bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transdiagnostic symptom subtypes across autism spectrum disorders and attention deficit hyperactivity disorder: validated by measures of neurocognition and structural connectivity
Authors: Zhang Manxue , Huang Yan , Jiao Jian , Yuan Danfeng , Hu Xiao , Yang Pingyuan , Zhang Rui , Wen Liangjian , Situ Mingjing , Cai Jia , Sun Xueli , Guo Kuifang , Huang Xia , Huang Yi 
Published: February 2022

Abstract
Backgrounds
Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders that exhibit within-disorder heterogeneity and cross-disorder phenotypic overlap, thus suggesting that the current disease categories may not fully represent the etiologic essence of the disorders, especially for highly comorbid neurodevelopmental disorders. In this study, we explored the subtypes of a combined sample of ASD and ADHD by integrating measurements of behavior, cognition and brain imaging.

Methods
A total of 164 participants, including 65 with ASD, 47 with ADHD, and 52 controls, were recruited. Unsupervised machine learning with an agglomerative hierarchical clustering algorithm was used to identify transdiagnostic symptom clusters. Neurocognition and brain structural connectivity measurements were used to assess symptom clusters. Mediation analysis was used to explore the relationship between transdiagnostic symptoms, neurocognition and brain structural connectivity.

Results
We identified three symptom clusters that did not fall within the diagnostic boundaries of DSM. External measurements from neurocognition and neuroimaging domains supported distinct profiles, including fine motor function, verbal fluency, and structural connectivity in the corpus callosum between these symptom clusters, highlighting possible biomarkers for ASD and ADHD. Additionally, fine motor function was shown to mediate the relationship between the corpus callosum and perseveration symptoms.

Conclusions
In this transdiagnostic study on ASD and ADHD, we identified three subtypes showing meaningful associations between symptoms, neurocognition and brain white matter structural connectivity. The fine motor function and structural connectivity of corpus callosum might be used as biomarkers for neurodevelopmental disorders with social skill symptoms. The results of this study highlighted the importance of precise phenotyping and further supported the effects of fine motor intervention on ASD and ADHD.
Integrating early stimulation and play at scale: study protocol for “MAHAY Mikolo”, a multi-arm cluster-randomized controlled trial
Authors: Galasso Emanuela , Ratsifandrihamanana Lisy , Weber Ann M. , Hemlock Caitlin , Col Mathilde , Dieci Maria , Rakotomalala Norotiana , Rambeloson Valerie , Fernald Lia C. H. 
Published: February 2022

Abstract
Background
Hundreds of millions of children living in poverty worldwide are not reaching their full, developmental potential. Programs to promote nurturing and responsive caregiving, such as those in which community health workers (CHWs) conduct home visits to support optimal early childhood development (ECD), have been effective in small trials, but have not achieved similar success at scale. This study will explore two approaches to scale-up: converting a home-visiting model to a group-based model; and integrating the ECD curriculum into an existing government program. The objectives of the study are to: 1) Measure how the integration of ECD activities affects time and task allocation of CHWs and CHW psychosocial wellbeing; 2) Examine how the integration of ECD activities affects caregiver-child dyad participation in standard health and nutrition activities; and 3) Explore how the availability of age-appropriate play materials at home affects caregiver-child dyad participation rates in a group-based ECD program.

Methods
We will randomize 75 communities in rural Madagascar into three arms: 1) [C], which is the status quo (community-based health and nutrition program); 2) [T], which is C + ECD group sessions [T]; and 3) [T +], which is T with the addition of an enhanced play materials package for home use. All children between 6–30 months old at the time of the intervention launch will be eligible to participate in group activities. The intervention will last 12 months and is comprised of fortnightly group sessions in which the CHWs provide caregiver-child dyads with information relating to ECD; CHWs will also include structured time for caregivers to practice the play and child stimulation activities they have learned. We will administer monthly surveys to measure CHW time use and task allocation, and we will leverage administrative data to measure caregiver-child dyad participation in the group sessions.

