bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study exploring the digital therapeutic alliance with fully automated smartphone apps
Authors: Brotherdale Rebecca , Berry Katherine , Bucci Sandra 
Published: December 2024

Background Digital mental health interventions are increasingly used to scale up access to mental health support, yet very few mental health apps are empirically supported, with high attrition rates. The therapeutic alliance between therapists and clients is a key factor in predicting psychological therapy retention and outcomes. Understanding how this concept translates to the digital context, the so-called digital therapeutic alliance (DTA), may help enhance retention and outcomes in digital mental health. Objectives To explore and conceptualise the DTA with mental health interventions delivered by standalone apps. Specifically: (1) whether people with mental health difficulties form an alliance with mental health apps; (2) what constitutes the DTA; and (3) the similarities and differences across the traditional therapeutic alliance and DTA. Methods Qualitative semi-structured interviews were conducted with 17 individuals utilising mental health apps. Interview topic examples included rationale for app support, goals around app use and perceived connection. Interviews were analysed using thematic analysis. Results Five core themes were identified: (1) connection with ‘an other’; (2) accessibility; (3) choice and empowerment; (4) goals and expectations: having lower expectations than in-person support; and (5) safe place: non-judgemental, loyalty, trust. Conclusions The study strengthens support for the concept of the DTA but adds to existing knowledge by suggesting that the DTA needs to be conceived differently to the traditional therapeutic alliance. App developers can enhance alliance by paying particular attention to the use of human voice features, validating statements, personalised interfaces, and multiple options for activities and strategies.
Trends in Sacroiliac Joint Fusion Costs and Utilization in the Privately Insured Population
Authors: Johnstone Thomas , Schonfeld Ethan , Sadeghzadeh Sina , Marianayagam Neelan J. , Yoo Kelly H. , Ratliff John K. , Veeravagu Anand 
Published: December 2024

Study Design Retrospective Cohort Study. Objective Despite innovations in minimally invasive (MI) techniques for sacroiliac joint fusion (SIJF), trends in utilization and associated costs remain unclear. In this study, we assessed these trends and costs in a database of privately insured patients. Methods Records of open and MI SIJFs were queried from the 2007-2021 MarketScan Databases with CPT codes. Net payments made by insurance carriers were identified, as were out-of-pocket payments made by patients for each encounter. Regression was used to model utilization, payments, and costs. Results 4124 SIJFs were identified, 1626 (39.4%) of which were MI SIJF. SIJF utilization increased by 1176.2% throughout the study period ( P < .001). However, open SIJF utilization peaked in 2012. Open SIJF utilization was not significantly associated with time ( P = .18). By contrast, the peak utilization for MI procedures occurred in 2021. Spine surgeons’ volume of MI SIJF increased by 258% over the study period ( P < .001), while nonsurgeon volume of MI SIJF increased by 990.9% ( P < .001). Conclusion Privately insured patients have increasingly utilized SIJF over the past several years. This is predominantly due to the adoption of MI techniques by spine surgeons and nonsurgeons.
Which Osteochondritis Dissecans Lesions Will Heal Nonoperatively? An Application of Machine Learning to the ROCK Prospective Cohort
Authors: Johnstone Thomas , Espiritu Joseph , Tompkins Marc , Milewski Matthew D. , Nissen Carl , Shea Kevin G. ,   the ROCK Group:, Nelson Bradley , Egger Anthony , Anderson Christian , Lee Pace James , Polousky John , Ellemann Jutta , Meenen Norbert , Edmonds Eric , Ellis Henry , Fabricant Peter , Krych Aaron , Myer Greg , Kocher Mininder , Carey James 
Published: December 2024

