bluuebunny/crossref_metadata_2025 huggingface dataset:
Placebo Effect in the Treatment of Patellar Tendinopathy and Its Influencing Factors: Systematic Review With Meta-analysis and Meta Regression of Randomized Controlled Trials
Authors: Previtali Davide , Albanese Jacopo , Romandini Iacopo , Merli Giulia , Taraballi Francesca , Filardo Giuseppe
Published: August 2024

Background:

The effectiveness of nonsurgical treatment of patellar tendinopathy is questioned due to the conflicting results of placebo-controlled randomized controlled trials (RCTs) in which placebo arms often show impressive results.

Purpose:

To quantify the magnitude of placebo effect of the different nonsurgical treatments of patellar tendinopathy. We also evaluated the influence of patients and treatments characteristics on the response to the placebo.

Study Design:

Systematic review; Level of evidence, 1.

Methods:

We searched PubMed, Web of Science, Embase, Scopus, Cochrane Library, and gray literature databases on May 10, 2023, with no time limitation. RCTs on nonoperative treatment of patellar tendinopathy, including a placebo control arm reporting the evolution of symptoms after placebo administration, were included. A single-arm meta-analysis was performed with the Victorian Institute of Sport Assessment-Patella (VISA-P) at mid-term follow-up (3-6 months) as the primary outcome. The VISA-P score at short-term (1-3 months) and long-term (6-12 months) follow-ups, as well as visual analog scale (VAS) for pain at all 3 time points were also analyzed. A subanalysis based on the type of placebo and a meta-regression were conducted to look for potential determinants of the placebo effect. Risk of bias and level of evidence were also analyzed using the revised tool for risk of bias in randomized trials and Grading of Recommendations Assessment, Development and Evaluation.

Results:

In total, 14 studies (251 patients) were included. VISA-P score at mid-term follow-up (3-6 months) showed statistically significant improvements of 13 of 100 points ( P = .001). The change at short-term follow-up (1-3 months) was not statistically significant, whereas at long-term follow-up (6-12 months) it was 27 of 100 points ( P < .001). Regarding VAS, results were statistically significant only at mid-term (MD = −1.5/10; P = .02) and long-term (MD = −3.2/10; P < .001) follow-ups. The meta-regression showed positive correlations between the response to placebo and the follow-up length ( P < .001) and the effect size in the experimental group ( P = .006). The level of evidence was moderate for mid- and long-term results and low for short-term results.

Conclusion:

The placebo effect for nonsurgical treatments of patellar tendinopathy is long-lasting (up to 12 months) and statistically and clinically significant. It has a perceived and true component and differs among treatments. The duration of follow-up and the effect size of experimental groups correlate with the magnitude of the placebo component, underlining the importance of RCTs to determine the effectiveness of new treatments of patellar tendinopathy.
Facilitators, Barriers, Conditions, and Recommendations of Pediatric Nurses Reassigned to Adult Care During COVID-19 Pandemic: A Mixed Methods Study
Authors: Pestana-Santos Marcia , Catlin Anita , Mendes Joana
Published: August 2024

Aims:

To describe the conditions, facilitators, barriers, and recommendations of pediatric nurses reassigned to adult care during the COVID-19 pandemic.

Background:

During COVID-19 pandemic, nurses who were certified, received advanced education, and with years of experience in their fields were asked to, or mandated to, care for adult patients, often with COVID-19 and in intensive care units.

Introduction:

Nurses struggled with this transition worldwide. Literature searches reflected no guidance in specialty reassignment during a pandemic.

Methods:

International, mixed method, convergent study using GRAMMS Mixed Methods framework. Two instruments disseminated internationally during 2021 on Survey Monkey© in three languages: (1) Researcher-developed, validated, feelings, beliefs, circumstances, and recommendations survey, (2) Medical-surgical skills survey from Canadian Association of Schools of Nursing. Integrated quantitative and qualitative design for investigatory depth. Analysis using SocialSciences calculator© and Narrative Inquiry methodology. Meleis's Transitions theory provided framework.

Results:

A total of 122 nurses from 12 countries responded. Sixty-four percent of pediatric nurses reported they were mandated to work with adults with no choice; 64% received no preparation for change in specialty. Respondents reported suffering, absence of training to care for adults, lack of COVID-19 related skills such as care of ventilated patient, proning, mental health support, palliative care, or comforting families of the dying. Ninety-two percent recommended improvement, advising advance planning for transition in assignments, making transitions smoother, and diminishing number of transitions. National and international policies on floating supported the participants’ recommendations.

Discussion:

Study reports challenges experienced by nurses reassigned outside of their specialties without training or preparation and offers critical recommendations to ensure both nurse and patient safety during future disasters or pandemics.

