bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Alterations in the Attentional Networks of People Living with HIV and Apathy: Preliminary Results and Pharmacoclinical Impact
Authors: Mazzoglio y Nabar Martin J. , Tornese Elba , Terren Emmanuel Leidi , Iturry Mónica 
Published: May 2021

AbstractObjectiveThe objective was to determine alterations in the care of people living with human immunodeficiency virus (PLHIV) with depressive disorder without and with apathy to determine differential parameters.MethodsWe studied 69 PLHIV, negativized viral load, of both sexes (19 women and 44 men), with depressive disorder (F32.9-DSM IV), 20 with apathy and 26 without apathy; negativized viral load, in highly effective antiretroviral treatment without therapeutic failure in the last 2 years and without protease inhibitors; without psychopharmacological treatment (except anxiolytics) or dementia due to HIV (American Academy of Neurology) or comorbidities (hepatitis C, CNS or central vascular infections). They were evaluated with MINI, Hamilton Depression Rating Scale, Apathy Evaluation Scale clinical version and Neuropsychiatric Inventory and neuropsychological tests were applied (Stroop, Trail Making A and B, digit-symbol substitution test, Visual and verbal direct digit span test, BTS−1 and BTS−3). Statistical tests were applied, and ethical-legal standards were met.ResultsPLHIV with depressive disorder had a high prevalence of apathy. In patients with apathy, there was a greater significant alteration, according to decreasing differential involvement, in sustained and divided care. The processing speed was slowed down without significant difference in the apathy group. Selective attention did not show significant differences between groups.ConclusionsApathy in patients living with HIV with depression presents specific and differential alterations in the attention domain. The alterations of sustained and divided attention were specific in this group, with affectation of the previous attention circuit and would be related to the subsequent cognitive disruption as a prodrome. These characteristics must be taken into account as the basis for establishing interdisciplinary treatment strategies (psychopharmacological, psychotherapeutic and neurocognitive rehabilitation).
Clinician-Reported Patient Awareness of Symptoms and Severity of Tardive Dyskinesia in Patients Prescribed VMAT2 Inhibitors
Authors: Meyer Jonathan M. , Franey Ericha , Lundt Leslie , Benning Betsy , Goldberg Edward , Yonan Chuck , Dhanda Rahul 
Published: May 2021

AbstractObjectiveVesicular monoamine transporter 2 (VMAT2) inhibitors including valbenazine are first-line therapies for tardive dyskinesia (TD), a persistent movement disorder associated with antipsychotic exposure. This real-world study was performed to assess the association between patient awareness of TD symptoms and clinician-assessed symptom severity.MethodsClinicians who treated antipsychotic-induced TD with a VMAT2 inhibitor within the past 24 months were asked to extract demographic/clinical data from patients charts and complete a survey for additional data, including patient awareness of TD (yes/no) and TD symptom severity (mild/moderate/severe).ResultsData for 601 patients were provided by 163 clinicians (113 psychiatrists; 46 neurologists; 4 primary care physicians). Patient demographics: 50% male; mean age 50.6 years; 55% schizophrenia/schizoaffective disorder; 29% bipolar disorder; 16% other psychiatric diagnoses. Positive relationships were seen between patient awareness and clinician-assessed symptom severity. Awareness was highest in patients with severe symptoms in specific body regions: face (88% vs 78%/69% [awareness by severe vs moderate/mild symptoms]); jaw (90% vs 80%/67%); wrists (90% vs 69%/63%). In other regions, awareness was similar in patients with severe or moderate symptoms: lips (85%/86% vs 68% [severe/moderate vs mild]); tongue (81%/80% vs 73%); neck (80%/78% vs 68%); arms (67%/66% vs 62%); knees (67%/67% vs 53%).ConclusionsIn patients prescribed a VMAT2 inhibitor for TD, patient awareness was generally higher in those determined to have moderate-to-severe symptom severity as assessed by the clinician. More research is needed to understand how awareness and severity contribute to TD burden, and whether different treatment strategies are needed based on these factors.FundingNeurocrine Biosciences, Inc.
Concerns from Community Mental Health Center (CMHC) Patients Regarding Drug-Induced Movement Disorders: Impact on Functioning and Treatment Beliefs
Authors: Stiles Allison , Franey Ericha , Goldberg Edward , Lundt Leslie , Yonan Chuck , Dhanda Rahul 
Published: May 2021

