bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cryptococcosis complicating diabetes mellitus: a scoping review
Authors: Nsenga Lauryn , Kajjimu Jonathan , Olum Ronald , Ninsiima Sandra , Kyazze Andrew Peter , Ssekamatte Phillip , Kibirige Davis , Baluku Joseph Baruch , Andia-Biraro Irene , Bongomin Felix 
Published: May 2021

Background: A better understanding of the epidemiology of cryptococcal infection in HIV-negative individuals is an international research interest. Immune dysfunction in diabetes mellitus (DM) significantly increases the risk of acquiring and reactivation of infection due to Cryptococcus neoformans. Risk factors and outcomes of cryptococcosis in DM are not well documented. Objective: The objective of this study was to determine the clinical characteristics and outcomes of cryptococcal infections in persons living with DM. Methods: MEDLINE (via PubMed), EMBASE, and the Cochrane Library databases were searched in November 2020. The searches covered the period between 1980 and 2020.We included studies that reported confirmed cryptococcosis in patients with DM. Reference lists of included articles were also searched, and additional studies were included if appropriate. No language restriction was applied. Single case reports, case series and original articles were included whereas review articles were excluded. Results: A total of 28 studies (24 single case reports, 4 retrospectives) were included involving 47 unique patients from Asia (17 cases), North America (six cases), South America (three cases) and Africa (two cases). Men constituted 75% ( n = 18) of the cases. Median age was 60.5 (range: 27–79) years. The majority of the patients had cryptococcal meningitis (68.1%, n = 32) followed by disseminated cryptococcosis (6.4%, n = 7), and others (isolated cutaneous disease one, peritonitis one, pleural one, thyroid one, adrenal one). Diagnosis was achieved through either culture and microscopy (38/47), cryptococcal antigen tests (9/47) or histopathology (9/47) singly or in a combination. All-cause mortality was 38.3% ( n = 18). Among those with meningitis mortality was 36.2%. Conclusion: A wide spectrum of cryptococcal infections with varying severity occurs in DM. Mortality remains unacceptably high. There is a need for more studies to characterize better cryptococcal disease in DM.
Cerebral Perfusion in Hemodialysis Patients: A Feasibility Study
Authors: Vanderlinden Jessica Anne , Holden Rachel Mary , Scott Stephen Harold , Boyd John Gordon 
Published: May 2021

Background: Patients on hemodialysis (HD) are known to exhibit low values of regional cerebral oxygenation (rSO2) and impaired cognitive functioning. The etiology of both is currently unknown. Objective: To determine the feasibility of serially monitoring rSO2 in patients initiating HD. In addition, we sought to investigate how rSO2 is related to hemodynamic and dialysis parameters. Design: Prospective observational study. Setting: Single-center tertiary academic teaching hospital in Ontario, Canada. Participants: Six patients initiating HD were enrolled in the study. Methods: Feasibility was defined as successful study enrollment (>1 patient/month), successful consent rate (>70%), high data capture rates (>90%), and assessment tolerability. Regional cerebral oxygenation monitoring was performed 1 time/wk for the first year of dialysis. A neuropsychological battery was performed 3 times during the study: before dialysis initiation, 3 months, and 1 year after dialysis initiation. The neuropsychological battery included a traditional screening tool: the Repeatable Battery for the Assessment of Neuropsychological Status, and a robot-based assessment: Kinarm. Results: Our overall consent rate was 33%, and our enrollment rate was 0.4 patients/mo. In total 243 rSO2 sessions were recorded, with a data capture rate of 91.4% (222/243) across the 6 patients. Throughout the study, no adverse interactions were reported. Correlations between rSO2 with hemodynamic and dialysis parameters showed individual patient variability. However, at the individual level, all patients demonstrated positive correlations between mean arterial pressure and rSO2. Patients who had more than 3 liters of fluid showed significant negative correlations with rSO2. Less cognitive impairment was detected after initiating dialysis. Limitation: This small cohort limits conclusions that can be made between rSO2 and hemodynamic and dialysis parameters. Conclusions: Prospectively monitoring rSO2 in patients was unfeasible in a single dialysis unit, due to low consent and enrollment rates. However, rSO2 monitoring may provide unique insights into the effects of HD on cerebral oxygenation that should be further investigated. Trial Registration: Due to the feasibility nature of this study, no trial registration was performed.
Mobile health apps: An exploration of user-generated reviews in Google Play Store on a physical activity application
Authors: Al-Abbadey Miznah , Fong Megan M-W , Wilde Laura J , Ingham Roger , Ghio Daniela 
Published: May 2021

