bluuebunny/crossref_metadata_2025_split huggingface dataset:
187 Buprenorphine/Naloxone (Suboxone and Bunavail)-Induced Glycolimia, an Indication of Undermedication?
Authors: Kress Stefany , Hirsch Alan 
Published: June 2018

AbstractINTRODUCTIONBuprenorphine/Naloxone combination drugs such as Suboxone and Bunavail have not been reported to induce glycolimia. Two such cases are presented.METHODSCASE STUDY: Case 1: A 30-year-old, right-handed, white female with a history of opioid abuse was started on 4.2 mg buprenorphine/0.7 mg naloxone (Bunavail) BID and began sweet cravings and consumption of sweet foods. In a typical day she would eat 16 strawberry pop-tarts and 2 boxes of Little Debbie cookies. This may have provoked the 10 pound weight augmentation in the first two weeks of treatment. She denied any craving for opioids and no evidence of opioid withdrawal was present. Her Clinical Opiate Withdrawal Scale (COWS) score =4 (normal).Case 2: A 51-year-old, right-handed, male with opiate dependence, four days following the initiation of Suboxone (8 mg buprenorphine/2 mg naloxone) BID, developed strong cravings for sugary foods including donuts and ice cream, of which he was previously never inclined to eat and gained 10 pounds in one month. His COWS score= 7 (mild symptoms).DISCUSSIONThere are myriad mechanisms that may be acting to induce sugar cravings with buprenorphine/naloxone. Humans and rats acutely withdrawing from opiates, such as heroin, develop strong urges for consumption of sugary substances (Lieblich et al., 1991; Sapira, 1968; Weiss, 1982). Glycolimia in the above cases may reflect early or subclinical withdrawal, which if becoming more severe, would manifest as opioid craving. If the value of the reward system induced by sweets doesn’t meet the threshold invoked by the opioid stimulation, this “withdrawal” may lead to further sugar cravings in an attempt to reach the same reward level. In animals, certain foods and drugs share the same neurological pathway involved in the “reward system” potentially explaining why opioids influence food palatability in humans (Pelchat, 2002).Alternatively, it is possible that buprenorphine induces hypoglycemia at high doses (Bullingham et al., 1981) such that hypoglycemia may paradoxically act to enhance sugar craving similar to the Somogyi effect in insulin dependent diabetics. Another possible mechanism of action is that since buprenorphine acts to decrease glucose metabolism in the brain (Walsh et al., 1994), this may lead to a neural compensatory response by increasing sugar access to the brain behaviorally via glycolimiaand somatically reducing insulin release, thus explaining the high hemoglobin A1c observed in opioid addicts (Giugliano, 1984). Given the above presentation, complaints of sugar craving may indicate consideration to increase buprenorphine dosing and trial of this in those with glycolimia without opioid dependence may be warranted.Funding AcknowledgementsNo funding.
189 Emetophobia: The Specific Phobia of Vomiting: 2 Case Studies With 1-Year Follow-up
Authors: Jahan Sultana , Bysani Sailaja 
Published: June 2018