AbstractObjectiveDrug-induced movement disorders (DIMDs) may occur in patients treated with antipsychotics. The CommonGround Program supports the recovery and healing of psychiatric outpatients through tools which facilitate better patient-doctor communication regarding psychiatric symptoms, DIMDs, and the effectiveness of treatment.MethodsPatients responses to CommonGround’s web-based waiting-room questionnaire were analyzed in patients who responded yes to having concerns about developing DIMDs (MD-YES) and those who responded no to this question (MD-NO). These groups were compared descriptively to assess the potential effects of DIMD concerns on self-reported functioning and beliefs about prescribed psychiatric medications.ResultsOf 7874 responding patients, 312 (4.0%) and 7562 (96.0%) were in the MD-YES and MD-NO subgroups, respectively. A higher percentage of MD-YES patients reported poor / not so good ability to keep up with daily responsibilities (21.2% vs 15.2% vs MD-NO), along with low energy levels (37.1% vs 26.3% for MD-NO), bothersome thoughts/beliefs/fears (30.5% vs 16.0%), and nervousness/anxiety (35.3% vs 27.5%) all / most of the time. MD-YES patients were also more likely to wonder about stopping their medications (9.3% vs 0.6% for MD-NO) and were concerned about side effects such as sleepiness (31.4% vs 3.9%) and weight gain (37.2% vs 5.7%).ConclusionPatients from community mental health centers who were concerned about developing DIMDs tended to express problems with daily functioning and concerns about their psychiatric medications. For these patients, recognizing their fears and concerns may help clinicians discuss treatment options for DIMDs, which could increase patient confidence, encourage adherence to current psychiatric medications, and potentially improve outcomes.
Knowledge of The Recognition and Management of Tardive Dyskinesia Markedly Improved Among Psychiatrists: Assessing the Impact of Online Medical Education
Authors: Finnegan Thomas , Mehra Anjali , Lubarda Jovana , Shah Chirag , Cutler Andrew J. 
Published: May 2021

AbstractIntroductionTardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotic medications that jeopardizes adherence to treatment and reduces quality of life. The recognition and management of TD can be challenging in many instances. An online activity was developed to assess the ability of continuing medical education (CME) to improve awareness of the recognition and management of TD among psychiatrists.MethodsThe online CME activity consisted of a 30-minute video discussion between three expert faculty. Educational effect was assessed by comparing a matched sample of psychiatrists’ responses to four identical questions pre- and post-activity. A chi-square test identified significant differences between pre- and post-assessment responses. Cramer’s V was used to calculate the effect size of the online education (≥ 0.16 is considerable). Data were collected between June 26 and August 6, 2019.ResultsActivity participation resulted in a considerable educational effect among psychiatrists (n=739; V=0.25, P<0.001). The following areas showed significant (P <0.05) pre- vs post-educational improvements: recognition of incidence of TD associated with different antipsychotic therapies, differentiation of TD from parkinsonism, and the personalized selection of therapies for the management of TD. 37% of psychiatrists had a measurable increase in confidence in understanding the role of the interprofessional team in recognizing TD after activity participation.ConclusionsThe results indicated that a CME-certified 30-minute video activity was effective at improving knowledge among psychiatrists for the recognition and management of TD. Future education should continue to address best practices in the care of patients with TD.FundingNeurocrine Bioscience, Inc
Is this Withdrawal or Intoxication? Case Report Regarding Complications of Unregulated Use of Tianeptine, Etizolam, and Phenibut in the USA
Authors: Ghani Sadia B. , Taylor Eric , Gopalakrishnan Siddesh 
Published: May 2021