Objective This study aimed to evaluate reviews that have been posted publicly on the app ‘MapMyRun’ to investigate which features were associated with usage of the app. A secondary aim was to determine whether MapMyRun consisted of specific behaviour change techniques that would have increased the likelihood of users being engaged with the app. Methods Reviews posted on MapMyRun by users between 1st May 2017- 30th April 2018 were extracted, coded and analysed using content analysis. Results Eleven behaviour change techniques were identified among the features of MapMyRun. A total of 3,253 reviews met the inclusion/exclusion criteria, and 12 codes were developed. The codes were grouped into 8 subthemes within 2 main themes: ‘Effort’ and ‘Self-monitoring’. Consistent with previous literature, ‘Goal-Setting’ and ‘Self-Monitoring of Behaviour’ were two techniques included in MapMyRun. Social features of MapMyRun facilitated competition among users, their family, and friends. Conclusions This was the first qualitative review to assess a single mobile health physical activity app and analyse it from the perspectives of the users. Creators of future mobile health apps should focus on user friendliness and the use of social features, as both may increase the chances of users’ continued use with the app.
Compiling Life-Oriented Moral Education Textbooks for Elementary Schools in China: The Mimetic Approach in Morality and Law
Authors: Tang (唐燕) Yan 
Published: May 2021

Purpose: This study explores a novel approach to compiling life-oriented moral textbooks for elementary schools in China, specifically focusing on Morality and Law. Design/Approach/Methods: Adopting Aristotle’s Poetics as its theoretical perspective, this study illustrates and analyzes the mimetic approach used in compiling the life-oriented moral education textbook, Morality and Law. Findings: The mimetic approach involves imitating children's real activities, thoughts, and feelings in textbooks. The mimetic approach to compiling life-oriented moral textbooks comprises three strategies: constructing children's life events as building blocks for textbook compilation, designing an intricate textual device exposing the wholeness of children's life actions, and designing inward learning activities leading to children's inner worlds. Originality/Value: From the perspective of Aristotle's Poetics, the approach to compilation in Morality and Law can be defined as mimetic. And the compilation activity in the life-oriented moral education textbook also can be described as a process of mimesis. So this article presents a new approach to compile moral education textbooks and an innovative way to understand the nature of one compiling activity.
Obesity Management Education Needs Among General Internists: A Survey
Authors: Nanda Sanjeev , Adusumalli Jayanth , Hurt Ryan T. , Ghosh Karthik , Fischer Karen M. , Hagenbrock Martha C. , Ganesh Ravindra , Ratrout Basem M. , Raslau David , Schroeder Darrell R. , Wight Elizabeth C. , Kuhle Carol L. , Thicke Lori A. , Lazik Natalia , Croghan Ivana T. 
Published: May 2021

Objective The purpose of this study was to determine self-reported knowledge, attitudes, prior experience, and perceived needs for the management of overweight and obese patients within a General Internal Medicine Practice. Patients and Methods An emailed cross-sectional survey was sent between June 20, 2019 and September 12, 2019 to 194 healthcare workers (93 primary care providers (PCPs) and 101 nurses) which focused on management of patients with weight issues. Results In total, 80 of the eligible 194 participants completed the survey (nurses = 42, PCPs = 38). Up to 87% were white, 74.7% female (74.7%). Most of the responders were either in the age group of 30’s (30%) or 50’s (30%). Among the responders, 48.8% reported some type of specialty training in weight management since their medical training with lectures being the most common form of training (36%). When asked about their interest in either weight management training or strategies to initiate weight conversations, 79% of the respondents reported an interest in education on weight management or strategies to initiate weight conversations, while 65.8% indicated they would be interested in both topics. Conclusion Our study suggests that healthcare workers have a self-reported need for further training in management of overweight and obese patients, irrespective of previous training in this area.
Subaxial Cervical Pedicular Screw Insertion via the Nonanatomic Axis: Technical Notes and Preliminary Clinical Report
Authors: Wang Yingbo , Hu Bo , Wu Jian , Chen Wei , Wang Zhong , Liu Mingyong , Zhao Jianhua , Liu Peng 
Published: May 2021

