bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adapted Dialectical Behavior Therapy for Adolescents with a High Risk of Suicide in a Community Clinic: A Pragmatic Randomized Controlled Trial
Authors: Santamarina‐Perez Pilar , Mendez Iria , Singh Manpreet K. , Berk Michele , Picado Marisol , Font Elena , Moreno Elena , Martínez Esteve , Morer Astrid , Borràs Roger , Cosi Alexandra , Romero Soledad 
Published: January 2020

ObjectiveThis study is a pragmatic randomized controlled trial, which compares the effectiveness of an adapted form of Dialectical Behavior Therapy for Adolescents (DBT‐A) and treatment as usual plus group sessions (TAU + GS) to reduce suicidal risk for adolescents in a community health mental clinic.MethodThirty‐five adolescents from a community outpatient clinic, with repetitive NSSI alone or with SA over the last 12 months and with current high suicide risk as assessed by the Columbia‐Suicide Severity Rating Scale (C‐SSRS), were enrolled. Participants were randomly assigned to undergo either DBT‐A (n = 18) or TAU + GT (n = 17) treatments over a 16‐week period. Primary outcomes were the difference between NSSI and SA recorded during the first 4 weeks and the final 4 weeks of treatment. Secondary outcomes included changes in Children’s Global Assessment Scale (C‐GAS), Suicidal Ideation Questionnaire (SIQ‐JR), and Beck Depression Inventory‐II (BDI‐II).ResultsDialectical Behavior Therapy for Adolescents was more effective than TAU + GS at reducing NSSI, use of antipsychotics, and improving C‐GAS. No SAs were reported in the two groups at the end of the treatment. Both treatments were equally effective in decreasing SIQ‐JR and BDI‐II scores.ConclusionsThese findings support the feasibility and effectiveness of DBT‐A for adolescents at high risk of suicide in community settings.
Farming from a Process‐Relational Perspective: Making Openings for Change Visible
Authors: Darnhofer Ika 
Published: January 2020

AbstractThe theoretical debates in sociology have highlighted the strengths, but also the limitations of perspectives building on, anthropocentrism, essentialism, or structural determinism. One school of thought that strives to overcome such limitations is relational sociology. The aim of this article is to explore how a process‐relational perspective can offer a new conceptual framework for farm‐level studies in rural sociology. It is an invitation to view the world as a tissue of interactions, of dynamic and often unpredictable processes. By injecting a dose of new materialism and thereby extending agency to nonhumans, the liveliness of nature and technology is also taken into account. Yet, reconceptualising farming in relational terms is not just a theoretical but also a political project: it spurs different imaginations, making other worlds thinkable. This would enable to show ever‐present openings for more socially just and environmentally friendly farming practices.
Using high‐resolution ultrasound imaging to characterize dermal striae in human skin
Authors: Carvalho Cátia Pinto , Costa‐Júnior José Francisco Silva , Ferreira da Silva Flavia Fernandes , D`Agostinho Juliana Geremia , Krüger Marco Antônio von , Pereira Wagner Coelho de Albuquerque 
Published: January 2020

AbstractBackground and ObjectiveThe improvement in the appearance of the skin with dermal striae (DS) is currently eval‐uated by invasive methods, such as biopsy. This study evaluates whether high‐resolution ultrasound (HRUS) could be used to identify skin lesions in vivo caused by DS, using 2D images and measuring the thickness of the dermal layer.MethodsHigh‐resolution ultrasound at frequencies of 20 and 30 MHz was used in this study in ten volunteers with DS. The thickness of the skin layers was estimated by tracing five vertical lines from epidermis (EP) to dermis (DE) and DE to hypodermis (H) surface.ResultsThe dermal lesions caused by striae appeared in ultrasonic images as poor echo areas. The average normal DE thickness varied from 1.07 to 1.65 mm, while the DE thickness with DS varied between 0.35 and 1.33 mm. A statistically significant reduction in the DE thickness was found (P‐value < .05) in the presence of DS. The mean values of the EP thickness without and with DS were 0.12 ± 0.03 mm and 0.11 ± 0.02 mm, respec‐tively. A total of 90.00% of the EP‐related groups did not present the normal distribu‐tion (P‐value < .05).ConclusionsHigh‐resolution ultrasound permitted the visualization of the three skin layers and the dermal lesions caused by striae. The dermal layer thicknesses with striae were thinner than those without. Therefore, ultrasound 2D imaging has shown to be a promising and financially feasible tool to be used as a noninvasive diagnostic method for evaluating therapeutic protocols used in the treatment of these dermal conditions.
Substantial genetic divergence and lack of recent gene flow support cryptic speciation in a colour polymorphic bumble bee (Bombus bifarius) species complex
Authors: Ghisbain Guillaume , Lozier Jeffrey D. , Rahman Sarthok Rasique , Ezray Briana D. , Tian Li , Ulmer Jonah M. , Heraghty Sam D. , Strange James P. , Rasmont Pierre , Hines Heather M. 
Published: January 2020

