure of sporting performance. Independent t tests showed significantly higher BIS (MD = 2.37, p = 0.003, 95% CI [0.79, 3.94], d = 0.31) and total BAS (MD = 11.71, p < 0.001, 95% CI [9.26, 14.15], d = 1.00) sensitivity in strength athletes than individuals in the control group. A 3-step hierarchical regression analysis revealed that the number of training years (β = 0.506, p < 0 .001), BIS (β = −203, p = 0.005) and BAS drive (β = 0.188, p = 0.012) made significant unique contributions to predicting the Wilks score, with no significant contributions of age, sex, BAS fun seeking, and BAS reward responsiveness. The findings indicate that the overall reward sensitivity (total BAS score) and reward seeking (BAS drive) are associated positively with participation and performance in strength sports, respectively. Given the association of these brain systems to addiction and other psychiatric disorders, the findings could have implications in psychiatric treatment and sporting recruitment.
Effects of Minimal-Equipment Resistance Training and Blood Flow Restriction on Military-Relevant Performance Outcomes

Abstract Cintineo, HP, Chandler, AJ, Mastrofini, GF, Lints, BS, McFadden, BA, and Arent, SM. Effects of minimal-equipment resistance training and blood flow restriction on military-relevant performance outcomes. J Strength Cond Res 38(1): 55–65, 2024—This study compared minimal-equipment resistance training (RT) with and without blood flow restriction (BFR) to traditional-equipment RT on performance and body composition changes over 6 weeks. Reserve officers' training corps cadets and midshipmen (N = 54, 40.7% female) were randomized into traditional-equipment RT (TRAD), minimal-equipment RT (MIN), or minimal-equipment RT with BFR (MIN + BFR). Performance and body composition were assessed pretraining and post-training, and measures of intensity and workload were evaluated throughout. Performance assessments included the army combat fitness test (ACFT), countermovement vertical jump, 3RM bench press, and V̇O2max; body composition measures included body fat percentage, fat-free mass, and muscle and tendon thickness. All groups trained 4 days per week after a full-body routine. Data were analyzed by mixed-effects models (α = 0.05). Group-by-time interactions for 3RM deadlift and 3RM bench press (p < 0.004) showed larger improvements for TRAD compared with MIN and MIN + BFR. Time main effects for all other performance variables, body fat percentage, fat-free mass, and muscle thickness (p ≤ 0.035) indicated improvements in all groups. A group-by-time interaction for blood lactate (p < 0.001) and group main effects for heart rate (p < 0.001) and workload variables (p < 0.008) indicated higher intensity and workload for MIN and MIN + BFR compared with TRAD. A sex-by-time interaction for 3RM deadlift (p = 0.008) and sex-by-group-by-time interaction for 3RM bench press (p = 0.018) were also found. Minimal-equipment RT improved performance and body composition, although strength improvements were greater with traditional equipment. Minimal-equipment RT and minimal-equipment RT with BFR exhibited higher exertion levels than TRAD, although adaptations were similar. Overall, individuals can improve performance and body composition using portable, field-expedient RT equipment.
Assessment of Ground Contact Time in the Field: Evaluation of Validity and Reliability

Abstract Weber, JA, Hart, NH, Rantalainen, T, Connick, M, and Newton, RU. Assessment of ground contact time in the field: evaluation of validity and reliability. J Strength Cond Res 38(1): e34–e39, 2024—The capacity to measure the kinetic and kinematic components of running has been extensively investigated in laboratory settings. Many authors have produced work that is of high value to practitioners within sporting environments; however, the lack of field-based technology to assess features of running gait validly and reliably has prevented the application of these valuable works. This paper examines the validity and reliability of a practical field-based methodology for using commercial inertial measurement units (IMUs) to assess ground contact time (GCT). Validity was examined in the comparison of GCT measured from ground reaction force by a force plate and that determined by a lumbar mounted commercial IMU and analyzed using a commercially available system (SPEEDSIG). Reliability was assessed by a field-based examination of within and between-session variability in GCT measured using a commercially available system (SPEEDSIG). Significance was set at p ≤ 0.05. Results for validity (intraclass correlation [ICC] 0.83) and reliability (ICC 0.91) confirm that the described field-based methodology is qualified for use to determine GCT in a practical setting. The implications of this study are important as they offer sport practitioners (S&C coaches, rehab specialists, and physios) a scalable method to assess GCT in the field to develop greater understanding of their athletes and improve performance, injury prevention, and rehabilitation interventions. Furthermore, these results provide the foundation for further work that could provide greater detail describing individual running gait in the field.