AbstractEDUCATIONAL OBJECTIVESAt the conclusion of the session, the participant should be able: 1) To recognize emetophobia & how it can lead to significant impairment & reduce quality of life; 2) To appreciate the prevalence of emetophobia among the general population, 3) To learn that the selective serotonin reuptake inhibitor sertraline can be effective for emetophobia; 4)Need for more research.INTRODUCTIONEmetophobia is an intense, irrational fear of vomiting. The prevalence rate of emetophobia in a community sample has been estimated to 8.8 % with a female to male ratio 4:1: It can occur at any age and can have a chronic course affecting one’s academic/career, family, and social life.METHODSCase 1: B. was a 7 year old female referred by her pediatrician for psychiatric evaluation for her intense fear ofvomiting. Mother shared that B’s overwhelming fear of vomiting started when she was 6 years old and it may have stemmed from an incident when one of B’s cousins threw up inside their van. At school, B constantly monitored whether or not anybody was getting sick around her. If she found out, someone was sick she began screaming and crying. B’s academic performance was negatively affected due to her intense irrational fear.Case 2: P was a 12 year male patient referred by his pediatrician for psychiatric evaluation after receiving 4 days inpatient treatment on the pediatric unit for dehydration. Patient reported that he was afraid of vomiting and gradually stopped eating and drinking & became so dehydrated that he was hospitalized. Several months prior to his hospitalization he had suffered from theflu & during that time he had intense vomiting and since then he has been fearful of a recurrence of the vomiting.After a complete psychiatric evaluation, a diagnosis of emetophobia was established for each patient. Both patients were treated with sertraline.RESULTSB and P both started with initial dose of sertraline 12.5mg daily and then increased gradually over a period of next few months. They responded well with sertraline. B and P continued sertraline 50mg daily and 25mg daily as a maintenance treatment respectively. At 1 year follow up visit both of them were symptoms free.CONCLUSIONSEmetophobia is a common and chronic debilitating mental illness. Still there are no treatment protocols and randomized controlled trials for the treatment of emetophobia. CBT/Exposure-based therapies are the most commonly used approaches for emetophobia per literature. More studies are needed for a better understanding of eremophobia, which is relatively deserted illness although it can cause as much suffering as other major psychiatric disorders do and any patient presenting with these symptoms deserve to be evaluated an managed with scientific understanding and guideline.Funding AcknowledgementsNo funding.
191 Multi-Watt Near Infrared Phototherapy as a Treatment for Traumatic Brain Injury
Authors: Henderson Theodore , Morries Larry D. 
Published: June 2018

AbstractBackgroundDepression treatment is hampered by low efficacy of antidepressant medications and concerns about alternative modalities. Animal studies of treatment with low-level (0.5 Watt or less) near infrared (NIR) light from diodes has shown some benefit in models of traumatic brain injury (TBI) with evidence of reduced lesion size, increased neurotrophin production, synaptogenesis, fewer apoptotic cells, and improved neurological function. Two small case series have demonstrated transient clinical improvement with low-level NIR treatment given on a daily basis over several weeks. We have previously shown marked and persistent clinical improvement in a case series of patients with chronic mild-to-moderate (m-MTBI) after treatmentwith NIR at a power of 9 Watts or greater. We also have published a review of the potential for application of NIR for the treatment of depression. The current study explores NIR efficacy in a proof-of-concept study as a treatment for depression.MethodsThirty-nine sequential patients treated for TBI between March 2013 and May 2017 provided depression self-assessment data and/or were administered the Hamilton Depression Rating Scale. Each completed the Quick Inventory of Depression Symptomatology-Self Reports (QIDS) before and after treatment. Patients received transcranial multi-Watt near-infrared light treatment (NILT) using near-infrared lasers (810/980 nm at 8-15 Watts) applied to forehead and temporal regions bilaterally for 9-12 minutes to each area.ResultsFor 36 of the 39 patients, after 16.82 + 6.26 treatments, QIDS scores indicated a robust response (decrease of QIDS total score by > 50%). For 32 of 39 patients post-treatment QIDS scores indicated a remission from depression (decrease of QIDS total score < 5). Overall, the QIDS score fell from 14.10 + 3.39 to 3.44 + 3.39 SD (p=6.29 X 10-19). With 12 or fewer treatments, QIDS score dropped from 14.83 + 2.55 to 4.17 + 3.93. Patients receiving 13 or more treatments showed a change in QIDS score from 13.67 + 3.64 to 3.11 + 3.14. Those (N=15) who received the entire treatment course within 8 weeks or less (5.33 + 1.72 weeks) showed a change in QIDS score from 13.86 + 3.14 to 4.5 + 3.94. Suicidal ideation resolved in all, but two patients. The non-responsive patients are described in detail. Patients remained in remission for up to 55 months after a single course of treatment.ConclusionThis is the first report of high-powered NILT showing efficacy for depression. Patients saw benefit often within 4 treatments and some had resolution of depressive symptoms in as little as 4 weeks. These data raise an intriguing possibility – that NILT may be a safe, effective, and rapid treatment for depression. A double-blind, placebo controlled trial is warranted to verify these proof-of-concept data.Funding AcknowledgementsNeuro-Laser Foundation
195 Current Use and Trends in the Management of Tardive Dyskinesia: Role of VMAT2 Inhibitors
Authors: Sreeram Venkatesh , Shagufta Shanila , Kagadkar Faisal , Qureshi Mustafa 
Published: June 2018

