bluuebunny/crossref_metadata_2025_split huggingface dataset:
How and when to use clozapine
Authors: Rubio J. M. , Kane J. M. 
Published: October 2019

ObjectiveClozapine is the only approved strategy for treatment‐resistant schizophrenia, although it is highly underutilized. We aim to generate practical and actionable evidence‐based recommendations for the use of this drug considering prescription barriers.MethodNarrative review.ResultsA consistent body of evidence supports the efficacy of clozapine reducing morbidity and mortality in schizophrenia. The main obstacles to its use are the lack of experience by prescribers and perceived treatment burden. Systematic screening of eligibility, utilization of available resources for consultation, developing a professional network with other stakeholders, as well as optimizing how clozapine is presented to patients is discussed. Furthermore, specific evidence‐based recommendations for initiation, maintenance, and safety monitoring with clozapine are provided.ConclusionClozapine prescription is one of the areas in psychiatry with the greatest mismatch between efficacy and utilization in clinical practice. Although multiple barriers to the use of clozapine exist, some of these may be overcome by updates of routine clinical practice.
Recurrence patterns identify aggressive form of human papillomavirus‐dependent vulvar cancer
Authors: McWhirter Rebekah E. , Otahal Petr , Taylor‐Thomson Debbie , Maypilama Elaine Lawurrpa , Rumbold Alice R. , Dickinson Joanne L. , Thorn Jane C. , Boyle Jacqueline A. , Condon John R. 
Published: October 2019

BackgroundVulvar cancer is rare and, as a result, is understudied. Treatment is predominantly surgery, irrespective of the type of vulvar cancer, and is associated with physical, emotional and sexual complications. A cluster of human papillomavirus (HPV)‐dependent vulvar cancer patients was identified in Arnhem Land Northern Territory (NT), Australia, in which young Indigenous women were diagnosed at 70 times the national incidence rate.AimsTo assess whether women from the Arnhem Land cluster differ from women with vulvar squamous cell carcinoma (VSCC) and vulvar intraepithelial neoplasia (VIN) resident elsewhere in the NT in recurrence after treatment, disease progression and mortality.Materials and methodsA retrospective cohort study of NT‐resident women diagnosed with VIN or invasive vulvar cancer (VSCC) between 1 January 1993 and 30 June 2015 was undertaken. Time to recurrence was assessed using cumulative incidence plots and Fine and Gray competing risk regression models. Mean cumulative count was used to estimate the burden of recurrent events.ResultsIndigenous women from Arnhem Land experienced more recurrences after treatment than non‐Indigenous women, the cancers recurred faster, and Indigenous women have worse survival at five years.ConclusionsIn characterising the epidemiological features of this cluster, we have identified a particularly aggressive form of vulvar cancer. This provides a unique opportunity for elucidating the aetiopathological pathways driving vulvar cancer development that may ultimately lead to preventive and therapeutic targets for this neglected malignancy. Further, these findings have important implications for clinical practice and HPV vaccination policy in the affected population.
Against the family veto in organ procurement: Why the wishes of the dead should prevail when the living and the deceased disagree on organ donation
Authors: Albertsen Andreas 
Published: October 2019

AbstractThe wishes of registered organ donors are regularly set aside when family members object to donation. This genuine overruling of the wishes of the deceased raises difficult ethical questions. A successful argument for providing the family with a veto must (a) provide reason to disregard the wishes of the dead, and (b) establish why the family should be allowed to decide. One branch of justification seeks to reconcile the family veto with important ideas about respecting property rights, preserving autonomy, and preventing harm. These arguments are ultimately unsuccessful. Another branch of arguments is consequentialist, pointing out the negative consequences of removing the veto. Whether construed as concerning family distress or as a potential drop in the organs available, these arguments are unsuccessful; the first fails to recognize the tremendous distress associated with waiting for an organ, while the second has little supporting evidence. A final section considers and rejects whether combining some of the arguments just examined could justify the family veto. We should thus remove the family veto in organ donation.
Social workers' reflexive understandings of their “everyday” communications with children
Authors: Hadfield Mark , Ruch Gillian , Winter Karen , Cree Viviene , Morrison Fiona 
Published: October 2019

