bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regulatory Intensity and Firm-Specific Exposure
Authors: Kalmenovitz Joseph 
Published: January 2023

Abstract
Building on administrative data and machine-learning models, I develop a firm-specific measure of regulatory intensity: cost of compliance with all federal paperwork regulations. Regulatory intensity increases the cost of goods sold and overhead spending (SGA). It also incentivizes companies to reduce capital investment, hire fewer employees, and lobby more. The effects are particularly strong among financially constrained firms and those with irreversible investment opportunities, suggesting that regulation affects companies through budgetary pressures and heightened uncertainty. The findings highlight the real effects of regulation and the underlying mechanisms.
Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
A Phase IB/IIA Study of Ex Vivo Expanded Allogeneic Bone Marrow Derived Mesenchymal Stem Cells for the Treatment of Perianal Fistulizing Crohn’s Disease
Authors: Lightner Amy L. , Reese Jane , Ream Justin , Nachand Douglas , Jia Xue , Dadgar Neda , Steele Scott R. , Hull Tracy 
Published: January 2023

BACKGROUND:
Mesenchymal stem cells have been used for the treatment of perianal Crohn’s fistulizing disease by direction injection. However, no studies to date have included patients with proctitis, anal canal involvement, and multiple branching tracts.

OBJECTIVE:
To determine safety and efficacy of mesenchymal stem cells for refractory perianal Crohn’s disease.

DESIGN:
Phase IB/IIA randomized control trial

SETTINGS:
Tertiary inflammatory bowel disease referral center

PATIENTS:
Adult Crohn’s patients with perianal fistulizing disease

INTERVENTION:
75 million mesenchymal stem cells were administered with a 22G needle by direct injection after curettage and primary closure of the fistula tract. A repeat injection of 75 million mesenchymal stem cells at 3 months was given if complete clinical and radiographic healing were not achieved.

MAIN OUTCOMES MEASURES:
Adverse and serious adverse events at post procedure day 1, week 2, week 6, month 3, month 6 and month 12. Clinical healing, radiographic healing per magnetic resonance imaging, and patient reported outcomes at the same time points.

RESULTS:
A total of 23 patients were enrolled and treated; 18 were treatment and 5 were control. There were no adverse or serious adverse events reported related to mesenchymal stem cells therapy. At six months, 83% of the treatment group and 40% of the control had complete clinical and radiographic healing. The perianal Crohn’s disease activity index, Wexner incontinence score, and VanAssche score had all significantly decreased in treatment patients at six months; none significantly decreased in the control group.

LIMITATIONS:
Single institution and single blinded.

CONCLUSIONS:
Bone marrow derived mesenchymal stem cells offer a safe and effective alternative treatment approach for severe perianal fistulizing Crohn’s disease. See Video Abstract at http://links.lww.com/DCR/C128
Stability and Change in Biopsychosocial Factors Associated With Fatigue 6 and 12 Months After Traumatic Brain Injury: An Exploratory Multilevel Study
Authors: Løke Daniel , Andelic Nada , Helseth Eirik , Vassend Olav , Andersson Stein , Ponsford Jennie L. , Tverdal Cathrine , Brunborg Cathrine , Løvstad Marianne 
Published: January 2023

Objective:
To explore factors associated with stability and change in fatigue from 6 to 12 months following traumatic brain injury (TBI).

Setting:
Combined in- and outpatient acute care and postacute rehabilitation settings.

Participants:
A total of 103 patients with confirmed intracranial injury were assessed 6 and/or 12 months following TBI.

Design:
A prospective observational study with repeated measures at 2 time points, analyzed with a hybrid mixed-effects model.

Main Measures:
Primary outcomes were the fatigue factor derived from items from several fatigue patient-reported outcome measures (PROMs; Fatigue Severity Scale, Chalder Fatigue Scale, Giessen Subjective Complaints List–fatigue subscale, and Rivermead Post-Concussion Symptoms Questionnaire–fatigue item) Secondary outcomes were PROMs relating to pain, somatic and psychological distress, insomnia, sleepiness, personality traits, optimism, resilience, behavioral activation and inhibition, and loneliness, as well as neuropsychological measures. Demographic variables and injury severity characteristics were included as covariates.