Study Design: Retrospective study. Objective: To report the technical details of subaxial cervical pedicular screw insertion via the nonanatomic axis (nAA-CPS) and evaluate its clinical safety and accuracy. Methods: The nAA-CPS technique was performed in 21 patients. Preoperative and intraoperative management-related details are described, and a manipulation protocol is presented. Clinical outcomes were used to assess the safety and accuracy of screws was evaluated using postoperative computed tomography (CT) according to the pedicle perforation grading system, and the nonanatomic pedicle transverse angle (nPTA) and nonanatomic pedicle axis length (nPAL) were assessed based on pre- and postoperative CT images. Results: According to “one constant entry point (EP) and two perpendicular trajectory angles” protocol, nAA-CPS was performed without much interference from the muscles. No intraoperative or postoperative neurovascular complications related to the technique were observed. Of the 112 inserted screws, 78 (69.64%) were assessed as grade 0, 24 (21.43%) as grade 1, 4 (3.57%) as grade 2 and 6 (5.36%) as grade 3. The overall rate of correct position (grades 0 and 1) was 91.07% (102/112), and the rate of malposition was 8.93% (10/112), including five screws implanted medially and the other five laterally. The nPTA was highly consistent on pre- and postoperative CT ( P < .05), while postoperative nPAL was significantly shorter than preoperative nPAL ( P > .05). Conclusions: Clinically, the accuracy and safety of nAA-CPS was similar to the traditional CPS technique. The protocol, derived from previous radiological studies and workshops, greatly helped standardize clinical manipulation; thus, nAA-CPS is a promising alternative to the traditional CPS.
Posterior Interosseous Nerve Graft: Utilizing External Landmarks and Anthropometric Ratios to Predict Available Length for Digital Nerve Reconstruction in a Cadaveric Study
Authors: Vivace Bradley J. , Kachare Swapnil D. , Meredith Luke T. , Kachare Milind D. , Kapsalis Christina N. , Muresan Claude , Choo Joshua H. , Kasdan Morton L. , Wilhelmi Bradon J. 
Published: May 2021

Objective: In digital nerve defects that require grafting, autografts remain the efficacious option. The sensory posterior interosseous nerve (PIN) is an ideal choice as it is of similar caliber to digital nerves and leaves no donor morbidity upon resection. However, a finite length of harvestable PIN exists, and considerable variations of this length have been reported in the literature. There exists no predictive model to estimate this length. We sought to determine a method to accurately predict the available length of PIN based on individual patient anthropometry. Methods: A cadaveric dissection study was performed in a fresh tissue laboratory. The length of the sensory branch of the PIN and various anthropometric measurements were made in respect to surface anatomy of the ulna to develop a predictable ratio for available PIN donor graft. Results: A total of 16 specimens were obtained. On average the length of the PIN was 5.7 cm (range: 3.3-9. cm) and the length of the ulna was 25.7 cm (range: 23.5-30.6 cm). The ratio of PIN to ulnar length was 0.222 ( r = 0.4651). Using one-fifth the length of the ulna, the mean predicted length of the PIN was 5.14 cm (range: 4.7-6.1 cm). On univariate analysis, there was no significant difference between the measured and predicted PIN length ( P = .249). Conclusion: An anthropometric ratio predicated on reproducible surface anatomy of the ulna is a useful tool in predicting the sensory PIN length. Such a prediction may be a useful in guiding patient discussions concerning surgical options for digital nerve reconstruction.
Concussion in National Football League Athletes Is Not Associated With Increased Risk of Acute, Noncontact Lower Extremity Musculoskeletal Injury
Authors: Jildeh Toufic R. , Meta Fabien , Young Jacob , Page Brendan , Okoroha Kelechi R. 
Published: May 2021

