bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of clozapine monitoring and adverse event management in a psychiatrist-only and a clinical pharmacist-psychiatrist collaborative clinic
Authors: Maryan Samantha , Harms Michelle , McAllister Erin , DeJongh Beth 
Published: March 2019

Abstract

Introduction
In an effort to establish clinical support for providers prescribing clozapine and to help reverse the national decline in clozapine utilization, a clinical pharmacist began seeing half the clozapine clinic patients, preceding the psychiatrist, at this facility in July 2017. The other half of the clozapine clinic patients continued being seen by the psychiatrist only. The purpose was to determine the impact of the pharmacist on clozapine management and identify barriers to clozapine use to potentially increase its utilization.

Methods
Baseline data (clozapine dose, number of antipsychotics and other psychotropics, A1c, lipids, pulse, body mass index, weight, blood pressure, and number of medications for adverse effects) were collected via chart review from the first clinic visit and each follow-up visit. A provider survey was used to identify barriers and solutions to prescribing clozapine.

Results
There were no statistically significant differences from baseline in patient outcomes between the collaborative and psychiatrist-only group. In the prepharmacist to postpharmacist analysis, there was a decrease in number of antipsychotics (−0.27 ± 0.65), number of other psychotropics (−0.18 ± 0.41), A1c (−0.04% ± 0.25%), clozapine dose (−7.96 mg ± 19.58 mg), and total cholesterol (−15.73 mg/dL ± 42.31 mg/dL). There were more pharmacologic (71 vs 19) and nonpharmacologic (154 vs 3) interventions documented in the collaborative group compared to the psychiatrist-only group. Eleven providers (69%) completed the survey. Providers' perception of patient refusal of monitoring was the barrier that received the most responses (54%). A pharmacist seeing every clozapine clinic patient was the solution that received the most responses (90%).

Discussion
Trends were seen for decreasing the number of antipsychotics, other psychotropics, A1c, and total cholesterol as well as an increased number of nonpharmacologic and pharmacologic interventions documented in the collaborative group. Providers identified that pharmacists seeing every clozapine clinic patient would be a solution to clozapine underutilization, which demonstrates the perceived value of pharmacist involvement.
Evaluation of dextromethorphan with select antidepressant therapy for the treatment of depression in the acute care psychiatric setting
Authors: Nofziger Jill L. , Paxos Chris , Emshoff Jessica , Mullen Chanda 
Published: March 2019

Abstract

Introduction
Dextromethorphan (DXM), an N-methyl-D-aspartate receptor antagonist, may have ketamine-like antidepressant effects. Dextromethorphan is extensively metabolized via cytochrome P450 (CYP) 2D6, and its half-life in extensive metabolizers is 2 to 4 hours. The purpose of this study was to evaluate the effects of DXM in combination with a moderate-to-strong CYP2D6 inhibitor antidepressant on depression in an acute care psychiatric setting.

Methods
This was a single-center, retrospective chart review of adult patients with a depressive disorder diagnosis. Patients who received select antidepressant therapy with or without scheduled DXM were included. The primary outcome was the difference in time to improvement of depressive symptoms, which was an average composite of physician documentation, nurse documentation, and first time to 24 hours without as-needed anxiolytics or antipsychotics. The study group consisted of patients who received DXM with select antidepressant therapy, whereas the control group included those who received only select antidepressant therapy.

Results
A total of 40 patients were included. The median time to clinical improvement was 3.00 days and 2.83 days for the study group and control group, respectively (P = .986). The incidence of perceptual disturbances and delusions was higher in the study group as compared with the control group (55% and 35% vs 30% and 25%, respectively).

Discussion
Dextromethorphan was not associated with a rapid antidepressant effect. The commonly used dose of 30 mg daily may have been too low to have an effect; additionally, the most frequently utilized select antidepressant, bupropion, has moderately less CYP2D6 inhibition than fluoxetine and paroxetine.
Rates of new antipsychotic prescriptions and continuation at discharge from a medical unit in a community teaching hospital serving rural counties
Authors: Phan Stephanie V. , Lugin Yelena , Morgan Katie 
Published: March 2019

Abstract

Introduction
Antipsychotics are commonly used during hospitalization to manage a variety of acute indications and may be inadvertently continued at discharge. The purpose of this study was to identify the rate at which patients admitted to nonpsychiatric units were continued on newly prescribed antipsychotics at discharge from a rural community teaching hospital.

