bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biochemical predictors of structural hypothalamus–pituitary abnormalities detected by magnetic resonance imaging in men with secondary hypogonadism
Authors: Cipriani S. , Todisco T. , Ghiandai N. , Vignozzi L. , Corona G. , Maggi M. , Rastrelli G. 
Published: May 2021

Abstract
Purpose
Organic conditions underlying secondary hypogonadism (SH) may be ascertained by magnetic resonance imaging (MRI) of the hypothalamic–pituitary region that could not be systematically proposed to each patient. Based upon limited evidence, the Endocrine Society (ES) guidelines suggest total testosterone (T) < 5.2 nmol/L to identify patients eligible for MRI. The study aims to identify markers and their best threshold value predicting pathological MRI findings in men with SH.

Methods
A consecutive series of 609 men seeking medical care for sexual dysfunction and with SH (total T < 10.5 nmol/L and LH ≤ 9.4 U/L) was retrospectively evaluated. An independent cohort of 50 men with SH was used as validation sample. 126 men in the exploratory sample and the whole validation sample underwent MRI.

Results
In the exploratory sample, patients with pathological MRI findings (n = 46) had significantly lower total T, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prostate specific antigen (PSA) than men with normal MRI (n = 80). Receiver Operating Characteristics analysis showed that total T, LH, FSH and PSA are accurate in identifying men with pathologic MRI (accuracy: 0.62–0.68, all p < 0.05). The Youden index was used to detect the value with the best performance, corresponding to total T 6.1 nmol/L, LH 1.9 U/L, FSH 4.2 U/L and PSA 0.58 ng/mL. In the validation cohort, only total T ≤ 6.1 nmol/L and LH ≤ 1.9 U/L were confirmed as significant predictors of pathologic MRI.

Conclusion
In men with SH, total T ≤ 6.1 nmol/L or LH ≤ 1.9 U/L should arise the suspect of hypothalamus/pituitary structural abnormalities, deserving MRI evaluation.
Multi-functionalization Strategies Using Nanomaterials: A Review and Case Study in Sensing Applications
Authors: Song Ji-Hyeon , Min Soo-Hong , Kim Seung-Gi , Cho Younggyun , Ahn Sung-Hoon 
Published: May 2021

AbstractRemarkable advances in nanomaterials and nanotechnology have led researchers in various fields. The scale effects imparted by nanomaterials are associated with unexpected macroscale phenomena and properties that find many applications. However, multi-functionalization may be accompanied by physical and commercial limitations. Therefore, research must proceed in several different directions. Here, we define multi-functionalization and the electrical applications thereof in terms of increasing performance, addition of new and valuable properties, and multi-physics in play. We deal with sensors, actuators, energy harvesters, and solar cells and explore research that seeks to increase sensitivity, append “stretchability”, and facilitate untethered communication. Furthermore, we analyze research trends in materials use and manufacturing, and highlight useful fabrication methods. With the aim of predicting future research trends, our review presents a roadmap that will aid research on sensing and multi-functional applications.
Sustaining Meaningful Patient Engagement Across the Lifecycle of Medicines: A Roadmap for Action
Authors: Cavaller-Bellaubi Maria , Faulkner Stuart D. , Teixeira Bryan , Boudes Mathieu , Molero Eva , Brooke Nicholas , McKeaveney Laura , Southerton Jeffrey , Vicente Maria José , Bertelsen Neil , García-Burgos Juan , Pirard Vinciane , Reid Kirsty , Ferrer Elisa 
Published: May 2021

Abstract
Background
There is increased recognition that incorporating patients’ perspectives and insights into the medicines development process results in better health outcomes and benefits for all involved stakeholders. Despite the increased interest and the existence of frameworks and practical recommendations, patient engagement (PE) is not yet considered standard practice. The objective of this work was to provide a roadmap to support systematic change in all stakeholder organisations involved in medicines development across Europe, patients and patient organisations, medicines developers, academia, regulatory authorities, Health Technology Assessment bodies, payers, policy-makers and public research funders, to sustain PE practices.