Background: There are limited evidence-based guidelines to predict which osteochondritis dissecans (OCD) lesions will heal with nonoperative treatment. Purpose: To train a set of classification algorithms to predict nonoperative OCD healing while identifying new clinically meaningful predictors. Study Design: Case-control study; Level of evidence, 3. Methods: Patients with OCD of the knee with open physes undergoing nonoperative management were prospectively queried from the Research on OCD of the Knee (ROCK) cohort ( https://kneeocd.org ) in April 2022. Patients were included if they met the study criteria for nonoperative treatment success or failure. Nonoperative treatment success was defined as complete healing on magnetic resonance imaging (MRI) and total return to sports participation. Failure was defined as the crossover from nonoperative management to surgery at any point at or beyond the 3-month follow-up. If a patient did not meet one of these criteria, they were not included. Normalized lesion size, lesion location, patient characteristics, and symptoms were used as clinically relevant predictors. Results: A total of 64 patients were included, of whom 24 (37.5%) patients successfully healed with nonoperative management. Multivariate logistic regression revealed that a 1% increase in normalized lesion width was associated with an increase in the likelihood of nonoperative failure (odds ratio [OR], 1.41 [95% CI, 1.17-1.81]; P < .01). By contrast, lesions in the posterior sagittal zone (OR, 0.08 [95% CI, 0.009-0.43]; P < .01) or the medial-most coronal zone (for lesions of the medial femoral) and lateral-most coronal zone (for lesions of the lateral femoral condyle) on MRI (OR, 0.05 [95% CI, 0.004-0.44]; P < .01) were associated with a decrease in the likelihood of nonoperative treatment failure. Support vector machines had a cross-validated area under the receiver operating characteristic curve of 0.89 and a classification accuracy of 83.3%. Conclusion: Lesion location in the posterior aspect of the condyle on sagittal MRI and lesion location in the medial-most or lateral-most locations on coronal MRI were identified as statistically significant predictors of increased nonoperative treatment success on multivariate analysis. Machine learning models can predict which OCD lesions will heal with nonoperative management with superior accuracy compared with previously published models.
Assessing Femoral Anteversion in Patients With Bilateral Recurrent Patellar Dislocations
Authors: Honkonen Essi E. , Sillanpää Petri J. , Reito Aleksi , Kiekara Tommi , Mäenpää Heikki , Mattila Prof Ville M. 
Published: December 2024

Background: After first-time lateral patellar dislocation, 44% to 70% of patients sustain redislocations. Increased femoral anteversion (FA) is considered to result in increased lateralizing forces on the patella, which might predispose one to patellar instability. When recurrent patellar dislocations (RPDs) are bilateral, it is unclear if the FA is even more increased. Hypothesis: Patients with bilateral RPD would have greater FA than patients with unilateral RPD. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 52 skeletally mature patients with RPD and a clinical suspicion of rotational malalignment underwent rotational computed tomography or magnetic resonance imaging. The uni- or bilaterality of the RPD was determined. A control group comprising 54 adult patients with trauma underwent computed tomography of both lower extremities as part of a multitrauma protocol. The FA values of both lower extremities were evaluated separately. Results: In total, 20 of 52 (38.5%) patients in the study group had a history of unilateral RPD and 32 of 52 (61.5%) patients had a bilateral RPD diagnosis. The mean FA of the asymptomatic limb in unilaterally symptomatic patients was 18.0° (SD, 11.2°; range, 0.5°-40.0°; median, 16.5°). In the symptomatic limb, the mean FA was 19.2° (SD, 9.1°; range, 2.0°-33.0°; median, 19.0°) (mean difference, 1.2°; 95% CI −1.3° to 3.8°). In bilaterally symptomatic patients, the mean FA on the right side was 23.2°, and 22.5° on the left. The mean differences between the symptomatic limbs in the unilateral RPD group and the right or left limbs in the bilateral RPD group were 4.0° ( P = .263) and 3.3° ( P = .326), respectively. In the control group without RPD, the mean FA was 12.5° (SD, 8.5°; range, 0.8°-33.0°; median, 10.9°). The mean difference between right limbs of the patients with bilateral RPD and right limbs of controls was 10.8° ( P = .001). Conclusion: Patients with bilateral RPD have bilaterally greater FA than patients without a history of RPD. Patients with unilateral RPD have greater FA on both sides compared with the control group without a history of lateral patellar dislocation. No statistically significant difference of FA can be seen between patients with bilateral or unilateral RPD.
Modern Treatment of Hallux Rigidus by Cheilectomy: A Systematic Review of Patient-Reported Outcomes in Minimally Invasive Techniques
Authors: Semelsberger Scott D. , Lee Michael S. , Dobson Cale B. , Miller Christopher P. , Gianakos Arianna L. 
Published: December 2024

