bluuebunny/crossref_metadata_2025 huggingface dataset:
Biographical Monuments
Authors: Frood Elizabeth
Published: January 2021

This chapter surveys the genre normally referred to by Egyptologists as ‘biography’ or ‘autobiography’, comprising texts, often inscribed on stone monuments, which recount, in various forms, events in a non-royal person’s life and/or aspects of their moral character. Such biographies are attested from the third millennium bc to Roman times, making them one of the longest-lived and most characteristic textual genres known from ancient Egypt. The chapter begins by briefly summarizing issues surrounding the genre’s definition, as well as the range of approaches taken by Egyptologists to its analysis. An overview of the display contexts for biography is then given, ranging across the walls of tomb-chapels to the bodies of stone statues set up in temples. The discussion deploys a broadly chronological structure in order to give a sense of development and scope. Some potential analytical implications of these contexts are highlighted, for example around performance and audience. The final discussion centres on features of content; these texts were products of a predominantly elite male world so, unsurprisingly, are usually highly idealizing presentations of character and action. The genre’s richness and diversity in terms of themes and expression within this framework is highlighted.
Engraved Lives
Authors: Schuler Christof , Forster Florian R.
Published: January 2021

Inscriptions—permanently incised texts on stone or bronze—are a characteristic feature of Greek and Roman Antiquity. It applies to all periods of ancient epigraphy that by far the most common genres of inscriptions are those directly related to individual persons: funerary inscriptions provide the most substantial single corpus, followed by religious dedications and honorific inscriptions. In their simplest forms, these kinds of texts are almost entirely reduced to a name, the crucial element used to identify a person. To be called biographical, an inscription should contain more substantial information on the various stages of a person’s life that serves to characterize them in greater detail and proposes a moral judgement of their lives. Unlike literary texts, inscriptions as artefacts were generally conceived to communicate condensed information on a restricted space. For this purpose, a special language with a fixed repertoire of standardized formulae was developed, and especially Latin epigraphy also makes heavy use of abbreviations. Only very long texts—that on the grounds of their exceptional importance were inscribed irrespective of their length and the effort required—can come close to biographies but account for only an infinitely small percentage of the extant epigraphic material.
Roman Biography in The Medieval West
Authors: Mortensen Lars Boje
Published: January 2021

This chapter focuses on medieval biography in the Latin world, with a special focus on the period c. 1050–c. 1220. An overwhelmingly large part of the life-writing that survives from the medieval West—whether in chronicles, fictional narratives, letters, or Lives—sets out to display virtues as a source of admiration and inspiration. Such Lives presented ideals that were held up as a high standard and as an entirely positive focus point for the cultural memory of a group. It is shown, however, that especially the inspiration from Sallust’s Jugurtha and Catilina facilitated more complex portraits, especially in historiography, here exemplified through Adam of Bremen’s portrait of archbishop Adalbert of Hamburg-Bremen (1043–1072). The power and persistance of classical Latin ‘anthropological’ concepts are furthermore demonstrated through a comparison of William of Tyre’s ruler portraits in his Chronicon (c. 1184) and its French translation, Éracles (c. 1220).
Ancient Biography and the Italian Renaissance
Authors: Hendrickson Thomas
Published: January 2021

This chapter discusses ancient biography in the Italian Renaissance. One way to reveal some of the major trends and developments of ancient biography in the Renaissance is to examine the models chosen by Renaissance biographers. This approach not only illuminates the legacy of ancient biography, but also sheds some light on modern suppositions about ancient biography. Some of the models chosen will hardly be a surprise. Suetonius’s Lives of the Caesars and the Augustan History provided a model for biography as a history of civic and military leaders. Jerome’s Illustrious Men remained a blueprint for biography as bibliography and as literary history. Yet humanists also found models in Cicero, Varro, and Pliny, all of whom are today rarely thought of as biographers. Moreover, Renaissance authors did not always take up what one might think of as their model’s characteristic features. The chapter considers how some of the major authors of Renaissance biography worked and reworked their models to suit new needs. It also addresses five sub-types of biography: collective biographies of historical figures; collective biographies of literary figures; individual and comparative biographies; collective biographies in dialogue form; and collective biographies with portraits.
Xenophon of Athens
Authors: Humble Noreen
Published: January 2021

This chapter focuses on Xenophon of Athens. Assessments of Xenophon’s literary skills have always been positive in discussions about ancient Greek biography and its development. Scholars have recognized how remarkably diverse the literary forms are which he uses in order to explore character and assess individual lives, even if they do not agree precisely on which of his works ought to fall within the ambit of the study of ancient biography. The chapter examines the pivotal role the figure of Socrates plays in Xenophon’s biographical experiments. The desire to capture Socrates’ essence, to understand how and why he lived as he did, inspired a whole genre of writing—Sokratikoi logoi—which undoubtedly drew on earlier anecdotal collections such as that of Ion of Chios, but which became something more comprehensive and more biographical. A certain flexibility with truth was allowed, for if a fictionalized scenario could better represent a deeper truth about Socrates’ character and life than strict historicity, then that in the end was what was important. This flexibility with the truth characterizes all of Xenophon’s biographical experiments, though in different ways, depending upon the other aims of these works.
Saint Thomas and His Sources
Authors: Torrell Jean-Pierre
Published: January 2021

