bluuebunny/crossref_metadata_2025_split huggingface dataset:
A CONVERSATION WITH MONTY ADKINS
Authors: Cummings Simon 
Published: June 2018

AbstractThis edited transcript of a conversation with composer Monty Adkins explores a wide range of topics: the fundamental aspects of Adkins’ compositional aesthetic, the history and development of his practice, musical influences, considerations of beauty, narrative vs. abstract approaches to composition, types of listening, perceptions of time, notions of the sacred, the imposition (and benefits) of compositional restrictions, the organisation/structuring of non-teleological music, combining electronics with live instruments, and Adkins’ relationship with the listener. The conversation took place on 24 February 2017 at the University of Huddersfield, during the annual Electric Spring festival. Audio of the complete, three-hour conversation can be downloaded and streamed at http://5against4.com/2017/04/18/the-dialogues-monty-adkins/.
100 Reciprocal Relationship Between Olfactory Ability and Olfactory Hallucination
Authors: Bardan Usama , Kress Stefany , Hirsch Alan R. 
Published: June 2018

AbstractIntroductionTransient fluctuation of smell concurrent with phantosmia has not been reported. Four such cases are presented.MethodsCase 1: A 27-year-old left handed (pathological) female, 7 years prior to presentation, noted constant olfactory hallucinations of dried blood and rotten sour eggs, level 8/10 in intensity.Results: Without phantosmia: Alcohol Sniff Test (AST): 14 (hyposmia). Brief Smell Identification Test (BSIT): 10 (normosmia). Retronasal Smell Index: 0 (abnormal).With phantosmia: AST: 1 (anosmia). BSIT: 12 (normosmia). Retronasal Smell Index: 0 (abnormal). Normal 72-hour EEG and MRI.Case 2: A 19 year old right-handed woman presented with a 4 month history of unpleasant, fruity, rotten phantosmia occurring three times a day, 6-7/10 in intensity.Results: Without phantosmia: Pocket Smell Test (PST): 3 (normosmia). AST: 30 (normosmia). With phantosmia: AST: 13 (hyposmia). CT scan: normal. MRI: normal.Case 3: A 40 year old right-handed female presented with ashtray/cigarette phantosmia , occurring 10 times a day, lasting seconds to all day, 10/10 in intensity. Her sense of smell is normal except when the phantosmia is present, during which time it decreases to 70% of normal.Results: Without phantosmia: BSIT: 11 (normosmia). AST: 30 (normosmia). With phantosmia: AST: 11 (hyposmia). PST: 3 (normosmia). EEG: normal. MRI: few subcortical white matter hyperintensities on flair imaging.Case 4: A 60 year old right handed male with type 1 diabetes mellitus presented with four months of phantosmia of sweet tobacco, level 8/10 in severity, involves both nostrils, lasting 10 seconds and occurring two times a day. Over time, the hallucinated odor changed to a soapy smell 2-3/10 in intensity.Results: Without phantosmia: AST: 6 (hyposmia). BSIT: 8 (hyposmia). With phantosmia: AST: 1 (anosmia). PST: 2 (hyposmia). CT scan: normal.DiscussionOlfactory ability should be assessed in those with phantosmia, both during and in the absence of hallucinated odors, to detect transient olfactory deficits in order to direct treatment towards this condition.