AbstractPhenotypic polymorphism can constitute an inherent challenge for species delimitation. This issue is exemplified in bumble bees (Bombus), where species can exhibit high colour variation across their range, but otherwise exhibit little morphological variation to distinguish them from close relatives. We examine the species status of one of the most abundant North American bumble bees, Bombus bifarius Cresson, which historically comprised two major taxa, bifarius s.s. and nearcticus. These lineages are recognized primarily by red and black variation in their mid‐abdominal coloration; however, a continuum from black (nearcticus) to red (bifarius s.s.) variation has led to their historic synonymization. Integrating mitochondrial and nuclear data and whole‐genome sequencing, we reveal a high level of both mitochondrial and nuclear divergence delimiting two morphologically cryptic species – the red bifarius s.s. and the colour‐variable (black to red) nearcticus. Population genomic analysis supports an absence of recent genomic admixture and a strong population structure between the two clades, even in sympatry. Species distribution models predict partially differentiated niches between the genetically inferred clades with annual precipitation being a leading differentiating variable. The bifarius s.s. lineage also occupies significantly higher elevations, with regions of sympatry being among the highest elevations in nearcticus. Our data also support a subspecies‐level divergence between the broadly distributed nearcticus and the island population vancouverensis. In this paper, we formally recognize the two species, Bombus bifarius Cresson and Bombus vancouverensis Cresson, the latter including the subspecies B. vancouverensis vancouverensis comb.n. and B. vancouverensis nearcticus comb.n., with vancouverensis the name bearer due to year priority.
Pharmacokinetics of platinum and safety evaluation of carboplatin‐impregnated calcium sulfate hemihydrate beads after implantation in healthy cats
Authors: Maxwell Elizabeth A. , Phillips Heidi , Clark‐Price Stuart C. , Vieson Miranda D. , Selmic Laura E. , Schaeffer David J. , Fan Timothy M. 
Published: January 2020

AbstractObjectiveTo evaluate the pharmacokinetics (PK) of platinum (Pt) and safety of carboplatin‐impregnated calcium sulfate hemihydrate (C‐I CSH) beads after implantation in healthy cats.Study designIn vivo experimental study.AnimalsSix healthy adult cats.MethodsThree C‐I CSH beads were implanted in muscle pockets over the right and left hemithoraces of each cat (~3.9 mg/kg of Pt; 60.4 mg/m2of calculated carboplatin). Hematology and blood chemistry were tested at baseline and 3, 7, 14, and 21 days postimplantation. Serum was analyzed for Pt at specific times from 1 hour to 21 days. Tissue was obtained for histopathology and analysis of Pt at 3, 7, 14, and 21 days at standardized distances from implantation sites.ResultsPlatinum was detected in tissues at all times and distances (range, 0.1‐4.19 μg/g). Serum Pt increased up to 2.6 hours (3.25 μg/mL) then decreased sharply. Samples containing muscle had higher Pt compared with samples without muscle (P= .004). Mild hypercalcemia was noted in four cats, and mild inflammatory reaction was noted on histopathology of all samples.ConclusionPlatinum was released from C‐I CSH beads differentially into surrounding tissues over 21 days. Systemic absorption of Pt was minimal, but mild hypercalcemia occurred.Clinical significanceImplantation was well tolerated by healthy adult cats. Securing beads within muscle may limit Pt diffusion to targeted tissue. Although Pt concentrations did not achieve levels reported to be cytotoxic for feline sarcoma cells in culture, results provide evidence to support evaluation of efficacy in the tumor microenvironment of cats with locally invasive cancers.
Evaporation of Lubricant Films Subjected to Laminar and Turbulent Boundary Layers
Authors: Gill Stephen James , Tuna Burak A. , Yarusevych Serhiy , Li Xianguo , Shi Fanghui 
Published: January 2020