Results:
In multilevel regression, female sex, years of education, and 3 factors related to injury severity, somatic vulnerability, and psychosocial robustness were all significantly associated with variation in fatigue between subjects, and explained 61% of the variance in fatigue that was due to stable between-subject differences. Fatigue levels declined significantly over time. Changes in pain severity, somatic symptom burden, psychological distress, and behavioral inhibition were positively associated with changes in fatigue, explaining 22% of the variance in fatigue within subjects.

Conclusions:
The study demonstrated that several previously implicated factors show robust effects in distinguishing individuals with TBI on levels of fatigue, but only a few show additional within-subject associations across time. Pain severity, somatic symptom burden, psychological distress, and behavioral inhibition correlated with fatigue across time, implicating these factors as crucial targets for rehabilitation of patients with TBI who suffer from persistent fatigue.
A Prospective Cohort Study of the Association Between Preinjury Psychosocial Function and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury: An A-CAP Study
Authors: Doan Quynh , Chadwick Leah , Tang Ken , Brooks Brian L. , Beauchamp Miriam , Zemek Roger , Craig William , Gravel Jocelyn , Yeates Keith Owen 
Published: January 2023

Objective:
We evaluated the moderating effect of preinjury psychosocial function on postconcussion symptoms for children with mild traumatic brain injury (mTBI).

Design, Setting, and Population:
We conducted a prospective cohort study of children ages 8.0 to 16.9 years with mTBI (n = 633) or orthopedic injury (OI; n = 334), recruited from 5 pediatric emergency departments from September 2016 to December 2018.

Main Measures:
Participants completed baseline assessments within 48 hours of injury, and postconcussion symptoms assessments at 7 to 10 days, weekly to 3 months, and biweekly to 6 months post-injury. Preinjury psychosocial function was measured using parent ratings on the Pediatric Quality of Life Inventory (PedsQL) and the Strengths and Difficulties Questionnaire (SDQ), retrospectively evaluating their child's status prior to the injury. Parent and child ratings on the Health and Behavior Inventory (HBI) (cognitive and somatic subscales) and the Post-Concussion Symptom Interview (PCS-I) were used as measures of postconcussion symptoms. We fitted 6 longitudinal regression models, which included 747 to 764 participants, to evaluate potential interactions between preinjury psychosocial function and injury group as predictors of child- and parent-reported postconcussion symptoms.

Results:
Preinjury psychosocial function moderated group differences in postconcussion symptoms across the first 6 months post-injury. Higher emotional and conduct problems were significantly associated with more severe postconcussion symptoms among children with mTBI compared with OI. Wald's χ2 for interaction terms (injury group × SDQ subscales) ranged from 6.3 to 10.6 (P values <.001 to .043) across parent- and child-reported models. In contrast, larger group differences (mTBI > OI) in postconcussion symptoms were associated with milder hyperactivity (Wald's χ2: 15.3-43.0, all P < .001), milder peer problems (Wald's χ2: 11.51, P = .003), and higher social functioning (Wald's χ2: 12.435, P = .002).

Conclusions:
Preinjury psychosocial function moderates postconcussion symptoms in pediatric mTBI, highlighting the importance of assessing preinjury psychosocial function in children with mTBI.
Incidence Rates of Medically Attended COVID-19 in Infants Less Than 6 Months of Age
Authors: Griffin Isabel , Irving Stephanie A. , Arriola Carmen Sofia , Campbell Angela P. , Li De-Kun , Dawood Fatimah S. , Doughty-Skierski Caroline , Ferber Jeannette R. , Ferguson Nickolas , Hadden Louise , Henderson Jillian T. , Juergens Mary , Kancharla Venkatesh , Naleway Allison L. , Newes-Adeyi Gabriella , Nicholson Erin , Odouli Roxana , Reichle Lawrence , Sanyang Mo , Woodworth Kate , Munoz Flor M. 
Published: January 2023

Background:
Studies suggest infants may be at increased risk of severe coronavirus disease 2019 (COVID-19) relative to older children, but few data exist regarding the incidence of COVID-19 episodes and associated risk factors. We estimate incidence rates and describe characteristics associated with medically attended COVID-19 episodes among infants younger than 6 months of age.

