bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatry on a Shoestring: Developing New Standards of Care for a Severe, Prolonged, and Widespread Emergency
Authors: Black James E. 
Published: May 2021

AbstractStudy ObjectiveThe COVID-19 crisis has severely stressed our healthcare system and pushed our economy to the brink. This long emergency will probably cause years of severe suffering in every region. Health expenses greatly increased, supply chains were disrupted, and governments coped with much less revenue. Good clinicians plan for ALL contingencies, and we need to consider that the current disaster may get much worse. How can we adapt psychiatry to a long emergency? This goes far beyond previous work on crisis standards of care because the emergency is severe, prolonged, and widespread. If we had to spend much less on psychotropics, which meds stay on the formulary? If we have to close hospitals, which patients get a bed? What adaptations could be used if demand exceeds the supply of providers? Very little is known about how to make severe, permanent cuts to healthcare. Our previous systematic review found no scholarship addressing the ethics of severe and prolonged healthcare rationing. Global catastrophes need a global health policy, but this one has no experts. The present study starts the project by surveying experts with related experience that could be useful in future plans.MethodWe used purposive sampling to find 18 professionals with experience in healthcare rationing from underserved, indigenous communities, homeless programs, and African nations. We also interviewed ethicists, pharmacists, administrators, NGO clinicians, and military. Interviews were transcribed and coded using basic inductive techniques. Because so little is known about this topic, we used grounded theory, an iterative approach to guide further sampling, refine interviews, and make some preliminary conclusions.ResultsParticipants all agreed this crisis planning is extremely important and complex. They described diverse concerns regarding ethical decision making, with some having confidence with top-down government policy, and others recommending a grassroots approach. Minority participants had less confidence in government. There was no consensus on any best ethical framework. Most had confidence that clinicians will ultimately do the right thing. Native American leaders had confidence in a holistic, preventive approach. All agreed that social justice should be central in measuring economic impact of long emergencies and choosing ethical options. We collected suggestions for innovative approaches to rationing.ConclusionsThis research program illuminates the difficult ethical questions about adapting psychiatry to a prolonged, widespread, and severe emergency. Our interviews identify areas where severe but ethical cuts can be made in medications, hospitals, clinical staff, and administration. Next steps include evidence-based formularies, utilitarian staff cuts, and ethical standards for closing beds or revamping state hospitals. Underserved and diverse communities with rationing experience must have a voice in the discussion.
Long-Term Efficacy of Combination Therapy of Transcranial Magnetic Stimulation with Ketamine for Patients with Treatment-Resistant Depression
Authors: Best Steve , Pavel Dan G. , Haustrup Natalie 
Published: May 2021

AbstractBackgroundRepetitive transcranial magnetic stimulation (rTMS) is a safe, effective and non-invasive treatment for many psychiatric illnesses, including treatment-resistant depression (TRD). Ketamine, an NMDA receptor antagonist, is also an effective antidepressant. This retrospective review examined the clinical benefits of combining these two established treatments for patients suffering from TRD in a novel approach coined combination TMS with ketamine (CTK).MethodsA group of 28 adult patients with a primary diagnosis of unipolar (n=18) or bipolar (n=10) depression received three CTK treatments a week at a private neuropsychiatric practice. Patients were given a concurrent treatment of rTMS (1Hz; 40 minutes; 130% of motor threshold) with bio-marker-determined IV ketamine infusions (0.2–4.7 mg/kg; 30 minutes). The TMS coil was positioned on the mid-prefrontal area. Frequency of treatment was dependent on patient responsiveness (10–30 sessions), which was measured as symptom reduction on the Clinical Global Impression (CGI) scale. CGI data was evaluated pre-treatment, post-treatment and at two-year follow-up.ResultsMean reduction in CGI severity for the patient group following CTK was 4.46 ± 0.54 at a 99% confidence interval and was deemed statistically significant using a paired t-test (a=0.01, t=22.81, p < 0.0001). This significant reduction in CGI severity was sustained for at least 2 years following treatment completion.ConclusionsDespite years of unsuccessful treatments, all 28 patients in this trial obtained substantial and enduring reductions in their depressive symptoms following CTK therapy. Further research into method optimization and randomized controlled trials are warranted.
Treating Comorbid Childhood Bipolar Disorder and ADHD
Authors: Nemeth Darlyne G. , Chustz Kayla M. , Capps Cody M. 
Published: May 2021