AbstractBackgroundThe internet allows easy access for the sales of psychoactive agents that are not regulated by the FDA. Some of those agents are used to help manage anxiety, depression and sleep, such as tianeptine, etizolam, and phenibut. These medications have the potential for abuse and potentially leading to altered mental status when intoxicated or withdrawing. This presents a challenge to clinicians who may not be aware of availability of such substances. Available literature has discussed the use of above substances individually, but how do you treat if there is use of more than one substance with different mechanisms of actions? Here we present a case of an adult male who has used all three agents simultaneously, leading to a hospital admission.Case HistoryA 32-year-old male presented to the emergency department (ED) for altered mental status (AMS). He has a documented history of anxiety but was never treated with prescription medications. No history of substance use was documented. He was self-medicating with concurrent use of tianeptine (atypical antidepressant with mu agonist properties,) phenibut (GABA mimetic) and etizolam (a benzodiazepine-like agent). During his stay, he was agitated and delirious with reports of visual hallucinations. Neuroimaging and lab studies were within normal limits, EEG showed no seizure activity. Over the course of his hospital stay, he was started on Depakote for agitation, a Valium taper for suspected benzodiazepine withdrawal and prevention of seizures, Seroquel for delirium, and baclofen for suspected GABAergic withdrawal symptoms. The patient’s AMS improved and he was discharged on hospital day 10.ConclusionsThis case illustrates the difficulty managing poly-substance use/abuse and stresses the importance for physicians to screen for psychoactive agents purchased over the internet or over the counter to improve treatment outcomes. Continued discussions with patients regarding risks/benefits of use of such substances would be beneficial and help increase awareness.
Discovering Non-Invasive Biomarkers Predictive of Opioid Use Disorder Treatment Response
Authors: Levine Amir , Clemenza Kelly , Weiss Shira , Bisaga Adam , Eitan Erez , Gerra Maria Carla , Donnini Claudia , Gerra Gilberto , Garcia Benjamin 
Published: May 2021

AbstractBackgroundOpioid use disorder (OUD) continues to be the driving force behind drug overdoses in the United States, killing nearly 47,000 people in 2018 alone. The increasing presence of deadlier fentanyl analogues in the heroin drug supply are putting users at a greater risk for overdose than ever before. Admissions to treatment programs for OUD have also nearly doubled since 2006, yet relapse rates remain high. In response to these alarming statistics, developing approaches to reduce overdose deaths has become an area of high priority. As it is not yet known which patients are most likely to benefit from a specific treatment, there is a dire need to utilize new molecular tools to guide precision medicine approaches and improve treatment outcomes. Here we describe a proof-of-concept study evaluating plasma-derived extracellular vesicle (EV) signatures and how they differ in patients who responded to two pharmacologically contrasting treatments for OUD: the μOR agonist methadone, and the μOR antagonist naltrexone.MethodsWe obtained blood samples from patients with OUD who remained abstinent from illicit opioids for at least 3 months during treatment with methadone (n=5) and naltrexone (n=5), as well as matched healthy controls (n=5). EVs were isolated from plasma and histones were isolated from peripheral blood mononuclear cells (PBMCs). EVs were then analyzed for lipid and histone post-translational modification (PTM) content using liquid chromatography-mass spectrometry. EV miRNA cargo was determined by RNA sequencing.ResultsWe found one lipid class and six miRNAs that differed significantly between the naltrexone group and the methadone and control groups. We also found that histone H3acK9acK14 was increasingly acetylated in PMBCs from both the methadone and naltrexone groups compared to controls.DiscussionNaltrexone, which is used in treatment of OUD and other substance use disorders as well as disorders of impulse control, was found to have multiple potential corresponding molecular signatures that can be identified after long-term treatment. It remains to be seen if these markers can also be a good predictor for treatment response. In addition, significant gender differences in EV content are found between men and women with OUD, which supports the importance of examining changes in response to treatment in a gender informed way.
Use of a Consultation Service Following Pharmacogenomic Testing in Psychiatry
Authors: Dowd Daniel , Krause David S. 
Published: May 2021