Methods:
We analyzed electronic medical record data from a cohort of infants born March 1, 2020–February 28, 2021. Data from 3 health care delivery systems included demographic characteristics, maternal and infant outpatient visit and hospitalization diagnoses and severe acute respiratory syndrome coronavirus syndrome 2 (SARS-CoV-2) test results. Medically attended COVID-19 episodes were defined by positive SARS-CoV-2 clinical tests and/or COVID-19 diagnosis codes during medical care visits. Unadjusted and site-adjusted incidence rates by infant month of age, low and high SARS-CoV-2 circulation periods and maternal COVID-19 diagnosis were calculated.

Results:
Among 18,192 infants <6 months of age whose mothers received prenatal care within the 3 systems, 173 (1.0%) had medically attended COVID-19 episodes. Incidence rates were highest among infants under 1 month of age (2.0 per 1000 person-weeks) and 1 month (2.0 per 1000 person-weeks) compared with older infants. Incidence rates were also higher for infants born to women with postpartum COVID-19 compared with women without known COVID-19 and women diagnosed with COVID-19 during pregnancy.

Conclusions:
Infants of women with postpartum COVID-19 had a higher risk of medically attended COVID-19 than infants born to mothers who were diagnosed during pregnancy or never diagnosed underscoring the importance of COVID-19 prevention measures for their household members and caregivers to prevent infections in infants.
Three dimensions of pain in osteoarthritis: development and validation of the Osteoarthritis Symptom Inventory Scale
Authors: Perrot Serge , Trouvin Anne-Priscille , Bouhassira Didier 
Published: January 2023

Abstract
We describe here the development and validation of the Osteoarthritis Symptom Inventory Scale (OASIS), a new self-administered questionnaire specifically designed to evaluate the various osteoarthritis (OA) pain symptoms with different dimensions related to OA pain mechanisms. The initial development phase and qualitative study generated a list of 17 descriptors reflecting OA pain and other associated symptoms, leading to the first version of the questionnaire (OASIS17). Each item was quantified on a 0 to 10 Numerical Scale. Validation was performed using 123 consecutive patients with OA pain recruited at 28 centers in France, mainly general practitioner offices. Validation involved (1) determining the questionnaire's factorial structure through exploratory and confirmatory analyses, (2) analyzing convergent and divergent validities (ie, construct validity), (3) assessing each item's test–retest reliability, and (4) evaluating OASIS ability to detect treatment effects (ie, sensitivity to change). The final OASIS version includes 9 items discriminating and quantifying 3 distinct, clinically relevant OA pain dimensions sensitive to treatment. OASIS9 psychometric properties suggest that it could improve the characterization of OA pain profiles for 3 clinically relevant domains: localized, neuropathic-like, and deep pain. The OASIS9 questionnaire could be used to phenotype OA pain patients and identify responders to various therapeutic interventions as a function of OA pain dimensions.
Factors Affecting Turnover of Advanced Practice Providers: A University Teaching Hospital Review
Authors: Venegas Brittany , Benitez Elida , Matthews Rachel , Brandt Anna Michelle , Efron Philip , Duckworth Laurie , McGough Edward 
Published: January 2023

Goal:
Retention of advanced practice providers (APPs) is an issue of critical importance to healthcare leaders. High APP turnover negatively affects an organization's ability to meet patient needs, maintain quality of care, and control costs. Our goal was to identify any association between intent to leave and specific survey factors; analyze the distribution of scale factors from the survey; and describe differences among the APP roles, specialties, and length of employment.

