bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Public Cost of Mental Health– and Addiction-Related Services for Youth (Ages 12-17) in Alberta
Authors: Jacobs Philip , Lesage Alain 
Published: August 2018

Objective: To measure the provincial government cost of mental health–related activities for youth ages 12 to 17 in Alberta in 2014 to 2015. Methods: The target population was Alberta youth ages 12 to 17 (the federal justice definition) who received or were funded for mental health–related or complementary services from Alberta Health Services, Alberta Health, Alberta Human Services, Alberta Justice and Solicitor General, and Alberta Education (public schools). Data on services and expenditures were obtained from each source for the target youth population. Results: Costs for mental health–related services for all ministries were $175 million for 27,169 youth who used mental health services as defined by Policy Wise, $6460 per youth. Public school special education supplements for youth with emotional problems was the largest group, amounting to 30% of all costs. Other prominent sources of expenditures were hospital inpatient mental health services (18%), community mental health services (11%), physician mental health services (10%), and secure services with treatment requiring judicial approval (9%). Conclusion: Economists in several countries have developed countrywide measures of mental health expenditures and have used these to generate national benchmarks for mental health spending. We have estimated spending for Alberta provincial mental health and addiction services for a distinct and highly vulnerable group. This measure can be used to develop measures and benchmarks for other provinces, which will be valuable policy indicators.
Blood adiponectin levels are not associated with risk of cardiovascular events in patients with type 2 diabetes
Authors: Jeon Ja Young , Ha Kyoung Hwa , Han Seung Jin , Kim Hae Jin , Lee Kwan-Woo , Kim Dae Jung 
Published: August 2018

Introduction: We examined whether circulating adiponectin levels are associated with further cardiovascular events in patients with type 2 diabetes. Methods: Between December 2004 and February 2005, 349 patients with type 2 diabetes were enrolled and followed-up until December 2015. Blood levels of total, middle-molecular weight and high-molecular weight adiponectin were measured at baseline. The primary composite outcome was the occurrence of the following events: cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or hospitalization for unstable angina and heart failure. Results: During a median follow-up of 9 years, cardiovascular events occurred in 14% of patients (50/349, 1.9% per year). Median blood levels of total, middle-molecular weight and high-molecular weight adiponectin were 4.8, 3.2 and 1.8 μg/mL, respectively. The cumulative incidence of cardiovascular events was not significantly different between the three groups based on total, middle-molecular weight, high-molecular weight or high-molecular weight/total adiponectin. After adjustment for potential confounding factors, blood adiponectin levels were positively associated with an increased number of cardiovascular events, but between tertiles, there was no significant difference. Conclusion: This observational cohort study suggested that blood adiponectin levels are not related to further cardiovascular events in patients with type 2 diabetes.
Contemplating Co-Occurring Cultures
Authors: De Santis Joseph P. , Quidley-Rodriguez Narciso , Valdes Beatriz , Alves Steve L. , Provencio-Vasquez Elias 
Published: August 2018

Introduction HIV infection continues to be a serious health concern globally. Of the 1.2 million people with HIV infection in the United States, men who have sex with men (MSM) account for 57% of cases. Hispanic/Latino individuals accounted for 24% of new HIV diagnoses, with male-to-male sexual contact responsible for the majority of cases. A factor in HIV prevention is the sexual decision-making process. The purpose of this study was to describe the process by which sexual decision making occurs among Hispanic MSM. Method Utilizing a grounded theory approach, 19 in-depth, semistructured interviews were conducted from participants ages 25 to 65 years living in South Florida. After consent, participants completed an in-depth interview. Interviews were audio-recorded and transcribed verbatim. Data were analyzed to identify categories and subcategories. Findings A theory grounded in the data called Contemplating Co-Occurring Cultures (Hispanic, gay, and health cultures) emerged that described the central phenomenon. These co-occurring cultures were the foundation of sexual decision making among participants. Conclusion Clinicians providing care to this population should be aware of the complexity of the sexual decision-making process. Awareness of these factors may provide the opportunity for HIV risk reduction strategies developed specifically for Hispanic MSM.
Quantitative T2 MRI Mapping and 12-Month Follow-up in a Randomized, Blinded, Placebo Controlled Trial of Bone Marrow Aspiration and Concentration for Osteoarthritis of the Knees
Authors: Shapiro Shane A. , Arthurs Jennifer R. , Heckman Michael G. , Bestic Joseph M. , Kazmerchak Shari E. , Diehl Nancy N. , Zubair Abba C. , O’Connor Mary I. 
Published: August 2018