Conclusion/Implications Nursing and Health Policy:

Planning for quality nursing care during transitions between specialties is possible. Staff nurses must be included, trained, and prepared. Literature on floating provides solid background for moving nurses between specialties.
Loneliness and Alcohol use among College Students During the COVID-19 Pandemic in Rural Appalachia
Authors: Ahuja Manik , Miller-Slough Rachel , Adebayo-Abikoye Esther , Williams Callon , Haubner Andrea , Dooley McKenzie G. , Bansal Minakshi , Sathiyaseelan Thiveya , Pons Amanda , Karki Arpana , Al Ksir Kawther , Samuel Brook , Tchoua Phoebe , Schuver Trisha , Fernandopulle Praveen
Published: August 2024

Objective

Binge drinking and heavy alcohol use are highly prevalent among college students. During the COVID-19 pandemic, due to lockdown restrictions and other challenges, many college students were burdened with loneliness, which can contribute to chronic stress, and substance use. The current study explores the association between loneliness and various levels of alcohol use among college students in the rural, underserved region of Central Appalachia, USA.

Methods

Data were collected from a regional sample (n = 320) of college age adults, age 18-25 in the Central Appalachian region. The UCLA-3 item Loneliness Scale (UCLA-3) was used in the study to evaluate loneliness. Logistic regression analysis was conducted to assess the association between levels of loneliness and three separate outcomes, including past year binge drinking, past year heavy alcohol use, and past year weekly alcohol use.

Results

Overall, 25.5% of the participants reported severe loneliness, 33.6% reported moderate, and 40.9% reported low levels of loneliness. Results of the adjusted models revealed that severe loneliness was associated with higher odds of heavy alcohol use (AOR = 1.89, 95% CI [1.02, 3.50]) and binge drinking (AOR = 2.96, 95% CI [1.16, 7.51]), and not associated with weekly alcohol use.

Conclusion

The study found that higher levels of loneliness were linked to both binged drinking and heavy alcohol use. Further efforts for counseling and treatment among college students who are burdened with severe loneliness should be considered. The chronic stress associated with severe loneliness needs to be further addressed, particularly among emerging adults.
Knotless Labral Repair Using the Inversion Technique in Hip Arthroscopy
Authors: Kolevar Matthew P. , Lingenfelter Cameron C. , Rocca Michael S. , Meredith Sean J.
Published: August 2024

Background:

Hip arthroscopy is technically demanding with a steep learning curve, and labral repair is an important component of the surgical treatment of femoroacetabular impingement (FAI) syndrome. As hip arthroscopy indications and techniques are evolving, it is important to remain focused on teaching techniques that are easily mastered and have a measurable benefit to patient outcomes.

Indications:

Patients with FAI syndrome and labral tear who have failed conservative treatment may benefit from hip arthroscopy, labral repair, and femoroplasty.

Technique Description:

Labral repair is an essential component of the surgical treatment of FAI syndrome. The hip is accessed in standard fashion, and multiple knotless anchors are used for labral repair. Repair sutures are passed around the labrum in an inverted fashion. This inversion technique ensures the labrum is not everted away from the acetabular rim and that the final position of the labrum will restore a good suction seal on the femoral head. Femoroplasty and capsule closure are always performed.

Results:

Patients can reliably expect improvements in hip pain and function. A cohort of 62 patients was investigated, and these patients demonstrated significant improvement in multiple patient-reported outcomes related to physical function, activity, and pain at 2 years after hip arthroscopy. Forty-seven percent stated they felt “completely better” at 2 years postoperatively.

Discussion/Conclusion:

Good hip arthroscopy technique in the proper patient can yield excellent results. The inversion labral repair technique reliably restores the suction seal and prevents eversion of the labrum to preserve normal function.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Racial Biases in AIs and Gemini's Inability to Write Narratives About Black People
Authors: Barroso da Silveira Julia , Alves Lima Ellen
Published: August 2024

This article addresses the racism that emerges in artificial intelligence based on an experiment carried out in Gemini, Google's text-generative tool that uses natural language. In an attempt to observe possible racial biases in the chatbot's responses, commands reproduced for the binary matrices man/woman and white/black were submitted in order to compare the responses, but Gemini, despite having text production as its primary function, was unable to generate narratives that involved black people. This empirical experimentation was analyzed according to a bibliographical review of authors who deal with racial themes, mainly considering the view of Denise Ferreira da Silva in relation to the idea of a transparent subjectivity, the temporal displacement of the black body discussed by Bhabha and the overlap between technology and race brought by Noble and Faustino and Lippold. This erasure of minoritized racial groups is not restricted to the tool or the algorithmic means, but is a symptom of other exclusionary practices observed in society.
The COVID-19 pandemic and methodological constraints: Autoethnographic and prefigurative responses
Authors: Williams Clare
Published: August 2024