Methods
A mixed-methods approach was used by the EU-funded Innovative Medicines Initiative PARADIGM Consortium to co-develop the sustainability roadmap including background work to identify success factors and scenarios for sustainable PE. The roadmap development was based on the Theory of Change concept and populated with findings from (1) interviews with national/ and international institutions with the potential to increase PE uptake by other stakeholders; (2) multi-stakeholder workshops and webinars; and (3) consultations with specific stakeholder groups, Consortium members and a consultative body formed by international PE initiatives.

Results
This roadmap sets strategic goals for the PE community to achieve meaningful and systematic PE through changes in the culture, processes and resources of stakeholder organisations. It brings in key PARADIGM outputs to work in a coordinated fashion with existing frameworks and mechanisms to achieve system-wide sustained PE.

Conclusions
The roadmap provides a framework for all stakeholders to take collective action within their organisations and across Europe to implement PE in a sustainable manner.
A simulation study to evaluate contamination during reuse of N95 respirators and effectiveness of interventions to reduce contamination
Authors: Li Daniel F. , Alhmidi Heba , Scott Jacob G. , Charnas Ian C. , Pearlmutter Basya , Silva Sandra Y. , Wilson Brigid M. , Donskey Curtis J. 
Published: May 2021

AbstractObjective:To assess the potential for contamination of personnel, patients, and the environment during use of contaminated N95 respirators and to compare the effectiveness of interventions to reduce contamination.Design:Simulation study of patient care interactions using N95 respirators contaminated with a higher and lower inocula of the benign virus bacteriophage MS2.Methods:In total, 12 healthcare personnel performed 3 standardized examinations of mannequins including (1) control with suboptimal respirator handling technique, (2) improved technique with glove change after each N95 contact, and (3) control with 1-minute ultraviolet-C light (UV-C) treatment prior to donning. The order of the examinations was randomized within each subject. The frequencies of contamination were compared among groups. Observations and simulations with fluorescent lotion were used to assess routes of transfer leading to contamination.Results:With suboptimal respirator handling technique, bacteriophage MS2 was frequently transferred to the participants, mannequin, and environmental surfaces and fomites. Improved technique resulted in significantly reduced transfer of MS2 in the higher inoculum simulations (P < .01), whereas UV-C treatment reduced transfer in both the higher- and lower-inoculum simulations (P < .01). Observations and simulations with fluorescent lotion demonstrated multiple potential routes of transfer to participants, mannequin, and surfaces, including both direct contact with the contaminated respirator and indirect contact via contaminated gloves.Conclusion:Reuse of contaminated N95 respirators can result in contamination of personnel and the environment even when correct technique is used. Decontamination technologies, such as UV-C, could reduce the risk for transmission.
Psychotic-like experiences? Trajectories and typologies of hallucinations and delusions from early adolescence to early adulthood in a population-based sample of Irish youth
Authors: Coughlan H. , Humphries N. , Clarke M.C. , Healy C. , Cannon M. 
Published: May 2021

Objectives:Hallucinations and delusions that occur in the absence of a psychotic disorder are common in children and adolescents. Longitudinal phenomenological studies exploring these experiences are notably lacking. The objective of the current paper was to explore the phenomenology and characteristics of hallucinations and delusions from early adolescence to early adulthood.Methods:Participants were 17 young people aged 18–21 years from the general population, all of whom had a history of childhood hallucinations and/or delusions. Longitudinal data on the phenomenological characteristics and attributions of reported hallucinatory and delusional phenomena spanning nine years were explored using content analysis.Results:Hallucinatory and delusional phenomena were transient for two-thirds of the sample. The remaining one-third reported reoccurring hallucinatory and delusional phenomena into early adulthood. In those, two typologies were identified: (1) Paranormal typology and (2) Pathological typology. The former was characterised by hallucinatory and delusional phenomena that were exclusively grounded in subcultural paranormal or spiritual belief systems and not a source of distress. The latter was characterised by delusion-like beliefs that were enmeshed with individuals’ mood states and a source of distress. The perceived source, the subcultural context and how young people appraised and integrated their experiences differentiated the Paranormal and Pathological typologies.Conclusions:Not all hallucinatory and delusion-like experiences are psychotic-like in nature. To reliably differentiate between pathological and non-pathological hallucinations and delusions, assessments need to explore factors including the phenomenology of individuals’ experiences, how people make sense and appraise them, and the subcultural contexts within which they are experienced.
Radiological findings in spontaneous cerebrospinal fluid leaks of the temporal bone
Authors: Hendriks T , Thompson A , Boeddinghaus R , Tan H E I , Kuthubutheen J 
Published: May 2021