Background: Minimally invasive cheilectomy is becoming a more prominent surgical approach in the management of mild to moderate hallux rigidus. This systematic review aims to analyze and present the current literature on patient-reported outcomes following minimally invasive (MIS) cheilectomy for mild to moderate hallux rigidus. Methods: PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were searched in April 2024. Inclusion criteria consisted of articles evaluating patients undergoing cheilectomy through an MIS approach either using fluoroscopy or arthroscopy, studies that reported patient-reported outcomes, and studies written in English. The primary outcome measure was scored patient-reported outcomes. The secondary outcome measures included complications, secondary surgeries, surgical techniques, return to activity, patient satisfaction, and grades of hallux rigidus. Results: Eight studies met the inclusion criteria, and a total of 296 patients were evaluated. Overall, 36 of 296 (12.2%) underwent arthroscopy with a shaver, 130 of 296 (43.9%) underwent an MIS percutaneous approach with burr, and 130 of 296 (43.9%) had a combination of both techniques. The mean reported range of motion (dorsiflexion) improved from 32.4 degrees (range, 6.3-50.0 degrees) to 61.2 degrees (range, 47.6-89.6 degrees). All studies that reported patient outcomes scores demonstrated improved outcomes regardless of surgical technique. Overall combined reported complication rate was 18 of 296 (6.1%), with the most common complication being dorsomedial cutaneous nerve problems, affecting 6 of 296 patients (2.0%). Conclusion: Minimally invasive cheilectomy results in positive patient outcomes, patient satisfaction, preserves range of motion, and has low complication rates for the treatment of mild to moderate hallux rigidus.
Positional trigger of epicrania fugax may suggest a secondary headache: Report of four cases
Authors: Gutti Nagendra Babu , Mahajan Roopali , Singh Vivek , Paliwal Vimal Kumar 
Published: December 2024

Background Epicrania fugax is a brief paroxysmal severe stabbing pain that travels on scalp in a straight/zig-zag line. There are no known red-flags against primary epicrania fugax. Methods We identified four patients with secondary epicrania fugax characteristically triggered by head/neck movement. Results Four patients (age range 25–65 years, 2 females) with epicrania fugax were secondary to (a) acute subdural hematoma, (b) C1, C2 vertebral expansile metastasis (adenocarcinoma of prostrate), (c) type 1 Chiari malformation with cervical syrinx, and (d) pontine/cerebellar tuberculoma. All patients had severe pain (visual analog score 8–9/10) triggered by head/neck movement or on assuming upright posture. Patients with subdural hematoma and tuberculoma improved with dexamethasone. One with Chiari malformation showed partial response to gabapentin and patient with metastatic disease did not improve despite local radiotherapy, hormone treatment, gabapentin, dexamethasone and tapentadol. Conclusions Epicrania fugax triggered by head/neck movement should be evaluated for an underlying structural etiology.
Migraine-inducing effects of sildenafil in men with migraine without aura: Protocol for a randomized, placebo-controlled crossover trial
Authors: Alnajjar Mira , Iversen Ditte Bork , Rausgaard Nete Lundager Klokker , Stage Tore Bjerregaard , Pellesi Lanfranco 
Published: December 2024

Background This study aims to assess the migraine-inducing effects of sildenafil in men with migraine without aura. While sildenafil has been shown to provoke migraine in women, its effect on men remains unknown. Methods The trial will enroll 12 men and 15 women, all diagnosed with migraine without aura. The men will participate in a randomized, placebo-controlled crossover trial and the women in an open-label study. Participants will be monitored for migraine attacks and associated symptoms for 12 h post-administration. The primary endpoints include the incidence of migraine attacks in sildenafil-treated men compared to placebo and between sildenafil-treated men and women. Secondary endpoints are headache incidence, heart rate, mean arterial pressure, and adverse events. Conclusion The findings will contribute to a better understanding of sex-related differences in migraine mechanisms, potentially leading to more tailored treatment approaches. Trial registration: The trial is registered in the Clinical Trial Information System (CTIS) of the European Union under the number 2024-512014-17-02.
Role of MR-proADM and Monocyte CD169 in Predicting In-Hospital and 60-Day Mortality in COVID-19 Patients
Authors: Venturini Sergio , Orso Daniele , Cugini Francesco , Del Fabro Giovanni , Callegari Astrid , Reffo Ingrid , Villalta Danilo , Santi Laura de , Pontoni Elisa , Giordani Dina , Doretto Paolo , Pratesi Chiara , Tonizzo Maurizio , Colussi Gian Luca , Crapis Massimo 
Published: December 2024