Methods
This study was a retrospective chart review of adult patients admitted to a large community teaching hospital and initiated on an antipsychotic from August 1, 2016, to August 31, 2017. Exclusion criteria were patients admitted to psychiatric or obstetrics/gynecology services, with a diagnosis of a psychotic disorder, or on an antipsychotic prior to hospitalization. The primary outcome measure was the number of new antipsychotic prescriptions during hospitalization that were continued at discharge. Secondary outcomes included antipsychotic characteristics and initiation indications. Descriptive statistics were used to describe antipsychotic use and demographic data.

Results
Of 100 patients included, 3 patients were discharged on an antipsychotic. Two patients had questionable indications, and 1 patient had a new psychotic disorder diagnosis. Of all antipsychotics newly initiated during hospitalization, haloperidol was the most commonly prescribed antipsychotic. The majority of doses were scheduled as 1-time or as-needed doses. Approximately 20% of antipsychotics were administered orally. No relevant indication was found for 35% of patients newly initiated on antipsychotics, and documented indications included agitation, psychosis, delirium, and anxiety.

Discussion
In an institution that largely serves a rural population, antipsychotic prescribing at discontinuation was not worse than what has been previously reported in other regions of the United States. Limitations for this study include the retrospective nature, single-center study, and small sample size. Although there was a lack of continuation after discharge, there was also a deficit of documentation with 35% of the antipsychotic initiations having no documented indication.
Evaluation and optimization of take-home naloxone in an academic medical center
Authors: Cooler Jordan , Ross Clint A. , Robert Sophie , Linder Lauren , Ruhe Ann Marie , Philip Achsah 
Published: March 2019

Abstract
With the United States in the midst of an opioid overdose epidemic, efforts to reduce overdose deaths have increased. Expanding access to the opioid antagonist naloxone can combat the epidemic. A pilot project in a psychiatric hospital resulted in the development of a screening tool in the electronic medical record (EMR) to help pharmacists identify adult inpatients at high risk of opioid overdose. Pharmacists can facilitate these patients being discharged with take-home naloxone. The purpose of this project was to optimize the screening tool for nonpsychiatric adult inpatient areas. Prior to implementation, a team of pharmacists familiar with the screening tool and take-home naloxone met with stakeholders to assess need for modification of the tool, determine barriers to implementation, and provide insight into the new service. In addition to expanding the tool into nonpsychiatric areas, a morphine-equivalents calculator was developed to identify patients receiving at least 100 mg of morphine equivalents per day to capture an additional at-risk population. Four short educational videos were developed to provide training to pharmacists. Initial performance of the screening tool was evaluated in general medicine patients over a 5-day period. Out of 44 admissions, 8 (18.2%) screened positive. The majority of those patients (5/8, 62.5%) screened positive for morphine equivalents greater than 100 mg. Anecdotally, the educational videos have been well received by pharmacy staff. Opioid overdose risk factors can be applied to nonpsychiatric inpatients for screening purposes in the EMR. Educational videos can be used to disseminate information to pharmacists on take-home naloxone and opioid overdose.
Bulk Nanostructured Materials Design for Fracture‐Resistant Lithium Metal Anodes
Authors: Liu Shan , Deng Lijun , Guo Wenqing , Zhang Chanyuan , Liu Xingjiang , Luo Jiayan 
Published: February 2019

AbstractLi metal is an ideal anode for next‐generation batteries because of its high theoretical capacity and low potential. However, the unevenly distributed stress in Li metal anodes (LMAs) induced by volume fluctuation may cause the electrode to fracture easily, especially during high‐rate plating/stripping processes. Here fracture‐resistant LMAs using the concept of bulk nanostructured materials are designed via a metallurgical process. In bulk nanostructured Li (BNL), ionic conducting phases exist at grain boundaries, which promote Li+ transport. The refined Li grain size and precipitation hardening in BNL enhances the mechanical strength and fatigue endurance, alleviating the unevenly distributed stress and preventing electrode pulverization. Density functional theory is used to investigate the binding energy between Li and various kinds of oxides and SiO2 is found to be optimal additive among screened oxides. BNL has 91% of the theoretical capacity of Li metal. In full cells with BNL anode, LiFePO4 could deliver capacity of 90 mAh g−1 at 10C, an order of magnitude higher than that in full cells with Li foil anode. This strategy is expected to pave the way for fracture‐resistant LMAs in high‐rate cycling with maximum capacity.
pH‐Regulated Heterostructure Porous Particles Enable Similarly Sized Protein Separation
Authors: Song Yongyang , Fan Jun‐Bing , Li Xiuling , Liang Xinmiao , Wang Shutao 
Published: February 2019

