Realistic Expectations Research Articles

Maxillary advancement surgery with vertical component: Impact on the nasolabial aesthetics

The aim of this study is to evaluate the changes in nasolabial soft tissues following Le Fort I osteotomies, focusing on the impact of maxillary vertical repositioning.This retrospective study included 39 patients with a history of Le Fort 1 osteotomy between 2013 and 2021. Patients were grouped based on their maxillary movement into three categories: pure advancement (group A), advancement with impaction (group B), and advancement with downward repositioning (group C). Preoperative and postoperative CBCT (Cone Beam Computed Tomography) data were analyzed to measure the changes in nasolabial soft tissues. The current study utilized Mimics Suite 20.0 for measuring linear and angular variables. The evaluated variables included intercanthal distance, nasal dorsal length, tip protrusion, mouth width, alar width, upper lip height, nostril dimensions, and angles of nasolabial, alar base, and upper lip. Among them intercanthal distance, nasal dorsal length, or tip protrusion showed no statistical difference (p > 0,05). Mouth width, alar width, alar base angle were increased and upper lip angle was decreased significantly (p < 0.001). Changes in upper lip height and nasolabial angle differed among the groups of the study. While upper lip height increased significantly in groups A and C (p < 0.05), there was a slight decrease in Group B with no significance (p > 0.05). Nasolabial angle decrased significantly on Groups A and B (p < 0.05).The results of this study revealed changes in several soft tissue parameters, some of which occurred regardless of vertical repositioning of the maxilla. Within the limitations of the study, maxillary advancement surgery can affect the aesthetics of the nasolabial region and cause specific changes in related soft tissues. Understanding these changes is essential to establish realistic patient expectations and achieve optimal functional and aesthetic outcomes.

Amplifying Their Voice: Inclusive Healthcare Provider Perspectives to Improve Advancement, Resilience, and Retention.

Addressing the issues of workplace advancement, resilience, and retention within medicine is crucial for creating a culture of equity, respect, and inclusivity especially towards women and nonbinary (WNB) providers including advanced practice providers (APPs), most notably those from marginalized groups. This also directly impacts healthcare quality, patient outcomes, and overall patient and employee satisfaction. The purpose of this study was to amplify the voices on challenges faced by WNB providers within a pediatric academic healthcare organization,to rank workplace interventions addressing advancement, resilience, and retention highlighting urgency towards addressing these issues, and, lastly, to provide suggestions on how to improve inclusivity. Participants were self-identified WNB providers employed by a pediatric healthcare organization and its affiliated medical university. An eligibility screener was completed by 150 qualified respondents, and 40 WNBs actually participated in study interviews. Interviews were conducted using a semi-structured interview guide to rank interventions targeted at improving equity, with time allotted for interviewees to discuss their personal lives and how individual circumstances impacted their professional experiences. WNB providers called for efficient workflows and reducing uncompensated job demands. Support for family responsibilities, flexible financial/compensation models, and improved job resources all were endorsed similarly. Participants ranked direct supervisor and leader support substantially lower than other interventions. Conclusions:Career mentorship and academic support for WNB individuals are recognized interventions for advancement and retention but were not ranked as top priorities. Respondents focused on personal supports as they relate to family, job resources, and flexible compensation models. Future studies should focus on implementing realistic expectations and structures that support whole lives including professional ambitions, time with family, personal pursuits, and self-care.

From Microbes to Microbiomes: Applications for Plant Health and Sustainable Agriculture.

Plant-microbe interaction research has had a transformative trajectory, from individual microbial isolate studies to comprehensive analyses of plant microbiomes within the broader phytobiome framework. Acknowledging the indispensable role of plant microbiomes in shaping plant health, agriculture, and ecosystem resilience, we underscore the urgent need for sustainable crop production strategies in the face of contemporary challenges. We discuss how the synergies between advancements in 'omics technologies and artificial intelligence can help advance the profound potential of plant microbiomes. Furthermore, we propose a multifaceted approach encompassing translational considerations, transdisciplinary research initiatives, public-private partnerships, regulatory policy development, and pragmatic expectations for the practical application of plant microbiome knowledge across diverse agricultural landscapes. We advocate for strategic collaboration and intentional transdisciplinary efforts to unlock the benefits offered by plant microbiomes and address pressing global issues in food security. By emphasizing a nuanced understanding of plant microbiome complexities and fostering realistic expectations, we encourage the scientific community to navigate the transformative journey from discoveries in the laboratory to field applications. As companies specializing in agricultural microbes and microbiomes undergo shifts, we highlight the necessity of understanding how to approach sustainable agriculture with site-specific management solutions. While cautioning against overpromising, we underscore the excitement of exploring the many impacts of microbiome-plant interactions. We emphasize the importance of collaborative endeavors with societal partners to accelerate our collective capacity to harness the diverse and yet-to-be-discovered beneficial activities of plant microbiomes.