St Thomas’s sources are to be found in the ‘authorities’ he quotes; he uses them according to precise criteria that make it possible to put them in a hierarchy. First, citations from the Bible have an authority that is absolute in principle. The argument from authority is the weakest of all in human reason, but it is the most efficacious if it is based on divine revelation. Second, the authority of the Fathers of the Church is great in the realm of faith, but not in other matters; they are susceptible to an expositio reverentialis. Third, when they speak the truth, the authorities of human reason represented by the philosophers likewise carry weight, since reason is not in itself contrary to faith. Since grace does not destroy nature, it is legitimate to have recourse to the philosophers. Thomas holds them in high regard, and the manner in which he behaves in respect to them remains exemplary for us all, whether we be philosophers or theologians.
The Catholic Reception of Aquinas in theDe auxiliisControversy
Authors: Gaetano Matthew T.
Published: January 2021

In the late sixteenth and seventeenth centuries, Catholic theologians debated how to reconcile God’s predestination and grace with human free choice. The de auxiliis controversy had as its touchstones the works of the Dominican Domingo Báñez and the Jesuit Luis de Molina. Pope Paul V concluded the debates in Rome on these questions, the Congregatio de auxiliis (1597–1607), by prohibiting the accusation of heresy from either side in this quarrel. Dominicans, initially accused of Calvinism, and Jesuits, charged at first with semi-Pelagianism, generally claimed that their conclusions were at least consistent with Thomas Aquinas’ principles. But key notions in this controversy, such as physical predetermination, middle knowledge, and efficacious grace, are not found in Aquinas’ corpus, which encouraged theologians to account for the appearance of novelty. In the aftermath of these debates, Thomism was associated with these soteriological questions, and many Catholic theologians envisioned Thomas Aquinas as Augustine’s faithful disciple.
Eighteenth- and Nineteenth-Century Reformed, Anglican, and Lutheran Reception of Aquinas
Authors: Duby Steven J.
Published: January 2021

This chapter provides an account of the way in which some major figures in eighteenth- and nineteenth-century Reformed, Anglican, and Lutheran theology interacted with the theology of Thomas Aquinas. As in contemporary Protestant engagement of Aquinas, this reception of the Angelic Doctor’s thought has both appreciative and critical moments. The section on the Reformed tradition discusses the role of Aquinas in the Systematic Theology of Charles Hodge and the early volumes of Herman Bavinck’s Reformed Dogmatics. The section on the Anglican tradition discusses the role of Aquinas in the ecclesiological reflections of E. B. Pusey and Charles Gore. Finally, the section on the Lutheran tradition discusses the role of Aquinas in the work of Isaak Dorner.
Nineteenth-Century Catholic Reception of Aquinas
Authors: Marschler Thomas
Published: January 2021

In the second half of the eighteenth century, under the influence of the Enlightenment, Catholic theology had increasingly turned away from its scholastic tradition. A renewal of Thomist thought started in the first decades of the nineteenth century, especially from Italy. Its original concern was to overcome the modern philosophies that were perceived as endangering faith. From the middle of the century, the movement spread to other parts of Europe, gaining support of the Church’s magisterium under Pope Pius IX. In the wake of the encyclical Aeterni Patris (1879) written by his successor Leo XIII, neo-scholasticism made its final breakthrough in Catholic academic life. Subsequently, numerous Thomist-oriented textbooks were published and Thomist academies were founded throughout Europe. The critical edition of the works of Aquinas (Editio Leonia) marked the beginning of a period of intense historical research on medieval theology and philosophy.
The Reception of Thomas Aquinas by Neo-Scholastic Philosophers in the First Half of the Twentieth Century
Authors: Schumacher Bernard N.
Published: January 2021

Thomism at the beginning of the twentieth century was situated largely within the context of the secular university that regarded medieval thought as nothing more than an archaic system belonging to a period devoid of philosophical reflection. The renewal of Thomism during the first two decades of the twentieth century was of very little concern to most academics and was marked principally by a debate, often polemical, over the theory of knowledge launched by Blondel. The Thomists of the period between the two world wars wanted to bring Thomism to the university scene and into the public arena by addressing contemporary questions in terms provided by Thomas Aquinas, while affirming that philosophy gains in depth and strength when it is rooted in theology and faith. Gilson developed a historical approach of medieval philosophy and theology, while Maritain and Pieper proposed to rethink contemporary problems analytically according to the method of Thomas Aquinas.
The Reception of Aquinas in Kuyper’sEncyclopaedie der heilige Godgeleerdheid
Authors: Eglinton James
Published: January 2021