AbstractBackground and objectiveSpontaneous cerebrospinal fluid leak of the temporal bone is an emerging clinical entity for which prompt and accurate diagnosis is difficult given the subtle signs and symptoms that patients present with. This study sought to describe the key temporal bone abnormalities in patients with spontaneous cerebrospinal fluid leak.MethodsA retrospective cohort study was conducted of adult patients with biochemically confirmed spontaneous cerebrospinal fluid leak. Demographics and radiological features identified on computed tomography imaging of the temporal bones and/or magnetic resonance imaging were analysed.ResultsSixty-one patients with spontaneous cerebrospinal fluid leak were identified. Fifty-four patients (88.5 per cent) underwent both temporal bone computed tomography and magnetic resonance imaging. Despite imaging revealing bilateral defects in over 75 per cent of the cohort, only two patients presented with bilateral spontaneous cerebrospinal fluid leaks. Anterior tegmen mastoideum defects were most common, with an average size of 2.5 mm (range, 1–10 mm).ConclusionTemporal bone computed tomography is sensitive for the identification of defects when suspicion exists. In the setting of an opacified middle ear and/or mastoid, close examination of the skull base is crucial given that this fluid is potentially cerebrospinal fluid.
Amoebicidal activity of Cassia angustifolia extract and its effect on Acanthamoeba triangularis autophagy-related gene expression at the transcriptional level
Authors: Boonhok Rachasak , Sangkanu Suthinee , Norouzi Roghayeh , Siyadatpanah Abolghasem , Mirzaei Farzaneh , Mitsuwan Watcharapong , Charong Nurdina , Wisessombat Sueptrakool , Pereira Maria de Lourdes , Rahmatullah Mohammed , Wilairatana Polrat , Wiart Christophe , Tabo Hazel Anne , Dolma Karma G. , Nissapatorn Veeranoot 
Published: May 2021

Abstract
NATO's strategic narratives: Angelina Jolie and the alliance's celebrity and visual turn
Authors: Wright Katharine A. M. , Bergman Rosamond Annika 
Published: May 2021

AbstractAngelina Jolie's high-profile visit to NATO in 2018 signals a move to brand the alliance's strategic narrative within the language of celebrity through engagement with popular culture. The partnership represents a significant change in the alliance's approach to global security. It also builds on a shift in NATO's self-narrative through the advocacy of gender justice related to the Women, Peace and Security (WPS) agenda. Rather than fading into the background, NATO appears to be pursuing the limelight for the purpose of ‘awareness raising’ as a tool to implement the WPS agenda. Drawing upon feminist scholarship on the WPS agenda, NATO, and research on celebrity humanitarianism and politics, we provide a critical study of this change in NATO's strategic narrative, through the analysis of visual and textual material related to Jolie's visit to NATO. Our focus is on the significance of this partnership and its contribution to legitimising the alliance's self-defined ‘military leadership’ in the area of conflict-related sexual violence. While Jolie's visit to NATO opened the alliance to public scrutiny it also symbolised a form of militarism, surrounded by orchestrated visual representations. As such, it only marginally disrupted the militarist logic present in NATO's wider WPS engagement.
Identifying gaps in parental support for families of children with hypoplastic left heart syndrome
Authors: Landry Meghan , Katers Meghan , Olson Erica , Cern Lynn , Nelson Timothy J , Campbell Katherine A 
Published: May 2021