Understanding the Strengths and Limitations of Online Oocyte Cryopreservation Calculators.

Between 2010 and 2016, elective oocyte cryopreservation (OC) increased in use by 880% in the United States; however, there have been increasing reports of regret among patients after elective OC. There is a growing need for individualized counseling on the timing and number of oocytes to cryopreserve for patients to make informed choices and set realistic expectations, but currently available tools seem to be insufficient. The purpose of this review is to describe the OC calculators currently available online, identify sources of regret, and illustrate the need for unified counseling tools for improved patient care and education. OC calculators were identified via Google search. Only calculators that cite scientific literature were included in the review. Calculators for in vitro fertilization or embryo transfer were excluded. Thirteen OC calculators were found; however, only six cited literature supporting the calculator's design. When entering the same hypothetical patient parameters for age and number of oocytes cryopreserved, the calculators provided drastically different probabilities of live births. The lack of cohesive online educational materials creates confusion and stress for patients considering OC, leading to unrealistic expectations and increased feelings of regret thereafter. Physicians need tools to provide comprehensive guidance to patients seeking to cryopreserve oocytes.

Predicting cochlear implant performance: Impact of demographic, audiologic, surgical factors, and cochlear health

Predicting cochlear implant performance: Impact of demographic, audiologic, surgical factors, and cochlear health Amit Walia, Matt Shew and Craig A. Buchman from Washington University School of Medicine, explain the challenges of understanding variables or factors informing CI performance and how this can be addressed. Cochlear implants (CIs) are highly effective for restoring hearing in individuals with moderate-to-profound hearing loss who do not gain sufficient benefit from hearing aids. Despite being one of modern medicine’s most successful advancements, there is wide inter-individual variability in speech perception outcomes (Figure 1). The drivers of this variability are not well understood, making it difficult to set realistic expectations for patients before surgery and to evaluate potential interventions that may enhance performance post-operatively. Accurate prediction of speech perception performance after surgery could significantly impact how we assess candidates, plan postoperative aural rehabilitation, choose surgical techniques, design and fit electrodes, and segment the patient population in future CI clinical trials.

'We need to help owners have more realistic expectations of pet lifespan'.

'We need to help owners have more realistic expectations of pet lifespan'.

P-147 Number of autologous mature oocytes as a predictor of live birth rate in women aged over 40 who do not accept egg donation