This chapter explores the reception of Thomas Aquinas in modern Dutch Reformed theology. It does so by focusing on Abraham Kuyper’s Encyclopaedie der heilige Godgeleerdheid (1894), one of that period’s most important, extensive, and subsequently neglected texts. As the architect of the neo-Calvinist movement—a resurgent form of Reformed theology that attempted to be recognizably orthodox and modern—Kuyper rose to a position of national influence, reimagining Dutch Reformed theology, establishing the Free University of Amsterdam in 1880, and serving as prime minister of the Netherlands from 1901 until 1905. This chapter charts the place of Aquinas in the Encyclopaedie—intended by Kuyper to be his magnum opus—noting the particular epistemological, historiographical, and theological commitments that led him to present neo-Calvinism as a paradigm shift of comparable significance in modernity to Aquinas’ achievements in the medieval period.
The Reception of Thomas Aquinas in Moral Theology and Moral Philosophy in the Late Twentieth Century
Authors: Kaczor Christopher
Published: January 2021

Richard McCormick, John Finnis, and Alasdair MacIntyre offer rival models of the reception of Aquinas in late twentieth century moral theology and philosophy. They differed in their interpretations of Aquinas as well as in how they conceived the relationship of Aquinas with predecessors such as Aristotle and with successors such as the neo-scholastic manualists. In a way, McCormick and MacIntyre are mirror images. McCormick became less and less Thomistic as the years went on, for he came to reject Thomas’s conclusions about many practical matters as well as coming to reject Thomistic principles. MacIntyre became more and more Thomistic as the years went on, coming to accept Thomas’s views, including on a great many matters that he had previously rejected. Finnis, by contrast to both, maintains a steady interest in Thomas over many decades and his reception of Thomas involves relatively minor organic developments.
The Reception of Aquinas’ Ethics
Authors: Knobel Angela
Published: January 2021

In this chapter I argue that the most productive way to approach long-standing, apparently ‘insoluble’ interpretive questions about Aquinas is to focus not on finding a definitive solution, but on the question of how Aquinas’ fundamental commitments ‘constrain’ the various solutions that can be offered. As an example of how this might be helpful, I apply this method to the long-standing debate over whether or not Aquinas recognized the possibility of so-called ‘pagan’ virtue. I argue that while Aquinas’ text can sustain multiple answers to this question, his most fundamental commitments regarding the good commensurate to human nature, man’s inherent capacity to pursue that good, and the effects of original sin create important limits on the different solutions that can be offered.
The Contemporary Reception of St Thomas on Law and Politics
Authors: Pakaluk Michael
Published: January 2021

The reception of Thomistic political and legal philosophy is considered with respect to what is called ‘political liberalism’. The appeal to a hypothetical state of nature should be rejected, as it misconstrues the social nature of human beings. Aquinas’ account of the origin of political society starts from an interpretation of human nature. On this basis one can account for human rights, the importance of the right to religious liberty, the family as the basic cell of society, civil society as including subsidiary authorities, the importance of private property, and the nature and role of freedom. A key question for the continued flourishing of a free society is what practically enables persons to govern for the genuine good of others.
Duns Scotus and William of Ockham
Authors: Cross Richard
Published: January 2021

Duns Scotus and William of Ockham engage with Aquinas’ thought in fundamentally negative ways. They never make distinctively Thomist positions their own, and when they use Aquinas’ thought, they do so merely as a way of sharpening their own theologies through the dialectical process of rejecting an opponent’s view. This chapter first considers the role of Aquinas’ thought in Scotus’ teaching on religious language and univocity, divine simplicity and omnipresence, the Trinity, cognitive theory, the question of the first object of cognition, angelic individuation, the beatific vision, the plurality of substantial forms, free will, and normative ethics. A second section discusses Aquinas’ place in Ockham’s teaching on common natures, intuitive cognition, divine ideas, and the nature of grace.
Creation, Fall, and Providence
Authors: te Velde Rudi A.
Published: January 2021

In this chapter, I explore the (implicit) presence of hermeneutical perspectives in the thought of Thomas Aquinas with respect to issues of faith, outside the reach of ‘scientific’ reason, concerning the Christian meaning of creation, history and the temporal condition of human existence. First, the chapter discusses Aquinas’ view on creation as including a temporal beginning of the world. In this discussion on the ‘eternity of the world’, hermeneutical reason obliquely plays a role in suggesting the positive meaning of the temporality of the world in the light of faith and God’s guidance through history to an end beyond time and history. Aquinas’ treatment of the Christian doctrine of original sin is another example of a hermeneutical turn of reason with respect to tenets of faith. In dealing with the reality of original sin, as confessed by faith, moral theory must be supplied with what one may call a theological hermeneutics of the Christian experience of actual human life in its dimension of sinfulness with respect to God.
Aquinas on Nature, Grace, and the Moral Life
Authors: Spezzano Daria
Published: January 2021

