bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decision analytic model exploring the cost and cost-offset implications of street triage
Authors: Heslin Margaret , Callaghan Lynne , Packwood Martin , Badu Vincent , Byford Sarah 
Published: February 2016

ObjectivesTo determine if street triage is effective at reducing the total number of people with mental health needs detained under section 136, and is associated with cost savings compared to usual police response.DesignRoutine data from a 6-month period in the year before and after the implementation of a street triage scheme were used to explore detentions under section 136, and to populate a decision analytic model to explore the impact of street triage on the cost to the NHS and the criminal justice sector of supporting people with a mental health need.SettingA predefined area of Sussex, South East England, UK.ParticipantsAll people who were detained under section 136 within the predefined area or had contact with the street triage team.InterventionsThe street triage model used here was based on a psychiatric nurse attending incidents with a police constable.Primary and secondary outcome measuresThe primary outcome was change in the total number of detentions under section 136 between the before and after periods assessed. Secondary analysis focused on whether the additional costs of street triage were offset by cost savings as a result of changes in detentions under section 136.ResultsDetentions under section 136 in the street triage period were significantly lower than in the usual response period (118 vs 194 incidents, respectively; χ2(1df) 18.542, p<0.001). Total NHS and criminal justice costs were estimated to be £1043 in the street triage period compared to £1077 in the usual response period.ConclusionsInvestment in street triage was offset by savings as a result of reduced detentions under section 136, particularly detentions in custody. Data available did not include assessment of patient outcomes, so a full economic evaluation was not possible.
Quaternary glacial history of the Cantabrian Mountains of northern Spain: a new synthesis
Authors: Serrano Enrique , González-Trueba Juan José , Pellitero Ramón , Gómez-Lende Manuel 
Published: February 2016

Abstract
Recent dating and morphostratigraphical studies on glaciations in the Cantabrian Mountains permit a first reconstruction of the glacial evolution of the area. Located in the north of the Iberian Peninsula, between the Atlantic coast and the inner Mediterranean upland of the Duero basin, the mountains were occupied by ice fields as well as alpine and cirque glaciers during the Pleistocene. Five glacial phases can be distinguished, four belonging to the last Pleistocene glacial cycle and one historical in the Little Ice Age (LIA). Pre-maximum phases (predating the Late Pleistocene glacier maximum), identified at only three places, need more data before they can be more fully understood. The maximum glacial advance (RGM or SI) of the Pleistocene glaciers occurred at around 48–35 ka, before the global Last Glacial Maximum (LGM). A period of later glacial equilibrium (SII), which was a colder but drier phase, occurred just after the LGM (deglaciation ages ranging from 25 to 18 cal ka BP). The different glacial behaviour of the Cantabrian Mountains can be explained by orographic barrier effects: a more southerly circulation of atmospheric currents with more frequent southwesterly flows feeding snowfall towards the southern massifs. An ‘altitude stage’ (SIII) represented by small glaciers located in the cirques – and mainly those orientated to the north – exists in many massifs. Finally, LIA glaciers were only present in the Picos de Europa.
Chromogranin A Is Preferentially Cleaved into Proangiogenic Peptides in the Bone Marrow of Multiple Myeloma Patients
Authors: Bianco Mimma , Gasparri Anna Maria , Colombo Barbara , Curnis Flavio , Girlanda Stefania , Ponzoni Maurilio , Bertilaccio Maria Teresa Sabrina , Calcinotto Arianna , Sacchi Angelina , Ferrero Elisabetta , Ferrarini Marina , Chesi Marta , Bergsagel P. Leif , Bellone Matteo , Tonon Giovanni , Ciceri Fabio , Marcatti Magda , Caligaris-Cappio Federico , Corti Angelo 
Published: February 2016