While sets of constraints have become normalised in research production, the COVID-19 pandemic mandated shifts in research ontologies, epistemologies and methodologies. The society-wide, real-time experiment of the pandemic lockdowns constructed a set of prefigurative counterfactual contexts in which alternative structures and processes came to be, albeit briefly, normalised. Two examples illustrate the risks and opportunities that emerged. Firstly, the turn to autoethnography and creative methods offers a methodological challenge to the minoritisation of certain voices within the academy. Secondly, and more substantively, pivots in response to lockdowns offered glimpses of labour market inclusion best practice through the prefiguration of alternative workplace norms, suggesting the potential value of prefigurative counterfactuals as research method. Nevertheless, both methodological and substantive insights explored here in the context of the COVID-19 pandemic were mediated by technology which has the potential to reproduce embedded dominant epistemologies and ontologies.
Modeling hospital resources based on global epidemiology after earthquake-related disasters
Authors: Merino Yvonne , Ceferino Luis , Pizarro Sebastian , de la Llera Juan C
Published: August 2024

Injured people require hospital emergency services and timely medical treatment after extreme earthquakes. Earthquake-related patients often have trauma injuries and stress-linked (ischemic) ailments that require multiple healthcare procedures, such as minor orthopedic treatment, surgical treatment of fractures, and thrombolysis or thrombectomy. Hospital operation models have been proposed to examine these healthcare procedures; however, they exhibit two fundamental gaps that hinder their ability to assess critical service areas after earthquakes. First, these models rest heavily on emergency procedures based on injury severity rather than type. Second, healthcare demands are often modeled from injury profiles after moderate earthquakes in the United States without including epidemiology data after large earthquakes globally. This approach has led to oversimplified hospital emergency services and resource utilization representation. This research presents a new hospital operations model based on patient injury type and worldwide earthquake epidemiology to fill these gaps. We build the model using discrete-event simulations to capture dynamic metrics on hospital operational outcomes after the earthquake, such as patient time-to-treatment and unassisted patient ratio. We then studied how these metrics vary with different levels of functional capacity in the specific hospital resources. Our results showed that waiting times for emergency department (ED)-level patients vary non-linearly with changes in the number of functional service areas. Also, significant reduction in the waiting time for hospital-level procedures was found for relatively small decrease in the bed occupancy rate, for example, if reverse triage procedures are activated (i.e. a discharge of non-critical patients admitted before the earthquake). Our findings provide a valuable tool for decision-making in hospital preparedness as they explicitly measure the impacts of functional capacity on key healthcare metrics for specific earthquake-related patients.
Time for health change: promoting community-based diabetes screening and prevention with video vignettes and social marketing
Authors: Jirjees Feras , Hasan Sanah , Krass Ines , Saidawi Ward , Al-Juboori Mohammed Khalid , Othman Amna M. , Alzoubi Karem H. , Alzubaidi Hamzah
Published: August 2024

Meaningful communication between health service users and providers is essential. However, when stakeholders are unfamiliar with new health services, innovative communication methods are necessary to engage them. The aim of the study was to create, validate, and evaluate a video-vignette to enhance stakeholders’ (physicians, pharmacists, and laypeople) engagement and understanding of an innovative pharmacy-based diabetes screening and prevention program. Also, to assess the video-vignette’s capacity to measure appetite and appeal for such preventive programs. This mixed-methods study consisted of two phases. In phase one, a video-vignette depicting the proposed screening and prevention program was developed and validated following established international guidelines (n = 25). The video-vignette was then evaluated by stakeholders (n = 99). In phase two, the video-vignette’s capacity as a communication tool was tested in focus groups and interviews to explore stakeholders’ perspectives and engagement on the proposed service (n = 22). Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis. In total, 146 stakeholders participated. The script was well-received, deemed credible, and realistic. Furthermore, the video-vignette received high ratings for its value, content, interest, realism, and visual and audio quality. The focus groups and interviews provided valuable insights into the design and delivery of the new service. The video-vignette compellingly portrayed the novel pharmacy-based diabetes screening and prevention service. It facilitated in-depth discussions among stakeholders and significantly enhanced their understanding and appreciation of such health services. The video-vignette also generated significant interest in pharmacy-based diabetes screening and prevention programs, serving as a powerful tool to promote enrollment in these initiatives.
“Learn from Errors”: Post-traumatic growth among second victims
Authors: Huang Huanhuan , Liu Tong , Peng Ying , Du Xingyao , Huang Qi , Zhao Qinghua , Xiao Mingzhao , Luo Yetao , Zheng Shuangjiang
Published: August 2024

Background

Second victims, defined as healthcare providers enduring emotional and psychological distress after patient safety incidents (PSIs). The potential for positive transformation through these experiences is underexplored but is essential for fostering a culture of error learning and enhancing patient care.

Objective

To explore the level and determinants of post-traumatic growth (PTG), applying the stress process model.

Methods

The study was conducted at a tertiary general hospital in Chongqing, China. A descriptive, cross-sectional study design was used. A total of 474 s victims were included. An online survey was conducted in November 2021 to assess various factors related to the second victim experience. These factors included PSIs (considered as stressors), coping styles, perceived threats, and social support (acting as mediators), as well as the outcomes of second victim syndrome (SVS) and PTG. Statistical description, correlation analysis, and structural equation modeling were utilized for the data analysis. A p-value ≤ 0.05 was considered to indicate statistical significance.

