bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Clinical Outcomes Between Nonoperative Treatment and Arthroscopically Assisted Stabilization in Patients With Acute Rockwood Type 5 Acromioclavicular Dislocation
Authors: Akgün Doruk , Gebauer Henry , Paksoy Alp , Eckl Larissa , Hayta Agahan , Ücertas Ata , Barthod-tonnot Nicolas , Hazra Rony-Orijit Dey , Lacheta Lucca , Moroder Philipp , Pawelke Jonas 
Published: November 2024

Background: Currently, Rockwood type 3 acromioclavicular (AC) joint dislocations are initially treated nonoperatively, whereas surgery is recommended for Rockwood type 5 dislocations. However, multiple studies have been published favoring nonoperative approaches in patients with high-grade Rockwood injuries. Purpose: To compare the clinical and radiological outcomes of patients with acute Rockwood type 5 AC joint dislocations treated nonoperatively versus with arthroscopically assisted stabilization. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 48 patients with acute Rockwood type 5 dislocation who were initially treated nonoperatively between June 2010 and June 2022 and 48 patients matched according to age, sex, affected side, and follow-up interval who underwent arthroscopically assisted coracoclavicular (CC) stabilization using a suture-button technique, with additional percutaneous AC tape cerclage. Clinical outcomes were assessed based on the Subjective Shoulder Value, Nottingham Clavicle Score, Constant score, and visual analog scale for pain. The radiographic assessment included the CC distance, CC difference ratio, and degree of horizontal instability at final follow-up (62 ± 43 months). Results: At the final follow-up, the Constant score was significantly higher in the nonoperative group ( P = .02). The operative group had significantly higher pain levels on palpation of the AC joint (1.2 ± 2.2 vs 0.19 ± 0.5 for the nonoperative group; P = .003). In the operative group, the mean CC difference ratio was significantly higher at the latest follow-up compared with postoperatively (1.3 ± 0.3 vs 0.67 ± 0.3, respectively; P < .001), whereas the CC difference ratio of the nonoperative group was significantly reduced at the latest follow-up compared with postinjury (2.0 ± 0.5 vs 2.6 ± 0.8, respectively; P < .001). The operative group had a significantly lower CC difference ratio compared with the nonoperative group at final follow-up ( P < .001). More than half of the patients (56%) who were treated operatively had a loss of reduction resulting in a Rockwood type 3 state at the latest follow-up, whereas 54% of patients treated nonoperatively had spontaneous reduction of injury severity from Rockwood type 5 to Rockwood type 3. Conclusion: Although 15% of the nonoperatively treated patients eventually required surgery, successful nonoperative treatment showed similar outcomes to initial operative treatment in patients with acute Rockwood type 5 dislocation.
Xenotime-(Gd), a new Gd-dominant mineral of the xenotime group from the Zimná Voda REE–U–Au quartz vein, Prakovce, Western Carpathians, Slovakia
Authors: Ondrejka Martin , Bačík Peter , Majzlan Juraj , Uher Pavel , Ferenc Štefan , Mikuš Tomáš , Števko Martin , Čaplovičová Mária , Milovská Stanislava , Molnárová Alexandra , Rößler Christiane , Matthes Christian 
Published: November 2024