AbstractOver the past two decades, the use of ethnographic research methods, in combination with a range of discursive, conversational, and multimodal analytical approaches, have provided vivid accounts of the complex nature of social workers' everyday communication. This paper discusses the potential and the problems of combining a video‐stimulated recall methodology with an explicit theoretical framework, in order to generate critical reflexive “insider” accounts of social workers' direct encounters with children. The framework employed was based on an adaptation of Goffman's concepts of “framing” and “footing,” which were integrated into an analytical process designed to theorize social workers' critiques regarding the nature of their communication with children. Three detailed case exemplars are used to demonstrate the potential of this methodology to explore the “delicate” agency required by social workers in the practice of authentic communication in complex professional inquiries with children. The paper concludes with a brief discussion of the theoretical and practical issues associated with utilizing reflexive methodologies in professional contexts.
Shared decision‐making in older children and parents considering elective adenotonsillectomy
Authors: MacDonald Amanda I. , Chorney Jill , Bezuhly Michael , Hong Paul 
Published: October 2019

AbstractObjectivesShared decision‐making describes a collaborative process in which healthcare providers and patients/families make treatment decisions using the best available evidence, while taking into account the patient's values and preferences. The objectives of this study were to assess the level of decisional conflict and shared decision‐making experienced by older children and their parents when considering elective adentonsillectomies.DesignA prospective cohort study.SettingPaediatric otolaryngology clinic in a teaching hospital.ParticipantsParticipants included 53 children older than 9 years and their parents who underwent consultation for tonsillectomy with or without adenoidectomy.Main outcomes measuresChildren and parents completed the Decisional Conflict Scale (DCS) and Shared Decision‐Making Questionnaire‐Patient Version (SDM‐Q‐9). Surgeons completed the Shared Decision‐Making Questionnaire‐Physician Version (SDM‐Q‐Doc).ResultsOverall, 10 (19%) parents and 18 (34%) children reported clinically significant decisional conflict. Parents who opted not to proceed with surgery had significantly higher DCS scores than those who decided to proceed with surgery. Both parents and children SDM‐Q‐9 and total DCS scores were significantly negatively correlated. Physician SDM‐Q‐Doc and parent total DCS scores were negatively correlated, while parent and physician SDM scores were positively correlated.ConclusionsMany older children and parents reported significant decisional conflict when considering elective paediatric otolaryngology surgery. Decisional conflict levels for both children and parents decreased with greater perceived levels of shared decision‐making. Older children did not appear to discern the same levels of shared decision‐making as parents and surgeons. Future research should assess methods to implement shared decision‐making into clinical practice for clinicians, parents and children when appropriate.
Dye removal using hydrophobic polyvinylidene fluoride hollow fibre composite membrane by vacuum membrane distillation
Authors: Li Hongbin , Feng Xiangwei , Shi Wenying , Zhang Haixia , Du Qiyun , Qin Longwei , Qin Xiaohong 
Published: October 2019

AbstractHydrophobic polyvinylidene fluoride (PVDF) hollow fibre composite membranes were prepared by the dilute solution coating process to build a special surface structure that was similar to the dual micro‐nano structure on the lotus leaf. Poly(vinylidene fluoride‐co‐hexafluoropropene) was chosen as the hydrophobic polymer candidate in dilute solution. Membrane morphology and surface hydrophobicity were evaluated by scanning electron microscopy and dynamic water contact angle measurement. The prepared PVDF hollow fibre membranes were employed to separate dyes (Congo Red and Methylene Blue) from water by vacuum membrane distillation. The effects of operational conditions (feed temperature, vacuum pressure and feed flow rate) on the vacuum membrane distillation performance of different PVDF membranes were investigated. The results indicated that the water contact angle values of PVDF composite membrane surfaces improved from 93.6° to 130.8°, which was mainly attributed to the formation of micro‐nano rods. This structure was similar to the dual micro‐nano structure on the lotus leaf. Under test feed temperature, vacuum pressure and feed flow rate conditions, the dye rejection rate of Congo Red and Methylene Blue by the hydrophobic PVDF hollow fibre membrane remained above 99.5% and 99%, which was higher than that of the pristine PVDF membrane (99% and 98%, respectively). In addition, the hydrophobic PVDF hollow fibre composite membrane showed higher permeation flux under different conditions compared with the pristine PVDF membrane, which was attributed to membrane surface hydrophobicity and the electrostatic interactions between dyes and the PVDF membrane surface.
Gender differences in the consumption of alcohol mixed with caffeine and risk of injury
Authors: Roemer Audra , Stockwell Tim , Zhao Jinhui , Chow Clifton , Vallance Kate , Cherpitel Cheryl 
Published: October 2019