Abstract Study question Is the number of mature oocytes (M2) retrieved a reliable predictor of success for women aged over 40 with autologous oocytes? Summary answer 79.5% of live births were achieved in patients with ≥3M2 retrieved, 14.3% in women with 2M2, and 6.5% in women with 1M2. What is known already The delayed desire for parenthood has become a social phenomenon, particularly among women over 35. Reproductive outcomes in women over 40, using their own oocytes, are usually poor due to a decrease in follicle and oocyte quantity and quality, along with an increased prevalence of oocyte chromosomal abnormalities. While using donated oocytes is often recommended, it remains an unacceptable option for many couples. Furthermore, in Argentina the legislation on Assisted Reproduction Technologies endorses assisted reproductive treatments employing womeńs own oocytes up to the age of forty-four. Study design, size, duration This retrospective observational study, was performed between January 2004 and December 2022 in 5757 patients aged 40 and above undergoing autologous oocyte retrieval and fresh embryo transfer because they do not accept PGTa. Statistical analysis was performed using the InStat GraphPad statistical package. One-way ANOVA and two-tailed Student’s t-test were performed as required. Participants/materials, setting, methods Group1(G1): 40 years (N = 1600); Group 2(G2): 41years (N = 1300); Group 3(G3): 42 years (N = 1087); Group 4(G4): 43 years (N = 735); Group 5(G5): 44 years (N = 496); Group 6(G6): 45 years (N = 302); Group 7(G7): 46 years (N = 140); Group 8(G8): 47 years (N = 61); Group 9(G9): 48 years (N = 23); Group 10(G10): 49 years (N = 13). Primary outcome was relationship between number of M2 and live birth rate. Secondary outcomes were live birth rate, cancellation rate, miscarriage rate, clinical pregnancy rate. Main results and the role of chance Number of M2 retrieved: G1=3.9±3.4 [1-16]; G2=3.6±2.7 [1-14]; G3= 3.5±2.3 [1-12]; G4= 3.4±2.8 [1-14], G5=2.5±1.5 [1-7]; G6=2.3±2.2 [1-12]; G7=1.8±1.5 [1-8]; G8=1.5±0.9 [1-3]; G9=1.3±0.6 [1-3]; G10=1.0±0 [1-1]. Cancelation rate (%): G1=18.2 (292/1600); G2=20.9(272/1300), G3=22.3(243/1087); Gr4= 29.9(220/735); G5=28.0(139/496); G6=38.1 (115/302); G7= 42.8(60/140); G8= 44.3 (27/61); G9=47.8 (11/23); G10= 61.5 (8/13). Clinical pregnancy/transfer rate(%): G1=24.2 (316/1308); G2=21.7 (223/1028); G3=18.0(152/844); G4=18.0 (93/515); G5=9.2 (33/357); G6=11.2 (21/187); G7=3.7 (3/80); G8=0 (0/34); G9=8.3 (1/12); G10=0 (0/5). Live birth rate (%): G1= 11.8 (147/1250); G2= 10.0 (99/993); G3= 6.8 (57/831); G4= 6.6 (34/515); G5= 3.2 (11/348); G6= 2.1 (4/187); G7= 1.2 (1/80); G8= 0 (0/34); G9=0 (0/12); G10=0 (0/5). Miscarriage rate (%) 40 to 46 years: G1= 43.0 (111/258); G2= 47.3 (89/188); G3= 59.0 (82/139); G4= 63.4 (59/93); G5= 66.7 (22/33); G6= 80.9 (17/21); G7=66.7 (2/3) and 100 (1/1) for 48 years (G9). Cancellation rates increased with age. The number of M2 retrieved was significantly associated with clinical pregnancy, live birth and miscarriage rates. The average number of mature oocytes retrieved in cases resulting in live births was consistently higher across all age groups: G1=5.8±2.7 [1-16]***; G2= 4.8±3.5 [1-14]***; G3= 4.0±2.1 [1-9]***; G4= 5.7±2.7 [3-13]***; G5= 4.2±1.4 [2-7]***; G7= 6.0±1.4 [5-8]***; G8= 7.0±0 [7,7]*** (***= p &amp;lt; 0.0001). Limitations, reasons for caution This extensive retrospective study’s conclusions should be cautiously applied, limited to a specific group of elderly women unwilling to consider egg donation. 106 clinical pregnancies were not included because we did not have information on live births. Wider implications of the findings Identifying parameters associated with higher live birth rates in this population may aid in providing realistic expectations for achieving pregnancy with autologous oocytes. This information could guide medical advice and potentially suggest alternative options, such as egg donation or adoption. Trial registration number NOT APPLICABLE

Poster 116: When do Patients Return to Sports? Arthroscopic Anatomic Glenoid Reconstruction Versus Bankart Repair

Objectives: Participation in contact or collision sports is a known risk factor for shoulder instability. Recurrent instability is a barrier to return to same level of athletic activities following surgical intervention. Previous literature has described that approximately 50% to 90% of patients return to sports following stabilization procedures. However, it is currently unknown the rate and timing of return to sports after Arthroscopic Anatomic Glenoid Reconstruction (AAGR). This study aimed to determine the rate of return and the time to return to sports of patients’ who underwent AAGR compared to a Bankart, alone. Methods: This is a subcohort of 100 patients who consented to a randomized controlled trial and were randomized for AAGR or Bankart procedure (1:1 ratio). The subgroup consists of individuals at a minimum 2-year follow up and participate in a sport at either the recreational or competitive level. A descriptive analysis was completed on the percentage of patients that returned to their preinjury sport, as well as when they returned and compared between groups. Descriptive reporting on why patients did not return was included. Results: Age, follow up, sex, and sport level were all statistically similar between the 2 groups. The rate to return was significantly larger for patients in the AAGR group (78%) compared with the Bankart group (60%). For those who did return to sports, time to return was not significantly different between the AAGR group (9.48 ± 4.2 months) and Bankart group (10.2 ± 6.2 months). For those who did not return in the Bankart group, redislocation was the greatest factor (38%). In the AAGR group, prioritizing work and life (30%) and lack of confidence (30%) were the top reasons for not returning. Conclusions: AAGR demonstrated superior rate of return to sports compared to those who underwent a Bankart repair. Patients in the Bankart group did not return due to redislocation events, whereas individuals in AAGR did not return due to a lack of confidence or prioritizing their work and life. These results can aid in setting realistic expectations for patients undergoing AAGR and can help guide discussions around postoperative rehabilitation.