Objectives: Mid-regional pro-adrenomedullin (MR-proADM) and monocyte CD169 (CD169) are valuable prognostic indicators of severe COVID-19. Methods: We assessed the predictive ability of a single measurement of MR-proADM and CD169 at emergency department (ED) admission to forecast in-hospital and 60-day mortality in adult COVID-19 patients. We analyzed clinical and laboratory data, with in-hospital mortality as the primary endpoint and 60-day mortality as the secondary endpoint. We examined associations with clinical and laboratory variables through univariate and multivariate analyses. Results: Data from 382 patients over 14 months were analyzed. Significant predictors of in-hospital mortality included age ⩾ 70 years (hazard ratio [HR] 8.1; 95% confidence interval [CI] 2.2-29.5), CD169 ratio ⩾ 20 (HR: 2.4; 95%CI: 1.6-5.6), MR-proADM ⩾ 1.1 mmol/L (HR: 5.1; 95%CI: 1.7-15.6), the need for invasive mechanical ventilation (HR: 6.8; 95%CI: 2.4-19.1), and active cancer (HR: 5.2; 95%CI: 1.8-15.2). For 60-day mortality, only elevated MR-proADM levels showed predictive value (HR: 6.7; 95%CI: 1.7-25.0), while high serologic titer was protective (HR: 0.4; 95%CI: 0.1-0.9). Conclusion: A single MR-proADM and CD169 measurement upon ED admission has prognostic value for in-hospital mortality, with MR-proADM also predicting 60-day mortality.
Design and Analysis of a Novel Schönflies Motion Parallel Robot with Full Cycle Rotation
Authors: Li Luquan , Fang Yuefa , Wang Lin , Yao Jiaqiang 
Published: December 2024

AbstractDue to the complex structures of multi-limbed parallel robots, conventional parallel robots generally have limited workspace, complex kinematics, and complex dynamics, which increases the application difficulty of parallel robot in industrial engineering. To solve the above problems, this paper proposes a single-loop Schönflies motion parallel robot with full cycle rotation, the robot can generate Schönflies motion by the most simplified structure. The novel Schönflies motion parallel robot is a two-limb parallel mechanism with least links and joints, and each limb is driven by a 2-degree of freedom (DOF) cylindrical driver (C-driver). The full cycle rotation of the output link is achieved by “…R-H…” structure, where the revolute (R) and helical (H) joints are coaxial. Mobility, kinematics, workspace and singularity analysis of the novel Schönflies motion parallel robot are analyzed. Then, dynamic model is formulated based on the principle of virtual work. Moreover, a pick-and-place task is implemented by the proposed Schönflies motion parallel robot and a serial SCARA robot, respectively. The simulation results verify the correctness of the theoretical model. Furthermore, dynamics performances of the proposed Schönflies motion parallel robot and a serial SCARA robot are compared, which reveal the performance merits of the proposed Schönflies motion parallel robot.
Management of a ciprofloxacin as a contaminant of emerging concern in water using microalgaebioremediation: mechanism, modeling, and kinetic studies
Authors: Salah Heba , Shehata Nabila , Khedr Noha , Elsayed Khaled N. M. 
Published: December 2024

AbstractPharmaceutical residues, now recognized as a new category of environmental pollutants, have potentially risks to both ecosystems and human health effects. Recently, biosorption has emerged as one of the most promising strategies for managing these pharmaceutical wastes in water. Nevertheless, the environmental impact of the adsorbents presents a challenge to the advancement of this process. Therefore, the present study proposed two biosorbent: Chlorella vulgaris and Synechocystis sp. microalgae to manage Ciprofloxacin (CIP) in water. The experimental findings revealed that the optimal conditions for adsorption conditions are CIP initial concentration 4.0 mg/L and pH 5 and 3 for Synechocystissp. and C. vulgaris, respectively. The adsorption process followed the Pseudo-second-order kinetic model. The main mechanism of biosorption is the complexation of CIP with carboxyl, hydroxyl, carbonyl, and amido groups which was confirmed by Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDX) analyses. These analyses confirmed the presence of CIP on the surface of tested microalgal cells. These results indicated that the adsorption mechanism of CIP by Synechocystis sp. PCC6803 and C. vulgaris offers theoretical insights into the biosorption mechanisms of pharmaceutical residues.
Brain endothelial permeability, transport, and flow assessed over 10 orders of magnitude using the in situ brain perfusion technique
Authors: Smith Quentin R. , Mandula Haritha , Parepally Jagan Mohan R. , Oki Jun , Thomas Fancy , Thorsheim Helen R. , Al-Ahmad Abraham J. , Abbruscato Thomas J. , Ask Per , Hage David S. , Robinson Peter J. 
Published: December 2024