Aquinas’ teaching on nature, grace and the moral life in the Summa theologiae outlines the graced movement of the rational creature from God to God, by perfection in the likeness of God. Reflection on causality, trinitarian exemplarity, and the communication of divine goodness shapes his thought. The human person, made to the image of God for knowledge and love of God, is elevated by grace to the supernatural end by a participation in the divine nature that assimilates the intellect and will to the trinitarian persons. This deification by grace, taking the form in the creature of the created habitus of infused charity and wisdom, makes the adopted child of God a new principle of activities directed towards supernatural beatitude and constantly moved by divine auxilium. The predestined human person, led in freedom by the Holy Spirit, manifests the divine goodness in the graced journey to union with God in eternal life.
Jesus Christ
Authors: Gaine Simon Francis
Published: January 2021

Historical research has confirmed that there can be no doubt of the importance of Jesus Christ to Aquinas’ faith, devotion, and theological enterprise. This scholarship has exposed the faults of unsympathetic portrayals of his Christology as docetic or Monophysite, and presented his doctrine of the incarnation afresh, particularly by manifesting its distinctiveness in context and its maturation over time. In this way Aquinas’ Christology has been made available for reception in contemporary Christology in a way that goes beyond the recounting of the history of medieval theology. For those who share his confession of faith, the tasks of contemporary Christology can benefit from the enduring worth of many of his conclusions, the arguments employed, and his organization of material. Such a reception can retrieve a sense of fundamental continuity in Christology, of how Christ is unlike as well as like us, and of the bearing this has on our salvation.
Fourteenth-Century Western Reception of Aquinas in Meister Eckhart, Hervaeus Natalis, and Durandus of St-Pourçain
Authors: Iribarren Isabel
Published: January 2021

Meister Eckhart, Hervaeus Natalis, and Durandus of St-Pourçain represent three different forms that the reception of Aquinas’ teaching adopted during the aftermath of the Correctoria controversy. Eckhart welcomes Aquinas’ insights as conceptual tools, but feels free to adapt them to his own theological programme and imperatives. Hervaeus’ reception of Aquinas’ doctrine is hardly dissociable from that of Durandus, in that it was fashioned in reaction to the latter’s alleged deviation in a context of rising ‘Thomist orthodoxy’ within the Dominican Order. Although Hervaeus’ position relied on an Aristotelian metaphysics which allowed compatibility with Aquinas’ position, his generous use of non-Thomist sources and enhanced interpretation of certain Thomist theses suggest that what was at stake in Durandus’ censure was the preservation of the Thomist doctrinal heritage by investing Aquinas’ teaching with the coherence and soundness that could merit the relative approval accorded to the ‘common opinion.’
Performance in the Public Sector
Authors: Taylor Jeannette
Published: January 2021

Big claims have been made about the application of performance management in the public sector. In addition to improving accountability, performance management has been widely promoted as a useful managerial tool that is capable of improving organizational performance. This chapter reviews the literature on performance management in the public sector, paying particular attention to empirical research on its implementation in the Australian public sector. The review findings suggest that the promise of the performance-enhancing effects of performance management in the public sector is likely to remain an illusion until public managers are able to effectively address the various challenges associated with its implementation, particularly around non-technical issues.
The Ethics of Placebo and Nocebo in Psychotherapy
Authors: Gaab Jens , Locher Cosima , Trachsel Manuel
Published: January 2021

There is as little doubt as much as there is empirical proof that psychotherapy is an effective intervention for psychological problems and disorders. However, there is ongoing controversy about the mechanisms underlying these often impressive, but also often overestimated effects, reaching back to the very origins of psychotherapy research. While this “great psychotherapy debate” vivifies both psychotherapy research and practice, it finally poses an ethical challenge for both psychotherapists and psychotherapy scholars. Basically, the lack of agreed and validated mechanisms impedes the attempt to inform patients about how changes of psychotherapy are brought about. Thus, even though patients can readily be furnished with possible and expectable benefits, costs and strains, the situation becomes more complex and less certain with regard to the specific mechanisms and determinants of change. In this chapter, psychotherapy scholars’ strivings and troubles for specificity will be briefly covered, touching the uncomfortable relationship with placebo and nocebo and finishing with an ethical plea for transparency in psychotherapy and of psychotherapists.
Religious Terrorism at the Turn of the Twenty-First Century
Authors: Juergensmeyer Mark
Published: January 2021

In the late twentieth and early twenty-first centuries, extreme violence associated with religion has become a global problem, appearing in Christian, Jewish, Muslim, Sikh, Hindu, and Buddhist cultures. Religion is associated with this violence but is not the cause of it. In other words, religion is not the problem, but it is problematic, in two ways. One is the way that religious identities and ideologies have become part of a global rebellion against the European Enlightenment notion of a secular state. The other is the way that certain features of religious actions and images—such as the performance of religious ritual and the awesome notion of cosmic war—are appropriated by violent actors seeking to justify their savage attempts at power and cloak them in religious garb.
Mafic Microgranular Enclaves Formed by Gas-driven Filter Pressing During Rapid Cooling: an Example from the Gangdese Batholith in Southern Tibet
Authors: Xu Wei , Zhu Di-Cheng , Wang Qing , Weinberg Roberto F , Wang Rui , Li Shi-Min , Zhang Liang-Liang , Zhao Zhi-Dan
Published: January 2021