AbstractObjectivesTardive Dyskinesia (TD) is a debilitating condition that requires prompt care and intervention. Studies demonstrated the probable role of Vesicular Monoamine Transport 2 (VMAT2) in the pathogenesis of TD and use of VMAT2inhibitors in managing TD. Our aim is to provide available data on the management of TD and to determine the efficacy ofvarious VMAT2 inhibitors for independent use. Also, to identify their use in combination and assess if there, any change inoutcome with early intervention.MethodsWe did a pivotal search of the scientific literature by querying PubMed and Google Scholar for studies on treatment modalities of TD including atypical antipsychotics and VMAT2 inhibitors. Also, references from publications were accessed for review.ResultsEarly detection and prevention are of paramount importance in managing TD. Cessate the antipsychotic been using andother dopamine blocking agents that probably implicated in causing the symptoms. Certain studies showed the use of new atypical antipsychotics like Paliperidone, Quetiapine in small titrated dose resolving the symptoms. According to the available data, using benzodiazepines, botulinum toxin injections and VMAT2 inhibitors like Valbenazine, Tetrabenazine, andDeutetrabenazine also managed TD with efficacy. Valbenazine has breakthrough global approval in resolving the symptoms. Although other VMAT2 inhibitors were used for TD earlier and showed to be effective in managing TD, larger trials are required showing their safety and reliability in efficacy.ConclusionsVMAT2 inhibitors were tested as efficacious in managing TD. Valbenazine and recently deutetrabenazine has been approved by US Food and Drug Administration (FDA) to treat TD. However, Tetrabenazine is yet to be approved by FDA. More clinical trials are required exploring their efficacy by comparing them or using them in combination. Our review also suggests timely detection and earlier intervening, especially if witnessed in children and adolescents would differ the outcome of TD.Funding AcknowledgementsNo funding.
Projecting future demand for informal care among older people in China: the road towards a sustainable long-term care system
Authors: Hu Bo 
Published: June 2018

AbstractThe long-term care system in China relies heavily on informal care provided by family members. This study makes projections on the demand for informal care among Chinese older people between 2015 and 2035 and quantifies the level of long-term care resources needed to meet their needs. The data come from longitudinal information in a nationally representative sample, China Health and Retirement Longitudinal Survey 2011 and 2013. The macrosimulation approach (PSSRU model) and the Markov approach are integrated into one Bayesian modelling framework. The Monte Carlo simulation technique is used to capture parameter uncertainty. We project that the demand for informal care will increase from 41.3 million people (95% CI: 39.9–42.7) in 2015 to 82.6 million people (95% CI: 78.3–86.9) in 2035. The long-term care system faces unbalanced pressure of demand for informal care from different groups of older people. The projected demand is sensitive to changes in older people’s disability trajectory and the availability of formal care provided by the government, but less sensitive to an increase in singleton households in the future. We discuss possible policy measures to alleviate the mounting pressure on the demand for informal care.
Modeling the Chemical Impact and the Optical Emissions Produced by Lightning‐Induced Electromagnetic Fields in the Upper Atmosphere: The case of Halos and Elves Triggered by Different Lightning Discharges
Authors: Pérez‐Invernón F. J. , Luque A. , Gordillo‐Vázquez F. J. 
Published: June 2018