Methods:
This study used a self-administered questionnaire for APPs at a large university medical center to determine job satisfaction rates and intent to resign. The survey used a modified Misener Nurse Practitioner Job Satisfaction Scale and Anticipated Turnover Scale.

Principal Findings:
We received surveys from 102 providers (for a 38.9% response rate). Results were used to determine the correlation between job satisfaction and intent to leave and to identify possible factors involved in APP commitment to the hospital and intent to stay. We found that APPs reported the most satisfaction in benefits, followed by time (i.e., time available for answering messages, reviewing laboratory and other test results, seeing patients, scheduling work). Intrapractice partnership/collegiality received the lowest satisfaction score. Extrinsic factors such as monetary bonuses available in addition to salary, reward distribution, involvement in research, conflict resolution, and opportunity to receive compensation for services performed outside normal duties were common dissatisfiers.

Practical Applications:
This survey may help hospitals identify in real time the triggers of APP dissatisfaction and intent to resign. In addition, the results may guide possible revisions to hospital policies and practice procedures to improve APP commitment and decrease turnover intent. Additional surveys in similar university teaching hospital systems could confirm comparable intrinsic and extrinsic factors that are relevant to the satisfaction and turnover of APPs.
For-Profit Hospital Reflections on Community Relationships in the Time of COVID-19
Authors: Cronin Cory E. , Choyke Kelly Lynn , Franz Berkeley 
Published: January 2023

Goals:
Throughout the COVID-19 pandemic, hospitals and their staffs have been pushed to their limits. Hospitals have had to rethink how they support community health while also providing critical acute care services to combat the morbidity and mortality associated with COVID-19. As anchor institutions, hospitals have a significant effect on not only community health and well-being but also on local economies as primary employers and contractors. This study aimed to understand how the pandemic reshaped interactions with community members, staff, and other community organizations and changed the nature of hospital–community engagement among for-profit hospitals.

Methods:
We recruited leaders of for-profit hospitals, systems, and a business association that represents for-profit hospitals. We interviewed 28 participants in various leadership roles via telephone or videoconferencing and then thematically coded interview transcriptions. The themes identified in early interviews guided the structure of forthcoming interviews.

Principal Findings:
For-profit hospitals appear motivated to address community health needs as anchor institutions in their communities, and these efforts have strengthened and changed in important ways as a result of the COVID-19 pandemic. In this study, three themes emerged regarding the influence of COVID-19 on hospital–community relationships: Hospitals refocused outreach and engagement efforts to support employees, found essential new ways to safely engage with the community through partnerships and collaborations, and were reminded of the critical roles of social and cultural factors in the health and well-being of individuals and communities.

Practical Applications:
Hospitals may be able to use lessons learned during the pandemic to support the growing need for community engagement and attention to social determinants of health. The themes that emerged from this study present valuable opportunities for hospitals to carry forward the lessons learned over the course of the pandemic, as they have the potential to improve the delivery of healthcare and community engagement in day-to-day operations as well as in crises.
Eating Difficulties and Relationship With Nutritional Status Among Patients With Dementia
Authors: CILIZ Ozlem , TULEK Zeliha , HANAGASI Hasmet , BILGIC Basar , GURVIT I. Hakan 
Published: January 2023

ABSTRACT

Background
One of the most common behavioral problems in patients with dementia is eating problems, which are known to increase the risk of malnutrition. However, few studies have been conducted in this patient group regarding the relationship between eating difficulties and nutritional status.

Purpose
This study was designed to determine the eating difficulties faced by patients with dementia and to evaluate the relationship in this population between eating difficulties and malnutrition.

Methods
This study was carried out in a dementia outpatient clinic of a university hospital in Istanbul, Turkey. This cross-sectional, case-control study included 50 patients and 50 healthy controls as participants. Participants were assessed for eating difficulties and for nutritional, cognitive, and functional statuses.