AbstractIntroduction and AimsThere is increasing evidence suggesting the consumption of caffeinated alcoholic beverages is associated with risks over and above alcohol use on its own; however, research in this area remains limited. We examined whether gender differences existed in the relationship between the combined use of alcohol and caffeine (Alc + Caff) and risk for injury.Design and MethodsThis emergency department study utilised case–control and case‐crossover analyses to examine in situ session specific Alc + Caff use and injury risk for men and women, while controlling for socio‐demographic variables, dose of alcohol and caffeine, other substance use, risk‐taking propensity and context. The sample comprised 2804 individuals aged 18‐years or older who presented to three hospital emergency departments in British Columbia.ResultsA relationship between Alc + Caff use and increased risk of injury was confirmed. Further, gender differences were found in the risk relationship between Alc + Caff use and injury. Women were found to have a higher risk injury propensity following Alc + Caff use in both the case–control (OR = 3.10, 95% CI = 1.78, 5.84) and case‐crossover analyses (OR = 3.21, 95% CI = 1.69, 6.12), relative to men (OR = 1.69, 95% CI = 1.30, 2.30; OR = 1.38, 95% CI = 1.08, 1.86). These results remained even after controlling for demographic factors, risk‐taking, context and other substance use.Discussion and ConclusionsWomen may be at higher risk of injury than men following the consumption of alcohol mixed with caffeine. The findings offer support for differential low‐risk drinking guidelines for men and women and the restriction and regulation of the sale and availability of caffeinated alcoholic beverages.
Pharmacokinetic interaction between modified Atkins diet and antiepileptic drugs in adults with drug‐resistant epilepsy
Authors: Kverneland Magnhild , Taubøll Erik , Molteberg Ellen , Veierød Marit B. , Selmer Kaja K. , Nakken Karl O. , Iversen Per O. 
Published: October 2019

AbstractObjectiveThe aim was to examine the influence of modified Atkins diet on serum concentration of antiepileptic drugs (AEDs).MethodsProspective data from 63 adult patients with either focal or generalized drug‐resistant epilepsy recruited to 12‐week dietary treatment as add‐on to AEDs are analyzed. AED serum concentrations, ketones, glucose, and hemoglobin A1c were measured before and after the dietary intervention. Paired t test was used and Spearman correlation coefficient, r, was estimated.ResultsMean age was 37 years (range 16‐65 years). Mean serum concentrations of carbamazepine, clobazam, and valproate were significantly reduced after 4 and 12 weeks of the diet period (<.001 ≤ P ≤ .02). Levels of lacosamide, lamotrigine, and topiramate were less reduced (.02 ≤ P ≤ .08), whereas the serum concentrations of oxcarbazepine, zonisamide, and levetiracetam were unchanged (.06 ≤ P ≤ .90). The largest reduction in serum concentration was found for clobazam: mean reduction after 12 weeks was 1.5 μmol/L (34%). Percent change in serum concentration after 4 and 12 weeks of all drugs analyzed was −10.5% (95% confidence interval [CI] −14.1 to −6.8; n = 60; P < .001) and −13.5% (95% CI −18.8 to −8.3; n = 56; P < .001), respectively. Percent change in serum concentration of AEDs was not significantly correlated to percent change in seizure frequency after 12 weeks of dietary treatment (r = .14, P = .33, n = 53) but negatively correlated to urine ketosis (r = −.43; P = .003; n = 46).SignificanceA reduction in AED serum concentrations may counteract a seizure‐reducing effect of the diet, and in patients without such an effect, it may cause seizure aggravation. Thus, we recommend that clinicians who are treating patients with ketogenic diets monitor serum concentrations of the concomitant AEDs.
Arctic shrub colonization lagged peak postglacial warmth: Molecular evidence in lake sediment from Arctic Canada
Authors: Crump Sarah E. , Miller Gifford H. , Power Matthew , Sepúlveda Julio , Dildar Nadia , Coghlan Megan , Bunce Michael 
Published: October 2019