AbstractThis work investigates experimentally the effects of grid-generated turbulence on the evaporation of thin oil films subjected to laminar, transitional, and turbulent boundary layers. Particle image velocimetry (PIV) is used to characterize flow development within a rectangular duct (20 mm × 40 mm) with a length of 1 m (∼40Dh). The inlet turbulence intensity is manipulated using wire meshes, and experiments are performed for Reynolds numbers based on the duct hydraulic diameter of 10,650, 17,750, and 35,500. Mass transfer measurements are conducted under the characterized boundary layers for oil films with initial thicknesses of 50 μm at a constant substrate temperature of 150 °C. The Reynolds number is shown to have a significant impact on the evaporation rate, whereas varying near-wall turbulence intensity is shown to have little effect for the parameters investigated in this study. This implies that mean wall shear and transport within the viscous sublayer are the predominant parameters governing the convection-limited mass transfer considered in this investigation.
Hybrid Descemet Membrane Endothelial Keratoplasty (H-DMEK): results of a donor insertion pull-through technique using donor stroma as carrier
Authors: Woo Jyh Haur , Htoon Hla Myint , Tan Donald 
Published: January 2020

AimTo evaluate the outcomes and complications of hybrid Descemet membrane endothelial keratoplasty (H-DMEK) using a Descemet stripping automated endothelial keratoplasty (DSAEK) pull-through donor inserter and donor stroma as carrier.MethodsThis was a retrospective interventional case series of eyes with bullous keratopathy (BK) and Fuchs endothelial corneal dystrophy (FECD), which underwent H-DMEK, performed using a bimanual pull-through technique using DSAEK-prepared donor stroma as carrier and the EndoGlide Ultrathin DSAEK donor insertion device. Complex cases with tube shunts, trabeculectomy, aphakia, aniridia, previous vitrectomy, keratoplasty or combined with intraocular lens exchange, were also included. The outcome measures were intraoperative and postoperative complications, best corrected visual acuity (BCVA) and endothelial cell loss after surgery.ResultsOf the 85 eyes from 79 patients, 43.5% (n=37) had BK, 28.2% (n=24) had FECD while 24.7% (n=21) had failed grafts. DMEK was performed in 37 complex eyes (43.5%). Four eyes (4.7%) required rebubbling for graft detachment and two cases of graft failure were observed. A BCVA of 20/25 or better was attained in 44.7% and 57.1% of eyes without pre-existing ocular pathology at 6 and 12 months, respectively. The overall endothelial cell loss was 32.2%±20.5% at 6 months, which improved from 37.2%±20.9% to 24.2%±17.5%, comparing the first 40 and last 45 cases (p=0.012).ConclusionHybrid DMEK offers a controlled ‘pull-through’ technique of donor insertion in the ‘endothelium-in’ configuration, which may be useful especially in complicated eyes. More studies are needed to confirm the long-term endothelial cell loss and graft survival associated with this technique.
Real-world evidence on sodium-glucose cotransporter-2 inhibitor use and risk of Fournier’s gangrene
Authors: Yang Jeff Yufeng , Wang Tiansheng , Pate Virginia , Buse John B , Stürmer Til 
Published: January 2020

BackgroundSodium-glucose cotransporter-2 inhibitors (SGLT2i) have been associated with increased occurrence of Fournier’s gangrene (FG), a rare but serious form of necrotizing fasciitis, leading to a warning from the Food and Drug Administration. Real-world evidence on FG is needed to validate this warning.MethodsWe used data from IBM MarketScan (2013–2017) to compare the incidence of FG among adult patients who initiated either SGLT2i, a dipeptidyl peptidase-4 inhibitor (DPP4i), or any non-SGLT2i antihyperglycemic medication. FG was defined using inpatient International Classification of Diseases, Ninth Edition and Tenth Edition diagnosis codes 608.83 and N49.3, respectively, combined with procedure codes for debridement, surgery, or systemic antibiotics. We estimated crude incidence rates (IRs) using Poisson regression, and crude and adjusted HRs (aHR) and 95% CIs using standardized mortality ratio-weighted Cox proportional hazards models. Sensitivity analyses examined the impact of alternative outcome definitions.ResultsWe identified 211 671 initiators of SGLT2i (n=93 197) and DPP4i (n=118 474), and 305 329 initiators of SGLT2i (n=32 868) and non-SGLT2i (n=272 461). Crude FG IR ranged from 3.2 to 3.8 cases per 100 000 person-years during a median follow-up of 0.51–0.58 years. Compared with DPP4i, SGLT2i initiation was not associated with increased risk of FG for any outcome definition, with aHR estimates ranging from 0.25 (0.04–1.74) to 1.14 (0.86–1.51). In the non-SGLT2i comparison, we observed an increased risk of FG for SGLT2i initiators when using FG diagnosis codes alone, using all diagnosis settings (aHR 1.80; 0.53–6.11) and inpatient diagnoses only (aHR 4.58; 0.99–21.21).ConclusionsNo evidence of increased risk of FG associated with SGLT2i was observed compared with DPP4i, arguably the most relevant clinical comparison. However, uncertainty remains based on potentially higher risk in the broader comparison with all non-SGLT2i antihyperglycemic agents and the rarity of FG.Trial registration numberEUPAS Register Number 30018.
Glucose time in range and peripheral neuropathy in type 2 diabetes mellitus and chronic kidney disease
Authors: Mayeda Laura , Katz Ronit , Ahmad Iram , Bansal Nisha , Batacchi Zona , Hirsch Irl B , Robinson Nicole , Trence Dace L , Zelnick Leila , de Boer Ian H 
Published: January 2020