Mafic microgranular enclaves (MMEs), widespread in intermediate to felsic arc plutons, carry significant information on the genesis and evolution of arc magmas, yet their origin remains debatable. Here, we examine MME-host diorite pairs from the c.200 Ma Cuijiu Igneous Complex in the eastern Gangdese Batholith, southern Tibet, to constrain the petrogenesis of MMEs and the evolution of arc magmas. Within the complex, MMEs are essentially similar to their host diorites with similar emplacement ages (∼200 Ma), mineral assemblages and mineral compositions, as well as whole-rock Sr–Nd–Hf and zircon Hf isotopic compositions. However, MMEs have higher modal contents of hornblende and biotite, and are enriched in compatible elements and depleted in incompatible elements. Zircons from some MME samples are characterized by dark cathodoluminescence (CL) cores overgrown by light-CL rims of varying thickness. The dark-CL cores show higher Th, U and rare earth elements (REE) abundances than the light-CL rims. Based on comparison with co-genetic mafic melts and mass-balance calculations, we propose that the MMEs were early-crystallized cumulates (autoliths) related to their host diorites. The chilled textures, flow microstructures and pillow shapes suggest that the MMEs experienced rapid cooling before being captured by the host magmas. The rapid cooling may result from contact between ascending diorite magmas and cooler wall rocks. As the magmas quickly crystallized, they reached second boiling and vesiculation, and separated into fine-grained crystal-rich margins and melt-rich centres. Gradients in crystallinity and pressure expelled interstitial melts from the crystal-rich margins to the crystal-poor centres, leading to crystal-liquid separation (gas-driven filter pressing). The dark-CL zircon cores with high Th and U abundances may crystallize from highly evolved interstitial melts within the crystal-rich margins. The fine-grained crystal-rich margins were subsequently captured and dragged as MMEs before their complete crystallization by later ascending host magmas. This differentiation process could have occurred over several kilometres of magma ascent, and have played an important role in the polybaric fractional crystallization of the Cuijiu Igneous Complex, feeding more differentiated andesitic magmas to upper crustal mushes.
TNFi-induced sustained clinical remission in peripheral spondyloarthritis patients cannot be maintained with a step-down strategy based on methotrexate
Authors: Carron Philippe , De Craemer Ann-Sophie , Renson Thomas , Colman Roos , Elewaut , Dirk , Van den Bosch Filip
Published: January 2021

Objectives

Treatment with golimumab monotherapy in early peripheral SpA (pSpA) results in higher rates of clinical remission compared with treatment in more longstanding disease. When reaching remission, treat-to-target recommendations suggest tapering of treatment. We therefore explored whether addition of MTX would permit discontinuation of golimumab in patients with pSpA in sustained clinical remission.

Methods

After a 2-year extension phase with golimumab treatment, patients with pSpA reaching clinical remission in the CRESPA trial were offered a tapering strategy leading to discontinuation of golimumab and replacement by MTX monotherapy. Patients were prospectively followed to assess the rate of sustained biologic-free clinical remission. In case of relapse of arthritis, enthesitis or dactylitis under MTX monotherapy, golimumab was restarted.

Results

Of the original 60 pSpA patients, 25 entered the step-down strategy. Currently, only 4 patients (16%) are still in sustained remission under MTX monotherapy. In 21 patients (84%), golimumab was reinstalled because of relapse of disease activity (n = 19) or development of adverse events related to MTX (n = 2). Restarting golimumab treatment promptly restored clinical remission in all patients within 12 weeks.

Conclusion

In patients with early pSpA achieving clinical remission after 2 years of golimumab treatment, step-down therapy to monotherapy with MTX led to high rates of clinical relapse. This underscores the overall weak efficacy of MTX in maintaining clinical remission in pSpA.

Trial registration

ClinicalTrials.gov, https://clinicaltrials.gov, NCT01426815.
A Network of Psychopathological, Cognitive, and Motor Symptoms in Schizophrenia Spectrum Disorders
Authors: Moura Bernardo Melo , van Rooijen Geeske , Schirmbeck Frederike , Wigman Johanna T W ,   Genetic Risk and Outcome of Psychosis (GROUP) investigators, Amelsvoort Therese van , Bartels-Velthuis Agna A , Bruggeman Richard , Cahn Wiepke , Haan Lieuwe de , Kahn Rene S , Simons Claudia J P , Madeira Luís , Harten Peter van , van Os Jim , Bakker P Roberto , Marcelis Machteld
Published: January 2021