Abstract
Angiogenesis has been postulated to be critical for the pathogenesis of multiple myeloma, a neoplastic disease characterized by abnormal proliferation of malignant plasma cells in the bone marrow (BM). Cleavage of the N- and C-terminal regions of circulating chromogranin A (CgA, CHGA), classically an antiangiogenic protein, can activate latent antiangiogenic and proangiogenic sites, respectively. In this study, we investigated the distribution of CgA-derived polypeptides in multiple myeloma patients and the subsequent implications for disease progression. We show that the ratio of pro/antiangiogenic forms of CgA is altered in multiple myeloma patients compared with healthy subjects and that this ratio is higher in BM plasma compared with peripheral plasma, suggesting enhanced local cleavage of the CgA C-terminal region. Enhanced cleavage correlated with increased VEGF and FGF2 BM plasma levels and BM microvascular density. Using the Vk*MYC mouse model of multiple myeloma, we further demonstrate that exogenously administered CgA was cleaved in favor of the proangiogenic form and was associated with increased microvessel density. Mechanistic studies revealed that multiple myeloma and proliferating endothelial cells can promote CgA C-terminal cleavage by activating the plasminogen activator/plasmin system. Moreover, cleaved and full-length forms could also counter balance the pro/antiangiogenic activity of each other in in vitro angiogenesis assays. These findings suggest that the CgA-angiogenic switch is activated in the BM of multiple myeloma patients and prompt further investigation of this CgA imbalance as a prognostic or therapeutic target. Cancer Res; 76(7); 1781–91. ©2016 AACR.
Long-term Relative Survival after Diagnosis of Testicular Germ Cell Tumor
Authors: Kvammen Øivind , Myklebust Tor Å. , Solberg Arne , Møller Bjørn , Klepp Olbjørn H. , Fosså Sophie D. , Tandstad Torgrim 
Published: February 2016

Abstract
Background: Long-term relative survival (RS) data for testicular germ cell tumor (TGCT) patients are scarce. We aimed to analyze long-term RS among TGCT patients diagnosed in Norway, between 1953 and 2012.
Methods: Data sources were the Cancer Registry of Norway and the Norwegian Cause of Death Registry. TGCT patients diagnosed during 1953 to 2012 were classified by time of diagnosis, histology, age, and disease extent at diagnosis. Estimates for RS were obtained, and a test comparing overall RS was performed. Corresponding data were obtained for men diagnosed with localized malignant melanoma before age 50.
Results: A total of 8,736 TGCT patients were included. RS generally continued to decline with increasing follow-up time, particularly beyond 15 to 30 years, unlike in localized malignant melanoma. Although RS was generally higher for seminomas, the continuing decline was more pronounced than for nonseminomas, even when diagnosed with localized disease. TGCT patients diagnosed before 1980 or after age 40 had lower RS.
Conclusions: Although TGCT RS has improved in recent decades, it continues to decline even beyond 30 years of follow-up, regardless of disease extent at diagnosis. The main cause is probably treatment-induced late effects, particularly affecting seminoma patients. The continued use of adjuvant radiotherapy in seminomas until year 2000 is suspected as a culprit.
Impact: Long-term TGCT survivors should be closely monitored for the development of late comorbidity. The challenge is to reduce negative consequences of previous and current TGCT treatment on RS while maintaining the excellent cure rates. Further research on causes of long-term morbidity and mortality among TGCT survivors is warranted. Cancer Epidemiol Biomarkers Prev; 25(5); 773–9. ©2016 AACR.
Effect of Coronary Atherosclerosis and Myocardial Ischemia on Plasma Levels of High-Sensitivity Troponin T and NT-proBNP in Patients With Stable Angina
Authors: Caselli Chiara , Prontera Concetta , Liga Riccardo , De Graaf Michiel A. , Gaemperli Oliver , Lorenzoni Valentina , Ragusa Rosetta , Marinelli Martina , Del Ry Silvia , Rovai Daniele , Giannessi Daniela , Aguade-Bruix Santiago , Clemente Alberto , Bax Jeroen J. , Lombardi Massimo , Sicari Rosa , Zamorano José , Scholte Arthur J. , Kaufmann Philipp A. , Knuuti Juhani , Underwood S. Richard , Clerico Aldo , Neglia Danilo 
Published: February 2016

Objective—
Circulating levels of high-sensitivity cardiac troponin T (hs-cTnT) and N terminal pro brain natriuretic peptide (NT-proBNP) are predictors of prognosis in patients with coronary artery disease (CAD). We aimed at evaluating the effect of coronary atherosclerosis and myocardial ischemia on cardiac release of hs-cTnT and NT-proBNP in patients with suspected CAD.