AbstractPurpose:The purpose of this study is to identify gaps in support for parents of children with Hypoplastic Left Heart Syndrome.Design and methods:Using a mixed-methods approach, the researchers first studied the parental and care team experience through interviews of Hypoplastic Left Heart Syndrome mothers and members of the inter-professional care team and then conducted an international survey of 690 Hypoplastic Left Heart Syndrome primary caregivers to validate the qualitative findings.Results:Parental and care team interviews revealed three main gaps in parental support, including lack of open communication, unrealistic parental expectations, and unclear inter-professional team roles. Survey results found that parents whose children were diagnosed with Hypoplastic Left Heart Syndrome after birth indicated significant dissatisfaction with the care team’s open communication and welcoming of feedback (p = 0.008). As parents progress through the stages of surgical intervention, they also indicate significant dissatisfaction with the care team’s anticipation of parental emotional needs and provision of coping resources (p = 0.003).Conclusions:Parental support interventions should focus on providing resources to help parents cope, helping the care team model open communication, and welcoming feedback on the parental experience.Practice implications:Interventions should be piloted with parents who are in the later stages of the surgical intervention timeline or whose children were diagnosed after birth as they are the populations who perceived the least support within this study.
Xylological Variant of Reverse Fregoli Syndrome, Delusions of Being a Tree
Authors: Bakhshi Harsimran Singh , Hirsch Alan Richard 
Published: May 2021

AbstractIntroductionThe delusion of being a living animate non-animal object has not heretofore been reported.MethodsA 21-year-old right-handed cisgender female, two months prior to presentation, noted stiffness and difficulty with ambulation. One-month prior to admission, she experienced recurrent depression with myriad vegetative and nonvegetative symptoms of depression. On admission her chief complaint was I am a tree, standing motionless and minimally responding to query. After treatment with quetiapine, mirtazapine and hydroxyzine for a one-week period, her perception of being a tree fully resolved.ResultsAbnormalities in Mental Status Examination: Anxious mood repeatedly stating, I am a tree. Standing still for long periods of time, refusing blood pressure to be obtained and expressing fear of constricting flow. Neuropsychiatric Testing: Beck Depression Inventory Type II: 33 (severe depression)DiscussionThe rapid response to risperidone is consistent with Cotard’s syndrome, which has been noted to respond rapidly to neuroleptics (Sharma, 2014). However, in Cotard’s syndrome, replacement by a living non-animal object has not hitherto been reported. Body infestation with animate objects, as in Ekbom syndrome, only includes animals not botanicals (Chaudhary, 2019). This could be viewed as Reverse Inanimate Capgras Syndrome: instead of an imposter replacing a close friend, who then is inserted into the sufferer; a tree has replaced the sufferer. Peradventure, this may fit into the construct of Intermetamorphosis, a misidentification syndrome associated with the belief that individuals have transformed into other persons (Jariwala, 2017). Botanical Intermetamorphosis, the belief by the sufferer that the other individual is transformed from a person into a plant has not been described. Reverse Intermetamorphosis is the projection of an external individual into the person suffering or a syndrome of altered physical and psychological identities of the self (Silva, 1990). However, in this situation, the objects are all human or animate animals not botanicals. In Fregoli syndrome, there is an altered physical identity of others. In Reverse Fregoli syndrome, the sufferer assumes the physical but not the psychological identity of the stranger (Silva, 1990). But in this instance, the stranger is human as opposed to a plant life form. In the current case there is only altered physical identity (into a tree) not psychological identity. The current case may also be interpreted as a Botanical Variant of Interparietal Syndrome. In this condition, parts of the body are perceived to be lifeless, due to lesions of the inferior parietal lobe including supramarginalis gyrus, angular gyrus and the basalis parietalis area (Angyal, 1935). Investigation for those whom have Intermetamorphosis, Fregoli syndrome, Capgras syndrome, Interparietal syndrome, and Cotard’s syndrome for the presence of delusions involving plant life is warranted.
Understanding the Evolving Continuing Medical Education Needs of Physicians Managing Patients with TD
Authors: Wiley Shereta , Cerenzia Wendy , Stacy Sylvie , Shah Chirag , Lundt Leslie , Farahmand Khody 
Published: May 2021