108 Lurasidone in Children and Adolescents With Bipolar Depression Presenting With Mixed Features
Authors: Siu Cynthia , Pikalov Andrei , Tocco Michael , Loebel Antony 
Published: June 2018

AbstractObjectiveTo evaluate the efficacy and safety of lurasidone in the treatment of children and adolescents with bipolar depression presenting with mixed features.MethodsPatients 10 to 17 years of age, inclusive, with a DSM-IV-TR diagnosis of bipolar I depression, were randomized to 6 weeks of double-blind treatment with once-daily, flexible doses of lurasidone 20-80 mg or placebo. The presence of mixed features (subthreshold hypomanic symptoms) was defined as a YMRS score > 5 at study baseline. Efficacy analyses included change from baseline to week 6 in Children Depression Rating Scale, Revised (CDRS-R) score (the primary outcome), and Clinical Global Impressions, Bipolar Severity of Depression Score (CGI-BP-S), using mixed model for repeated measures (MMRM) analysis.ResultsAt baseline, mixed features were present in 54.2% of patients (lurasidone, n=97/173; placebo, n=89/170). Treatment with lurasidone (vs placebo) was associated with significantly greater reductions in CDRS-R scores at week 6 in the mixed features group (-21.5 vs -15.9; P<0.01; effect size, 0.45), and in the group without mixed features (-20.4 vs -14.8; P<0.01; effect size, 0.45). Likewise, lurasidone was associated with greater effect size (vs placebo) for reductions inCGI-BP-S scores at week 6 in the mixed features group (-1.6 vs -1.1; P<0.001; effect size 0.57), and in the group without mixed features (-1.3 vs -1.0; P=0.05; effect size 0.30). Rates of protocol-defined treatment-emergent hypomania or mania were similar for lurasidone and placebo in patients with mixed features(lurasidone 8.2% vs. placebo 9.0%) and without mixed features (lurasidone 1.3% vs. placebo 3.7%).ConclusionsIn this post-hoc analysis, lurasidone was found to be efficacious for treating child and adolescent patients with bipolar depression presenting with mixed features(assessed cross-sectionally at study baseline). There was no increased risk of treatment-emergent mania observed in patients with or without mixed features.Funding AcknowledgementsSunovion Pharmaceuticals Inc.
109 Comparative Efficacy and Tolerability of Lurasidone Versus Other Oral Atypical Antipsychotics for Pediatric Schizophrenia: A Network Meta Analysis
Authors: Arango Celso , Ng-Mak Daisy , Finn Elaine , Byrne Aidan , Rajagopalan Krithika , Loebel Antony 
Published: June 2018

AbstractStudy ObjectiveThis analysis assessed the relative efficacy and tolerability of lurasidone versus other atypical antipsychotics in the treatment of pediatricschizophrenia.MethodsA systematic literature review identified 13 randomized-controlled trials for the treatment of pediatric schizophrenia. A Bayesian network meta-analysis compared the efficacy and tolerability of the following atypical antipsychotics: aripiprazole, asenapine, clozapine, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, andziprasidone. Patients were 7-17 years old and trial duration ranged from 6-12 weeks. Outcomes included Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions-Severity (CGI-S), weight gain, all-cause treatment discontinuation, and extrapyramidal symptoms. Results from the fixed effect models were reported as mean differences for continuous outcomes and odds ratios for binary outcomes; each with a 95% credible interval.ResultsLurasidone had significantly greater improvement compared with placebo for PANSS (-7.95 [-11.76, -4.16]) and CGI-S (-0.44 [-0.67, -0.22]), but did not differ from comparators. The differences in weight gain for lurasidone relative to comparators were as follows: clozapine (-3.81kg [-8.03, 0.42]), olanzapine (-3.62kg [-4.84, -2.41]), quetiapine (-2.13kg [-3.20, -1.08]), risperidone (-1.16kg [-2.14, -0.17]), asenapine (-0.98kg [-1.71, -0.24]), paliperidone (-0.85kg [-1.57, -0.14]), aripiprazole (-0.15kg [-0.88, 0.58]), and ziprasidone (0.38kg [-0.49, 1.24]); all were statistically significant except for clozapine, aripiprazole, and ziprasidone. Rates of all-cause discontinuation andextrapyramidal symptoms were similar for lurasidone and comparators, except aripiprazole and paliperidone, which had higher rates of all-cause discontinuation.ConclusionsIn this network meta-analysis of atypical antipsychotics for the treatment of adolescent schizophrenia, lurasidone was associated with similar efficacy, but less weight gain than active comparators.Funding AcknowledgementsThis study was funded by Sunovion Pharmaceuticals Inc.