Approach and Results—

Hs-cTnT and NT-proBNP were measured in 378 patients (60.1±0.5 years, 229 males) with stable angina and unknown CAD enrolled in the Evaluation of Integrated Cardiac Imaging (EVINCI) study. All patients underwent stress imaging to detect myocardial ischemia and coronary computed tomographic angiography to assess the presence and characteristics of CAD. An individual computed tomographic angiography score was calculated combining extent, severity, composition, and location of plaques. In the whole population, the median (25–75 percentiles) value of plasma hs-cTnT was 6.17 (4.2–9.1) ng/L and of NT-proBNP was 61.66 (31.2–132.6) ng/L. In a multivariate model, computed tomographic angiography score was an independent predictor of the plasma hs-cTnT (coefficient 0.06, SE 0.02;
P
=0.0089), whereas ischemia was a predictor of NT-proBNP (coefficient 0.38, SE 0.12;
P
=0.0015). Hs-cTnT concentrations were significantly increased in patients with CAD with or without myocardial ischemia (
P
<0.005), whereas only patients with CAD and ischemia showed significantly higher levels of NT-proBNP (
P
<0.001).

Conclusions—
In patients with stable angina, the presence and extent of coronary atherosclerosis is related with circulating levels of hs-cTnT, also in the absence of ischemia, suggesting an ischemia-independent mechanism of hs-cTnT release. Obstructive CAD causing myocardial ischemia is associated with increased levels of NT-proBNP.
Risk Score for Neurological Complications After Endovascular Treatment of Unruptured Intracranial Aneurysms
Authors: Ji Wenjun , Liu Aihua , Lv Xianli , Kang Huibin , Sun Liqian , Li Youxiang , Yang Xinjian , Jiang Chuhan , Wu Zhongxue 
Published: February 2016

Background and Purpose—
Procedure-related neurological complications are common after endovascular treatment of unruptured intracranial aneurysms. We aimed to develop a score to quantify individual patient risk.

Methods—
We retrospectively analyzed consecutive patients who underwent endovascular treatment for unruptured intracranial aneurysms between January 2012 and September 2015. After excluding those who lost to follow-up and those with fusiform unruptured intracranial aneurysms, included patients were randomly divided into a derivation group (60%) and a validation group (40%). A neurological complication was defined as any transient or permanent increase in the modified Rankin Scale score after aneurysm embolization. A risk score for neurological complications was derived from multivariable logistic regression analyses in the derivation group and validated in the validation group.

Results—

Overall, 1060 patients were included (636 in the derivation group and 424 in the validation group). The incidence of neurological complications was 5.5% (95% confidence interval, 3.8%–7.4%). A 3-point risk score (S-C-C) was derived to predict neurological complications (size [≥10 mm=1], core areas [yes=1], and cerebral ischemic comorbidity [yes=1]). The incidence of neurological complications varied from 2.2% in 0-point patients to 25.0% in 3-point patients. The score demonstrated significant discrimination (
C
-statistic, 0.714; 95% confidence interval, 0.624–0.804) and calibration (McFadden
R
2
, 0.102) in the derivation group. Excellent prediction, discrimination, and calibration properties were reproduced in the validation group.

Conclusions—
One in 20 patients will develop neurological complications after endovascular treatment of unruptured intracranial aneurysms. The S-C-C score may be useful for predicting these adverse outcomes based on variables in daily practice.
Role of Lipocalin-2 in Thrombin-Induced Brain Injury
Authors: Mao Shanshan , Xi Guohua , Keep Richard F. , Hua Ya 
Published: February 2016

Background and Purpose—
Thrombin and lipocalin-2 (LCN2) contribute to intracerebral hemorrhage–induced brain injury. Thrombin-induced brain damage is partially through a thrombin receptor, protease-activated receptor-1. LCN2 is involved in cellular iron transport and neuroinflammation. This study investigated the role of LCN2 in thrombin-induced brain injury.

Methods—
There were 3 parts in this study. First, male adult C57BL/6 wild-type or LCN2 knockout (LCN2 KO) mice had an intracaudate injection of thrombin (0.4 U) or saline. Second, LCN2 KO mice had an injection of thrombin (0.4 U) with recombinant mouse LCN2 protein (1 μg) into the right caudate. Third, protease-activated receptor-1 KO or wild-type mice had an intracaudate injection of thrombin or saline. All mice had T2-weighted magnetic resonance imaging and behavioral tests. Brains were used for histology, immunohistochemistry, and Western blotting.