AbstractObjectivesPediatric mania is difficult to distinguish from childhood hyperactivity. Both share 3 common symptoms: distractibility, motoric hyperactivity, and talkativeness. Oftentimes, children are referred from their pediatrician due to a lack of appropriate response to stimulant medication. Pediatricians have learned that merely raising the dose or changing the stimulant does not work. A thorough neuropsychological evaluation often reveals bipolar mania. They may have comorbid bipolar disorder and ADHD. This poster paper will examine measures that can assist in this important differential diagnosis as well as offer treatment options, including medication management.MethodsThis case study includes three pediatric patients diagnosed with childhood bipolar disorder and ADHD. A comprehensive psychoeducational assessment was conducted for each of the patients, which resulted in this comorbid diagnosis.ResultsOne of the most helpful measures was the TOVA (i.e., Test of Variables of Attention). When a child’s attention and impulsivity scores are normal, and response time and variability scores are abnormal, both on and off medication, that is an indication of a mood disorder, These children also performed poorly on measures of processing speed, and verbal learning and interference tasks. Measures of affect and personality were important diagnostically. A combination of amantadine and either clonidine HCL ER or propranolol, as prescribed by a medical psychologist, were found to be effective in controlling the symptoms of this comorbid diagnosis.ConclusionsAn evaluation of children’s intellectual, attentional, behavioral, mood, and personality functioning is crucial for a differential diagnosis. In cases of comorbidity, ADHD and childhood bipolar disorder, the sooner the child is on appropriate medications, the better. When just the surface diagnosis of ADHD is medicated, the outcome is often problematic. There may be a poor response to treatment and a higher rate of suicide.
Proximal and distal influences on dietary change among a diverse group with prediabetes participating in a pragmatic, primary care nurse-led intervention: a qualitative study
Authors: Abel Sally L , Whitehead Lisa C , Tipene-Leach David C , Coppell Kirsten J 
Published: May 2021

AbstractObjective:To understand motivators, facilitators and challenges to dietary change amongst a diverse sample of New Zealanders with prediabetes participating in a primary care nurse-led individualised dietary intervention.Design:A qualitative study involving semi-structured, face-to-face interviews with a stratified sample of adults with prediabetes and BMI ≥ 25 kg/m2, purposefully selected from a larger 2-year primary care-based prediabetes dietary intervention study. Thematic analysis was undertaken. A socio-ecological model guided interpretation.Setting:Hawke’s Bay, Aotearoa/New Zealand, April 2018–March 2020.Participants:Fifty-eight people aged 28–69 years, with similar numbers of men and women, indigenous Māori and non-Māori, and those who had and had not regressed to normoglycaemia at 6 months.Results:Motivators for wanting to make dietary changes were determination not to progress to diabetes; wanting to be healthy and contribute to others and encouragement by others. Facilitators for adopting and maintaining changes were a strong desire to be healthy; personal determination and feeling supported. Challenges were compromised control over life and environmental factors; feeling unsupported by others; social occasions; financial constraints and living with other health conditions. Developing their own strategies to overcome challenges was empowering, enabling a sense of control. These factors were similar across demographic and glycaemic outcome groups.Conclusions:Influences on dietary change involved personal, interpersonal, organisational, environmental and policy factors. Although findings appeared similar across groups, dietary interventions need to address the specific ways motivators, facilitators and challenges manifest for individuals and social groups and be tailored accordingly within the context of the wider obesogenic and socio-economic environment.
Reassessing Eastern Mediterranean Tectonics and Earthquake Hazard From the 365 CE Earthquake
Authors: Ott Richard F. , Wegmann Karl W. , Gallen Sean F. , Pazzaglia Frank J. , Brandon Mark T. , Ueda Kosuke , Fassoulas Charalampos 
Published: May 2021