​ObjectiveCompared with hemoglobin A1c (HbA1c), continuous glucose monitoring (CGM) may better capture risk of diabetes complications in patients with chronic kidney disease (CKD), including diabetic peripheral neuropathy (DPN). We hypothesized that glucose time in range (TIR), measured by CGM, is associated with DPN symptoms among participants with type 2 diabetes mellitus (type 2 DM) and moderate-to-severe CKD.​Research design and methodsWe enrolled 105 people with type 2 DM treated with insulin or sulfonylurea, 81 participants with CKD (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2) and 24 matched control participants with eGFR ≥60 mL/min/1.73 m2. Each participant wore a CGM for two 6-day periods. Calculated glycemic measures included TIR (glucose 70–180 mg/dL) and glucose management indicator (GMI). DPN symptoms were assessed using the Michigan Neuropathy Screening Instrument (MNSI) questionnaire, with a positive MNSI score defined as ≥2 symptoms.​ResultsParticipants with CKD had a mean age of 68 years, diabetes duration 20 years, eGFR 38 mL/min/1.73 m2and HbA1c 7.8%, 61 mmol/mol. Sixty-two participants reported ≥2 DPN symptoms, 51 (63%) with CKD and 11 (46%) controls. Less TIR and higher GMI were associated with higher risk of MNSI questionnaire score ≥2 (OR 1.25 (95% CI 1.02 to 1.52) per 10% lower TIR, and OR 1.79 (95% CI 1.05 to 3.04) per 1% higher GMI, adjusting for age, gender and race). Similar results were observed when analyses were restricted to participants with CKD. In contrast, there was no significant association of HbA1c with DPN symptoms.​ConclusionsSymptoms of DPN were common among participants with long-standing type 2 DM and CKD. Lower TIR and higher GMI were associated with DPN symptoms.
Impact of transforming mental health services for young people in England on patient access, resource use and health: a quasi-experimental study
Authors: Rocks Stephen , Fazel Mina , Tsiachristas Apostolos 
Published: January 2020

ObjectiveTo evaluate the impact of child and adolescent mental health services (CAMHS) transformation in South East England on patient access, resource utilisation and health outcomes.DesignIn an observational study, we use difference-in-differences analysis with propensity score matching to analyse routinely collected patient level data.SettingThree CAMHS services in South East England.ParticipantsAll patients attending CAMHS between April 2012 and December 2018, with more than 57 000 spells of care included.Main outcome measuresThe rate and volume of people accessing CAMHS; waiting times to the first contact and waiting times between the first and second contact; and health outcomes, including the Strengths and Difficulties Questionnaire (SDQ) and the Revised Child Anxiety and Depression Scale (RCADS).ResultsThe intervention led to 20% (incidence rate ratio: 1.20; 95% CI: 1.15 to 1.24) more new patients starting per month. There was mixed evidence on waiting times for the first contact. The intervention led to 10% (incidence rate ratio: 1.10; 95% CI: 1.02 to 1.18) higher waiting time for the second contact. The number of contacts per spell (OR: 1.08; 95% CI: 0.94 to 1.25) and the rereferral rate (OR: 1.06; 95% CI: 0.96 to 1.17) were not significantly different. During the post intervention period, patients in the intervention group scored on average 3.3 (95% CI: −5.0 to −1.6) points lower on the RCADS and 1.0 (95% CI: −1.8 to -0.3) points lower on the SDQ compared with the control group after adjusting for the baseline score.ConclusionsOverall, there are signs that transformation can help CAMHS achieve the objectives of greater access and improved health outcomes, but trade-offs exist among different performance metrics, particularly between access and waiting times. Commissioners and providers should be conscious of any trade-offs when undertaking service redesign and transformation.
Performance of cardiovascular risk prediction equations in Indigenous Australians
Authors: Barr Elizabeth Laurel Mary , Barzi Federica , Rohit Athira , Cunningham Joan , Tatipata Shaun , McDermott Robyn , Hoy Wendy E , Wang Zhiqiang , Bradshaw Pamela June , Dimer Lyn , Thompson Peter L , Brimblecombe Julie , O'Dea Kerin , Connors Christine , Burgess Paul , Guthridge Steven , Brown Alex , Cass Alan , Shaw Jonathan E , Maple-Brown Louise 
Published: January 2020