AbstractArctic shrubification is an observable consequence of climate change, already resulting in ecological shifts and global‐scale climate feedbacks including changes in land surface albedo and enhanced evapotranspiration. However, the rate at which shrubs can colonize previously glaciated terrain in a warming world is largely unknown. Reconstructions of past vegetation dynamics in conjunction with climate records can provide critical insights into shrubification rates and controls on plant migration, but paleoenvironmental reconstructions based on pollen may be biased by the influx of exotic pollen to tundra settings. Here, we reconstruct past plant communities using sedimentary ancient DNA (sedaDNA), which has a more local source area than pollen. We additionally reconstruct past temperature variability using bacterial cell membrane lipids (branched glycerol dialkyl glycerol tetraethers) and an aquatic productivity indicator (biogenic silica) to evaluate the relative timing of postglacial ecological and climate changes at a lake on southern Baffin Island, Arctic Canada. The sedaDNA record tightly constrains the colonization of dwarf birch (Betula, a thermophilous shrub) to 5.9 ± 0.1 ka, ~3 ka after local deglaciation as determined by cosmogenic 10Be moraine dating and >2 ka later than Betula pollen is recorded in nearby lake sediment. We then assess the paleovegetation history within the context of summer temperature and find that paleotemperatures were highest prior to 6.3 ka, followed by cooling in the centuries preceding Betula establishment. Together, these molecular proxies reveal that Betula colonization lagged peak summer temperatures, suggesting that inefficient dispersal, rather than climate, may have limited Arctic shrub migration in this region. In addition, these data suggest that pollen‐based climate reconstructions from high latitudes, which rely heavily on the presence and abundance of pollen from thermophilous taxa like Betula, can be compromised by both exotic pollen fluxes and vegetation migration lags.
Refractory orthostatic hypotension after creation of a brachio‐basilic arteriovenous fistula
Authors: Abuzeineh Mohammad , Yerram Preethi , Misra Madhukar 
Published: October 2019

AbstractArteriovenous fistulas (AVFs) are preferred vascular access in patients with end‐stage renal disease (ESRD) undergoing hemodialysis (HD). However, AVFs, can occasionally lead to clinically significant complications. Of these, cardiovascular complications have been well described in the literature. In this report, we describe a case of a 78‐year‐old Caucasian male with ESRD who presented with severe debilitating dizziness and orthostatic hypotension that started soon after the creation of left brachiobasilic AVF. The patient had no significant cardiovascular history apart from essential hypertension. His symptoms persisted despite extensive evaluation and interventions, and abated only after banding of the AVF. This report describes the timeline of the patient's clinical course beginning from the day of creation of his AVF, through the course of his hospitalization leading to AVF banding and ending with postoperative recovery phase with resolution of symptoms. We will also review the pathophysiologic effects of AVF on cardiovascular system, as well as the potential causes of our patient's clinical presentation.
Comparative analysis of spray‐drying microencapsulation of Bifidobacterium adolescentis and Lactobacillus acidophilus cultivated in different growth media
Authors: Lin Ta‐Chen , Chen Bang‐Yuan , Chen Chun‐Yeh , Chen Yuh‐Shuen , Wu Haibo 
Published: October 2019