Predictability of ecological and evolutionary dynamics in a changing world.

Ecological and evolutionary predictions are being increasingly employed to inform decision-makers confronted with intensifying pressures on biodiversity. For these efforts to effectively guide conservation actions, knowing the limit of predictability is pivotal. In this study, we provide realistic expectations for the enterprise of predicting changes in ecological and evolutionary observations through time. We begin with an intuitive explanation of predictability (the extent to which predictions are possible) employing an easy-to-use metric, predictive power PP(t). To illustrate the challenge of forecasting, we then show that among insects, birds, fishes and mammals, (i) 50% of the populations are predictable at most 1 year in advance and (ii) the median 1-year-ahead predictive power corresponds to a prediction R 2 of only 20%. Predictability is not an immutable property of ecological systems. For example, different harvesting strategies can impact the predictability of exploited populations to varying degrees. Moreover, incorporating explanatory variables, accounting for time trends and considering multivariate time series can enhance predictability. To effectively address the challenge of biodiversity loss, researchers and practitioners must be aware of the information within the available data that can be used for prediction and explore efficient ways to leverage this knowledge for environmental stewardship.

Family expectations and demand for home-based videogaming therapy in children with cerebral palsy in Costa Rica: a mixed methods study

Purpose To understand the expectations and demand for a movement-tracking videogame (Bootle Blast) for home-based, upper limb (UL) rehabilitation among Costa Rican children with cerebral palsy (CP). Methods Data were collected via telephone screening (demand) and child-parent dyads Zoom interviews (expectations). Descriptive statistics and data transformation were used to report on demand success criteria (i.e., recruitment rate, having an appropriate screen and space to play, setting a weekly play time goal (PTG) ≥45 min, identifying one UL therapy goal). The DEPICT model for collaborative qualitative analysis was used in the thematic analysis of interview data. Results Fifteen dyads participated (1.6 ± 1 recruited/month). All had a flat-screen TV in a suitable location to play, were able to set a UL therapy goal, and established PTGs ranging from 45–120 min per week. Identified themes were: 1) Socio-cultural factors heighten demand, 2) Feelings of hope prevail for the intervention, and 3) Collaborative goal setting supports realistic expectations for Bootle Blast. Conclusions Dyads had positive and realistic expectations about implementing the proposed videogaming intervention. This study provides insights on tailoring a family-centered, therapy gaming intervention to improve access to motor rehabilitation for children with CP in rural/remote settings and low-middle income countries.

Bouncing back with bliss: nurturing body image and embracing intuitive eating in the postpartum: a cross-sectional replication study

ABSTRACT Aims/Background Social pressure to ‘bounce back’ and unrealistic body expectations place postpartum women at risk of body image dissatisfaction, depressive symptomology, and disordered eating. Prior research suggests that intuitive eating may reduce these risks. This study replicated a previous 2016 study between intuitive eating, postpartum depression, disordered eating, and body image satisfaction. Design/Method Women over 18 who had given birth in the last four years were recruited through social media to complete an online survey. The final sample comprised 163 women aged between 21 and 42 years (M = 33.61, SD = 4.59) who were between one and 208 weeks postpartum (M = 78.27, SD = 53.40). Results Correlation analyses revealed significant negative associations between intuitive eating and body dissatisfaction, disordered eating, depression, and BMI. A hierarchical multiple linear regression demonstrated that body image dissatisfaction significantly predicted 29% of the variance in intuitive eating scores after controlling for BMI, disordered eating, and postpartum depression F(4, 133) = 68.71, p < .001. Body image dissatisfaction fully mediated the relationships between intuitive eating and disordered eating (c’ = -0.01, p = .359), and depression (c’ = 0.01, p = .427). There was a significant reduction in body dissatisfaction scores in the present sample compared to the 2016 cohort t(292.87) = 3.38, p < .001. Conclusion These findings highlight the central role of body image and intuitive eating in postpartum wellbeing and emphasise the need for tailored interventions promoting realistic postpartum body expectations and adaptive eating behaviours.