AbstractThis study sought to understand the evolving continuing medical education (CME) needs of physicians managing patients with tardive dyskinesia (TD). A case-based survey was developed, and later updated, to assess current practice, knowledge, and attitudes of neurologists and psychiatrists in the management of patients with TD. The original and updated survey were fielded in May 2018 and March 2020, respectively, to US-practicing psychiatrists and neurologists. Results were obtained from 213 psychiatrists and 187 neurologists in 2018 and from 125 psychiatrists and 128 neurologists in 2020. Less than half of physicians in both 2018 and 2020 were able to correctly identify the prevalence of TD in patients on maintenance antipsychotics, with many underestimating reported prevalence. Respondents reported moderate familiarity with VMAT2 inhibitor therapies for TD, with self-reported familiarity increasing more among neurologists than psychiatrists since the 2018 study. Psychiatrists are more likely than neurologists to take responsibility for medical management of TD symptoms and antipsychotic medication adjustment. Despite recommendations from APA guidelines and AAN reviews, 15% of physicians would use an anticholinergic to manage TD symptoms and only about half would opt for a VMAT2 inhibitor. There was a larger increase in VMAT inhibitor use between 2018 and 2020 among neurologists as compared to psychiatrists. The findings support the need for CME on TD focused toward specific provider groups. While both types of specialists would benefit from CME on the topic of TD epidemiology, there is an increased need for CME that includes treatment updates among psychiatrists.Funding. Neurocrine Biosciences, Inc.
Phase 3 Safety and Tolerability Results of the Combination Olanzapine and Samidorphan in Patients with Schizophrenia: The 1 Year ENLIGHTEN-2-Extension
Authors: Kahn Rene , Silverman Bernard , DiPetrillo Lauren , Graham Christine , Jiang Ying , Yin Jiani , Simmons Adam , Bhupathi Vasudev , Yu Bei , Hopkinson Craig , McDonnell Davidd 
Published: May 2021

AbstractObjectiveCombination olanzapine and samidorphan (OLZ/SAM) is in development for treatment of schizophrenia and bipolar I disorder and is intended to provide the antipsychotic efficacy of olanzapine while mitigating olanzapine-associated weight gain. This 52-week open-label extension study (NCT02873208; ENLIGHTEN-2-EXT) in schizophrenia assessed the safety and tolerability of OLZ/SAM. Methods: Patients completing the 24-week, randomized, double-blind, phase 3 ENLIGHTEN−2 study comparing weight gain with OLZ/SAM vs olanzapine were eligible for ENLIGHTEN-2-EXT enrollment. Initial OLZ/SAM doses were based on olanzapine dose (10 or 20 mg) received at the conclusion of ENLIGHTEN-2; subsequent olanzapine dose adjustments were allowed. The samidorphan dose (10 mg) remained fixed throughout. Assessments included adverse events (AEs), weight, waist circumference, metabolic laboratory parameters, and Positive and Negative Syndrome Scale (PANSS) scores. Analyses were based on observed results using descriptive statistics. Baseline was relative to the first OLZ/SAM dose in the extension study.Results265 patients received OLZ/SAM; 167 (63.0%) completed the extension study. Common AEs (= 5%) were weight decreased (n=23; 8.7%), extra dose administered (n=21; 7.9%), headache (n=18; 6.8%), and weight increased (n=16; 6.0%). At week 52, mean (SD) change from baseline for weight and waist circumference was −0.03 (6.216) kg and −0.35 (6.115) cm, respectively. Changes in fasting lipid and glycemic parameters were generally small and remained stable over 52 weeks. PANSS total scores remained stable during the extension.ConclusionsOLZ/SAM was generally well tolerated over 52 weeks. Weight, waist circumference, metabolic laboratory parameters, and schizophrenia symptoms remained stable throughout the study.FundingAlkermes, Inc.