AbstractHalos and elves are transient luminous events produced in the lower ionosphere as a consequence of lightning‐driven electromagnetic fields. These events can influence the upper atmospheric chemistry and produce optical emissions. We have developed different two‐dimensional self‐consistent models that couple electrodynamical equations with a chemical scheme to simulate halos and elves produced by vertical cloud‐to‐ground lightning discharges, compact intracloud discharges and energetic in‐cloud pulses. The optical emissions from radiative relaxation of excited states of molecular and atomic nitrogen and oxygen have been calculated. We have upgraded previous local models of halos and elves to calculate for the first time the vibrationally detailed optical spectra of elves triggered by compact intracloud discharges and energetic in‐cloud pulses. According to our results, the optical spectra of elves do not depend on the type of parent lightning discharge. Finally, we have quantified the local chemical impact in the upper atmosphere of single halos and elves. In the case of the halo, we follow the cascade of chemical reactions triggered by the lightning‐produced electric field during a long‐time simulation of up to 1 s. We obtain a production rate of NO molecules by single halos and elves of 1016 and 1014 molecules/J, respectively. The results of these local models have been used to estimate the global production of NO by halos and elves in the upper atmosphere at ∼10−7 Tg N/year. This global chemical impact of halos and elves is 7 orders of magnitude below the production of NO in the troposphere by lightning discharges.
Statistical Interpolation of Groundwater Hydrographs
Authors: Peterson Tim J. , Western Andrew W. 
Published: June 2018

AbstractGroundwater observation bores are often monitored irregularly and infrequently. The resulting groundwater hydrographs are consequently less informative for understanding groundwater level trends, seasonality, flow directions, drawdown, and recovery. This paper presents an approach to temporally interpolate a groundwater hydrograph that has an irregular observation frequency to daily time steps. The approach combines nonlinear transfer function noise modeling with temporal kriging of the model residuals to produce an interpolated hydrograph that honors all water level observations input to the modeling and accounts for meteorological forcing between the observations. The reliability of the approach was evaluated using six observation bores having extended periods of daily data and by resampling them to six observation frequencies ranging from weekly to annually. The analysis showed that for weekly to monthly resampled data, >90% of the observed daily variability can be simulated at four of six bores. The performance declined with observation step size, as expected, but even at a biannual time step the error corrected interpolation can explain >70% of the variance at three of six bores. Additionally, an application shows that (1) the probability of a water level depth being exceeded can be estimated from quarterly resampled data and (2) the median annual water level range can be estimated from monthly resampled data. Supplementing less frequent observations with 6 and 12 months of daily data was also examined, with the addition of a 12‐month period significantly improving interpolation results at three of the four analyzed bores. The approach has been incorporated into theHydroSighttoolboxhttp://peterson‐tim‐j.github.io/HydroSight/.
Seminal Evidence of a 2.5‐Sol Ultra‐Fast Kelvin Wave in Mars' Middle and Upper Atmosphere
Authors: Gasperini Federico , Hagan Maura E. , Forbes Jeffrey M. 
Published: June 2018

AbstractThe structure and dynamics of Mars' middle and upper atmosphere is significantly impacted by waves propagating from the lower atmosphere. Using concurrent temperature and neutral density measurements taken by the Mars Reconnaissance Orbiter and Mars Atmosphere and Volatile EvolutioN satellites, we demonstrate for the first time that a 2.5‐sol ultra‐fast Kelvin wave is a prominent global‐scale feature of the low‐latitude middle (i.e., 30–80 km) and upper (approximately 150 km) atmosphere of Mars. Further, we present evidence of secondary waves arising from nonlinear interactions between this ultra‐fast Kelvin wave and solar tides, and based on their amplitudes we surmise that they could represent an important source of tidal and longitudinal variability in the aerobraking region.
Greenland Ice Sheet: Higher Nonlinearity of Ice Flow Significantly Reduces Estimated Basal Motion
Authors: Bons P. D. , Kleiner T. , Llorens M.‐G. , Prior D. J. , Sachau T. , Weikusat I. , Jansen D. 
Published: June 2018

AbstractIn times of warming in polar regions, the prediction of ice sheet discharge is of utmost importance to society, because of its impact on sea level rise. In simulations the flow rate of ice is usually implemented as proportional to the differential stress to the power of the exponentn = 3. This exponent influences the softness of the modeled ice, as higher values would produce faster flow under equal stress. We show that the stress exponent, which best fits the observed state of the Greenland Ice Sheet, equalsn = 4. Our results, which are not dependent on a possible basal sliding component of flow, indicate that most of the interior northern ice sheet is currently frozen to bedrock, except for the large ice streams and marginal ice.
Foreshock Properties at Typical and Enhanced Interplanetary Magnetic Field Strengths: Results From Hybrid‐Vlasov Simulations
Authors: Turc L. , Ganse U. , Pfau‐Kempf Y. , Hoilijoki S. , Battarbee M. , Juusola L. , Jarvinen R. , Brito T. , Grandin M. , Palmroth M. 
Published: June 2018