Results

The participants reported moderate distress (SVS = 2.84 ± 0.85) and PTG (2.72 ± 0.85). The total effects on SVS of perceived threat, negative coping, social support, positive coping, and PSIs were 0.387, 0.359, -0.355, -0.220, and 0.115, respectively, accounting for 47% of the variation in SVS. The total effects of social support, positive coping, and PSIs on PTG were 0.355, 0.203, and − 0.053, respectively, accounting for 19% of the variation in PTG.

Conclusions

The study provides novel insights into the complex interplay between perceived threats, coping styles, and social support in facilitating PTG among second victims. By bolstering social support and promoting adaptive coping strategies, the adverse effects of PSIs can be mitigated, transforming them into opportunities for resilience and growth, and offering a fresh perspective on managing PSIs in healthcare settings.
How does online postal self-sampling (OPSS) shape access to testing for sexually transmitted infections (STIs)? A qualitative study of service users
Authors: Spence Tommer , Howarth Alison , Reid David , Sheringham Jessica , Apea Vanessa , Crundwell David , Day Sara , Dewsnap Claire , Jackson Louise , Mercer Catherine H. , Mohammed Hamish , Ross Jonathan D. C. , Sullivan Ann , Williams Andy , Winter Andrew , Wong Geoff , Burns Fiona , Gibbs Jo
Published: August 2024

Background

Sexually transmitted infections (STIs) are a serious public health issue in many countries. Online postal self-sampling (OPSS) is increasingly used to test for STIs, a trend accelerated by the COVID-19 pandemic. There remains limited understanding of how service users experience OPSS and what leads them to access it over clinic-based services, or vice versa. This research seeks to address these gaps, by undertaking a large qualitative study which sits within the ASSIST study, a mixed-methods, realist evaluation of OPSS.

Methods

Participants were recruited via clinic-based and online sexual health services in three case study areas in England. Purposive sampling was used to over-represent populations disproportionately affected by poor sexual health: young people; people of colour; men who have sex with men; and trans and non-binary people. Semi-structured interviews were analysed using Levesque’s conceptual framework of access to healthcare.

Results

We interviewed 100 service users. Participants typically became aware of OPSS from sexual health services, the internet or word of mouth. Acceptability of OPSS was facilitated by the perceived privacy it offered over clinic-based services, which some participants found embarrassing to access. OPSS also enabled participants to overcome barriers to reaching clinic-based services, such as a lack of appointment availability, although difficulty obtaining OPSS kits in some areas undermined this. As all services in our case study areas were free to use, affordability did not significantly shape access, although OPSS enabled some participants to avoid costs associated with travelling to clinic-based services. Participants were usually able to engage with OPSS, finding it easy to use and reliable, although blood self-sampling was challenging for most. Participants valued the support offered by clinic-based services beyond STI testing, including the opportunity to access contraception or ask staff questions, and felt this was more appropriate when they had specific concerns about their sexual health, such as STI symptoms.

Conclusions

Our findings constitute one of the largest qualitative studies to have explored OPSS and offer valuable insights to providers. OPSS shapes access to STI testing in a number of ways, including facilitating access in many circumstances, but users also want to retain access to clinic-based services, particularly for when they believe they need support beyond STI testing.
Clinical and radiological features associated with rupture of pulmonary artery pseudoaneurysm: a retrospective study
Authors: Liu Min , Liu Jixiang , Yu Wei , Gao Xiaoyan , Chen Shi , Qin Wei , Zhu Ziyang , Li Chenghong , Li Fajiu , Zhai Zhenguo
Published: August 2024

Background

Hemoptysis resulting from rupture of the pulmonary artery pseudoaneurysm (PAP) is massive and fatal, while factor contributing to the rupture of pseudoaneurysm remains elusive. This study aimed to elucidate the clinical and radiological features of PAP and identify the risk factors associated with rupture.

Methods

Patients who developed hemoptysis with PAP were collected from January 2019 to December 2022 retrospectively. Clinical data of the demographic characteristics, radiological findings, treatment strategies, and prognosis were collected. A comparative analysis was performed on the characteristics in the ruptured and non-ruptured cases.

Results

A total of 58 PAPs were identified in the 50 patients. The most common causes were infection (86%) and cancer (8%). The PAPs were located predominantly in the upper lobes of both lungs, and 57 (99.3%) were distributed in the segmental or subsegmental pulmonary arteries. The median diameter was 6.1(4.3–8.7) mm. A total of 29 PAPs were identified adjacent to pulmonary cavitations, with the median diameter of the cavity being 18.9 (12.4–34.8) mm. Rupture of pseudoaneurysm occurred in 21 cases (42%). Compared to unruptured group, the ruptured group had a significantly higher proportion of massive hemoptysis (57.1% vs. 6.9%, p < 0.001), larger pseudoaneurysm diameter (8.1 ± 3.2 mm vs. 6.0 ± 2.3 mm, p = 0.012), higher incidence of pulmonary cavitation (76.2% vs. 44.8%, p = 0.027), and larger cavitation diameters (32.9 ± 18.8 mm vs. 15.7 ± 8.4 mm, p = 0.005). The mean pulmonary artery pressure (mPAP) in the ruptured group was also significantly higher than that in the unruptured group [23.9 ± 7.4 mmHg vs. 19.2 ± 5.0 mmHg, p = 0.011]. Endovascular treatment was successfully performed in all 21 patients with ruptured PAP, of which the clinical success rate was 96.0%. Five patients experienced recurrent hemoptysis within one year.