110 Increased Intracranial Pressure induced Mal de Debarquement Syndrome
Authors: Rekhi Angela , Hirsch Alan R. 
Published: June 2018

AbstractStudy ObjectiveMal de Debarquement Syndrome (MdDS) is a prolonged rocking or swaying type of imbalance that occurs after lengthy exposure to motion, yet ensuing in the absence of motion. The provoking motion is most commonly following sea travel. MdDS has not heretofore been described in association with increased intracranial pressure. Such a case is presented.MethodsCase Study: A 46-year-old female, with a history of hydrocephalus after infantile meningitis with ventriculoperitoneal shunt placement and multiple revisions, has a constant feeling of ‘rocking side to side’. One year and one-half year prior to presentation, she suffered two epochs of severe bilateral headaches coinciding with, as she describes, “the feeling of rocking, as if on a ship”. Both of these episodes were constant and lasted all day, progressively increasing in intensity for one week. During these events, she admits to nausea, but denied any vomiting, spinning, epigastric rising, or déjà vu or jamais vu. During the epochs there was no tinnitus, orthostatic hypertension, visual obscuration, loss of consciousness, syncope, seizures, weakness or falls. Prior to, or associated with the swaying sensation, she denies lightheadedness, pallor, salivation, blurred vision, tachycardia, visual auras or other neurological auras. There were no alleviating or aggravating factors, and were unrelated to position change, head movement, neck extension or rotation, coughing, or urination. She denies any recent air-travel, diving, sleeping on a waterbed, or alcohol use. In both epochs, shunt malfunction and associated increased intracranial pressure were discovered. Immediate resolution of the headache and dizziness episodes were achieved after shunt revision with correction of increased intracranial pressure.ResultsAbnormalities in Cranial Nerve (CN) Examination: CN I: Alcohol Sniff Test: 14 (hyposmia). CN II: Visual Acuity OS 20/25. CN III, IV, VI: Saccadization of horizontal eye movement. Bilateral ptosis left > right. CN IX, X: Uvula deviated to the right. Motor Examination: Drift Testing: Left upward and outward drift with left Abductor Digiti Minimi sign. Reflexes: 3+ throughout.ConclusionsTypically seen in middle aged woman, MdDS is a rare, self-limiting condition in which an abnormal sensation of rocking or swaying back and forth is perceived after exposure to air, car, land or sea travel (Nwagwu 2015). The phantom perception of self-motion occurs upon return to ground (Nwagwu 2015). This has been postulated to be due to maladaptation of the vestibulo-ocular reflex (Hain 2016) or disorder of connection between the entorhinal cortex and amygdala (Cha 2012). Increased intracranial pressure can affect the entire neural axis, including brainstem and cortical areas associated with MdDS. In those who present with intractable MdDS, measurement of intracranial pressure and treatment of any elevations may be warranted.Funding AcknowledgementsSmell and Taste Treatment and Research Foundation
117 RE-KINECT: Real-World Dyskinesia Screening Study and Registry in Patients Taking Antipsychotic Agents: Interim Baseline Burden of Illness Results
Authors: Cutler Andrew , Caroff Stanley , Tanner Caroline , Lenderking William R. , Yeomans Karen , Shalhoub Huda , Pagé Véronique , Yonan Chuck 
Published: June 2018