Results
The patients with dementia had more difficulties in terms of self-feeding skills. Although problems related to manipulating food on the plate and the use of utensils were not seen in the control group, these problems were found in 30% of the participants in the dementia group (p < .001). Moreover, 30% of the patients in the dementia group were unable to eat without assistance (p < .001). Associations were found between eating difficulties and age, duration of illness, and cognitive and functional (basic and instrumental activities of daily living) statuses. In addition, self-feeding skills were found to be associated with nutritional status. Rate of malnutrition or risk of malnutrition was higher in patients with dementia than in those in the control group.

Conclusions
In this study, compared with the control group, patients with dementia had more problems in self-feeding skills such as manipulation of food on a plate, use of utensils, need for assistive tools, ability to eat without assistance, and negative eating behaviors (refusal to eat). An association was found between eating difficulties and nutritional status. Evaluating eating difficulties is recommended in patients with dementia to prevent nutritional deterioration.
Low-Load Blood-Flow-Restricted Exercise to Prevent Muscle Atrophy and Decline in Functional Performance in a Patient Recovering From a Malleolus Fracture. A Case Report
Authors: Mortensen Louise , Mechlenburg Inger , Langgård Jørgensen Stian 
Published: January 2023

Abstract:
This present case presentation offers supportive evidence that low-load blood-flow-restriction exercise (LL-BFRE) may be a feasible intervention to preserve skeletal muscle mass and, in part, lower-limb muscle function after a fracture of the lateral malleolus. A 28-year-old female patient sustained a radiographically verified stabile fracture of the lateral malleolus and was treated with a walker cast. She was allowed weight bearing on the limb within the limits of her pain threshold and to perform unloaded plantar and dorsiflexion movements of the ankle. The patient performed 12 weeks of home-based LL-BFRE 4 times per week to diminish declines in functional performance, muscle strength, and skeletal muscle atrophy. We observed that LL-BFRE was feasible with no exercise-related adverse events in the early stage of rehabilitation. The patient experienced no-or-low pain during exercise. Vastus lateralis muscle volume, and thigh and calf circumference was preserved.
Implementation of the International Olympic Committee Sport Mental Health Assessment Tool 1: Screening for Mental Health Symptoms in a Canadian Multisport University Program
Authors: Mountjoy Margo , Edwards Carla , Cheung Christian P. , Burr Jamie , Gouttebarge Vincent 
Published: January 2023

Objective:
To apply the International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) to determine the prevalence of mental health symptoms in a cohort of university student athletes over an academic year. A secondary objective was to explore the internal consistency of the screening tools from the SMHAT-1.

Design:
Cross-sectional design with 3 repeated measurements over an academic year.

Setting:
A large university multisport program.

Participants:
Five hundred forty-two university-level student athletes from 17 sports.

Intervention:
N/A.

Main Outcome Measures:
On 3 occasions, the participants completed the SMHAT-1, which consists of the Athlete Psychological Strain Questionnaire. If an athlete's score was above the threshold (≥17), the athlete completed step 2, consisting of (1) Generalized Anxiety Disorder-7; (2) Patient Health Questionnaire-9; (3) Athlete Sleep Screening Questionnaire; (4) Alcohol Use Disorders Identification Test Consumption; (5) Cutting Down, Annoyance by Criticism, Guilty Feeling, and Eye-openers Adapted to Include Drugs; and (6) Brief Eating Disorder in Athletes Questionnaire. Internal consistency of the SMHAT-1 was also measured.

Results:
Participants reported mental health symptoms with prevalence of 24% to 40% for distress, 15% to 30% for anxiety, 19% to 26% for depression, 23% to 39% for sleep disturbance, 49% to 55% for alcohol misuse, 5% to 10% for substance use, and 72% to 83% for disordered eating. Female athletes were more likely to suffer psychological strain, depression, and sleep disturbance; male athletes were more likely to report substance use.

Conclusions:
The SMHAT-1 was feasible to implement with good internal consistency. University-level athletes suffer from a variety of mental health symptoms underscoring the necessity for team physicians to have the clinical competence to recognize and treat mental health symptoms.