Conclusions

Massive hemoptysis, pseudoaneurysm diameter, pulmonary cavitation, and elevated mPAP were the risk factors for rupture of pseudoaneurysm. Our findings facilitate early identification and timely intervention of PAP at high risk of rupture.
Post-race reactions: The emotional paradox of high performance and anxiety – a conventional content analysis
Authors: Augustsson Sofia Ryman , Bergh Malin , Petersson Kornelia
Published: August 2024

Background

Studies examining post-race emotional experiences in the context of endurance races among recreational athletes are scarce. The purpose of this study was to describe how recreational athletes experience the time after completing an endurance race.

Methods

In this study, a qualitative study design was used, and data collection was carried out with semi-structured interviews. The selection of subjects was completed systematically through criterion selection. The selection criteria were men and women, aged 18 years or older, who had completed an endurance race, and finished, lasting at least 180 min within the past 12 months. The interviews were analyzed using conventional qualitative content analysis.

Results

Sixteen recreational endurance athletes who, within six months, had completed an endurance race of running, cycling, cross-country skiing or Ironman, participated and were interviewed. Four overarching themes emerged from the analysis: “High on life”, “Loss of energy, Ambivalence and Melancholy”, “Activity-charged emotions”, and “Dimensions of emotions over time and new goals”, describing the content of the interviews.

Conclusions

Endurance athletes experienced varied post-race emotions that were both physically and mentally challenging, suggesting a holistic approach to managing post-race emotions would be beneficial. From the athletes’ perspectives, post-race feelings were dependent on many factors, including time spent training for a specific race, and perceived inability to set new goals for an upcoming training period. Setting future goals prior to an event may be a tool for reducing the risk of negative post-race emotions, including post-race blues.
Important aspects of experiences from patients and parents related to medications in Child and Adolescents Mental Health Services (CAMHS) - a qualitative study
Authors: Steiro Asbjørn Kulseng , Iversen Hilde Hestad
Published: August 2024

Purpose

Patient-reported experiences are a key source of information on quality in mental health care. Most patient experience surveys are limited to assessments from adults, including those conducted by parents or proxies on behalf of others. The aim of this study was to produce findings to inform development of modules on patient and parent experiences with medication in outpatient CAMHS in Norway, for use in previously validated instruments applied in national surveys.

Patients and methods

We developed survey questions based on a systematic literature review, expert-group consultations, interviews with adolescents and parents, and pretesting of the modules in a pilot study. This study included adolescents aged 12–17 years and parents with experiences from outpatient CAMHS and we present findings from semi-structured interviews.

Results

Adolescents with ADHD emphasized the following aspects as important concerning medication use in CAMHS: positive effects of medication like better function and concentration in school and change of behaviour. They also stressed the importance of side effects such as eating problems, nausea, loss of appetite, insomnia, and changes in thoughts and feelings. In addition, adolescents highlighted the significance of aspects as support in daily routines for taking medications, while parents highlighted needs for a professional follow-up care. Parents emphasized aspects regarding their children’s medication included both positive effects and change in behaviour, as well as their identification of negative side effects.

Conclusion

Our findings from semi-structured interviews identified important aspects reported by both patients and parents on functions, side effects and follow-up care related to medication. The results indicated that both groups emphasized corresponding aspects of what was important regarding medication. However, when it came to follow-up care, the two groups highlighted distinct aspects, indicating differing priorities or concerns in this area.
Perioperative chemotherapy with nivolumab for HER2-negative locally advanced gastric cancer: a case series
Authors: Toji Yuta , Takeuchi Shintaro , Ebihara Yuma , Kurashima Yo , Harada Kazuaki , Hayashi Mariko , Abe Hirotake , Wada Hideyuki , Yorinaga Satoko , Shichinohe Toshiaki , Tomaru Utano , Komatsu Yoshito , Hirano Satoshi
Published: August 2024

Background

Nivolumab with chemotherapy has been transformative for metastatic gastric cancer (GC). The potential of this regimen for local tumor control could be utilized for perioperative chemotherapy in locally advanced GC with bulky tumors or lymph node metastasis involving other organs.