AbstractBackgroundTardive dyskinesia (TD) is associated with prolonged exposure to dopamine receptor blockers including antipsychotics. This registry describes the prevalence and impact of involuntary movements (possible TD) in a real-world population of patients taking antipsychotics.MethodsRE-KINECT (NCT03062033) aims to enroll 1,000 patients from 70 US psychiatric practices. Adults with ≥3 months lifetime exposure to antipsychotic(s) and ≥1 psychiatric disorder are eligible for two-tier screening: informal observation, and then clinician observation of abnormal involuntary movements in general body regions (head/face, neck/trunk, upper/lower limbs) and confirmation of possible TD. Based on clinician assessment, patients are assigned to Cohort 1 or Cohort 2 (without or with abnormal involuntary movements, respectively). In both cohorts, the following baseline assessments are included: clinician’s assessment of clinical psychiatric severity, patient perceived health‐related quality of life (EuroQOL 5-Dimensions), social burden/disability questionnaire (Sheehan Disability Scale), and 12-month retrospective chart review ofmedical and treatment history. Cohort 2 also participate in 12-month longitudinal evaluation. Interim baseline data are available from four sites.ResultsBaseline data are currently available for 116 patients—mean age, 49.6 years; female, 60.3%; schizophrenia/schizoaffective disorder, 32.8%; at least 1 mood disorder, 84.5%, and 10.4 years mean cumulative lifetime exposure to antipsychotic(s). The most concerning health condition for both cohorts is their mental health (69.0%), followed by physical activity and nutrition (33.6%). 32.8% of subjects had clinician confirmation of possible TD.ConclusionThis novel registry aims to evaluate the real-world potential impact/burden of TD. Preliminary analyses suggest that TD is common in patients with schizophrenia and mood disorders taking antipsychotics. Further analyses will explore the burden of illness in this population.Funding AcknowledgementsThis study was funded by Neurocrine Biosciences, Inc.
118 Demographics and Real World Healthcare Cost and Utilization for Patients With Probable Tardive Dyskinesia
Authors: Polson Michael , Yonan Chuck , Williams Ted 
Published: June 2018

AbstractBackgroundTardive dyskinesia (TD) is a movement disorder associated with prolonged exposure to antipsychotics. The current study was designed to describe demographics and comorbidities for patients with a dyskinesia diagnosis as probable TD (cohort 1), patients likely to have undiagnosed/uncoded TD (cohort 2), and a control population.MethodsThis retrospective study analyzed Medicaid claims data from July 2013-March 2017. For a pool of patients with a history of 3 months or more of taking an antipsychotic, three cohorts were evaluated: cohort 1 (ICD-9/10 codes for dyskinesia); cohort 2 (propensity score matching to cohort 1); and cohort 3 (patients withschizophrenia, major depressive disorder [MDD], and/or bipolar disorder [BD] and history of ≤2 antipsychotic medications). Outcomes included patient characteristics, Charlson Comorbity Index (CCI) and healthcare utilization (pre-and post [12-month] period).ResultsCohort sizes and characteristics were: cohort 1 (n=1,887; female, 68%; mean age, 42 years; MDD, 17%; BD, 48%); cohort 2 (n=1,572; female, 58%; mean age, 39 years; MDD, 22%; BD, 48%); cohort 3 (n=25,949; female, 67%; mean age, 40 years; MDD, 11%; BD, 49%). Cohorts 1 and 2 had higher comorbidity burden than cohort 3 (mean pre-index CCIs: 0.68, 0.79, and 0.47, respectively; p<0.001 for each cohort). After 12 months, mean per member per year healthcare costs were higher in cohort 1 and2 compared to cohort 3 ($21,293, $18,988, and $11,522, respectively), as were mean claims per member per year (185, 138, and 109, respectively).ConclusionIn the study population, patients likely suffering from TD, ICD-9/10 code-confirmed or unconfirmed, have a higher overall comorbidity burden and healthcareutilization than those who probably do not have TD.Funding AcknowledgementsThis study was funded by Neurocrine Biosciences, Inc.