Results—

Intracerebral thrombin injection caused LCN2 upregulation and brain injury in mice. Thrombin-induced brain swelling, blood–brain barrier disruption, neuronal death, and neurological deficits were markedly less in LCN2 KO mice (
P
<0.05) and were exacerbated by exogenous LCN2 coinjection. In addition, thrombin injection resulted in less LCN2 expression and brain injury in protease-activated receptor-1 KO mice.

Conclusions—
Thrombin upregulates LCN2 through protease-activated receptor-1 activation and causes brain damage.
Preliminary Evaluation of Functional Swallow After Total Laryngectomy Using High-Resolution Manometry
Authors: Lippert Dylan , Hoffman Matthew R. , Britt Christopher J. , Jones Corinne A. , Hernandez Jodi , Ciucci Michelle R. , McCulloch Timothy M. 
Published: February 2016

Introduction: Understanding of swallowing pressures after total laryngectomy (TL) and what constitutes a “functional” swallow are limited. Mobile structures are altered or removed after TL, with consequent effects on pressure profiles. High-resolution manometry (HRM) can characterize these pressures. Methods: Six TL subjects without dysphagia and 6 controls underwent pharyngeal HRM. Timing and pressure variables for the velopharynx, mesopharynx, and upper esophageal sphincter (UES) were compared. Changes in variables due to bolus volume were evaluated in TL subjects. Results: The TL subjects had increased duration of velopharyngeal pressure ( P = .012). Maximum mesopharyngeal pressure was lower versus controls ( P = .003). Maximal and total pre-opening ( P = .002, P = .002) and post-closure ( P = .001, P = .002) UES pressures were lower. Maximum mesopharyngeal pressure ( P = .032) decreased with increasing bolus volume. Conclusions: Increased velopharyngeal pressure duration and total swallow duration reflect separation of the pharynx into distinct conduits for air and food, thus ensuring successful bolus passage without the need for respiration. Decreased UES pressure highlights the effects of disrupting the cricopharyngeal and rostral esophageal muscle fibers from their attachments to the larynx and performing a cricopharyngeal myotomy. Additional studies including subjects with dysphagia could further characterize the functional TL swallow and identify aspects susceptible to dysfunction.
Health education: Effects on classroom climate and physical activity
Authors: Efstathiou Nicholas T , Risvas Grigorios S , Theodoraki Eleni-Maria M , Galanaki Evangelia P , Zampelas Antonios D 
Published: February 2016

Objective: The objective of this study was to investigate the relationship between classroom psychological climate and the physical and sedentary behaviour of primary school students after the implementation of an innovative education programme regarding nutrition and physical activity. Design: Randomised controlled trial. Setting: Study participants were 729 students, aged 8–10 years, in the third and fourth grade of 30 public primary schools in the Athens Metropolitan Area. Methods: Students were randomly assigned to three study groups: an Intensive Intervention Group (IIG) that underwent an intensive nutrition and physical activity education programme delivered by specialised personnel and teachers, an Intervention Group (IG) that underwent a less intensive programme delivered by their regular teacher and a Control Group (CG) that received no instruction. Classroom Psychological Climate (CPC) was measured in all groups, and the data regarding physical activity and sedentary lifestyle habits, such as the time spent viewing TV or video games (screen time), were recorded. Results: Friction declined and satisfaction increased significantly after the intervention in the IG compared with the CG. There was no significant difference in physical activity and screen time between the groups. Daily screen time was positively associated with increased friction, which is a measure of conflicts between students in the school environment. Conclusion: A school nutrition and physical activity education programme was shown to decrease friction by decreasing daily screen time and increasing outdoor activities. These findings also suggest that teachers alone may be more effective in delivering optional health education programmes than specialised personnel and instructors.
Integrating palliative care across settings: A retrospective cohort study of a hospice home care programme for cancer patients
Authors: Tan Woan Shin , Lee Angel , Yang Sze Yee , Chan Susan , Wu Huei Yaw , Ng Charis Wei Ling , Heng Bee Hoon 
Published: February 2016