Background: Impaired neuromuscular function after concussion has recently been linked to increased risk of lower extremity injuries in athletes. Purpose: To determine if National Football League (NFL) athletes have an increased risk of sustaining an acute, noncontact lower extremity injury in the 90-day period after return to play (RTP) and whether on-field performance differs pre- and postconcussion. Study Design: Cohort study, Level of evidence, 3. Methods: NFL concussions in offensive players from the 2012-2013 to the 2016-2017 seasons were studied. Age, position, injury location/type, RTP, and athlete factors were noted. A 90-day RTP postconcussive period was analyzed for lower extremity injuries. Concussion and injury data were obtained from publicly available sources. Nonconcussed, offensive skill position NFL athletes from the same period were used as a control cohort, with the 2014 season as the reference season. Power rating performance metrics were calculated for ±1, ±2, and ±3 seasons pre- and postconcussion. Conditional logistic regression was used to determine associations between concussion and lower extremity injury as well as the relationship of concussions to on-field performance. Results: In total, 116 concussions were recorded in 108 NFL athletes during the study period. There was no statistically significant difference in the incidence of an acute, noncontact lower extremity injury between concussed and control athletes (8.5% vs 12.8%; P = .143), which correlates with an odds ratio of 0.573 (95% CI, 0.270-1.217). Days (66.4 ± 81.9 days vs 45.1 ± 69.2 days; P = .423) and games missed (3.67 ± 3.0 vs 2.9 ± 2.7 games; P = .470) were similar in concussed athletes and control athletes after a lower extremity injury. No significant changes in power ratings were noted in concussed athletes in the acute period (±1 season to injury) when comparing pre- and postconcussion. Conclusion: Concussed, NFL offensive athletes did not demonstrate increased odds of acute, noncontact, lower extremity injury in a 90-day RTP period when compared with nonconcussed controls. Immediate on-field performance of skill position players did not appear to be affected by concussion.
Return to Sport After Hip Resurfacing Arthroplasty
Authors: Morse Kyle W. , Premkumar Ajay , Zhu Andrew , Morgenstern Rachelle , Su Edwin P. 
Published: May 2021

Background: Femoroacetabular impingement and degenerative hip osteoarthritis (OA) affect athletes across a wide variety of sports. Hip resurfacing arthroplasty (HRA) has emerged as a surgical treatment for active individuals with end-stage hip OA to provide pain relief and allow return to high-impact activities. Return to professional sports after HRA has not been well characterized. Purpose/Hypothesis: The aim of this study was to report on a series of elite athletes in a variety of sports who underwent HRA. We hypothesized that professional and elite-level athletes would be able to return to sports after HRA for end-stage hip OA. Study Design: Case series; Level of evidence, 4. Methods: A retrospective case series was conducted on professional athletes who underwent HRA at a single institution between 2007 and 2017. All surgeries were performed by a single surgeon using the posterolateral approach. Athletes’ return to play and sport-specific performance statistics were obtained using self-reported and publicly available data sources. Athletes were matched to an age- and performance-based cohort to determine changes in performance-based metrics. Results: Eight professional athletes were identified, including 2 baseball pitchers, 1 ice hockey defenseman, 1 foil fencer, 1 men’s doubles tennis player, 1 basketball player, 1 ultramarathoner, and 1 Ironman triathlete. All 8 patients returned to sports; 6 of 8 (75%) patients were able to return for at least 1 full season at a professional level after surgery. There were no significant differences between performance statistics for athletes who returned to play and their preoperative performance measures for the years leading up to surgery or the age- and performance-matched cohort. Conclusion: HRA remains a surgical alternative for end-stage hip OA in young, high-impact, active patients. While the primary goals of surgery are pain control and quality of life improvement, it is possible to return to elite-level sporting activity after HRA.
Biomechanical Strength of All-Inside ACL Reconstruction Grafts Using Side-to-Side and Backup Fixation
Authors: Graf-Alexiou Lucas , Karpyshyn Jillian , Baptiste Jonelle Jn , Hui Catherine , Sommerfeldt Mark , Westover Lindsey 
Published: May 2021