Objective Bone marrow aspiration and concentration (BMAC) is becoming a more common regenerative therapy for musculoskeletal pathology. In our current pilot study, we studied patients with mild-to-moderate bilateral knee osteoarthritis, compared pain at 12-month follow-up between BMAC-injected and saline-injected knees, and examined cartilage appearance measured by magnetic resonance imaging (MRI) T2 quantitative mapping. Design Twenty-five patients with mild-to-moderate bilateral osteoarthritic knee pain were randomized to receive BMAC into one knee and saline placebo into the other. Bone marrow was aspirated from the iliac crests, concentrated in an automated centrifuge, combined with platelet-poor plasma for knee injection, and compared with saline injection into the contralateral knee. Primary outcome measures were T2 MRI cartilage mapping at 6-month and Visual Analog Scale and Osteoarthritis Research Society International Intermittent and Constant Osteoarthritis Pain scores and radiographs at 12-month follow-up. Results Constant, intermittent, and overall knee pain remained significantly decreased from baseline at 12-month follow-up (all P ⩽ 0.01), with no apparent difference between BMAC- and saline-treated knees (all P ⩾ 0.54). A similar significant increase from baseline to 12-month follow-up regarding quality of life was observed for both BMAC- and saline-treated knees (all P ⩽ 0.04). T2 quantitative MRI mapping showed no significant changes as a result of treatment. Conclusions BMAC is safe to perform and relieves pain from knee arthritis but showed no superiority to saline injection at 12-month follow-up. MRI cartilage sequences failed to show regenerative benefit with single BMAC injection. The mechanisms of action that led to pain relief remain unclear and warrant further studies.
Intra-Articular Delivery of Quercetin Using Thermosensitive Hydrogel Attenuate Cartilage Degradation in an Osteoarthritis Rat Model
Authors: Mok Sze-Wing , Fu Sai-Chuen , Cheuk Yau-Chuk , Chu I-Ming , Chan Kai-Ming , Qin Ling , Yung Shu-Hang , Kevin Ho Ki-Wai 
Published: August 2018

Objective Quercetin (Que), a bioflavonoid, is both anti-inflammatory and antioxidative. Que has been used as an oral supplement for osteoarthritis (OA) with inconsistent findings because of its low bioavailability. We encapsulated Que in a mPEG-polypeptide thermogel to prolong its bioactivity. The efficacy of this formulation was evaluated in a posttraumatic OA rat model. Design Methoxy-poly(ethylene glycol)-l-poly(alanine) (mPEG-PA) polymer was synthesized and characterized in terms of cytotoxicity and release kinetics in vitro. At 12 weeks old, Sprague-Dawley rats underwent anterior cruciate ligament transection (ACLT). At 24 weeks post-operation, rats received either an intra-articular (IA) injection of saline, hydrogel, or hydrogel with Que (50 or 500 μg). Gait analysis was performed at pre-ACLT, pre-treatment, and at 4, 8, and 12 weeks post-treatment. At 12 weeks post-treatment, knee joints were collected for histopathological evaluation. Results In vitro studies showed that chondrocytes were viable after 72 hours of incubation with mPEG-PA, and the release of Que could be sustained for >28 days. Among all OA rats, the limb idleness index (LII) were significantly increased at 24 weeks post-ACLT. Rats that received hydrogel with Que (50 μg) showed the most reduction in LII at both 4 and 8 weeks post-treatment. The Osteoarthritis Research Society International score of rats received hydrogel with Que (50 μg) was significantly lower than the control group. All rats suffered from low-grade synovitis (Krenn score: 2-4). Conclusion This study suggests that a sustained delivery of Que (50 μg) could provide symptom relief and also delay the progression of OA in the knee.
Thromboprophylaxis in Adults With Atrio-Pulmonary Fontan
Authors: Small Adam J. , Aboulhosn Jamil A. , Lluri Gentian 
Published: August 2018