Case presentation

Five patients with HER2-negative advanced GC were treated with nivolumab and oxaliplatin-based chemotherapy. All patients presented with clinical stage III or IVA GC with tumors in contact with either the pancreas or liver. Following chemotherapy, all tumors demonstrated shrinkage, allowing successful radical gastrectomies including four minimally invasive approach without postoperative complications. Four patients avoided combined resection of other organs.

Conclusions

Perioperative chemotherapy with nivolumab was effective for local disease control in this case series. This regimen could be a promising treatment approach for locally advanced GC; however, its survival benefits should be evaluated in clinical trials.
Deterministic modelling of implied volatility in cryptocurrency options with underlying multiple resolution momentum indicator and non-linear machine learning regression algorithm
Authors: Leung F. , Law M. , Djeng S. K.
Published: August 2024

Modeling implied volatility (IV) is important for option pricing, hedging, and risk management. Previous studies of deterministic implied volatility functions (DIVFs) propose two parameters, moneyness and time to maturity, to estimate implied volatility. Recent DIVF models have included factors such as a moving average ratio and relative bid-ask spread but fail to enhance modeling accuracy. The current study offers a generalized DIVF model by including a momentum indicator for the underlying asset using a relative strength index (RSI) covering multiple time resolutions as a factor, as momentum is often used by investors and speculators in their trading decisions, and in contrast to volatility, RSI can distinguish between bull and bear markets. To the best of our knowledge, prior studies have not included RSI as a predictive factor in modeling IV. Instead of using a simple linear regression as in previous studies, we use a machine learning regression algorithm, namely random forest, to model a nonlinear IV. Previous studies apply DVIF modeling to options on traditional financial assets, such as stock and foreign exchange markets. Here, we study options on the largest cryptocurrency, Bitcoin, which poses greater modeling challenges due to its extreme volatility and the fact that it is not as well studied as traditional financial assets. Recent Bitcoin option chain data were collected from a leading cryptocurrency option exchange over a four-month period for model development and validation. Our dataset includes short-maturity options with expiry in less than six days, as well as a full range of moneyness, both of which are often excluded in existing studies as prices for options with these characteristics are often highly volatile and pose challenges to model building. Our in-sample and out-sample results indicate that including our proposed momentum indicator significantly enhances the model’s accuracy in pricing options. The nonlinear machine learning random forest algorithm also performed better than a simple linear regression. Compared to prevailing option pricing models that employ stochastic variables, our DIVF model does not include stochastic factors but exhibits reasonably good performance. It is also easy to compute due to the availability of real-time RSIs. Our findings indicate our enhanced DIVF model offers significant improvements and may be an excellent alternative to existing option pricing models that are primarily stochastic in nature.
Vessel-based CTA-image to spatial anatomy registration using tracked catheter position data: preclinical evaluation of in vivo accuracy
Authors: Tangen Geir Arne , Aadahl Petter , Hernes Toril A. N. , Manstad-Hulaas Frode
Published: August 2024

Electromagnetic tracking of endovascular instruments has the potential to substantially decrease radiation exposure of patients and personnel. In this study, we evaluated the in vivo accuracy of a vessel-based method to register preoperative computed tomography angiography (CTA) images to physical coordinates using an electromagnetically tracked guidewire. Centerlines of the aortoiliac arteries were extracted from preoperative CTA acquired from five swine. Intravascular positions were obtained from an electromagnetically tracked guidewire. An iterative-closest-point algorithm registered the position data to the preoperative image centerlines. To evaluate the registration accuracy, a guidewire was placed inside the superior mesenteric, left and right renal arteries under fluoroscopic guidance. Position data was acquired with electromagnetic tracking as the guidewire was pulled into the aorta. The resulting measured positions were compared to the corresponding ostia manually identified in the CTA images after applying the registration. The three-dimensional (3D) Euclidean distances were calculated between each corresponding ostial point, and the root mean square (RMS) was calculated for each registration. The median 3D RMS for all registrations was 4.82 mm, with an interquartile range of 3.53–6.14 mm. A vessel-based registration of CTA images to vascular anatomy is possible with acceptable accuracy and encourages further clinical testing.

Relevance statement

This study shows that the centerline algorithm can be used to register preoperative CTA images to vascular anatomy, with the potential to further reduce ionizing radiation exposure during vascular procedures.

Key Points

Preoperative images can be used to guide the procedure without ionizing intraoperative imaging.

Preoperative imaging can be the only imaging modality used for guidance of vascular procedures.

No need to use external fiducial markers to register/match images and spatial anatomy.

Acceptable accuracy can be achieved for navigation in a preclinical setting.