Analysis of Treatment Discontinuation in Orthokeratology: Studying Efficacy, Safety, and Patient Adherence Over Six Months.

This study aimed to evaluate the efficacy, safety, and participant compliance of orthokeratology treatment for the correction of myopic refractive errors over a six-month prospective study and to define the potential reasons for early treatment discontinuation. A total of 32 participants with low-to-moderate myopia were fitted with the spherical model of corneal refractive therapy (CRT) orthokeratology lenses (Paragon Vision Sciences) and followed over six months, with specific attention to alterations in refractive error, corneal topography, and epithelial thickness. Concurrently, participant feedback and reasons for any treatment discontinuation were documented. Significant changes in refractive error and in corneal topography were observed, with approximately 50% of the refractive error being corrected on the first night of use and 100% by the first two weeks ( P <0.001). Central epithelial thickness experienced substantial thinning, reducing to 15.65±4.49 μm (67.38%) ( P <0.001) after 6 months of lens use. Six participants withdrew from this study for varied reasons, including unmet visual expectations and difficulty adhering to the lens-wearing regimen. Notably, the dropout group exhibited higher baseline low-order aberrations and less prolate corneas than those who persisted with the treatment ( P <0.05). Orthokeratology with CRT is efficacious and safe for the correction of low-to-moderate myopia in adults, but a portion of patients discontinue the treatment in the first 6 months of contact lens wear. Special care should be taken when recommending orthokeratology in patients with higher levels of myopia and corneas with less prolate shape, providing more realistic expectations and even changing to dual axis or more sophisticated designs.

Factors influencing gastrostomy tube removal

Background When commencing enteral feeding, patients and families will want to know the likelihood of returning to an oral diet. There is a paucity of data on the prognosis of patients with gastrostomies. We describe a large dataset of patients, which identifies factors influencing gastrostomy removal and assesses the likelihood of the patient having at home enteral nutrition. Methods Retrospective data was collected on patients from Sheffield Teaching Hospitals who had received a gastrostomy and had outpatient enteral feeding between January 2016 and December 2019. Demographic data, indication and outcomes were analysed. Results A total of 451 patients were assessed, median age: 67.7. 183/451(40.6%) gastrostomies were for head and neck cancer, 88/451 (19.5%) for stroke, 28/451 (6.2%) for Motor Neuron Disease, 32/451 (7.1%) for other neurodegenerative causes, 120/451 (26.6%) other. Of the 31.2% who had their gastrostomy removed within 3 years, head and neck cancer was the most common indication (58.3%) followed by stroke (10.2%), Motor Neuron Disease (7.1%) and other neurodegenerative diseases (3.1%). Gastrostomy removal was significantly influenced by age, place of residence, and having head and neck cancer (p < 0.05). There was the greatest likelihood of removal within the first year (24%). 70.5% had enteral feeding at home. Conclusion This large cohort study demonstrates 31.2% of patients had their gastrostomy removed within 3 years. Head and neck cancer patients, younger age and residing at home can help positively predict removal. Most patients manage their feeding at home rather than a nursing home. This study provides new information on gastrostomy outcomes when counselling patients to provide realistic expectations.

Parents' Needs When Experiencing the Transition to Twin Parenthood.

(1) Background: The transition to twin parenthood is a demanding challenge with a higher risk of maternal and fetal complications during pregnancy and a postpartum period that involves caring for more than one newborn at the same time with similar and simultaneous needs. (2) Aim: To find out about parents' needs when experiencing the transition to twin parenthood and to describe the intervention of their specialized nursing support network. (3) Methodology: A descriptive exploratory study, based on a proper non-probabilistic sample of 15 nurses and 55 couples who are parents of twins, using two online questionnaires publicized on social networks. (4) Results: The couple's needs were identified through knowledge of their experiences and difficulties during pregnancy and after the twin birth. Couples' and nurses' perceptions differed on the identified needs. The specialized nursing support network focuses its intervention on providing informative guidance on twin pregnancy and postpartum period, health education, group sharing experiences, home visits, planning, and including a family support network in the management of twin care and the creation of a daily routine. (5) Conclusions: There is a need to implement a program focused on the needs of parents of twins, promoting realistic expectations for the birth and parenting of twins, preparing parents, improving their well-being, and creating a specialized nursing support network available to this population.