AbstractTo screen the optimal lactic acid bacteria (LAB) from nine strains LAB and culture media composition for spray‐drying microencapsulation in advance, the physicochemical and physiological properties of microencapsulation including cell permeability, viable cell count, and survival rate were analyzed. According to the primary results of the bacterial growth, pH determination, and quantification of organic acids, the optimal LAB of two from nine strains selected to be better promising LAB for spray drying was found to be Bifidobacterium adolescentis and Lactobacillus acidophilus. The viable cells count and survival rate were significantly higher for both B. adolescentis and L. acidophilus cultivated in MRS broth with glucose of carbon source containing 10% (w/w) green tea extract(p < .05). Thus, the optimal LAB and culture medium for spray‐drying microencapsulation were obtained, which is beneficial to human health and has potential applications in the health food industry.Practical applicationsThis study evaluated the physicochemical and physiological properties of microcapsules with various compositions and their potential for application in the encapsulation of probiotic microorganisms such as B. adolescentis and L. acidophilus. The highest survival rate of the microcapsule with a carrier composition of 95% maltodextrin (MD) + 5% isomaltooligosaccharide (IMOS) was found at inlet/outlet temperatures of 120/60°C in both B. adolescentis and L. acidophilus. Encapsulation increases the cell permeability, cell viability, and survival rate and plays an important role in the spray‐drying of food products, resulting in a high stability, and viability during storage.
Activation of liver X receptor promotes hippocampal neurogenesis and improves long‐term cognitive function recovery in acute cerebral ischemia‐reperfusion mice
Authors: Chen Lili , Song Dan , Chen Beibei , Yang Xuemei , Cheng Oumei 
Published: October 2019

AbstractCerebral ischemia (CI) leads to cognitive dysfunction due to the loss of hippocampal neurons. Liver X receptors (LXRs), including the LXRα and LXRβ isoforms, are critical for neurogenesis, synaptic plasticity, neurodegeneration, and cholesterol metabolism. However, the potential role of LXRs in the pathogenesis of CI‐induced cognitive impairment is unclear. Therefore, we investigated the effects of LXR activation on hippocampal neurogenesis and cognitive function in mice with CI. C57 mice were randomized into four groups that included a sham group and three treatment groups with CI [Vehicle, TO901317 (TO90, an agonist of LXRs) and GSK2033 (an antagonist of LXRs)]. Mice were subjected to bilateral common carotid artery occlusion for 20 min to induce transient CI. The Morris water maze test was executed to detect spatial learning and memory. Proliferation, differentiation, and immature neurons in the subgranular zone (SGZ) were examined using Immunofluorescence. Western blot assay was used to detect the expression of the Wnt/β‐catenin signaling pathway‐associated protein. TO90 significantly improved spatial learning and memory deficits induced by CI on 28 days. It enhanced the proliferation of neural stem cells, the number of immature neurons and the differentiation from nascent cells to neurons. The expression of the Wnt/β‐catenin signaling pathway‐associated protein level was totally increased. The forenamed effects of TO90 were decreased in GSK2033 group. Thus, our findings suggest that LXRs activation can improve long‐term cognitive dysfunction caused by CI by increasing neurogenesis, and LXRs may serve as a potential therapeutic target for cerebral ischemia.
image
Cover Image for this issue: doi: 10.1111/jnc.14753.
Pasta noodles enriched with sweet potato starch: Impact on quality parameters and resistant starch content
Authors: Kolarič Lukáš , Minarovičová Lucia , Lauková Michaela , Karovičová Jolana , Kohajdová Zlatica 
Published: October 2019

AbstractThis research is focusing on the texture, rheology, and sensory properties of pasta products enriched with the sweet potato starch (SPS) as well as on the content of resistant starch (RS) in these products. SPS was extracted from orange sweet potatoes using 1 mol. L−1 Sodium chloride solution. Durum wheat flour semolina was partially supplemented with 10, 20, and 30% (w/w) by SPS in the pasta formulation and the influence of enrichment on the cooking quality, mechanical and sensory properties, and the color was observed. SPS addition resulted in decreased water absorption and shorter dough development time, but the stability of the dough was also decreased. The optimum cooking time for pasta was reduced, but only slightly, on the other side, the swelling index increased, which negatively impacted on the firmness of the products. Increasing of the SPS content also resulted in higher stickiness values for pasta. When up to 20% of wheat flour was replaced, the color of finished products was less acceptable. In the products, the resistant and total starch content were determined. Pasta cooking resulted in the reduction of RS content, which was then increased by storing products for 24 hr. It can be concluded that the substitution of part of semolina flour with SPS increased the level of RS, but on the other side, it caused some significant differences from the quality of pasta made from semolina only.