AbstractThe hallmark of great earthquakes in the Mediterranean is the 21 July 365 CE earthquake and tsunami that destroyed cities and killed thousands of people throughout the Eastern Mediterranean. This event is intriguing because most Mediterranean subduction forearcs exhibit pervasive crustal extension and minimal definitive evidence exists for great subduction megathrust earthquakes, consistent with weak seismic coupling. This conundrum has led many to favor rupture of a previously unrecognized upper plate splay fault south of Crete in an M
w 8.3–8.5 earthquake, uplifting a Cretan Holocene paleoshoreline by up to 9 m. Similar source mechanisms have been adapted for the region, which are commonly used for seismic and tsunami hazard estimation. We present an alternative model for Holocene paleoshoreline uplift and the 365 CE tsunami that centers on known active normal fault systems offshore of western and southwestern Crete. We use new and published radiocarbon dates and historical records to show that uplift of the Cretan paleoshoreline likely occurred during two or more earthquakes within 2–3 centuries. Visco‐elastic dislocation modeling demonstrates that the rupture of these normal faults fits observed data as well as reverse fault models but requires reduced slip and lower cumulative earthquake energy release (∼M
w 7.9). Tsunami modeling shows that normal‐fault ruptures produce strong tsunamis that better match historical reports than a hypothetical reverse fault. Our findings collectively favor the interpretation that damaging earthquakes and tsunamis in the Eastern Mediterranean can originate on normal faults, highlighting the potential hazard from tsunamigenic upper plate normal fault earthquakes.
An Unexpected Whistler Wave Generation Around Dipolarization Front
Authors: Chen G. , Fu H. S. , Zhang Y. , Su Z. P. , Liu N. G. , Chen L. , Ge Y. S. , Du A. M. , Liu C. M. , Wang Z. , Chen F. 
Published: May 2021

AbstractDipolarization front (DF)—a sharp boundary separating hot tenuous plasmas from cold dense plasmas—is followed by a strong Bz region, which is termed flux pileup region (FPR) or dipolarizing flux bundle (DFB). Using 9‐year (2001–2009) Cluster data, we show that the FPR hosts whistler waves because of the pancake distribution of electrons, whereas the DF boundary hosts lower hybrid drift waves due to the strong density and magnetic gradients statistically. Different from statistical results, we report an unexpected case: whistler waves are generated at the DF boundary rather than inside the FPR. Using Cluster data, we observed strong whistler waves at DF boundaries but no whistlers inside FPRs, although flux tubes inside the FPRs are significantly compressed and suprathermal electrons there are perpendicularly anisotropic. We calculate wave growth rates and successfully explain the generation/damping of these whistlers. We find that 1–4 keV electrons are responsible for generation/damping of these whistlers.
Simulating Melting in 2D Seismic Fault Gouge
Authors: Mollon Guilhem , Aubry Jérôme , Schubnel Alexandre 
Published: May 2021

AbstractDuring an earthquake, fault slip weakening is often explained by frictional heating phenomena, generally promoting melt production on the fault surface. Here, we investigate the influence of melt production at the scale of the grains composing a fault gouge. We use a modern version of Discrete Element Modeling able to deal with realistic grain shapes in 2D, and couple it with a Multibody Meshfree Approach able to provide a satisfactory proxy for the mechanical behavior of molten grains. Frictional sliding of solid grains and viscous shearing of molten grains are monitored during simulations. Our results confirm the natural tendency of granular gouge to localize deformation in a thin layer, and thus to trigger local melt production. We also show that the appearance of melt is likely to enhance this localization, and might create a positive feedback to its own production. We propose guidelines for the future writing of a friction model including melting, inspired by these simulation results.
Laboratory Experiments on Tsunamigenic Discrete Subaqueous Volcanic Eruptions. Part 2: Properties of Generated Waves
Authors: Shen Yaxiong , Whittaker Colin N. , Lane Emily M. , White James D. L. , Power William , Nomikou Paraskevi 
Published: May 2021