AbstractPorous particles are frequently used for various healthcare applications that involve protein separation processes. However, conventional porous particles, either homogeneous particles or those subjected to surface modification with a layer of specific molecules, often encounter bottlenecks in separating proteins with similar size. Here, it is reported that heterostructure‐enabled separation particles (HESP), synthesized by a double emulsion interfacial polymerization process, can effectively and rapidly separate similarly sized proteins. Double emulsion interfacial polymerization endows the HESP with a nanoscale carboxylic layer outside the particles and inside the pores, allowing pH‐regulated selective adsorption of proteins. Thus, by optimizing the environmental pH, proteins with similar size can be effectively and rapidly separated. These HESP are expected to show potential in widespread applications ranging from biomolecule adsorption, encapsulation, and separation to controlled release and other biomedical fields.
Supramolecular Crosslinked Polymer for Efficient Organic Dye Removal from Aqueous Solution
Authors: Wu Xuan , Chen Yong , Liu Yu 
Published: February 2019

AbstractRemoval of organic dyes from aqueous solution has attracted considerable attention in the field of environmental science and for industrial application. Herein, a crosslinked pillar[5]arene polymer (Ru‐P5C) is synthesized by a click reaction between a hydrophobic azide‐modified pillar[5]arene (N3‐P5) and a hydrophilic alkyne‐modified Ru derivative. The synthesized material can efficiently remove various anionic organic dyes from aqueous solution upon irradiation at 450 nm in the air. The numerous positive charges on the nanoparticles facilitate adsorption of the dyes, and Ru‐catalyzed photolysis, promoted by the hydrophobic environment of the nanoparticles, leads to their degradation. The removal efficiency after ≈25 min exceeds 95%, which is much higher than the removal efficiencies of TiO2 (P25), BiOBr, and Ru(bipy)3Cl2. Moreover, the polymer not only exhibits good regeneration ability but also shows excellent performance for dye removal under irradiation from sunlight as well as in the wastewater system containing a number of dyes.
Tailor‐Made Core‐Multishell Nanocarriers for the Delivery of Cationic Analgesics to Inflamed Tissue
Authors: Unbehauen Michael L. , Łabuz Dominika , Schwarzl Richard , Moré Sam , Netz Roland R. , Stein Christoph , Machelska Halina , Haag Rainer 
Published: February 2019

AbstractU50,488H (U50) is a κ‐opioid receptor agonist exerting effective analgesia in animal pain models. Yet, side effects such as sedation and depression‐like symptoms mediated in the brain limit its therapeutic potential. In this study, tailor‐made core‐multishell (CMS) nanocarriers are presented containing U50 that, despite their small size, exhibit a pH‐dependent retention effect via non‐covalent interactions with the drug. The nanocarriers and their non‐functionalized counterparts are characterized regarding their release properties in vitro, including a theoretical modeling of the release parameters which show the beneficial features of the additional functionalization. Finally, the U50‐containing nanocarriers are tested in an in vivo rat model of inflammatory pain, with the results showing prolonged analgesic effect.
Synthesis and Electrochemical Activity of Some Na(Li)‐Rich Ruthenium Oxides with the Feasibility to Stabilize Ru6+
Authors: Otoyama Misae , Jacquet Quentin , Iadecola Antonella , Saubanère Matthieu , Rousse Gwenaëlle , Tarascon Jean‐Marie 
Published: February 2019