Background: Although aspirin has been compared to warfarin for thromboembolic prophylaxis in the general Fontan population, little is known about the optimal preventative strategy for the atriopulmonary right atrium–pulmonary artery [RA-PA]) Fontan particularly. Methods: A retrospective cohort study was performed including adult patients identified in the Ahmanson/UCLA Adult Congenital Heart Disease Center database with a history of RA-PA Fontan and use of either aspirin or warfarin as most recent primary prophylaxis against thromboembolism. Primary outcome was incident thromboembolism, defined as space-occupying lesion on imaging consistent with thrombus within the Fontan or pulmonary arterial circuit. Secondary outcomes were death, transplantation, Fontan conversion, and bleeding requiring either transfusion or invasive intervention. Follow-up was terminated upon achievement of a primary outcome or achievement of a secondary outcome other than bleeding. Kaplan-Meier analysis of freedom from thrombosis was performed. Results: Twenty-six patients met inclusion criteria. Thirteen (50%) received aspirin as most recent primary prophylaxis and 13 (50%) received warfarin. Tricuspid atresia was the most common underlying diagnosis (42%), followed by double-inlet left ventricle (38%). Median age at Fontan operation was 8.2 years; median age at prophylaxis initiation was 25.9 years. After six years, the aspirin group had 50% ± 35% freedom from thrombosis and the warfarin group 92% ± 8% ( P = .15). Incidences of secondary outcomes were not significantly different between the groups. Conclusion: In this cohort of long-term Fontan survivors with RA-PA Fontan, the risk of thromboembolic complications is high, especially in those taking aspirin rather than warfarin. Larger studies are needed to confirm these findings.
Long-term efficacy and effectiveness of a behavioural and community-based exercise intervention (Urban Training) to increase physical activity in patients with COPD: a randomised controlled trial
Authors: Arbillaga-Etxarri Ane , Gimeno-Santos Elena , Barberan-Garcia Anael , Balcells Eva , Benet Marta , Borrell Eulàlia , Celorrio Nuria , Delgado Anna , Jané Carme , Marin Alicia , Martín-Cantera Carlos , Monteagudo Mónica , Montellà Nuria , Muñoz Laura , Ortega Pilar , Rodríguez Diego A. , Rodríguez-Roisin Robert , Simonet Pere , Torán-Monserrat Pere , Torrent-Pallicer Jaume , Vall-Casas Pere , Vilaró Jordi , Garcia-Aymerich Judith 
Published: August 2018

There is a need to increase and maintain physical activity in patients with chronic obstructive pulmonary disease (COPD). We assessed 12-month efficacy and effectiveness of the Urban Training intervention on physical activity in COPD patients.This randomised controlled trial (NCT01897298) allocated 407 COPD patients from primary and hospital settings 1:1 to usual care (n=205) or Urban Training (n=202). Urban Training consisted of a baseline motivational interview, advice to walk on urban trails designed for COPD patients in outdoor public spaces and other optional components for feedback, motivation, information and support (pedometer, calendar, physical activity brochure, website, phone text messages, walking groups and a phone number). The primary outcome was 12-month change in steps·day−1 measured by accelerometer.Efficacy analysis (with per-protocol analysis set, n=233 classified as adherent to the assigned intervention) showed adjusted (95% CI) 12-month difference +957 (184–1731) steps·day−1 between Urban Training and usual care. Effectiveness analysis (with intention-to-treat analysis set, n=280 patients completing the study at 12 months including unwilling and self-reported non-adherent patients) showed no differences between groups. Leg muscle pain during walks was more frequently reported in Urban Training than usual care, without differences in any of the other adverse events.Urban Training, combining behavioural strategies with unsupervised outdoor walking, was efficacious in increasing physical activity after 12 months in COPD patients, with few safety concerns. However, it was ineffective in the full population including unwilling and self-reported non-adherent patients.
Transcriptome profiling reveals the complexity of pirfenidone effects in idiopathic pulmonary fibrosis
Authors: Kwapiszewska Grazyna , Gungl Anna , Wilhelm Jochen , Marsh Leigh M. , Thekkekara Puthenparampil Helene , Sinn Katharina , Didiasova Miroslava , Klepetko Walter , Kosanovic Djuro , Schermuly Ralph T. , Wujak Lukasz , Weiss Benjamin , Schaefer Liliana , Schneider Marc , Kreuter Michael , Olschewski Andrea , Seeger Werner , Olschewski Horst , Wygrecka Malgorzata 
Published: August 2018