Schizophrenia spectrum disorders (SSDs) are complex syndromes involving psychopathological, cognitive, and also motor symptoms as core features. A better understanding of how these symptoms mutually impact each other could translate into diagnostic, prognostic, and, eventually, treatment advancements. The present study aimed to: (1) estimate a network model of psychopathological, cognitive, and motor symptoms in SSD; (2) detect communities and explore the connectivity and relative importance of variables within the network; and (3) explore differences in subsample networks according to remission status. A sample of 1007 patients from a multisite cohort study was included in the analysis. We estimated a network of 43 nodes, including all the items from the Positive and Negative Syndrome Scale, a cognitive assessment battery and clinical ratings of extrapyramidal symptoms. Methodologies specific to network analysis were employed to address the study’s aims. The estimated network for the total sample was densely interconnected and organized into 7 communities. Nodes related to insight, abstraction capacity, attention, and suspiciousness were the main bridges between network communities. The estimated network for the subgroup of patients in remission showed a sparser density and a different structure compared to the network of nonremitted patients. In conclusion, the present study conveys a detailed characterization of the interrelations between a set of core clinical elements of SSD. These results provide potential novel clues for clinical assessment and intervention.
Open But Segregated? Class Divisions And the Network Structure of Social Capital in Chile
Authors: Otero Gabriel , Volker Beate , Rozer Jesper
Published: January 2021

This paper studies how social capital is divided across classes in Chile, one of the most unequal countries in the world. We analyse the extent to which upper-, middle-, and lower class individuals congregate in social networks with similar others, while following Bourdieu and expecting that in particular the networks of the higher social strata are segregated in terms of social capital. We test our argument with large-scale, representative survey data for the Chilean urban population aged 18–75 years (n = 2,517) and build an integrated indicator of people’s social class that combines measures of education, occupational class, and household income. Our regression analyses show that upper-class individuals have larger networks and access to more varied and prestigious social resources than their middle- and lower class counterparts. Interestingly, however, we found a U-shaped relationship between social class and class homogeneity, indicating that network segregation is high at the top as well as at the bottom of the class-based social strata. In contrast, the classes in the middle have more heterogeneous class networks, possibly forming an important bridge between the “edges” of the class structure. These findings demonstrate that whereas social and economic capital cumulates in higher classes, the lower classes are socially deprived next to their economic disadvantage.
Behavior change techniques in mobile apps targeting self-harm in young people: a systematic review
Authors: Panagiotopoulou Elena , Peiris Celeste , Hayes Daniel
Published: January 2021

Despite the high prevalence of self-harm among young people, as well as their extensive use of mobile apps for seeking support with their mental healthcare, it is unclear whether the design of mobile apps aimed at targeting self-harm is underpinned by behavior change techniques (BCTs). To systematically analyze and identify (a) what BCTs and (b) what theories are present in self-harm apps for young people in an attempt to understand their active components. Systematic searches in Apple store, followed by thorough screening, were conducted to identify free mobile apps targeting self-harm in young people. Five apps met the inclusion criteria and were used by trained researchers, who coded identified features against the BCT Taxonomy V1. Despite the majority of apps being underpinned by principles of Dialectical Behavior Therapy (DBT), no other information is available about specific theories underpinning these apps. Nineteen of the 93 BCTs were identified across the five apps. The most frequently used BCT was “Distraction” (54.2%), offering ideas for activities to distract users from self-harming. Other techniques that were used often were “Social Support (unspecified)” (27.0%) and “Behavior Substitution” (10.6%). This study provides the first analysis of BCTs present in mental health apps which are designed to target the reduction of self-harm in young people. Future research is needed to evaluate the effectiveness of the apps, as well as assess the effectiveness of the BCTs present.
“Blood pressure monitoring should be a habit”: adaptation of the Check. Change. Control. program for Asian American older adults, from group-based in-person to one-on-one telephone delivery
Authors: Jang Sou Hyun , Brown Emily V R , Lee Eun Jeong , Ko Linda K
Published: January 2021

Asian Americans have the lowest rate of awareness about hypertension, including controlled hypertension, among all racial/ethnic groups in the USA. A high proportion of Asian American older adults have limited English proficiency (LEP) and hypertension. This study adapted the Check. Change. Control. (CCC) program, a community-based intervention for hypertension control delivered in a face-to-face group setting, to phone-based delivery and evaluated the acceptability of the program among Asian American older adults with LEP. Thirteen participants received phone-based educational sessions on hypertension control over 4 months. After 4 months of interventions, we interviewed the 13 Asian American older adults and 4 counselors to examine the acceptability of the adapted CCC program. Both Asian American older adults and counselors found the phone-based delivery of the CCC program to be acceptable, and some participants recommended holding an in-person meeting before telephone delivery to review the program content and clarify information. Future study needs to explore the effectiveness of the phone-based delivery of the program on blood pressure management among larger groups of Asian American older adults.
Adapting Compassion Education Through Technology-Enhanced Learning: An Exploratory Study
Authors: Sukhera Javeed , Poleksic Jelena
Published: January 2021

Purpose

Compassion is central to health care. Efforts to promote compassion through educational interventions for health professionals show promise, yet such education has not gained widespread dissemination. Adapting compassion education through technology-enhanced learning may provide an opportunity to enhance the scale and spread of compassion education. However, challenges are inherent in translating such curricula for online delivery. In this study, the authors explored how technology influences the delivery of compassion education for health professionals.