AbstractXenotime-(Gd), ideally GdPO4, is a new mineral of the xenotime group. It was discovered at the Zimná Voda REE–U–Au occurrence near Prakovce, Western Carpathians, Slovakia. It forms rare crystal domains (≤20 μm, usually ≤10 μm in size) in Gd-rich xenotime-(Y) crystals (≤100 μm in size), in association with monazite-group minerals, uraninite, fluorapatite and uranyl arsenates–phosphates. The hydrothermal REE–U–Au mineralisation occurs in a quartz–muscovite vein, hosted in Palaeozoic phyllites near exocontact with Permian granites. The density is 5.26 g/cm3, based on calculated average empirical formula and unit-cell parameters. The average chemical composition (n = 6) measured by electron microprobe is as follows (wt.%): P2O5 30.1, As2O5 0.5, SiO2 0.2, UO2 0.3, Y2O3 15.7, (La, Ce, Pr, Nd)2O3 0.5, Sm2O3 5.7, Eu2O3 1.4, Gd2O3 29.2, Tb2O3 3.9, Dy2O3 10.4, Ho2O3 0.4, (Er, Tm, Yb, Lu)2O3 2.1, (Ca, Fe, Pb, Mn, Ba)O 0.1, total 100.5. The corresponding empirical formula calculated on the basis of 4 oxygen atoms is: (Gd0.37Y0.32Dy0.13Sm0.08Tb0.05Eu0.02Er0.01Tm0.01Nd0.01…)Σ1.01(P0.98As0.01Si0.01)O4. The empirical formula of the Gd-richest composition is: (Gd0.38Y0.31Dy0.13Sm0.08Tb0.05Eu0.02Er0.01Nd0.01Ho0.01…)Σ1.01(P0.98As0.01Si0.01)O4. The ideal formula is GdPO4. The xenotime-type structure has been confirmed by micro-Raman spectroscopy and a Fast Fourier-Transform pattern using HRTEM. Xenotime-(Gd) is tetragonal, space group I41/amd, a = 6.9589(5) Å, c = 6.0518(6) Å, V = 293.07(3) Å3 and Z = 4. The new mineral is named as an analogue of xenotime-(Y) and xenotime-(Yb) with Gd dominant among the REE. The middle REE enrichment of xenotime-(Gd) is shared with the associated monazite-(Gd) and Gd-rich hingganite-(Y). This exotic REE signature and precipitation of Gd-bearing minerals is a product of selective complexing and enrichment in MREE in low-temperature hydrothermal fluids by alteration of uraninite, brannerite and fluorapatite on a micro-scale. The existence of xenotime-(Gd) and monazite-(Gd) is the first naturally documented dimorphism among REE phosphates. In addition, xenotime-(Gd) is only the third approved Gd-dominant mineral, after lepersonnite-(Gd) and monazite-(Gd).
Randomised trial of assessing diagnostic yield in transbronchial biopsy with guide sheath
Authors: Chang Hao-Chun , Kuo Yao-Wen , Lin Ching-Kai , Chang Lih-Chyun , Chen You-Yi , Yang Ching-Yao , Chien Jung-Yien , Hsu Chia-Lin , Tsai Tzu-Hsiu , Ho Chao-Chi , Shih Jin-Yuan , Yu Chong-Jen 
Published: November 2024

ObjectivesRadial probe endobronchial ultrasound (rEBUS)-guided transbronchial biopsy (TBB) with a guide sheath (GS) is widely used to diagnose peripheral lung lesions (PPLs), but there is no consensus on whether it increases the diagnostic yield. We conducted this prospective study to compare the diagnostic yield of the GS method to the conventional method without a GS.MethodsFrom November 2019 to March 2023, patients with PPLs were recruited and randomly assigned to rEBUS-TBB with a GS (GS group) or without a GS (conventional group). The histopathology, cytology, and microbiology yield rates, as well as procedure time and post-procedure adverse events of the two groups were compared.ResultsA total of 102 patients were enrolled (54 in the GS group and 48 in the conventional group). The pathology yield showed no statistical difference between the two groups (75.9%versus68.8%, p=0.418), while the yield rates of brushing cytology (64.3%versus42.9%, p=0.030) and washing cytology (41.5%versus20.0%, p=0.0443) were higher in the GS group. Meanwhile, the yield from GS washing culture was lower than the bronchial washing culture yield (0%versus57.1%, p=0.017). The bleeding risk was also lower in the GS group (9.3%versus20.8%, p=0.049).ConclusionThe pathology yield of rEBUS TBB with a GS did not significantly differ from the conventional method. However, GS could improve the cytology yield rate and reduce the risk of bleeding. To enhance the microbiology yield, additional bronchial washing should be utilised.
Predicting persistent back pain causing severe interference with daily activities among community-dwelling older adults: the OPAL cohort study
Authors: Williamson Esther , Sanchez-Santos Maria T. , Fairbank Jeremy , Wood Lianne , Lamb Sarah E. 
Published: November 2024

Abstract
Background
Many older adults experience disabling back and leg pain. This study aimed to identify factors associated with back pain causing severe interference with daily activities over 2 years.

Methods
Participants were 2,109 community-dwelling adults (aged 65–100 years; mean age 74.2 (SD 6.3)) enrolled in a prospective cohort study who reported back pain at baseline and provided back pain data at 2 years follow-up. Baseline data included demographics, socio-economic factors, back pain presentation and age-associated adverse health states (e.g. frailty, falls, walking confidence). At 2 years follow-up, we asked if they were currently experiencing back pain and if so, asked participants to rate how much their back pain interfered with their daily activities on a scale of 0–10. Severe back pain interference was defined by a rating of 7 or more. The association between baseline factors and severe back pain interference at two years was assessed using logistic regression models.