AbstractIn this paper, we present a detailed study of the effects of the interplanetary magnetic field (IMF) strength on the foreshock properties at small and large scales. Two simulation runs performed with the hybrid‐Vlasov code Vlasiator with identical setup but with different IMF strengths, namely, 5 and 10 nT, are compared. We find that the bow shock position and shape are roughly identical in both runs, due to the quasi‐radial IMF orientation, in agreement with previous magnetohydrodynamic simulations and theory. Foreshock waves develop in a broader region in the higher IMF strength run, which we attribute to the larger growth rate of the waves. The velocity of field‐aligned beams remains essentially the same, but their density is generally lower when the IMF strength increases, due to the lower Mach number. Also, we identify in the regular IMF strength run ridges of suprathermal ions which disappear at higher IMF strength. These structures may be a new signature of the foreshock compressional boundary. The foreshock wave field is structured over smaller scales in higher IMF conditions, due to both the period of the foreshock waves and the transverse extent of the wave fronts being smaller. While the foreshock is mostly permeated by monochromatic waves at typical IMF strength, we find that magnetosonic waves at different frequencies coexist in the other run. They are generated by multiple beams of suprathermal ions, while only a single beam is observed at typical IMF strength. The consequences of these differences for solar wind‐magnetosphere coupling are discussed.
Including Farmer Irrigation Behavior in a Sociohydrological Modeling Framework With Application in North India
Authors: O'Keeffe Jimmy , Moulds Simon , Bergin Emma , Brozović Nick , Mijic Ana , Buytaert Wouter 
Published: June 2018

AbstractUnderstanding water user behavior and its potential outcomes is important for the development of suitable water resource management options. Computational models are commonly used to assist water resource management decision making; however, while natural processes are increasingly well modeled, the inclusion of human behavior has lagged behind. Improved representation of irrigation water user behavior within models can provide more accurate and relevant information for irrigation management in the agricultural sector. This paper outlines a model that conceptualizes and proceduralizes observed farmer irrigation practices, highlighting impacts and interactions between the environment and behavior. It is developed using a bottom‐up approach, informed through field experience and farmer interaction in the state of Uttar Pradesh, northern India. Observed processes and dynamics were translated into parsimonious algorithms, which represent field conditions and provide a tool for policy analysis and water management. The modeling framework is applied to four districts in Uttar Pradesh and used to evaluate the potential impact of changes in climate and irrigation behavior on water resources and farmer livelihood. Results suggest changes in water user behavior could have a greater impact on water resources, crop yields, and farmer income than changes in future climate. In addition, increased abstraction may be sustainable but its viability varies across the study region. By simulating the feedbacks and interactions between the behavior of water users, irrigation officials and agricultural practices, this work highlights the importance of directly including water user behavior in policy making and operational tools to achieve water and livelihood security.
Reflective chiral meta-holography: multiplexing holograms for circularly polarized waves
Authors: Wang Qiu , Plum Eric , Yang Quanlong , Zhang Xueqian , Xu Quan , Xu Yuehong , Han Jiaguang , Zhang Weili 
Published: June 2018

AbstractBy allowing almost arbitrary distributions of amplitude and phase of electromagnetic waves to be generated by a layer of sub-wavelength-size unit cells, metasurfaces have given rise to the field of meta-holography. However, holography with circularly polarized waves remains complicated as the achiral building blocks of existing meta-holograms inevitably contribute to holographic images generated by both left-handed and right-handed waves. Here we demonstrate how planar chirality enables the fully independent realization of high-efficiency meta-holograms for one circular polarization or the other. Such circular-polarization-selective meta-holograms are based on chiral building blocks that reflect either left-handed or right-handed circularly polarized waves with an orientation-dependent phase. Using terahertz waves, we experimentally demonstrate that this allows the straightforward design of reflective phase meta-holograms, where the use of alternating structures of opposite handedness yields independent holographic images for circularly polarized waves of opposite handedness with negligible polarization cross-talk.