Background: The all-inside anterior cruciate ligament reconstruction (ACLR) procedure uses a single hamstring tendon folded twice and secured to itself to form a 4-stranded graft. There are several possible configurations for preparing the graft. Purpose: To investigate the biomechanical properties of a new graft preparation technique in comparison with 2 commonly used configurations. Study Design: Controlled laboratory study. Methods: Five porcine flexor tendons were prepared into the test graft configuration: side-to-side fixation with a backup fixation at the button loop (graft M). The test configuration was compared with the results of a previous study that included grafts with simple interrupted sutures (graft A; n = 5) and end-to-end fixation (graft C; n = 5). All grafts were subjected to the same mechanical testing protocol to determine the mean failure load, stiffness, rate of elongation, and total elongation during both cyclic loading and pull to failure. Differences between groups were evaluated. Results: Graft A had a significantly lower failure load (637 ± 99 N) compared with graft M (883 ± 66 N; P = .002) and graft C (846 ± 26 N; P = .002). Graft A also had significantly lower stiffness (166 ± 12 N/mm) compared with graft M (215 ± 8 N/mm; P < .001) and graft C (212 ± 11 N/mm; P < .001). Graft C had a significantly lower elongation during cyclic loading (3.42 ± 0.24 mm) compared with graft M (4.37 ± 0.74 mm; P = .026) and graft A (4.90 ± 0.88 mm; P = .006). The unsecured fixation was the weakest graft, with the lowest failure load and stiffness. The new side-to-side configuration and end-to-end configuration were equally strong. Conclusion: The new side-to-side configuration was not biomechanically superior to the end-to-end configuration; however, they were both stronger than unsecured fixation. Clinical Relevance: As the all-inside ACLR is gaining popularity, this study provides surgeons with a new method of preparing grafts and evaluates the method with respect to currently used configurations.
Eliciting Preferences for Adult Orthodontic Treatment: A Discrete Choice Experiment
Authors: Fenton G.D. , Cazaly M.H.M. , Rolland S.L. , Vernazza C.R. 
Published: May 2021

Introduction: There has been little research to explore how adults financially value private orthodontic treatment and whether they have preferences for different attributes of treatment. This study used a discrete choice experiment and aimed to determine whether the recognized skill level of the dental professional and the type of orthodontic appliance influence the values that the public places on private adult orthodontic treatment. Methods: In total, 206 adult patients or the parents/guardians of children attending general dental practices in the northeast of England were recruited to complete a discrete choice experiment. Three attributes were included: the type of dental professional providing treatment, the type of orthodontic appliance, and cost. Also collected were demographic and orthodontic history characteristics. Results were analyzed with conditional logistic regression and elicited marginal willingness to pay (MWTP). Results: Participants value the training and expertise of the dental professional providing private orthodontic treatment greater than the type of orthodontic appliance. MWTP for orthodontic treatment increased in conjunction with the recognized skill level of the dental professional. Participants were willing to pay more for aesthetic appliances over a fixed metal appliance. Conclusions: Participants value the training and expertise of the dental professional providing private adult orthodontic treatment greater than the type of orthodontic appliance. These preferences concur with other discrete choice experiments undertaken in medical specialties that included attributes focusing on the qualification, skill, or expertise of the health care professional. MWTP for orthodontic treatment increased in conjunction with the recognized skill level of the dental professional. Participants were willing to pay more for aesthetic appliances than metal fixed appliances. The cost of orthodontics is significant, and adults appreciate the importance of having options and making choices. Knowledge Transfer Statement: The results of this study suggest that patients are willing to pay more for orthodontic services provided by clinicians with higher levels of formal training. In a competitive market where the public appears to prefer the provider over treatment modality, there is an incentive for clinicians to optimize their knowledge and skills to deliver the high-quality orthodontic treatment that patients are demanding. Orthodontic clinicians should be mindful of the demand for the different adult orthodontic appliances and tailor their skill sets accordingly.