AbstractSubmarine volcanic eruptions have the potential to generate tsunamis, which can cause destruction well beyond the range of the eruption itself. Here, we present a series of underwater eruption experiments in which a non‐condensing gas was injected into a water tank with a range of water depths and applied pressures. This study proposes an effective scaled water depth and categorizes underwater eruptions into three types: deep‐water eruptions, intermediate‐water eruptions, and shallow‐water eruptions. In deep‐water eruptions, most of the energy is dissipated within the water column before the plume reaches the surface, and negligible waves are generated. In intermediate‐water eruptions, reductions in water depth reduce the loss of energy to the water column, leaving more energy available for wave generation. This causes an increase in wave heights as water shallows, up to a point. In sufficiently shallow‐water cases, the water depth is so small that almost all of the energy from the eruptive jet or plume passes through the water and is dissipated into the air, so there is only small wave‐making potential, even with relatively intense source strength. Therefore, there exists a critical water depth at which an eruption with a given source intensity will generate the largest waves. That depth lies at the boundary between the intermediate‐ and shallow‐depth regimes, where the energy available for wave generation is at a maximum. This research reveals fundamental wave generation mechanisms related to underwater gas eruptions, thereby extending our understanding of submarine volcanic tsunami generation and providing a foundation for future hazard assessment.
Assessment of internal fit and micro leakage of conventionally fabricated ceramometallic restoration versus CAD wax and press veneering (in-vitro study)
Authors: Mansour Fatema Khaled , Ibrahim Rabab Mohammed , Mansour Hoda , Hamdy Ahmed Mohamed 
Published: May 2021

AbstractStatement of problemAccuracy of internal fit and microleakage for CAD-CAM systems used in metal coping fabrication and veneered with layering or pressing porcelain in ceramometallic restoration is unclear.Material and methodsA master metal die was milled to resemble the right mandibular first molar preparation for coverage with ceramometallic restoration. Master die was duplicated to twenty-four resin specimen dies.They were divided into two groups according to metal coping construction technique using either conventional (C) or CAD (D) wax. Each group was subdivided into two subgroups (n = 6) according to the technique of porcelain veneering (layered or pressed) to fabricate ceramometallic restorations, where subgroup (CL, DL) were conventionally layered by porcelain and (CP, DP) were press veneered. A standardized thickness of metal and porcelain was performed in all specimens as per manufacturer’s instructions for techniques ceramometallic restoration construction.Evaluation of internal fit was done with silicone replica technique using stereomicroscope at ×24 magnification where the thickness of silicon layer was measured at 20 reference points on each specimen. Then specimens were subjected to thermocycling. Sectioned specimens were assessed for microleakage using a stereomicroscope at ×12 magnification along die-cement interface with a five scale score.ResultsMean internal gap values of veneering showed a statistically nonsignificant difference between specimens made with layering(L) and pressing(P). Different techniques of wax construction showed a non-significant difference in internal gap values between specimens made with conventional(C) and CAD(D) waxing. However, a significant difference was found in the internal gap at different sites. The highest internal gap was found at the occlusal surface, while the lowest gap was found at the finish line. The highest mean microleakage score was found with CAD wax and press veneering, while the lowest mean microleakage score was found with conventional wax and press veneering.ConclusionBoth construction techniques of ceramometallic restoration were considered reliable in restoration production within a clinically acceptable range regarding internal fit and microleakage. There is a strong positive correlation between internal fit and microleakage of ceramometallic restoration constructed.
An infection-induced RhoB-Beclin 1-Hsp90 complex enhances clearance of uropathogenic Escherichia coli
Authors: Miao Chunhui , Yu Mingyu , Pei Geng , Ma Zhenyi , Zhang Lisong , Yang Jianming , Lv Junqiang , Zhang Zhi-Song , Keller Evan T. , Yao Zhi , Wang Quan 
Published: May 2021

AbstractHost cells use several anti-bacterial pathways to defend against pathogens. Here, using a uropathogenic Escherichia coli (UPEC) infection model, we demonstrate that bacterial infection upregulates RhoB, which subsequently promotes intracellular bacteria clearance by inducing LC3 lipidation and autophagosome formation. RhoB binds with Beclin 1 through its residues at 118 to 140 and the Beclin 1 CCD domain, with RhoB Arg133 being the key binding residue. Binding of RhoB to Beclin 1 enhances the Hsp90-Beclin 1 interaction, preventing Beclin 1 degradation. RhoB also directly interacts with Hsp90, maintaining RhoB levels. UPEC infections increase RhoB, Beclin 1 and LC3 levels in bladder epithelium in vivo, whereas Beclin 1 and LC3 levels as well as UPEC clearance are substantially reduced in RhoB+/− and RhoB−/− mice upon infection. We conclude that when stimulated by UPEC infections, host cells promote UPEC clearance through the RhoB-Beclin 1-HSP90 complex, indicating RhoB may be a useful target when developing UPEC treatment strategies.
High-frequency head impact causes chronic synaptic adaptation and long-term cognitive impairment in mice
Authors: Sloley Stephanie S. , Main Bevan S. , Winston Charisse N. , Harvey Alex C. , Kaganovich Alice , Korthas Holly T. , Caccavano Adam P. , Zapple David N. , Wu Jian-young , Partridge John G. , Cookson Mark R. , Vicini Stefano , Burns Mark P. 
Published: May 2021