Results
At two years, 77% of participants (1,611/2,109) still reported back pain, 25% (544/2,083) also reported leg pain and 14% (227/1,611) reported severe back pain interference with activities. Improvements in symptoms were observed over the two years follow-up in 880/2,109 participants (41.7%), 41.2% (869/2,109) of participants report no change and worsening symptoms was reported by 17.1% (360/2109) of participants. After adjusting for back pain troublesomeness at baseline, factors associated with reporting severe interference were adequacy of income (careful with money [OR 1.91; 95% CI 1.19–3.06]; prefer not to say [OR 2.22; 95% CI 1.11–4.43]), low endorsement of exercise in later life (OR 1.18; 95% CI 1.02–1.37), neurogenic claudication symptoms (OR 1.68 (95% CI 1.15–2.46)], multisite pain (OR 1.13; 95% CI 1.02–1.24) and low walking confidence (OR 1.15; 95% CI 1.08–1.22).

Conclusion
After adjusting for baseline pain severity, we identified five factors that were associated with severe pain limitation at two years follow-up among a cohort of community dwelling older people reporting back and leg pain. These included other pain characteristics, walking confidence and attitude to activity in later life. We also identified a socioeconomic factor (perceived adequacy of income). Future research should focus on whether identifying individuals using these risk factors in order to intervene improves back pain outcomes for older people.
Study protocol of the ALMA-CKD trial; an electronic triggering decision-support system to improve the detection, recognition, and management of patients with chronic kidney disease in primary care
Authors: Andersson-Emad Jacob , Thunholm Arvid , Nash Stephen , Evans Marie , Lind af Hageby Sara , Ärnlöv Johan , Hilderman Marie , Forseth Martin , Sjölander Arvid , Jacobson Stefan H. , Carrero Juan Jesus 
Published: November 2024

Abstract
Background
Chronic kidney disease (CKD) is a global health problem affected by under-recognition and under-treatment in primary care settings. Electronic clinical decision support (CDS) triggering systems have the potential to improve detection and management of people with CKD by assisting clinicians in adhering to guideline recommendations. We aimed to test whether an electronic CDS triggering system would improve the detection, recognition, and management of patients with CKD in primary care.

Method/Design
This is a pragmatic cluster-randomized controlled trial where 66 primary healthcare centers from the Stockholm Region, Sweden were randomized 1:1 to receive either a new expanded CDS-triggering system offering kidney-specific advice or to continue with their current CDS-triggering system. The expanded CDS system reminds and provides practical facilitators of the processes of CKD screening, recognition with a diagnosis, management and referral to specialist care. The trial duration is 24 months and it is embedded into the Stockholm CREAtinine measurements (SCREAM) project, a repository of healthcare data from the region, which minimizes disturbances with healthcare praxis due to the trial and makes it fully pragmatic. The primary outcomes are the number of eligible patients screened for creatinine and albuminuria once annually and the re-testing of these labs within 6 months in patients with abnormal eGFR or albuminuria. Secondary outcomes are the proportions of issued clinical diagnoses among those fulfilling criteria, proportions of patients with significant albuminuria receiving prescribed nephroprotective medications, proportions of accepted referrals to nephrologist care among those fulfilling criteria and proportion of referrals for ultrasound of the kidneys.

Discussion
Prior pragmatic trials of CDS-systems in CKD has shown an improvement in quality indicators primarily in patients already diagnosed with CKD. This study expands this evidence by focusing on the process of screening, identification, monitoring and diagnostic work-up.

Conclusion
This pragmatic trial will assess the value of CDS for improved adherence to CKD guidelines in primary care. Clinicaltrials.gov registration: NCT06386172, submitted 2024-04-23.
Perspective matters in recovery: the views of persons with severe mental illness, family and mental health professionals on collaboration during recovery, a qualitative study
Authors: Burger Thijs J. , van Eck Robin M. , Lachmeijer Marjolein , de Wilde-Schutten Kimriek R. G. , Lansen Mette , van Alphen Carola , van Haasteren Niek , Groen Karin , Schirmbeck Frederike , Vellinga Astrid , Kikkert Martijn J. , Dekker Jack , de Haan Lieuwe , de Koning Mariken B. 
Published: November 2024

Abstract
Background
Recovery from severe mental illness, including psychosis has been described as a personal and unique process, but it rarely is a journey undertaken without profound influences of significant others (family, mental health professionals). Diverging perspectives between persons with severe mental illness, family and professionals are frequent during the recovery process, notably in psychotic disorders. We aimed to explore processes of collaboration during recovery, to inform recovery supporting practices.