Despite the beneficial effects of pirfenidone in treating idiopathic pulmonary fibrosis (IPF), it remains unclear if lung fibroblasts (FB) are the main therapeutic target.To resolve this question, we employed a comparative transcriptomic approach and analysed lung homogenates (LH) and FB derived from IPF patients treated with or without pirfenidone.In FB, pirfenidone therapy predominantly affected growth and cell division pathways, indicating a major cellular metabolic shift. In LH samples, pirfenidone treatment was mostly associated with inflammation-related processes. In FB and LH, regulated genes were over-represented in the Gene Ontology node “extracellular matrix”. We identified lower expression of cell migration-inducing and hyaluronan-binding protein (CEMIP) in both LH and FB from pirfenidone-treated IPF patients. Plasma levels of CEMIP were elevated in IPF patients compared to healthy controls and decreased after 7 months of pirfenidone treatment. CEMIP expression in FB was downregulated in a glioma-associated oncogene homologue-dependent manner and CEMIP silencing in IPF FB reduced collagen production and attenuated cell proliferation and migration.Cumulatively, our approach indicates that pirfenidone exerts beneficial effectsviaits action on multiple pathways in both FB and other pulmonary cells, through its ability to control extracellular matrix architecture and inflammatory reactions.
Continuous positive airway pressure effect on visual acuity in patients with type 2 diabetes and obstructive sleep apnoea: a multicentre randomised controlled trial
Authors: West Sophie D. , Prudon Benjamin , Hughes Joan , Gupta Rajen , Mohammed Seid B. , Gerry Stephen , Stradling John R. ,   for the ROSA trial investigators
Published: August 2018

We sought to establish whether continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA) in people with type 2 diabetes and diabetic macular oedema (DMO) improved visual acuity.We randomly assigned 131 eligible patients aged 30–85 years from 23 UK centres with significant DMO causing visual impairment (LogMAR letters identified ≥39 and ≤78, score 0.92–0.14) plus severe OSA on screening to either usual ophthalmology care (n=67) or usual ophthalmology care plus CPAP (n=64) for 12 months.Mean age of participants was 64 years, 73% male, mean body mass index 35.0 kg·m−2. Mean 4% oxygen desaturation index was 36 events·h−1. There was no significant difference in the visual acuity at 12 months between the CPAP group and the control group (mean LogMAR 0.33 (95% CI 0.29–0.37)versus0.31 (95% CI 0.27–0.35); p=0.39), and no significant correlation between change in LogMAR and average CPAP use. The median±sd(range) daily CPAP use was 3.33±2.25 (0–7.93) h at 3 months, 3.19±2.54 (0–8.07) h at 6 months and 3.21±2.70 (0–7.98) h at 12 months.CPAP therapy for OSA did not improve visual acuity in people with type 2 diabetes and DMO compared with usual care alone over 12 months.
Beneficial Intervertebral Disc and Muscle Adaptations in High-Volume Road Cyclists
Authors: BELAVY DANIEL L. , QUITTNER MATTHEW , RIDGERS NICOLA D. , LING YUAN , CONNELL DAVID , TRUDEL GUY , RANTALAINEN TIMO 
Published: August 2018

ABSTRACT

Purpose
Cycling is widely practiced as a mode of transportation, a leisurely pursuit, and a competitive sport. Approximately half of cyclists experience low back pain. Yet, there has been limited study of spine tissue adaptations due to cycling.

Methods
To investigate potential risk factors for spinal pain, we compared 18 high-volume cyclists (>150 km·wk−1 for ≥5 yr) to 18 height-matched nonsporting referents. Participants had no history of spinal pathology. Magnetic resonance imaging was used to quantify intervertebral disc (IVD) morphology and hydration, and psoas, erector spinae, quadratus lumborum, and multifidus muscle size and fat content. Endurance of trunk muscles (flexors and extensors) was measured, and physical activity levels were assessed objectively using accelerometry.

Results
Cyclists’ IVD showed prolonged T2 time (+10.0% ± 17.3%; P = 0.021), implying better IVD hydration and glycosaminoglycan content, compared with referents. Lower thoracic and upper lumbar IVD T2 time were longer in cyclists (P ≤ 0.029) but not at the lower lumbar spine. T2 time differences were larger in the nucleus pulposus compared with the annulus fibrosus. Cyclists showed larger psoas muscles with less fat content compared with referents. Cyclists also exhibited longer isometric trunk endurance times (P ≤ 0.036) and higher physical activity levels (osteogenic index, P = 0.038).