AbstractRepeated head impact exposure can cause memory and behavioral impairments. Here, we report that exposure to non-damaging, but high frequency, head impacts can alter brain function in mice through synaptic adaptation. High frequency head impact mice develop chronic cognitive impairments in the absence of traditional brain trauma pathology, and transcriptomic profiling of mouse and human chronic traumatic encephalopathy brain reveal that synapses are strongly affected by head impact. Electrophysiological analysis shows that high frequency head impacts cause chronic modification of the AMPA/NMDA ratio in neurons that underlie the changes to cognition. To demonstrate that synaptic adaptation is caused by head impact-induced glutamate release, we pretreated mice with memantine prior to head impact. Memantine prevents the development of the key transcriptomic and electrophysiological signatures of high frequency head impact, and averts cognitive dysfunction. These data reveal synapses as a target of high frequency head impact in human and mouse brain, and that this physiological adaptation in response to head impact is sufficient to induce chronic cognitive impairment in mice.
RHOA signaling defects result in impaired axon guidance in iPSC-derived neurons from patients with tuberous sclerosis complex
Authors: Catlett Timothy S. , Onesto Massimo M. , McCann Alec J. , Rempel Sarah K. , Glass Jennifer , Franz David N. , Gómez Timothy M. 
Published: May 2021

AbstractPatients with Tuberous Sclerosis Complex (TSC) show aberrant wiring of neuronal connections formed during development which may contribute to symptoms of TSC, such as intellectual disabilities, autism, and epilepsy. Yet models examining the molecular basis for axonal guidance defects in developing human neurons have not been developed. Here, we generate human induced pluripotent stem cell (hiPSC) lines from a patient with TSC and genetically engineer counterparts and isogenic controls. By differentiating hiPSCs, we show that control neurons respond to canonical guidance cues as predicted. Conversely, neurons with heterozygous loss of TSC2 exhibit reduced responses to several repulsive cues and defective axon guidance. While TSC2 is a known key negative regulator of MTOR-dependent protein synthesis, we find that TSC2 signaled through MTOR-independent RHOA in growth cones. Our results suggest that neural network connectivity defects in patients with TSC may result from defects in RHOA-mediated regulation of cytoskeletal dynamics during neuronal development.
FUNDC1-dependent mitochondria-associated endoplasmic reticulum membranes are involved in angiogenesis and neoangiogenesis
Authors: Wang Cheng , Dai Xiaoyan , Wu Shengnan , Xu Wenjing , Song Ping , Huang Kai , Zou Ming-Hui 
Published: May 2021

AbstractFUN14 domain-containing protein 1 (FUNDC1) is an integral mitochondrial outer-membrane protein, and mediates the formation of mitochondria-associated endoplasmic reticulum membranes (MAMs). This study aims to determine the contributions of FUNDC1-mediated MAMs to angiogenesis in vitro and in vivo. In cultured endothelial cells, VEGF significantly increases the formation of MAMs and MAM-related proteins, including FUNDC1. Endothelial cell-specific deletion of FUNDC1, which disrupts MAM formation in endothelial cells, lowers VEGFR2 expression and reduces tube formation, spheroid-sprouting, and functional blood vessel formation in vitro and in vivo. Conversely, increased MAM formation using MAM linkers mimics the effects of VEGF and promotes endothelial angiogenesis. Mechanistically, increased MAMs formation led to increased levels of Ca2+ in cytosol, promoted the phosphorylation of serum response factor (SRF) and enhanced the binding of SRF to VEGFR2 promoter, resulting in increased VEGFR2 production, with consequent angiogenesis. Moreover, blocking FUNDC1-related MAM formation with a cell-penetrating inhibitory peptide significantly suppresses the expressions of downstream angiogenic genes and inhibits tumor angiogenesis. We conclude that decreased MAMs formation by silencing FUNDC1 can inhibit angiogenesis by decreasing VEGFR2 expression, and targeting FUNDC1-dependent MAMs might be a promising approach for treating human disorders characterized by defective angiogenesis.