bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract
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

AbstractThis 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

Abstract
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

Abstract
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.
A literature review of commercially available demineralized bone matrix products and their clinical evidence in acute fractures, nonunions, and fusion procedures
Authors: Downing Michael , Niedzielak Timothy , De La Rosa Charles , Ting Alexander , Berko Joshua , Lampasona Nicholas , Cross Brian 
Published: January 2021

Demineralized bone matrix (DBM) is an allograft obtained from human cadaveric bone that has osteoinductive and osteoconductive properties. A wide array of specific DBM products is available, and each has its own biochemical, safety, and efficacy profiles. This study reviews comparison studies of brand-specific DBM products, including Allomatrix (Wright Medical Technology, Memphis, Tennessee), DBX (Depuy Synthes, Suchwil, Switzerland), Grafton (Osteotech, Eatontown, New Jersey), Orthoblast (Integra Orthobiologics, Plainsboro, New Jersey), and Osteosponge (Bacterin International, Belgrade, Montana), in an attempt to propose the most efficacious DBM product for bone grafting of various orthopaedic applications. Secondarily, we evaluate these specific DBM products in their potential use of tibial plateau fractures, which our future clinical research aims to achieve. A definitive gold-standard DBM product is lacking for orthopaedic use because of the scarcity of clinical research comparing specific brand products, limited study sample sizes, and lack of standardization in the creation of DBM products.

Level of Evidence:
Level III.
The Spectrum of Cutaneous Reactive Angiomatoses in End Stage Renal Failure
Authors: Bali Radhika , Wali Gorav Neel , Ieremia Eleni 
Published: January 2021

Abstract:
Cutaneous reactive angiomatoses encompass a spectrum of conditions driven by underlying occlusive vasculopathy. We present 2 cases of reactive angioproliferation in the context of end-stage renal failure (ESRF) manifesting as painful cutaneous ulceration. The first case demonstrates histologic features of diffuse dermal angiomatosis. The second case illustrates a nonspecific pattern of vascular proliferation which does not conform to any of the classically described subtypes, therefore reinforcing the concept of a spectrum of histopathologic changes in reactive angioproliferations. Diffuse dermal angiomatosis has been described in ESRF alone and in association with calciphylaxis, a life-threatening condition. Recognizing the patterns of reactive angioproliferation in the context of ESRF therefore has clinical relevance. Earlier identification may facilitate mitigation of risk factors and improve prognosis.
High-resolution magnetic resonance imaging in the detection of subtle nuances of uterine adenomyosis in infertility
Authors: Khandeparkar Meenal S. , Jalkote Shivsamb , Panpalia Madhavi , Nellore Swarup , Mehta Trupti , Ganesan Karthik , Parikh Firuza R. 
Published: January 2021

Introduction:
Magnetic resonance imaging (MRI) is the current reference standard for noninvasive imaging of the pelvis. In patients with infertility potentially earmarked for in vitro fertilization/intracytoplasmic sperm injection procedures, the distinction between adenomyosis and its mimics is extremely vital. This article highlights the vital role of MRI in the detection of subtle nuances of adenomyosis in infertility and the key imaging features of its associated conditions and mimics.

Materials and Methods:
This is a retrospective Health Insurance Portability and Accountability Act compliant study. Inclusion criteria consisted of (a) clinically diagnosed cases of primary infertility; (b) suspicion of adenomyosis on transabdominal and transvaginal ultrasonography; (c) nonvisualization/obscuration of the junctional zone; (d) multiparametric MRI performed at 3 T. Exclusion criteria included (a) other causes of primary infertility including Mullerian ductal anomalies, ovulation factors, and, hormonal factors such as hypothalamic-pituitary axis abnormalities; (b) secondary infertility. We identified a cohort of 114 patients who underwent multiparametric pelvic MRI on a 3 T system between July 2011 and March 2017 at our institution to rule out adenomyosis as a cause of primary infertility.

Results:
A total of 38 of 114 patients were diagnosed with adenomyosis, with focal adenomyosis seen in 20 patients and diffuse adenomyosis in 18 patients. Isolated adenomyosis was seen in 10 patients, whereas 28 patients had adenomyosis in combination with other pelvic pathologies. Twelve patients had isolated junctional zone thickening without any other features of adenomyosis or deep pelvic endometriosis.

Conclusions:
Pelvic MRI is the reference standard for the noninvasive detection of the subtle nuances of uterine adenomyosis, and, its associations including deep pelvic endometriosis in patients with infertility.