Methods
Current qualitative study had a participatory design and was set within long-term mental healthcare for severe mental illness. We conducted semi-structured interviews and focus groups with persons with severe mental illness (most had a history of psychosis), family and professionals on their mutual contact during recovery. Using reflexive thematic analysis, we developed themes representing processes of collaboration during recovery.

Results
We described roles persons with severe mental illness, family and professionals attribute to each other in mutually influential terms of unconditional and meaningful contact (which takes time to establish) and problem-oriented aspects. Secondly, experienced differences over problem definition, “needing help” and consequently over the role parties attribute to one another, may result in negative interactions, in the area of having expectations; (not) informing; (not) having agency to change; experiencing (dis)agreement or struggle.

Conclusions
unconditional, meaningful contact and knowing each other’s perspective are important to fruitful interaction in a triad when perspectives on mental health problems diverge. Relationally centered and process oriented care with continuity of family and professionals involved are needed to advance recovery in severe mental illness, especially psychosis.
Long-term effectiveness of aripiprazole once monthly on functioning and quality of life in schizophrenia: results of year 2 of the ReLiAM study
Authors: Roy Marc-André , Therrien François , Boucher Matthieu , Oluboka Oloruntoba 
Published: November 2024

Abstract
Background
Aripiprazole once-monthly (AOM) has proven effective in the treatment of schizophrenia, although little is known about its impact on global functioning and quality of life beyond 1 year. Here, we investigate the continued impact of AOM on the participants of the ReLiAM study during the second year of follow-up.

Methods
The participants who were evaluated at ≥ 1 time point during the second year of the ReLiAM study (months 15, 18, 21, and 24; year 1 completers) were assessed via the GAF scale. Secondary outcomes were reported on the SOFAS, CGI-S, and QLS.

Results
109 (86%) completed at least 1 post-12-month visit and 33 (30.3%) patients completed the final assessment at month 24. The improvements observed in the year 1 completers in GAF total score were maintained through to year 2 completers. The improvements in CGI-S and SOFAS that were observed at the end of year 1 were also maintained through the end of the second year. Similar trends of sustained improvement in GAF total score, CGI-S score, and SOFAS were observed in the post-hoc analyses of the year 2 completers. Seventy-four percent (74.3%) of year 1 completers experienced mild treatment-emergent adverse events during the second year, the most frequently reported being weight gain, akathisia, and insomnia. Seventeen percent (17.4%) experienced serious adverse events. Similar findings regarding effectiveness and tolerability were reported in the year 1 completers and in year 2 completers.

Conclusions
These findings suggest that the favorable effectiveness, including tolerability observed during the first year following AOM initiation, are maintained and may even continue to improve during the second year of treatment.

Trial registration
ClinicalTrials.gov NCT02131415, first posted on May 6, 2014. Overall trial status: Terminated.
Making plaque assessment easier – a validation study of simplified versions of the Marginal Plaque Index
Authors: Weik Ulrike , Eidenhardt Zdenka , Deinzer Renate 
Published: November 2024

Abstract
Background
The assessment of plaque indices may be time-consuming and error-prone. Simplification of these indices may increase their utility without compromising their validity. The aim of this study was to evaluate the validity of two simplified versions of the Marginal Plaque Index (MPI).

Methods
Two simplified versions of the MPI as well as the Plaque Control Record (PCR) were derived from full-scale MPI assessments in two studies with four age groups (N = 42 10-year-olds; N = 24 15 year-olds; N = 53 university students (18y-33y); N = 66 parents (32y-57y). Correlations with the Turesky modification of the Quigley-Hein Index (TQHI) and the Papillary Bleeding Index (PBI) were calculated.

Results
The indices derived from the MPI showed high convergence with each other (all r ≥ 0.94) and with the TQHI (r ≥ 0.80). The concurrent validity of the MPI with the PBI was equal to that of the TQHI in all age groups. The simplified versions of the MPI and the PCR show a lower convergent validity with the PBI than the MPI within parents (p < 0.05). In the other age groups, their convergent validity was equal to that of the MPI.