Graphical Abstract
Research reviews on myosin head interactions with F-actin
Authors: Park Yoon Ho , Song Gang San , Jung Hyun Suk
Published: August 2024

The sliding filament theory and the cross-bridge model have been fundamental in understanding muscle contraction. While the cross-bridge model explains the interaction between a single myosin head and actin filament, the native myosin molecule consists of two heads. This review explores the possibility and mechanism of two-headed binding in myosin II to the actin. Recent studies using electron tomography and resonance energy transfer have provided evidence in support of the occurrence of two-headed binding. The flexibility of the regulatory light chain (RLC) appears to play a significant role in enabling this binding mode. However, high-resolution structures of the RLCs in the two-headed bound state have not yet been reported. Resolving these structures, possibly through sub-tomogram averaging or single-particle analysis, would provide definitive proof of the conformational flexibility of RLCs and their role in facilitating two-headed binding. Further investigations are also required to address questions such as the predominance of two-headed versus single-headed binding and the influence of the state of each of the heads on the other. An understanding of the mechanism of two-headed binding is crucial for developing a comprehensive model of the cross-bridge cycle of the native myosin molecule.
A qualitative study identifying implementation strategies using the i-PARIHS framework to increase access to pre-exposure prophylaxis at federally qualified health centers in Mississippi
Authors: Arnold Trisha , Whiteley Laura , Giorlando Kayla K. , Barnett Andrew P. , Albanese Ariana M. , Leigland Avery , Sims-Gomillia Courtney , Elwy A. Rani , Edet Precious Patrick , Lewis Demetra M. , Brock James B. , Brown Larry K.
Published: August 2024

Background

Mississippi (MS) experiences disproportionally high rates of new HIV infections and limited availability of pre-exposure prophylaxis (PrEP). Federally Qualified Health Centers (FQHCs) are poised to increase access to PrEP. However, little is known about the implementation strategies needed to successfully integrate PrEP services into FQHCs in MS.

Purpose

The study had two objectives: identify barriers and facilitators to PrEP use and to develop tailored implementation strategies for FQHCs.

Methods

Semi-structured interviews were conducted with 19 staff and 17 PrEP-eligible patients in MS FQHCs between April 2021 and March 2022. The interview was guided by the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework which covered PrEP facilitators and barriers. Interviews were coded according to the i-PARIHS domains of context, innovation, and recipients, followed by thematic analysis of these codes. Identified implementation strategies were presented to 9 FQHC staff for feedback.

Results

Data suggested that PrEP use at FQHCs is influenced by patient and clinic staff knowledge with higher levels of knowledge reflecting more PrEP use. Perceived side effects are the most significant barrier to PrEP use for patients, but participants also identified several other barriers including low HIV risk perception and untrained providers. Despite these barriers, patients also expressed a strong motivation to protect themselves, their partners, and their communities from HIV. Implementation strategies included education and provider training which were perceived as acceptable and appropriate.

Conclusions

Though patients are motivated to increase protection against HIV, multiple barriers threaten uptake of PrEP within FQHCs in MS. Educating patients and providers, as well as training providers, are promising implementation strategies to overcome these barriers.
Surgical management of aorto-right atrial fistula induced by Stanford type A aortic dissection: a case report
Authors: Yokoyama Takahito , Tsuda Yasutoshi , Shigehara Katsuyuki , Niside Ryo , Sato Daiki , Nakajima Masato
Published: August 2024

Background

The occurrence of aorto-right atrial fistula in a patient with Stanford type A aortic dissection is exceedingly rare, and the treatment has not been established.

Case presentation

A 60-year-old male presented to the emergency department with acute lumbar pain and, based on contrast-enhanced computed tomography, was diagnosed with Stanford type A aortic dissection. Emergency surgery was performed. Transesophageal echocardiography during the surgery did not reveal an aorto-right atrial fistula. After establishing cardiopulmonary bypass, circulatory arrest was induced, and the primary entry in the proximal ascending aorta for the aortic dissection was identified. The aorta was dissected between the right brachiocephalic artery and the left common carotid artery, and an artificial conduit was anastomosed. After re-establishing circulation, venous blood flow from the dissected area at the base of the aortic root was observed, indicating communication between the aorta and the right atrium. Circulatory arrest was induced again, and the ruptured outer aortic adventitia was repaired by continuous suturing using 5–0 prolene. The atrial fistula was repaired from within the right atrium using 5–0 prolene with felt reinforcement. Thus, successful closure was achieved. Proximal anastomosis and right brachiocephalic artery reconstruction were subsequently performed. Postoperative transesophageal echocardiography revealed no shunt flow and no bleeding from the aortic root. The patient recovered smoothly and was discharged without significant complications.