Method

Using constructivist grounded theory methodology, the authors conducted semistructured interviews with 13 participants from across Ontario, Canada, from March to October 2019. The sample consisted of individuals who had experience with the design and evaluation of compassion education for health professionals. The interviews were coded and inductively analyzed to identify pertinent themes using constant comparative analysis. The study originated at the Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.

Results

Participants provided a range of responses regarding technology and compassion education. While participants revealed concerns about the constraints of technology on human interaction, they also described technology as both inevitable and necessary for the delivery of future compassionate care curricula. Participants also shared ways in which technology may enhance compassion education for health professionals by increasing accessibility and learner comfort with vulnerability. Addressing technological ambivalence, improving facilitation, and maintaining a balance between face-to-face instruction and technology-enhanced learning were identified as elements that could advance compassion education into the future.

Conclusions

Compassion education can be enhanced by technology; however, evidence-informed adaptation may require deliberate efforts to maintain some level of face-to-face interaction to ensure that technology does not erode human connection. Further research is required to address the uncertainties surrounding technology and compassion education as identified by participants. These findings provide educators with guidance for adapting compassionate care curricula into a digital domain.
The debit side of stem-cell joint injections: a prospective cohort study
Authors: Pritchett James W.
Published: January 2021

Background:

There is little long-term information and no prior report that used independently collected data describing the effectiveness and complications of intraarticular injections of stem cells.

Methods:

This study reviewed the records of 2964 patients who received stem-cell injections in the hip, knee, or shoulder and 2971 patients who had injections of steroids or viscosupplementation (comparison group).

Results:

Pain improved initially in 2104 (71%) of patients who received stem cells. At a mean follow-up of 5.6 yr, 563 (15%) patients continued to report less pain, and the mean time of pain reduction was 17 mo (range, 1 to 84 mo). The mean cost of stem-cell care was $6000 (range, $1200 to $13,000). There were 115 (8%) complications using autologous stem cells, 113 (8%) with donor cells, and 13 (9%) when both were used. Stem-cell complications included six tumors, 14 infections, 48 syncopal, arrhythmia, seizure, or vasovagal reactions, 42 chronic culture-negative effusions, 18 injection site rashes, 44 instances of systemic viral like syndrome or herpes zoster-like reactions, 31 new allergies, and 39 instances of acute and severe worsening of pain and function. There were 82 hospitalizations. For the comparison group, there were 61 (2%) complications and eight hospitalizations.

Conclusions:

The frequency (8%) and severity of complications with stem cell-injections is higher than for steroid or viscosupplementation injections (2%). Stem-cell joint injections are a costly and speculative treatment and should only be used with a deep understanding of the risk. Practitioners providing stem cell joint injections must include long-term follow-up as part of their care. Additional validated scientific studies are needed.

Level of Evidence:

Level II.
Outcome of single radius constrained condylar device in primary and revision total knee arthroplasty: a retrospective cohort study
Authors: Keemu Hannes , Knifsund Jani , Koivisto Mari , Laaksonen Inari , Virolainen Petri , Mäkelä Keijo
Published: January 2021

Background:

Instability is a common cause of failure after total knee arthroplasty (TKA). It can be reduced with constrained condylar knee (CCK) devices. Our aims were to evaluate survivorship and functional outcomes of CCK implants in primary and revision TKA.

Methods:

We assessed 136 patients (138 knees) who underwent a primary (75) or revision (63) arthroplasty with a CCK TKA between 2008 and 2011. Implant survival was assessed with Kaplan-Meier estimate, and functional outcome was assessed with Knee injury and Osteoarthritis Outcome Score (KOOS).

Results:

Mean follow-up was 3.8 yr. Three (4%) primary CCK TKA patients and nine (14%) first time revision CCK TKA patients required a second operation. Five-year implant survival rate for primary CCK TKA was 96% (95% CI, 0.88 to 0.99), and for revision CCK TKA 85% (95% CI, 0.66 to 0.94). Mean KOOS pain score was 79 in the primary TKA group, and 61 in the revision TKA group.

Conclusions:

Implant survival was excellent after primary CCK, and acceptable after revision CCK.

Level of Evidence:

Level III.
What is the effect of smoking on postoperative outcomes after ankle-fracture surgery? A retrospective cohort study
Authors: Elmallah Randa D. Kamal , Sbravati Nathanael , Hendrix Steven Tal , Greggory Tharp Jack , Bergin Patrick
Published: January 2021

Background:

Smoking is a primary modifiable factor associated with postoperative complications after ankle-fracture fixation. Although most literature concludes that smoking is detrimental to wound healing and tissue oxygenation, there remains disparity in studies reporting on outcomes after ankle-fracture surgery. Therefore, our purpose was to evaluate the differences in (1) infection; (2) malunion and nonunion rates; (3) return to the operating room; and (4) overall complication rates between smokers and nonsmokers who underwent ankle-fracture fixation.

Methods:

Patients who had ankle-fracture surgery at our institution between July 2012 and April 2014 were retrospectively identified. Information was collected on demographics, injury data, and smoking status. The incidences of infection, malunion or nonunion, and postoperative complications and revision surgery were determined. A P value of 0.05 was used to determine statistical significance. There were 263 patients included in this study, 112 smokers and 151 nonsmokers.