ObjectiveTo assess the performance of cardiovascular disease (CVD) risk equations in Indigenous Australians.MethodsWe conducted an individual participant meta-analysis using longitudinal data of 3618 Indigenous Australians (55% women) aged 30–74 years without CVD from population-based cohorts of the Cardiovascular Risk in IndigenouS People(CRISP) consortium. Predicted risk was calculated using: 1991 and 2008 Framingham Heart Study (FHS), the Pooled Cohorts (PC), GloboRisk and the Central Australian Rural Practitioners Association (CARPA) modification of the FHS equation. Calibration, discrimination and diagnostic accuracy were evaluated. Risks were calculated with and without the use of clinical criteria to identify high-risk individuals.ResultsWhen applied without clinical criteria, all equations, except the CARPA-adjusted FHS, underestimated CVD risk (range of percentage difference between observed and predicted CVD risks: −55% to −14%), with underestimation greater in women (−63% to −13%) than men (−47% to −18%) and in younger age groups. Discrimination ranged from 0.66 to 0.72. The CARPA-adjusted FHS equation showed good calibration but overestimated risk in younger people, those without diabetes and those not at high clinical risk. When clinical criteria were used with risk equations, the CARPA-adjusted FHS algorithm scored 64% of those who had CVD events as high risk; corresponding figures for the 1991-FHS were 58% and were 87% for the PC equation for non-Hispanic whites. However, specificity fell.ConclusionThe CARPA-adjusted FHS CVD risk equation and clinical criteria performed the best, achieving higher combined sensitivity and specificity than other equations. However, future research should investigate whether modifications to this algorithm combination might lead to improved risk prediction.
Cardiomyopathy associated with the Ala143Thr variant of the α-galactosidase A gene
Authors: Valtola Kati , Nino-Quintero Juanita , Hedman Marja , Lottonen-Raikaslehto Line , Laitinen Tomi , Maria Maleeha , Kantola Ilkka , Naukkarinen Anita , Laakso Markku , Kuusisto Johanna 
Published: January 2020

ObjectiveTo investigate whether the Ala143Thr variant of the α-galactosidase A gene (A143T/GLA), with conflicting interpretations of pathogenicity, is associated with Fabry cardiomyopathy.MethodsThe index patient, a woman in her 60s with cardiomyopathy, was screened for variants in 59 cardiomyopathy-related genes. A143T/GLA, the only rare variant found, was screened in 10 relatives. GLA activity and lyso-Gb3 levels were measured and echocardiography was performed in 8 of 9 subjects carrying A143T/GLA. Cardiac magnetic resonance (CMR) imaging and 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT) were performed in four adult A143T/GLA carriers. Endomyocardial biopsy was obtained from two adult A143T/GLA carrying sons of the index patient.ResultsThe index patient and her elder son had a pacemaker implantation because of sick sinus syndrome and atrioventricular block. GLA activities were decreased to 25%–40% of normal in both sons and one granddaughter. Lyso-Gb3 levels were elevated in both sons. In CMR, the index patient and her two sons had left ventricular (LV) hypertrophy and/or dilatation. The elder son had late gadolinium enhancement, high CMR-derived T1 time and positive FDG signal in PET/CT in the basal inferolateral LV wall. The younger son had low T1 time and the mother had positive FDG signal in PET/CT in the basal inferolateral LV wall. Endomyocardial biopsy of both sons showed myocardial accumulation compatible with glycolipids in light and electron microscopy, staining with anti-Gb3 antibody available for the younger son. Five female relatives with A143T/GLA had no cardiomyopathy in cardiac imaging.ConclusionsA143T/GLA is likely a late-onset Fabry cardiomyopathy causing variant with incomplete penetrance.