Conclusion
Despite previous studies reporting higher than average prevalence of back pain in cyclists, the high-volume road cyclists in our cohort showed no anatomical or functional deficiency in spinal structures. By contrast, we found evidence for beneficial adaptations to the IVD and psoas muscles in high-volume cyclists compared with referents. These data support the notion that cycling is not detrimental to the spine, rather, by contrast, may be associated with beneficial changes at the spine.
Split-bolus contrast injection protocol enhances the visualization of the thoracic vasculature and reduced radiation dose during chest CT
Authors: Zein-El-Dine Salah , Bou Akl Imad , Mohamad Maha , Chmaisse Ahmad , Chahwan Stephanie , Asmar Karl , El-Merhi Fadi , Saade Charbel 
Published: August 2018

Objective
To investigate the visualization of mediastinal lymph nodes during thoracic CT employing a multiphasic contrast media (CM) protocol.

Methods
Institutional review board approved retrospective study consisting of 300 patients with known chest malignancy. Patients were allocated to one of two CM protocols: Protocol A, consisted of dual bolus (Phase 1:100 ml CM followed by 100 ml saline chaser) i.v. injected at 2.5 ml s−1; Protocol B employed 100 ml of CM using a multiphasic injection protocol (Phase 1 and 2:60 ml contrast and saline, followed by Phase 3 and 4:40 ml contrast and saline injected at 2.5 ml s−1) with a fixed scan delay of 70 s for each acquisition. Attenuation profiles of the thoracic arteries and veins were calculated as well as the arterio-venous contrast ratios (AVCR). Receiver operating characteristic (ROC), visual grading characteristic (VGC), and Cohen's kappa analysis were assessed.

Results
Arterial opacification was up to 24% (p &lt; 0.032) higher in protocol B than A, whereas, in the veins it was significantly lower in protocol B than A, with a maximum reduction of up to 84% (p &lt; 0.0001). There was no statistical significance between the central and peripheral pulmonary arteries [&gt;263 Hounsfield units (HU)] in each protocol. Protocol B, demonstrated significant improvement in AVCR at various anatomical sites (p &lt; 0.002). Radiation dose was significantly reduced in protocol B compared to A (p &lt; 0.004). Both ROC and VGC demonstrated significantly higher Az score for protocol B compared to A (p &lt; 0.0001) with an increased inter reader agreement from poor to excellent.

Conclusion
Employing a multiphasic CM protocol significantly improves opacification of the thoracic vasculature and visualization of mediastinal lymph nodes during thoracic CT.

Advances in knowledge
Uniform opacification between thoracic arteries and veins increases the delineation between vasculature and lymph nodes, reduces radiation dose when employing a multiphase contrast media injection protocol.
Environmental variation obscures species diversity in southern European populations of the moss genus Ceratodon
Authors: Nieto-Lugilde Marta , Werner Olaf , McDaniel Stuart F. , Ros Rosa M. 
Published: August 2018

AbstractA major problem in taxonomy is to determine if morphological variation in field–collected specimens is caused by genetic differentiation, and therefore corresponds to evolutionary distinct units, or is caused by environmental variation acting on a single interbreeding population. To evaluate the effect of environmental variation on the taxonomy of the moss genus Ceratodon, we compared biometric analyses based on 22 morphological characters on both field–collected plants and cultivated plants to a clustering based on DNA sequence and genome size data published previously. We sampled Ceratodon species from mountainous areas of the Mediterranean region, and other mountain regions and lowlands, mostly from southern Europe. We found that the expression of several gametophytic traits changed between field and laboratory conditions, confirming that environmental variability complicates taxonomic inferences, and suggesting that some characters should be used with caution in distinguishing among species. However, consistent with the genetic and flow cytometry data, we found a clear biometric discontinuity between some plants collected from southern Spain, and those from other parts of the world. Samples considered of hybrid origin, based on genetic data, were morphologically indistinguishable from plants from the southern Spanish mountains. Integrative taxonomy based on genetic, genome size and morphological data unambiguously support the recognition of a new species, Ceratodon amazonum. These data also suggest that the previously recognized C. conicus is a recombinant between C. amazonum and C. purpureus and is considered here to be a nothospecies, for which an epitype is designated because the lectotype is demonstrably ambiguous.