Discussion
Simplification of the MPI does not affect its convergent validity with other plaque indices but may reduce its concurrent validity with the PBI in middle-aged adults.
Association between sick child facility readiness and quality of care at the individual and facility level in five low- and middle-income countries
Authors: Carter Emily D. , Sheffel Ashley , Requejo Jennifer , Kosek Margaret , Campbell Harry , Eisele Thom , Munos Melinda K. 
Published: November 2024

Abstract
Background
Raising the quality of health services is key to continued progress in improving child health, however, data on service quality are limited and difficult to interpret. The relationship between facility readiness and the quality of care is complex.

Methods
Using publicly available data sets from five low- and middle-income countries (LMICs), we assessed the relationship between structural factors and the clinical quality of care for managing sick children. We developed indices for readiness and quality accounting for available indicators, expert opinion, and alignment with integrated management of childhood illness (IMCI) guidelines. In each country, we assessed the association between readiness and quality, with and without adjusting for other factors. We considered associations overall, by domain, and by provider type, explored non-linear associations, and compared associations at the individual and facility-level.

Results
The analysis included data from 3,149 health facilities and 11,159 sick child observations. In four of the five countries included in the analysis, we observed for every 10%-point increase in readiness, quality increased by about 1% point after adjusting for facility type and managing authority. There was little evidence of a non-linear relationship or a threshold effect altering the relationship between readiness and quality of care. Beyond readiness, younger child age, higher cost of care, and having a respiratory, digestive, or febrile diagnosis were most often associated with a higher quality of care. Higher “human resources” readiness domain scores were most consistently associated with better quality of care, while the quality of care domain of “treatment” was the least influenced by readiness. Facility-level associations did not vary greatly from individual-level associations.

Conclusions
The weak correlation observed suggests readiness plays an important role in quality but as currently measured cannot be used to characterize clinical quality of care. Data for assessing quality of health services are limited, presenting challenges for understanding impediments, assessing interventions, and gauging changes in the quality of care over time. We need better data to assess the quality of care being delivered in LMICs to understand what factors drive quality, with the goal of improving the management of sick children.
Exploring dysfunctional barrier phenotypes associated with glaucoma using a human pluripotent stem cell-based model of the neurovascular unit
Authors: Lavekar Sailee S. , Hughes Jason M. , Gomes Cátia , Huang Kang-Chieh , Harkin Jade , Canfield Scott G. , Meyer Jason S. 
Published: November 2024

AbstractGlaucoma is a neurodegenerative disease that results in the degeneration of retinal ganglion cells (RGCs) and subsequent loss of vision. While RGCs are the primary cell type affected in glaucoma, neighboring cell types selectively modulate RGCs to maintain overall homeostasis. Among these neighboring cell types, astrocytes, microvascular endothelial cells (MVECs), and pericytes coordinate with neurons to form the neurovascular unit that provides a physical barrier to limit the passage of toxic materials from the blood into neural tissue. Previous studies have demonstrated that these barrier properties may be compromised in the progression of glaucoma, yet mechanisms by which this happens have remained incompletely understood. Thus, the goals of this study were to adapt a human pluripotent stem cell (hPSC)-based model of the neurovascular unit to the study of barrier integrity relevant to glaucoma. To achieve this, hPSCs were differentiated into the cell types that contribute to this barrier, including RGCs, astrocytes, and MVECs, then assembled into an established Transwell®-insert model. The ability of these cell types to contribute to an in vitro barrier model was tested for their ability to recapitulate characteristic barrier properties. Results revealed that barrier properties of MVECs were enhanced when cultured in the presence of RGCs and astrocytes compared to MVECs cultured alone. Conversely, the versatility of this system to model aspects of barrier dysfunction relevant to glaucoma was tested using an hPSC line with a glaucoma-specific Optineurin (E50K) mutation as well as a paired isogenic control, where MVECs then exhibited reduced barrier integrity. To identify factors that could result in barrier dysfunction, results revealed an increased expression of TGFβ2 in glaucoma-associated OPTN(E50K) astrocytes, indicating a potential role for TGFβ2 in disease manifestation. To test this hypothesis, we explored the ability to modulate exogenous TGFβ2 in both isogenic control and OPTN(E50K) experimental conditions. Collectively, the results of this study indicated that the repurposing of this in vitro barrier model for glaucoma reliably mimicked some aspects of barrier dysfunction, and may serve as a platform for drug discovery, as well as a powerful in vitro model to test the consequences of barrier dysfunction upon RGCs in glaucoma.