Discussion
The results from the trial will provide the evidence base required to implement an integrated package of nutrition, health and ECD promotion activities at scale in Madagascar, and findings may be relevant in other low-income countries.

Trial registration
This trial is registered on the AEA Social Science Registry (AEARCTR-0004704) on November 15, 2019 and on ClinicalTrials.gov (NCT05129696) on November 22, 2021.
Biomechanics of extreme lateral interbody fusion with different internal fixation methods: a finite element analysis
Authors: Li Xiao-hua , She Li-jun , Zhang Wei , Cheng Xiao-dong , Fan Jin-peng 
Published: February 2022

Abstract
Background
Establishing a normal L3–5 model and using finite element analysis to explore the biomechanical characteristics of extreme lateral interbody fusion (XLIF) with different internal fixation methods.

Method
The L3–5 CT image data of a healthy adult male volunteer were selected to establish a normal lumbar finite element model (M0). The range of motion (ROM) of L3–4 and L4–5, under flexion, extension, left bending, right bending, left rotation, and right rotation, together with L3–4 disc pressure was analyzed. Then the L4–5 intervertebral disc was excised and implanted with a cage, supplemented by different types of internal fixation, including lateral two-hole plate model (M1), lateral four-hole plate model (M2), VerteBRIDGE plating model (M3), lateral pedicle model (M4), posterior unilateral pedicle screw model (M5) and posterior bilateral pedicle screw model (M6). The ROM,the maximum stress value of the cage, and the maximum stress value of the intervertebral disc of L3–4 were analyzed and studied .

Results
The ROM of L3–4 and L4-L5 segments in the validation model under various motion states was basically consistent with previous reports. The lumbar finite element model was validated effectively. After XLIF-assisted internal fixation, the range of activity in L3–4 segments of each internal fixation model was greater than that of the normal model under various working conditions, among which the M5、M6 model had the larger range of activity in flexion and extension. After the internal fixation of L4–5 segments, the mobility in M1-M6 was significantly reduced under various motion patterns. In terms of flexion and extension, the posterior pedicle fixation model (M5、M6) showed a significant reduction,followed by M2. The maximal von mises cage stress of M1 was obviously greater than that of other models (except the left bending). Compared with M0, the intervertebral disc stress of M1-M6 at L3–4 segments was increased.

Conclusions
It is recommended that the posterior bilateral pedicle screw model is the first choice, followed by the lateral four-hole plate model for fixation during XLIF surgery. However, it is still necessary to be aware of the occurrence of adjacent segment degeneration (ASD) in the later stage.
Surgical treatment, complications, reoperations, and healthcare costs among patients with clavicle fracture in England
Authors: Wolf Simone , Chitnis Abhishek S. , Manoranjith Anandan , Vanderkarr Mollie , Plaza Javier Quintana , Gador Laura V. , Holy Chantal E. , Sparks Charisse , Lambert Simon M. 
Published: February 2022

Abstract
Introduction
The clinical and economic burden of clavicle fractures in England is not well documented. This study evaluated rates of surgical treatment, post-surgical complications, reoperations and costs in patients with clavicle fractures using the Clinical Practice Research Datalink (CPRD) database.

Methods
CPRD data were linked to National Health Service Hospital Episode Statistics data. Patients with a diagnosis of clavicle fracture between 2010–2018 were selected in CPRD (date of fracture = index date). Of those, patients with surgical intervention within 180 days from index fracture were identified. Rates of post-surgical complications (i.e., infection, non-union, and mal-union), reoperations (for device removal or for postoperative complications), post-operative costs and median time to reoperations were evaluated up to 2 years after surgery.