Unplanned return to the operating room (UPROR) occurs in 40% of MCGR patients at an average of 2years after initial implantation.

This study calculated the rates of Unplanned Return to the Operating Room (UPROR) in early-onset scoliosis patients who had no previous spine surgery and underwent Magnetically Controlled Growing Rod (MCGR) implantation. We reviewed surgical, radiographic, and UPROR outcomes for EOS patients treated with the MCGR implant < 12years + 11months of age, had complete preop/postop major curve measurements, and had complete MCGR details. 376 patients underwent MCGR implantation at a mean age of 7.7years (1.8-12.9). Diagnoses included 106 (28%) idiopathic, 84 (22%) syndromic, 153 (41%) neuromuscular, and 33 (9%) congenital. The mean preop-cobb was 76.7° (9-145°), and an immediate postop correction was 41% (0-84%). We found that 38% (142/376) of patients experienced an UPROR prior to the maximal actuator length being achieved. UPROR occurred at mean 2years (3days-5years) after initial implantation. Of the 142 patients who experienced UPROR there were 148 complications that lead to an UPROR. The most common reason for UPROR was anchor (55/148: 37%) or MCGR implant related (33/148: 22%). Wound related (22/148:15%), Neuro related 4/148: 3%), and other (34/148: 23%) accounted for the remaining UPROR occurrences. In conclusion, the MCGR UPROR rate was 142/376 (38%) after an average of 2years post implantation. At 2-year follow-up, only 20% of MCGR patients had experienced an UPROR. However, between 2 and 5years, the development of an UPROR increased precipitously with only 39% of MCGR patients remaining UPROR free at 5years post MCGR implantation. The most common reason for UPROR was related to anchor or MCGR implant-related complications. This information can be utilized to set realistic expectations about the need and timing of future surgical procedures with patients and their families.

Harnessing authentic leadership to transform an academic health system: Tampa General Hospital case study

The US healthcare industry is changing faster than ever before, and its evolution should be expected to continue — and at an even more accelerated rate. Research shows that to adapt and thrive in this ever-changing landscape and best meet the needs of patients, healthcare leaders must be prepared to navigate present-day challenges, including unprecedented levels of burnout and turnover, talent shortages and cost pressures while simultaneously anticipating future needs such as digital transformation, new care models and strategic growth initiatives. To act on this framework, healthcare leaders must also lead their organisations with authenticity, transparency, kindness and vulnerability to unite and activate their teams around a common vision and realistic expectations for how it will be achieved. This paper, in case study format, defines the enterprise leadership and AKTiVe leadership models; details how this authentic leadership framework was deployed at Tampa General Hospital to accelerate growth and innovation; and provides an overview of outcomes, influence and lessons learned through implementation.

Patience is Key: The Time It Takes to See Benefits from Continuous Auditing

SYNOPSIS Despite research showing numerous benefits of continuous auditing, uptake by internal audit functions has been quite slow. Using a case study approach and field data from a multinational company, we study two possible reasons for the slow uptake of continuous auditing: (1) the time it takes for continuous auditing to result in measurable reductions in audit risks and (2) that not every type of risk is equally likely to improve from continuous auditing. In our case company, it takes three years (on average) before observing significant risk reductions from implementing continuous auditing. We also find that the benefits of implementing continuous auditing vary by risk factor, ranging from no improvement to 51.6 percent for each additional year of continuous auditing use. These findings can provide internal auditors with a realistic expectation of the benefits and limitations, as well as the timetable for realizing benefits, when adopting continuous auditing. Data Availability: The data used in this study cannot be made publicly available due to confidentiality agreements with the participating organization. JEL Classifications: M42; G32.

Psychometric Properties of the Automated Insulin Delivery: Benefits and Burdens Scale for Adults with Type 1 Diabetes.