122 Use of Pimavanserin in Patients With Parkinson’s Disease Psychosis: Subgroup Analysis of Efficacy and Safety in Patients With and Without Cognitive Impairment
Authors: Weintraub Daniel , Norton James , Coate Bruce , Andersson Candace , Fredericks Doral , Ballard Clive 
Published: June 2018

AbstractObjectiveA planned subgroup analysis of a phase 3 study was performed to evaluate the efficacy and safety of pimavanserin (PIM) in Parkinson’s disease psychosis (PDP) patients withglobal cognitive impairment.BackgroundPDP is frequent, distressing, a leading cause of institutionalization, complicates PD management and is linked to increased morbidity, incident dementia and mortality. PIM, a selective serotonin receptor (5-HT2A) inverse agonist/antagonist, is newly FDA-approved for the treatment of hallucinations and delusions associated with PDP.MethodsIn Study 020, a 6-week FDA registration study, 199 patients with baseline Mini-Mental State Examination (MMSE) score ≥21, moderate-severe psychosis, and on stable PD meds, were randomized to PIM (34 mg/day) or placebo (PBO) for 6 weeks. This subgroup analysis evaluates efficacy and safety between two groups: those with MMSE total score ≥21 but <25 (cognitively impaired; equivalent to Montreal Cognitive Assessment [MoCA] score 15-19) and those with score ≥25 (cognitively normal; equivalent to MoCA score 20-30). Safety assessments were performed on the full safety dataset (i.e., three 6-week placebo-controlled studies) including 614 subjects (PIM=382, PBO=231).ResultsOverall, patients in the PIM group experienced a statistically significant improvement in SAPS-PD scores from baseline to Day 43 compared with PBO (-5.79 vs. -2.73; p=0.001). In the subgroup analysis stratifying by baseline MMSE score, the change from baseline to Day 43 compared with PBO in the cognitively-impaired group (N=50) was numerically larger (-7.11 vs. -0.47; p=0.002). In the full safety dataset examining cognitively impaired patients, there were no between-group (PIM vs. PBO) differences in any treatment-emergent adverse event (TEAE) (57.6% vs. 56.1%) or serious TEAE (6.8% vs. 5.3%). The most common TEAEs occurring at ≥5% in either group were fall (7.4% vs.10.5%), confusional state (6.5% vs.1.8%), and orthostatic hypotension (0.0% vs. 8.8%).ConclusionsIn this subgroup analysis of PDP patients, the treatment effect of PIM on SAPS-PD was larger in the cognitively-impaired group, with similar TEAE and serious TEAE rates. These results hold promise for cognitively-impaired patients that will be further elucidated in future studies.Funding AcknowledgementsClinical study was funded by ACADIA Pharmaceuticals Inc.
125 Short Duration Monoballismus
Authors: Dhillon Davinder , Batta Priya , Hirsch Alan R. 
Published: June 2018

AbstractStudy ObjectiveWhile monoballismus has been reported to be associated with hemorrhagic lesions in the subthalamic nucleus (Ohnishi, 2009) and multiple sclerosis (MS) (Rosa, 2011), the duration has been reported to be at least six days (Soysal, 2012). A patient with epochs of monoballismus lasting for 45 minutes is presented.MethodsCase Study: A 57 year old right handed female with attention deficit hereditary disorder predominantly inattentive on amphetamine sulphate, presented with two years of memory loss. For instance, after ordering food in restaurants, by the time the food arrives, she could not recall what she ordered. At the onset of this symptom, she noted three epochs of her left arm jerking for 45 minutes. The jerking would begin with low amplitude and low frequency and rapidly progress to the forearm and arm of greater magnitude and low frequency. With her right hand she would try to hold down her left arm without success. There was no associated paresis, sensory phenomena, headaches, dizziness, presyncope, loss of consciousness, or strong emotions. She admitted to frequent jamais vu.ResultsAbnormalities: Neurological Examination: Mental Status Examination: Memory: Immediate Recall: 5 digits forward and 2 digits backwards. Cranial Nerve (CN) Examination: CN I: Alcohol Sniff Test 8 (hyposmia). CN XII: tongue tremor on protrusion. Motor Examination: Drift Test: positive right pronator drift. Gait Examination: Tandem Gait: unstable. Reflexes: 0-1 throughout. Neuropsychiatric Examination: Go-No-Go Test: 6/6 (normal). Animal Fluency Test: 15 (normal). Clock Drawing Test: 3 (abnormal). Center for Neurologic Study Lability Scale: 16 (pseudobulbar affect). Other: MRI with and