Background: Terminally ill patients at the end-of-life do transit between care settings due to their complex care needs. Problems of care fragmentation could result in poor quality of care. Aim: We aimed to evaluate the impact of an integrated hospice home care programme on acute care service usage and on the share of home deaths. Settings/participants: The retrospective study cohort comprised patients who were diagnosed with cancer, had an expected prognosis of 1 year or less, and were referred to a home hospice. The intervention group comprised deceased patients enrolled in the integrated hospice home care programme between September 2012 and June 2014. The historical comparison group comprised deceased patients who were referred to other home hospices between January 2007 and January 2011. Results: There were 321 cases and 593 comparator subjects. Relative to the comparator group, the share of hospital deaths was significantly lower for programme participants (12.1% versus 42.7%). After adjusting for differences at baseline, the intervention group had statistically significantly lower emergency department visits at 30 days (incidence rate ratio: 0.38; 95% confidence interval: 0.31–0.47), 60 days (incidence rate ratio: 0.61; 95% confidence interval: 0.54–0.69) and 90 days (incidence rate ratio: 0.69; 95% confidence interval: 0.62–0.77) prior to death. Similar results held for the number of hospitalisations at 30 days (incidence rate ratio: 0.48; 95% confidence interval: 0.40–0.58), 60 days (incidence rate ratio: 0.71; 95% confidence interval: 0.62–0.82) and 90 days (incidence rate ratio: 0.77; 95% confidence interval: 0.68–0.88) prior to death. Conclusion: Our results demonstrated that by integrating services between acute care and home hospice care, a reduction in acute care service usage could occur.
Effects of short-term quetiapine treatment on emotional processing, sleep and circadian rhythms
Authors: Rock Philippa L , Goodwin Guy M , Wulff Katharina , McTavish Sarah FB , Harmer Catherine J 
Published: February 2016

Background: Quetiapine is an atypical antipsychotic that can stabilise mood from any index episode of bipolar disorder. This study investigated the effects of seven-day quetiapine administration on sleep, circadian rhythms and emotional processing in healthy volunteers. Methods: Twenty healthy volunteers received 150 mg quetiapine XL for seven nights and 20 matched controls received placebo. Sleep-wake actigraphy was completed for one week both pre-dose and during drug treatment. On Day 8, participants completed emotional processing tasks. Results: Actigraphy revealed that quetiapine treatment increased sleep duration and efficiency, delayed final wake time and had a tendency to reduce within-day variability. There were no effects of quetiapine on subjective ratings of mood or energy. Quetiapine-treated participants showed diminished bias towards positive words and away from negative words during recognition memory. Quetiapine did not significantly affect facial expression recognition, emotional word categorisation, emotion-potentiated startle or emotional word/faces dot-probe vigilance reaction times. Conclusions: These changes in sleep timing and circadian rhythmicity in healthy volunteers may be relevant to quetiapine’s therapeutic actions. Effects on emotional processing did not emulate the effects of antidepressants. The effects of quetiapine on sleep and circadian rhythms in patients with bipolar disorder merit further investigation to elucidate its mechanisms of action.
Mesenteric panniculitis: review of consecutive abdominal MDCT examinations with a matched-pair analysis
Authors: Protin-Catteau Laure , Thiéfin Gérard , Barbe Coralie , Jolly Damien , Soyer Philippe , Hoeffel Christine 
Published: February 2016

Background The relationship between mesenteric panniculitis (MP), a benign condition involving adipose mesenteric tissue, and malignancy is still being questioned. Purpose To investigate the prevalence of MP and study its relationship with malignancy. To investigate the 5-year outcome of MP patients for the development of malignancy. Material and Methods Retrospective search for MP reviewing 3054 consecutive multidetector row computed tomography (MDCT) scans. Two radiologists in consensus selected the final MP population. For each MP, two subsequent MDCT scans of patients matched by gender and age. Five-year follow-up data regarding cancer occurrence after index MDCT scans were obtained for the MP and control groups. Comparisons between groups were performed using univariate conditional logistic regression. Results A total of 160 patients had at least three of the five MDCT features defining MP. Sixty-four were excluded owing to disease causing mesenteric infiltration or contiguous neoplastic involvement. The final population included 96 MP and 192 control patients. The prevalence of MP was 3.14%. Most cases of MP were discrete (66.7%), 2.1% were marked. In total, 60.4% and 59.4% of MP and control patients, respectively, had cancer ( P = 0.86). There was no significant association between MP score and presence of cancer ( P = 0.06) nor any relationship between the course of associated cancer and MP evolution. In total, 80/96 MP patients and 50/78 control patients without associated cancer had a 5-year follow-up at least. No significant difference between both groups for new tumor occurrence during follow-up was found ( P = 0.15). Conclusion Our results do not suggest that patients with incidentally found MP should be followed up for early detection of a cancer.