Results:

The overall infection rate in the smoker cohort was 29.4% compared with 9.9% in the nonsmoker cohort, and there was a four-fold higher rate of malunions and nonunions in the smoker compared with the nonsmoker cohort (8.7% vs. 2%). The overall rate of return to the operating room was higher in the smoker compared to nonsmoker group (67.8 vs. 43.7%), as well as complication rates (8.9% vs. 2.6%; odds ratio [OR] 3.6, 95% confidence interval [CI] 1.1 to 11.8).

Conclusions:

This study showed that tobacco smoking had a direct adverse effect on infection rates, union, and return to the operating room in patients who underwent ankle-fracture fixation. These findings reiterated the importance of advocating for smoking cessation to improve postoperative clinical outcomes.

Level of Evidence:

Level III.
Incidence of rotational malalignment and its effect on functional outcome after nail osteosynthesis of unstable trochanteric fractures: a prospective cohort study
Authors: Pande Hrishikesh , Tankala Mahendra , Basavaraj Manibanakar Naveen , Kumar Narinder
Published: January 2021

Background:

Trochanteric fractures are common to general, trauma, and geriatric orthopaedic practice. We undertook this study to measure the degree of malrotation after fixation of unstable trochanteric fractures and its effect on functional outcomes in an elderly patient population.

Methods:

With strict inclusion and exclusion criteria, a total of 58 patients were included in this analysis. Based on postoperative CT, the patients were divided into the nonmalalignment group (NMG, n=38 with rotational malalignment less than 15 degrees) and the malalignment group (MG, n=20 with rotational malalignment greater than 15 degrees). The patients returned for follow-up at 3 mo, 12 mo, and 24 mo, at which time Harris hip scores (HHS), Oxford Hip scores (OHS), Oxford knee scores (OKS) and visual analogue scores (VAS) were recorded and analyzed.

Results:

There were no significant differences in mean age, fracture sub types by AO Foundation/Orthopaedic Trauma Association classification (AO/OTA), number of comorbidities, time from injury to surgery, or duration of surgery in these two groups. Only the gender distribution was different, with significantly more female patients in the malalignment group. The mean malrotation in the MG and the NMG was 24.9 degrees and 7.73 degrees, respectively, which were significantly different. We found that the HHS, OHS, OKS, and VAS were significantly better in the NMG. More patients in the MG had significant gait abnormality, significant deterioration of knee function, significantly reduced ability to squat and sit cross-legged, and greater requirement of assistive devices for ambulation when compared with the NMG.

Conclusions:

Rotational malalignment after trochanteric fracture fixation is unavoidable despite best efforts, and these patients have a significantly poorer functional outcome when compared with patients in whom there is no malalignment.

Level of Evidence:

Level IV.
Utilization and costs of postoperative physical therapy after multiligament knee surgery: a retrospective cross-sectional study
Authors: Qin Charles , Baker Hayden , Qin Mia M. , Athiviraham Aravind
Published: January 2021

Introduction:

The aim of this study was to analyze the use of and charges related to physical therapy (PT) after multiligament knee surgery across different postoperative time points and to identify factors related to increased utilization.

Methods:

The Humana Claims Database was queried for all patients who underwent a multiligament knee reconstruction procedure. We identified patients with a PT-related Current Procedural Terminology (CPT) code at 14 days, 30 days, 90 days, and 6 mo postoperatively. The mean charge per patient and mean number of billed encounters were analyzed. Chi-square and linear regression analysis were used to identify factors related to increased PT utilization.

Results:

Data for 497 patients undergoing multiligament knee reconstruction surgery was available. The number of patients utilizing PT at 14 days, 30 days, 90 days, and 6 mo after surgery was 315, 423, 484, and 497, respectively. The mean cost of PT in these groups were $315.65, $580.05, $1490.55, and $1796.52, respectively. The mean number of visits were 6, 12, 32, and 38, respectively. Patients with subsequent surgery for arthrofibrosis had significantly higher mean cost ($3528.40 vs. $1546.43; P<0.001) and higher mean number of visits (73 vs. 35; P<0.001) than those without. When compared with patients without a diagnosis of knee dislocation, patients with a knee-disclocation diagnosis had significantly higher mean cost ($2204.85 vs. 1627.45; P<0.001) and higher mean number of visits (43 vs. 31; P<0.001). Finally, privately insured patients had higher mean cost ($1933.07 vs. $1051.70) and mean number of visits (40 vs. 25) than publicly insured patients. Regression coefficients were $-390.86 for obesity, $409.50 for knee dislocation, $807.53 for private insurance, and $1845.00 for surgery for arthrofibrosis.

Conclusions:

There was increased utilization of PT among patients who had a diagnosis of knee dislocation, those who required surgery for arthrofibrosis, and those who had private insurance after multiligament knee reconstruction surgery.

Level of Evidence:

Level III.