Results
21,340 patients with clavicle fractures were identified (mean age 35.0 years(standard deviation (SD): 26.5), 66.7% male). Surgery was performed on 672 patients (3.2% of total cohort) at an average 17.1 (SD: 25.2) days post-fracture. Complications (i.e., infection, non-union, or malunion) affected 8.1% of surgically treated clavicle fracture patients; the rate of infection was 3.5% (95% CI, 1.7%- 5.2%), non-union 4.4% (95% CI, 2.4%-6.5%), and mal-union 0.3% (95% CI, 0%-0.7%). Adjusting for age, gender, comorbidities and time to surgery, the all-cause reoperation rate was 20.2% (13.2%-30.0%) and the adjusted rate of reoperation for implant removal was 17.0% (10.7%-25.9%)—84% of all-cause reoperations were thus performed for implant removal. Median time to implant removal was 254 days. The mean cost of reoperations for all causes was £5,000. The most expensive reoperations were for cases that involved infection (mean £6,156).

Conclusions
Complication rates following surgical clavicle fracture care averaged 8.1%. However, reoperation rates exceed 20%, the vast majority of reoperations being performed for device removal. Technologies to alleviate secondary device removal surgeries would address a significant clinical unmet need.
Liner dissociation in a large-diameter ceramic-bearing acetabular component: a report of five cases
Authors: Kostretzis Lazaros , Martinov Sagi , Lavigne Martin , Massé Vincent , Vendittoli Pascal-André 
Published: February 2022

Abstract
Background
Ceramic-on-ceramic (CoC) bearings for total hip arthroplasty (THA) have been offering very favorable results and survivorship since their introduction. In order to increase range of movement (ROM) and decrease dislocation rates, some manufacturers have introduced larger diameter head (LDH) CoC bearings. This has been achieved with the use of preassembled cup designs, in which the ceramic liner is already fitted into the metal backing and implanted as a monoblock component by the surgeon. In this report we present data from a series of 5 patients with ceramic liner dissociation from a monoblock cup.

Case presentation
All cases were overweight men with acetabular components of 56 or 58 mm. After a mean of 5.5 (range, 3.5-6.7) years, all patients reported sudden pain and audible noise when performing activities of daily living. Liner displacement was suspected on plain radiographs and confirmed by Ct-scan. Pneumarthrosis was present in all cases. Taper modular junction wear and corrosion signs were observed in the four revised patients.

Conclusion
Although one of our case is still treated conservatively, implant revision is probably inevitable. Further LDH CoC implant design should take in consideration this potential complication by avoiding bearing diameters over 40mm and/or improving locking mechanism or by providing a real monoblock acetabular implant.
Projected number of osteoarthritis patients in Austria for the next decades – quantifying the necessity of treatment and prevention strategies in Europe
Authors: Hitzl Wolfgang , Stamm Tanja , Kloppenburg Margreet , Ritter Markus , Gaisberger Martin , van der Zee-Neuen Antje 
Published: February 2022

Abstract
Background
The present study aimed to predict the expected number of patients with osteoarthritis (OA) in Austria up to the year 2080.

Methods
Demographic data and population projections between 2019 and 2080 were obtained from European authorities. Information about recent age- and sex-stratified prevalence of patients with self-reported physician-diagnosed OA was obtained from the Austrian Health Interview Survey (n = 15,771). Projections were stratified by age and sex; sensitivity analyses were performed based on aging, main (most likely), and growth scenarios of the population.

Results
Based on the projection, the overall increase in the total number of patients with OA from 2019 to 2080 will be 38% for men and women. In 2019, the highest number of OA-patients nested in the groups of persons aged 70-79 (n = 238,749) and 60-69 (n = 237,729) years. In 2080, the 80+ age group is predicted to have the highest number of OA with 421,548 individuals (i.e. factor 3.45 and factor 2.48 increase in the male and female group, respectively, compared to 2019), followed by the group aged 70-79 with 314,617 individuals (factor 1.45 and factor 1.28 increase in the male and female group, respectively, compared to 2019). Similar trends were found in the ageing and growing scenarios.