Abstract
Background
Cerebral blood flow normally places a limit on the magnitude of brain vascular permeability (P) that can be measured in vivo. At normal cerebral blood flow, this limit falls at the lower end of lipophilicity for most FDA-approved CNS drugs. In this study, we report on two methods that can be used to overcome this limitation and measure brain vascular permeability values that are up to ~1000 times higher using the in situ brain perfusion technique.

Methods
Rat brain was perfused with physiological saline at increased flow rate and in the presence of various concentrations of plasma protein, serum albumin or alpha-acid glycoprotein. Plasma protein was added to the saline perfusion fluid to lower extraction into the measurable range using the Crone Renkin “diffusion-flow” equation to calculate brain PoS.

Results
Cerebrovascular Po was determined for 125 solutes, of which 78 showed little or no evidence of active efflux transport. Fifty of the solutes were in the lipophilicity zone (Log Poct 1–5) of most FDA-approved CNS drugs. Care was taken to ensure the integrity of the brain vasculature during perfusion and to measure flow accurately using markers that had been verified for the flow rates. The results showed a linear relationship between Log Po and Log Poct over ~10 orders of magnitude with values for diazepam, estradiol, testosterone, and other agents that exceed prior published values by fivefold to 200-fold.

Conclusions
The results show that brain vascular permeability can be measured directly in vivo for highly lipophilic solutes and the PS values obtained match reasonably with that predicted by the Crone-Renkin flow diffusion equation with care taken to validate the accuracy for the component measurements and with no need to invoke “enhanced” or “induced” dissociation.
Stereotactic body radiotherapy as metastasis-directed therapy in oligometastatic prostate cancer: a systematic review and meta-analysis of randomized controlled trials
Authors: Persson Astrid E. , Hallqvist Andreas , Bjørn Larsen Louise , Rasmussen Mette , Scherman Jonas , Nilsson Per , Tønnesen Hanne , Gunnlaugsson Adalsteinn 
Published: December 2024

Abstract
Background
The use of stereotactic body radiotherapy (SBRT) to definitively treat oligometastases in prostate cancer has drawn large clinical and research interests within radiation oncology. However, the evidence is considered in its early stages and there is currently no systematic review of randomized controlled trials (RCTs) in this field. We aimed to evaluate the efficacy and safety of SBRT as metastasis-directed therapy (MDT) in oligometastatic prostate cancer (OMPC) compared to no MDT reported in RCTs.

Methods
MEDLINE, Embase, CINAHL Complete, and Cochrane Library were searched on October 28, 2023. Eligible studies were RCTs comparing SBRT as MDT with no MDT in extracranial OMPC, without restrictions on follow-up time, publication status, language, or year. Participant subsets fulfilling the eligibility criteria were included. Critical outcomes were overall survival and grade ≥ 3 toxicity, and additional important outcomes were progression-free survival (PFS), local control, grade 5 toxicity, health-related quality of life, and systemic therapy-free survival. Meta-analyses were planned. Risk of bias was assessed using the Cochrane risk-of-bias tool version 2, and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation.

Results
In total, 1825 unique study reports were identified and seven phase II RCTs with 559 eligible participants were included. Four trials included multiple types of primary cancer. Outcome definitions were heterogeneous except for overall survival and toxicity. For overall survival, only one study reported events in both arms. Meta-analysis of the grade ≥ 3 toxicity results from two trials showed no difference (pooled risk ratio 0.78, 95% confidence interval 0.37–1.65, p = 0.52). Four trials reported significantly longer PFS, with a pooled hazard ratio of 0.31 (95% confidence interval 0.21–0.45, p < 0.00001). Risk of bias was of some concerns or high. Quality of evidence was low or moderate.

Conclusions
Phase II trials have shown promising improvements in PFS for several OMPC states without excess toxicity. Overall survival comparisons are immature. In future confirmatory phase III trials, adequately large sample sizes, blinding of outcome assessors, and/or increased adherence to assigned intervention could improve the quality of evidence.
PROSPERO registration number: CRD42021230131.