AbstractBackgroundThere is a plethora of drugs available to psychiatrists for treatment of mental illness, which can vary in efficacy, tolerability, metabolic pathways and drug-drug interactions. Psychotropics are the second most commonly listed therapeutic class mentioned in the FDA’s Table of Pharmacogenomic Biomarkers in Drug Labeling. Pharmacogenomic (PGx) assays are increasingly used in psychiatry to help select safe and appropriate medication for a variety of mental illnesses. Our commercial laboratory offers PGx expert consultations by PharmDs and PhDs to clinician-users. Our database contains valuable information regarding the treatment of a diverse and challenging population.MethodsGenomind offers a PGx assay currently measuring variants of 24 genes relevant for selection of drugs with a mental illness indication. Since 2012 we have analyzed > 250,000 DNA samples. Between 10/18 - 8/20 6,401 reports received a consult. The data contained herein are derived from those consults. Consultants record information on prior meds, reason for failure or intolerability, potential risk-associated or useful drugs based on the genetic variants. Consultants only recommend specific drugs and doses consistent with a published PGx guideline.ResultsThe 5 most commonly discussed genes were SLC6A4, MTHFR, CACNA1C, COMT and BDNF. The 3 most commonly discussed drugs were fluoxetine, lithium and duloxetine. The most common reasons for drug failure were inefficacy and drug induced “agitation, irritability and/or anxiety”. SSRIs were the most common class of discontinued drug; sertraline, escitalopram and fluoxetine were the three most commonly reported discontinuations and were also the 3 most likely to be associated with “no improvement”. Aripiprazole was the most commonly reported discontinued atypical antipsychotic. The providers rated 94% of consultations as extremely or very helpful at the time of consult. An independent validation survey of 128 providers confirmed these ratings, with 96% reporting a rating of “very helpful” or “extremely helpful”. In addition, 94% reported that these consults were superior to PGx consults provided through other laboratories. Patient characteristics captured during consults via a Clinical Global Impressions-Severity (CGI-S) scale revealed that the majority of patients were moderately (54%) or markedly ill (23%). The most frequent symptoms reported were depression, anxiety, insomnia and inattentiveness.DiscussionThe large variety of psychotropic drugs available to providers, and their highly variable response rates, tolerability, capacity for drug-drug interactions and metabolic pathways present a challenge for even expert psychopharmacologists. Consultation with experts in PGx provides additional useful information that may improve outcomes and decrease healthcare resource utilization. This database may provide future opportunities for machine learning algorithms to further inform implications of included gene variants.FundingGenomind, Inc.
‘Indian Money’, Intra-Shīʿī Polemics, and the Bohra and Khoja Pilgrimage Infrastructure in Iraq's Shrine Cities, 1897–1932
Authors: O'SULLIVAN MICHAEL 
Published: May 2021

AbstractUsing sources in Arabic, Gujarati, Ottoman, Persian and Urdu, this article examines the foundation of Bohra and Khoja pilgrimage institutions straddling western India and Iraq's Shīʿī shrine cities between 1897 and 1932. As manifestations of ‘locative piety’, these institutions were an outgrowth of the commercial capital Bohra and Khoja merchants had acquired in Indian Ocean trade over the previous half century, and the distinct caste and sectarian identities this wealth augmented. The Bohra and Khoja (both Twelver and Ismāʿīlī) mercantile and religious elites supplied their constituents with a well-ordered pilgrimage to Iraq, certainly by the standards of contemporary Hajj. To achieve this, community-run institutional nodes in Karachi, Bombay and the Shīʿī shrine cities were integrated into wider transport, administrative, and financial infrastructures connecting India and Iraq. Yet at a time when Najaf and Karbala's economic and religious fortunes were plagued by sectarianism, political upheavals and divisions among themujtahids, the growing presence of western Indian Shīʿīs in the shrine cities was fiercely condemned by some Twelver Shīʿī clerics. One of their number, Muḥammad Karīm Khurāsānī, published a substantial polemic against the Bohras and Khojas in 1932, signalling how these pilgrimage infrastructures worked to exacerbate intra-Shīʿī disputes.
Impact of loco-regional treatment including radiotherapy in patients presenting with metastatic breast cancer
Authors: Yadav Budhi Singh , Sunku Rubu , Dahiya Divya 
Published: May 2021