Conclusions
The projected increase in the occurrence of OA will likely lead to a substantial socioeconomic burden for the Austrian healthcare system in the near and far future. The current findings plead for the development of sustainable concepts for the treatment and prevention of OA by European authorities.
Motivations and future plans of the final year students in a Chinese dental school
Authors: Xu Chao , Gao Liang , Zhang Shuai , Zhang Jiamin , Li Chen , Zhang Dongmei , Pan Yaping , Liu Jingbo 
Published: February 2022

Abstract
Background
Understanding dental students’ future career choice and motivation could provide beneficial references for both educators and students, but there were few studies on students in a Chinese dental school. The study aimed to investigate Chinese final year dental students’ the short-term and long-term plans, motivations, and identify the influence of gender on the future plans.

Methods
A total of 265 final year dental school students of the School of Stomatology, China Medical University from 2016 through 2020 were invited to complete an anonymous, 27-item questionnaire. Moreover, almost all of questions were in multiple-choice formats. Data were categorized and analysed using chi-square comparative analyses.

Results
88.3% of respondents decided to pursue a graduate degree after graduating from dental school. Moreover, the single most important reason influencing their plans was “eligible for better jobs” (42.8%). More females than males studied dentistry (222 vs 111), and gender had an influence on the choice of specialty.

Conclusions
This study listed the selection tendency and influencing factors of students in a Chinese dental school for the reference of educators and students. And the results could raise some useful influence and feedback effect on current health and education policy, and on the career development of practicing dentists or dental students.
Impact of COVID-19 pandemic on diagnostic pathology in the Netherlands
Authors: van Velthuysen M. L. F. , van Eeden S. , le Cessie S. , de Boer M. , van Boven H. , Koomen B. M. , Roozekrans F. , Bart J. , Timens W. , Voorham Q. J. M. 
Published: February 2022

Abstract
Background
The COVID-19 pandemic has a huge impact on healthcare provided. The nationwide pathology registry of the Netherlands, PALGA, offers an outstanding opportunity to measure this impact for diseases in which pathology examinations are involved.

Methods
Pathology specimen numbers in 2020 were compared with specimen numbers in 2019 for 5 periods of 4 weeks, representing two lockdowns and the periods in between, taking into account localization, procedure and benign versus malignant diagnosis.

Results
The largest decrease was seen during the first lockdown (spring 2020), when numbers of pathology reports declined up to 88% and almost all specimen types were affected. Afterwards each specimen type showed its own dynamics with a decrease during the second lockdown for some, while for others numbers remained relatively low during the whole year. Generally, for most tissue types resections, cytology and malignant diagnoses showed less decrease than biopsies and benign diagnoses. A significant but small catch-up (up to 17%) was seen for benign cervical cytology, benign resections of the lower gastro-intestinal tract, malignant skin resections and gallbladder resections.

Conclusion
The COVID-19 pandemic has had a significant effect on pathology diagnostics in 2020. This effect was most pronounced during the first lockdown, diverse for different anatomical sites and for cytology compared with histology. The data presented here can help to assess the consequences on (public) health and provide a starting point in the discussion on how to make the best choices in times of scarce healthcare resources, considering the impact of both benign and malignant disease on quality of life.
Enhanced intestinal protein fermentation in schizophrenia
Authors: Liang Ying , Shi Xing , Shen Yang , Huang Zhuoran , Wang Jian , Shao Changjun , Chu Yanan , Chen Jing , Yu Jun , Kang Yu 
Published: February 2022

Abstract
Background
Emerging findings highlighted the associations of mental illness to nutrition and dysbiosis in the intestinal microbiota, but the underlying mechanisms, especially in schizophrenia (SZ), remain unclarified.

Methods
We conducted a case-control study of SZ patients (case to control=100:52) by performing sequencing of the gut metagenome; measurement of fecal and plasma non-targeted metabolome; including short-, medium-, and long-chain fatty acids; and targeted metabolites, along with recorded details of daily intakes of food.