Objective: To evaluate the psychometric properties of a patient-reported outcome measure, the Automated Insulin Delivery-Benefits and Burdens Scale (AID-BBS), which was designed to assess benefits and burdens of AID use in adults with type 1 diabetes (T1D). The measure was hypothesized to have validity, reliability, and clinical utility for predicting likelihood of continued use of an AID system. Research Design and Methods: A total of 217 adults with T1D (ages from 18 to 82 years) who were enrolled in an AID system research trial completed AID-BBS items at study midpoint (6 weeks) and at the end of the trial (13 weeks). Data were collected on pre-post glycemic outcomes. Participants completed other patient-reported psychosocial outcome measures (e.g., emotional well-being, diabetes distress, attitudes toward diabetes technology, diabetes treatment satisfaction) at Week 13. Likelihood of continued device use was assessed with three items at 13 weeks. Results: Exploratory factor analysis supported a one-factor structure for each subscale (15-item benefit and 9-item burden subscale) when evaluated separately. Convergent, discriminant, and predictive validity, internal consistency, and test-retest reliability were supported. Benefit and burden subscales at week 6 predicted usage intention above and beyond device impact on glycemic outcomes, also controlling for baseline glycemic outcomes. Conclusion: Findings support the AID-BBS as a psychometrically valid, reliable, and useful instrument for assessing burdens and benefits associated with AID system use in adults with T1D. The measure can be used to help health care providers set realistic expectations and proactively address modifiable burdens. Clinical Trial Registration Number: NCT04200313.

The Impact of Performance Expectancy, Workload, Risk, and Satisfaction on Trust in ChatGPT: Cross-Sectional Survey Analysis.

ChatGPT (OpenAI) is a powerful tool for a wide range of tasks, from entertainment and creativity to health care queries. There are potential risks and benefits associated with this technology. In the discourse concerning the deployment of ChatGPT and similar large language models, it is sensible to recommend their use primarily for tasks a human user can execute accurately. As we transition into the subsequent phase of ChatGPT deployment, establishing realistic performance expectations and understanding users' perceptions of risk associated with its use are crucial in determining the successful integration of this artificial intelligence (AI) technology. The aim of the study is to explore how perceived workload, satisfaction, performance expectancy, and risk-benefit perception influence users' trust in ChatGPT. A semistructured, web-based survey was conducted with 607 adults in the United States who actively use ChatGPT. The survey questions were adapted from constructs used in various models and theories such as the technology acceptance model, the theory of planned behavior, the unified theory of acceptance and use of technology, and research on trust and security in digital environments. To test our hypotheses and structural model, we used the partial least squares structural equation modeling method, a widely used approach for multivariate analysis. A total of 607 people responded to our survey. A significant portion of the participants held at least a high school diploma (n=204, 33.6%), and the majority had a bachelor's degree (n=262, 43.1%). The primary motivations for participants to use ChatGPT were for acquiring information (n=219, 36.1%), amusement (n=203, 33.4%), and addressing problems (n=135, 22.2%). Some participants used it for health-related inquiries (n=44, 7.2%), while a few others (n=6, 1%) used it for miscellaneous activities such as brainstorming, grammar verification, and blog content creation. Our model explained 64.6% of the variance in trust. Our analysis indicated a significant relationship between (1) workload and satisfaction, (2) trust and satisfaction, (3) performance expectations and trust, and (4) risk-benefit perception and trust. The findings underscore the importance of ensuring user-friendly design and functionality in AI-based applications to reduce workload and enhance user satisfaction, thereby increasing user trust. Future research should further explore the relationship between risk-benefit perception and trust in the context of AI chatbots.

Utilizing machine learning to predict post-treatment outcomes in chronic non-specific neck pain patients undergoing cervical extension traction

This study explored the application of machine learning in predicting post-treatment outcomes for chronic neck pain patients undergoing a multimodal program featuring cervical extension traction (CET). Pre-treatment demographic and clinical variables were used to develop predictive models capable of anticipating modifications in cervical lordotic angle (CLA), pain and disability of 570 patients treated between 2014 and 2020. Linear regression models used pre-treatment variables of age, body mass index, CLA, anterior head translation, disability index, pain score, treatment frequency, duration and compliance. These models used the sci-kit-learn machine learning library within Python for implementing linear regression algorithms. The linear regression models demonstrated high precision and accuracy, and effectively explained 30–55% of the variability in post-treatment outcomes, the highest for the CLA. This pioneering study integrates machine learning into spinal rehabilitation. The developed models offer valuable information to customize interventions, set realistic expectations, and optimize treatment strategies based on individual patient characteristics as treated conservatively with rehabilitation programs using CET as part of multimodal care.