AbstractBackground:The impact of loco-regional treatment (LRT) with radiotherapy (RT) in patients presenting with metastatic breast cancer (MBC) has not been widely studied. The aim of this study was to review the treatment outcomes of LRT including RT in patients with MBC.Materials and methods:Patients who presented with MBC were included in this retrospective study. Analysis was undertaken to determine the difference in local disease control, overall survival (OS) and progression-free survival (PFS) with systemic treatment alone, surgery alone, surgery plus RT and RT alone with long-rank test. Multivariate analysis was done, using the cox regression for factors affecting PFS and OS.Results:From 2007 to 2014, data of 257 patients with MBC were collected. Totally, 185 patients received LRT and 72 did not. LRT was surgery plus RT, surgery only and RT only in 113, 47 and 25 patients, respectively. Cytotoxic chemotherapy and hormone therapy were received by 205 and 166 patients, respectively. Median follow-up was 36 months (6–120 months). PFS and OS at 3 years with and without LRT were 31% versus 6% (p < 0·001) and 41% versus 17% (p < 0·001), respectively. PFS at 3 years with surgery plus RT, RT alone and surgery was 40, 33 and 6%, respectively. OS at 3 years with surgery plus RT, RT alone and surgery was 50, 38 and 17%, respectively. Patients without LRT had worse PFS and OS, 6 and 17%, respectively. RT had significant impact on PFS and OS along with chemotherapy and hormone treatment.Conclusion:In patients with MBC, improved local control, PFS and OS were achieved with loco-regional RT. Loco-regional RT along with chemotherapy and hormones were significant factors for PFS and OS irrespective of surgery.
Respiratory gating in patients with lung carcinoma undergoing radiotherapy
Authors: Hubers D. , van Dieren E. B. , Woutersen D. P. , Slump C. H. 
Published: May 2021

AbstractAim:This study aims to compare the gating signals of patients with lung cancer recorded during the planning computed tomography scan with the ones recorded during treatment fractions. The results provide insights into how representative the respiratory signals from the planning scan are for radiation dose partitioning.Materials and methods:The amplitude and frequency of the respiratory signals of 29 patients with lung carcinoma were analysed and compared with the amplitude and frequency of those recorded during their planning scans. Moreover, a cross-correlation analysis was performed between the difference between the planning scan and fractions and features from the planning scan.Results:Two patients showed significantly different amplitude and frequency during treatment fractions compared to those from the planning scan. These patients showed low variances in frequency and amplitude during the different fractions. The difference between planning scan and fractions is correlated with the variances within the planning scan.Findings:Respiratory signals can differ between the planning scan and the fractions. In this case, a new planning scan may be beneficial. The respiratory signals from the planning scan may be predictive of whether the planning scan will be representative and usable as a control measure during radiotherapy fractions.
The partisan politics of employment protection legislation: Social democrats, Christian democrats, and the conditioning effect of unemployment
Authors: Zohlnhöfer Reimut , Voigt Linda 
Published: May 2021

AbstractPolitical parties are likely to hold differing views about employment protection legislation (EPL). While pro-welfare parties could support EPL, pro-market parties might focus on labour market deregulation. In this paper, we investigate empirically whether partisan politics, especially the government participation of Social democrats and Christian democrats, matter for EPL in 21 established OECD countries from 1985 to 2019. We show that during the golden age of the welfare state, the level of EPL was much higher where Social and Christian democrats dominated the government than elsewhere. After the golden age and under conditions of high unemployment, these unconditional effects mostly disappeared. Instead, the level of unemployment conditions partisan differences. Christian democrats liberalize EPL for regular employment significantly less than other parties under high levels of unemployment. In contrast, Social democrats defend high levels of EPL for regular and temporary employment when unemployment is low. Against expectations, they even liberalize employment protection for labour market insiders more than other parties at very high levels of unemployment.
Dispositional Greed Scales
Authors: Zeelenberg Marcel , Seuntjens Terri G. , van de Ven Niels , Breugelmans Seger M. 
Published: May 2021

Abstract. In recent years, different scales have been developed to assess individual differences in dispositional greed. We report two studies ( N1 = 300, N2 = 1,000) on the comparative psychometric properties of these scales. We find that all scales are reliable and that they correlate highly, suggesting that all can be used to assess dispositional greed. Exploratory factor analyses, using the Empirical Kaiser Criterion, the Hull method, and Parallel Analysis as extraction methods, were done on the separate scales and all items together. These analyses reveal that there is quite some consistency in the scales, as in both studies a one-factor solution seems to describe the data best. These results imply that these different scales all assess dispositional greed, although the results also suggest that some items may be deleted from the scales.