without infusion: normal.ConclusionTransient tonic-clonic movements of one limb have been described with focal epilepsy associated with diabetic non-ketotic hyperglycemia (Grant, 1985). A metabolic abnormality such as transient hypoglycemia or hyperkalemia can cause a focal dystonia (Soysal, 2012), which theoretically could manifest with monoballismus. This could be a somatic manifestation of underlying conflict, conversion disorder, or as a result of a physical manifestation of panic attack with hyperventilation and tetany (Mihai, 2008). This may be the first manifestation of a generalized cerebral disorder associated with chorea or ballismus such as Wilson’s disease, or Huntington’s Chorea (Mihai, 2008). It is possible that this is a variant of Alien Hand Syndrome with parietal lobe involvement (Shrestha, 2015). But this is unlikely given the absence of hemineglect or hemiagnosia. It is possible that amphetamines may have induced a monochorea. Chronic amphetamine use has been demonstrated to cause chorea (Klawans, 1974) and it theoretically could have caused ballismus movements in this case. In patients who present with short duration monoballismus, evaluation for subthalamic nuclei function, seizure disorders and other origins of ballismus are warranted.Funding AcknowledgementsSmell & Taste Treatment and Research Foundation
133 Cognitive Impairment Following Overdose on Lamotrigine
Authors: Chandrashekar Geetha , Ash David , Singh Garima 
Published: June 2018

AbstractObjectiveTo generate hypotheses, accumulate scientific data about rare presentations, and serve as a major educational tool.MethodThis is a retrospective case report of a patient in inpatient unit.IntroductionLamotrigine is a mood stabilizer with unique mechanisms of action. At therapeutic levels, it has been reported that Lamotrigine is neuroprotective and improves cognition. In this case, we present a patient who suffered significant cognitive slowing following overdose on Lamotrigine.CaseA 17yo white male with a diagnosis of Autism spectrum disorder and Bipolar disorder type 1 was admitted for bizarre behavior and profound cognitive impairment. His past psychiatric history was significant for two suicide attempts - first by overdose on baby aspirin and second by overdose on Lamotrigine, both of which had occurred about six months prior to his presentation and had each required an inpatient hospitalization. His family reported that since his overdose on Lamotrigine, he had been withdrawn, aloof, and appeared depressed. His school teachers had noticed significant decline in his memory, attention and concentration, and there had been noticeable impairment in his ability to follow commands or complete a task. On assessment, he was noted to have significant psychomotor slowing, latency in speech and thought blocking. At the time of his presentation, he was on Lithium 300mg BID. A careful review of his previous medical records revealed that he had been on a combination of Seroquel, Lamotrigine and Lithium prior to his overdose attempt on Lamotrigine. During this hospitalization, Seroquel was restarted. Patient tolerated the medication well. There were no safety concerns and he was deemed safe to discharge under 24hr supervision of his family. He has since been followed up in clinic. Although he continues to have some cognitive slowing, overall, he has demonstrated slow but steady improvement.DiscussionLamotrigine acts by blocking voltage sensitive sodium channels. It also reduces release of glutamate, a major excitatory neurotransmitter in the central nervous system. Glutamate modulates synaptic plasticity, a property thought to be vital for memory and learning. While too much glutamate causes over activation of NMDA receptors resulting in increased intracellular oxidative stress and eventually apoptosis, too little glutamate may lead to decreased glutamate mediated postsynaptic excitation of neural cells and thus impacting memory formation, learning and cognition. At therapeutic levels (2.5- 15mcg/ml), it has been reported that Lamotrigine is neuroprotective and improves cognition. At the time of overdose, our patient had a Lamotrigine level of 21.5mcg/ml. There is limited literature on cognitive effect of supra-thrapeutic levels of Lamotrigine. As such, a causal relationship cannot be determined from a single care report. Also in differentials to consider are schizophrenia and seizures from lamotrigine withdrawal.Funding AcknowledgementsNo funding.