Results
The metagenome analysis uncovered enrichment of asaccharolytic species and reduced abundance of carbohydrate catabolism pathways and enzymes in the gut of SZ patients, but increased abundance of peptidases in contrast to their significantly reduced protein intake. Fecal metabolome analysis identified increased concentrations of many protein catabolism products, including amino acids (AAs), urea, branched short-chain fatty acids, and various nitrogenous derivates of aromatic AAs in SZ patients. Protein synthesis, represented by the abundance of AA-biosynthesis pathways and aminoacyl-tRNA transferases in metagenome, was significantly decreased. The AUCs (area under the curve) of the diagnostic random forest models based on their abundance achieved 85% and 91%, respectively. The fecal levels of AA-fermentative enzymes and products uniformly showed positive correlations with the severity of psychiatric symptoms.

Conclusions
Our findings revealed apparent dysbiosis in the intestinal microbiome of SZ patients, where microbial metabolism is dominated by protein fermentation and shift from carbohydrate fermentation and protein synthesis in healthy conditions. The aberrant macronutrient metabolism by gut microbes highlights the importance of nutrition care and the potential for developing microbiota-targeted therapeutics in SZ.
Meeting people where they are: implementing hospital-based substance use harm reduction
Authors: Perera Rachel , Stephan Louise , Appa Ayesha , Giuliano Ro , Hoffman Robert , Lum Paula , Martin Marlene 
Published: February 2022

AbstractBackgroundHospital-based addiction care focuses on assessing and diagnosing substance use disorders, managing withdrawal, and initiating medications for addiction treatment. Hospital harm reduction is generally limited to prescribing naloxone. Hospitals can better serve individuals with substance use disorders by incorporating harm reduction education and equipment provision as essential addiction care. We describe the implementation of a hospital intervention that provides harm reduction education and equipment (e.g., syringes, pipes, and fentanyl test strips) to patients via an addiction consult team in an urban, safety-net hospital.MethodsWe performed a needs assessment to determine patient harm reduction needs. We partnered with a community-based organization who provided us harm reduction equipment and training. We engaged executive, regulatory, and nursing leadership to obtain support. After ensuring regulatory compliance, training our team, and developing a workflow, we implemented this harm reduction program that provides education and equipment to individuals whose substance use goals do not include abstinence.ResultsDuring a 12-month period we provided 195 individuals harm reduction kits.ConclusionsThis intervention allowed us to advance hospital-based addiction care, better educate and engage patients, staff, and clinicians, and reduce stigma. By establishing a community harm reduction partner, obtaining support from hospital leadership, and incorporating feedback from staff, clinicians, and patients, we successfully implemented harm reduction education and equipment provision in a hospital setting as part of evidence-based addiction care.Trial registration: Commentary, none.
Evaluation of pulmonary function among detergent powder factory workers- a cross sectional study in Semnan, Iran
Authors: Malek Farhad , Ranjbari Elham , Mirmohammadkhani Majid , Pahlevan Daryoush 
Published: February 2022

AbstractOccupational respiratory diseases are the most prevalent occurring work-related diseases that contribute to global health concerns. The present study aimed to assess pulmonary function among detergent powder factory workers.In a cross-sectional study, 305 employees working at a detergent powder company in Semnan, Iran were enrolled. Demographic characteristics, health- and job-related information were recorded using a checklist. Subsequently, spirometer was used at baseline, before and after shift-working for recording respiratory ailments and pulmonary function tests (PFT).According to the results, the mean percentage of all spirometric indices significantly reduced after shift-work including forced vital capacity (FVC) (P < 0.01), forced expiratory volume in one second (FEV1) (P < 0.01), FEV1/FVC ratio (P = 0.038), peak expiratory flow (PEF) (P = 0.13) and forced expiratory flow at 25 and 75% of the pulmonary volume (FEF (25–75)) (P < 0.01). Although the mean percentage of FEV1 significantly improved upon wearing the protective mask (P = 0.014). Moreover, FVC and FEV1 indices were significantly less in smoking workers than in non-smoking participants (P = 0.005 and P = 0.003, respectively).This study revealed that using effective preventive measures should be tightly performed to promote health conditions. However, despite the occupational health programs for preventing and reducing work-related respiratory diseases, these can be considered as a serious threat for detergent powder factory workers that need to apply more control strategies and health assessment.