Conclusions

Aorto-right atrial fistula associated with Stanford type A aortic dissection is rare, and in this case, the shunt blood flow was low, making preoperative diagnosis difficult. However, after intraoperative diagnosis, direct suture was used to complete the treatment, which was a simple and effective method.
The influence of lamination and fracture on the velocity anisotropy of tectonic coals
Authors: Gong Fei , Huang Aner , Kang Wujiang , Shi Suzhen , Zou Guangui , Zhang Zhaoji , Wang Guowei
Published: August 2024

The elastic anisotropy of coal formations is important for the prediction of unconventional coalbed methane reservoir performance and hydraulic fracturing. Although essential for several geophysical applications, the elastic anisotropy of coals is still poorly understood. Therefore, three sets of cylindrical coal samples are drilled parallel and perpendicular to the bedding plane, and the ultrasonic velocities under different confining pressures are measured in the laboratory. We combine experimental observations and modeling analysis to evaluate the elastic anisotropy of the coals. The results suggest that the velocity of coals parallel to the bedding plane is less sensitive to confining pressure than those perpendicular to the bedding plane. The fracture densities of coals parallel to the bedding plane are much lower than those perpendicular to the bedding plane, and most of the fractures are closed when the pressure is higher than 15 MPa. The organic matter (OM), clay content, and their preferred orientation play dominant roles in velocity anisotropy, and the fracture effect can significantly enhance it. The velocity anisotropy parameters of coals are positively correlated with the OM and clay content, and the preferred orientation of OM and clay plays a significant role in coal anisotropy. The results in this study are helpful in the characterization of the fractures of coals and can provide an important rock-physics basis for microseismic fracture monitoring and reservoir prediction.
A Meta-Analysis of Medication Reduction and Motor Outcomes After Awake Versus Asleep Deep Brain Stimulation for Parkinson Disease
Authors: Li Luyuan , Rae Ali I. , Burchiel Kim J.
Published: August 2024

BACKGROUND AND OBJECTIVES:

There remains significant debate regarding the performance of deep brain stimulation (DBS) procedures for Parkinson disease (PD) under local or general anesthesia. The aim of this meta-analysis was to compare the clinical outcomes between “asleep” DBS (general anesthesia) and “awake” DBS (local anesthesia) for PD.

METHODS:

We conducted a comprehensive literature review of all published studies on DBS for PD following PRISMA guideline on PubMed and Cochrane library from January 2004 to April 2023. Inclusion criteria included cohort ≥15 patients, clinical outcomes data which included Unified Parkinson's Disease Rating Scale (UPDRS) score and levodopa equivalent daily dosage (LEDD), and ≥3 months of follow-up. Analysis was conducted using Stata software.

RESULTS:

There were 18 articles that met inclusion criteria. On meta-analysis, there were no significant differences between awake or asleep DBS with regard to percent change in UPDRS III “off” med/“on” DBS condition (P = .6) and LEDD score (P = .99). On subgroup analysis, we found that the choice of target had no significant effect on improvement of UPDRS III (P = 1.0) or LEDD (P = .99) change for the asleep vs awake operative approach. There were also no statistically significant differences between microelectrode recording (MER) use and no MER use in postoperative UPDRS III (P = 1.0) or LEDD improvement (P = .90) between awake and asleep surgery.

CONCLUSION:

There was no significant difference in the primary motor outcomes and LEDD improvement between asleep vs awake DBS. The variables of target selection and MER use had no statistically significant impact on outcome. We find that asleep techniques are both safe and effective compared with the awake technique.
Integral Dose or Mean Dose for Predicting Radiosurgery Response in Patients With Trigeminal Neuralgia: A Proposal to Target the Narrowest Part of the Nerve
Authors: Meng Ying , Santhumayor Brandon , Mashiach Elad , Bernstein Kenneth , Gurewitz Jason , Cooper Benjamin T. , Sulman Erik , Silverman Joshua , Kondziolka Douglas
Published: August 2024

BACKGROUND AND OBJECTIVES:

Stereotactic radiosurgery (SRS) is effective for patients with medically refractory trigeminal neuralgia with a 75%-90% response rate. Consideration of the integral dose (ID) to the target nerve within the 50% isodose line was reported to help select prescription doses to maximize effectiveness and minimize bothersome numbness. The objective of this study was to externally validate the ID as a predictor of outcomes after SRS.

METHODS:

We reviewed the outcomes and parameters of 94 consecutive patients of type 1 trigeminal neuralgia who had SRS for the first time where nerve ID was calculated. 70% of the prescription doses were 80 Gy, with 28% at 85 Gy, and 2% at 70 Gy.

RESULTS:

The median follow-up time was 14.4 months. A total of 85 (90%) patients reported significant pain relief (Barrow Neurological Institute I-III) after initial SRS. The median pain recurrence-free survival was 82 months (95% CI 41.1-NA), and estimates at 1, 3, and 5 years were 80.5%, 65.5%, and 55.9%, respectively. The ID was not significantly associated with initial pain relief, or affect the risk of pain recurrence or sensory dysfunction after SRS using the Cox proportional hazards model. A nerve mean dose ≥65 Gy was associated with a reduced risk of pain recurrence on multivariate analysis (hazard ratio 0.408, P = .039). Twenty (21%) patients experienced sensory dysfunction after SRS with 3 (3%) requiring further medications, which was not correlated with the prescription dose or brainstem maximum dose.

CONCLUSION:

The ID did not predict recurrence-free survival or sensory dysfunction. Our observations suggest improved nerve coverage by the most powerful area of the isocenter, for instance, by targeting a narrower segment if feasible, could result in more durable pain relief. Further studies to validate these findings are needed.