AbstractThe capacity of Li‐ion cathode materials has recently been greatly improved by the feasibility to trigger both cationic and anionic redox reactions within the same material. This concept has rapidly been implemented to Na‐ion batteries to boost their energy density. The electrochemical properties of Na3RuO4 with Li3RuO4 are reported and compared herein. Strikingly, it is found that 3 Na can be extracted from Na3RuO4 with the charge compensation mechanism enlisting first the oxidation of Ru5+ to Ru6+, leading to Na2RuO4, and then the oxidation of oxygen during the rest of the charge. This drastically contrasts with the behavior of the Li counterpart since Ru never reaches that high oxidation state during lithium removal. By comparing the phase diagrams of AxRuO4 (A being Li, Na, or K) together with density functional theory calculations, this finding is rationalized and it is demonstrated that this difference is mainly rooted in the size of the alkali cation. The bigger the alkali, the lower the coordination of Ru will be, stabilized by the same higher oxidation states. This work highlights the difference between Li and Na materials toward anionic redox and suggests the unusual coexistence of Ru6+ and (O2)n−, hence setting new challenges to theoreticians and opening opportunities for materials design.
Humans as inverted bats: A comparative approach to the obstetric conundrum
Authors: Grunstra Nicole D. S. , Zachos Frank E. , Herdina Anna Nele , Fischer Barbara , Pavličev Mihaela , Mitteroecker Philipp 
Published: February 2019

AbstractObjectivesThe narrow human birth canal evolved in response to multiple opposing selective forces on the pelvis. These factors cannot be sufficiently disentangled in humans because of the limited range of relevant variation. Here, we outline a comparative strategy to study the evolution of human childbirth and to test existing hypotheses in primates and other mammals.MethodsWe combined a literature review with comparative analyses of neonatal and female body and brain mass, using three existing datasets. We also present images of bony pelves of a diverse sample of taxa.ResultsBats, certain non‐human primates, seals, and most ungulates, including whales, have much larger relative neonatal masses than humans, and they all differ in their anatomical adaptations for childbirth. Bats, as a group, are particularly interesting in this context as they give birth to the relatively largest neonates, and their pelvis is highly dimorphic: Whereas males have a fused symphysis, a ligament bridges a large pubic gap in females. The resulting strong demands on the widened and vulnerable pelvic floor likely are relaxed by roosting head‐down.ConclusionsParturition has constituted a strong selective force in many non‐human placentals. We illustrated how the demands on pelvic morphology resulting from locomotion, pelvic floor stability, childbirth, and perhaps also erectile function in males have been traded off differently in mammals, depending on their locomotion and environment. Exploiting the power of a comparative approach, we present new hypotheses and research directions for resolving the obstetric conundrum in humans.
Unraveling the dispersal patterns and the social drivers of natal emigration of a cooperative breeding mammal, the golden lion tamarin
Authors: Romano Valéria , Martins Andreia F. , Ruiz‐Miranda Carlos R. 
Published: February 2019

AbstractThe study of the social drivers of animal dispersal is key to understanding the evolution of social systems. Among the social drivers of natal emigration, the conspecific attraction, aggressive eviction, and reduced social integration hypotheses predict that sexually mature individuals who receive more aggressive behavior and are engaged in less affiliative interactions are more likely to disperse. Few reports have explored these proximate factors affecting emigration in cooperatively breeding species, particularly of Neotropical primates. In this study, we investigated the dispersal patterns and tested the social drivers of natal emigration in the golden lion tamarin (Leontopithecus rosalia) — an endangered species inhabiting Atlantic rainforests fragments in Brazil. We used behavioral and demographic data collected during 7 years from 68 groups of tamarins inhabiting 20 forest fragments. Our analyses from the 160 dispersing individuals showed that dispersal success is higher for males and for those engaged in parallel dispersal, but that males and females use different strategies to enhance their dispersal success, males immigrate into established groups while females form new groups. We did not find high levels of agonistic behavior among group members before natal emigration. Instead we found that conspecific attraction drives natal emigration in both sexes, while additionally the low level of affiliative interactions within the natal group triggers male emigration. We discuss natal emigration in the broader perspective of the cooperative breeding system and the implications of these findings for the conservation of the species.
A SERS Optophysiological Probe for the Real‐Time Mapping and Simultaneous Determination of the Carbonate Concentration and pH Value in a Live Mouse Brain
Authors: Wang Weikang , Zhao Fan , Li Mingzhi , Zhang Chuanping , Shao Yuanhua , Tian Yang 
Published: February 2019

AbstractTo have a profound understanding of the physiological and pathological processes in a brain, both chemical and electrical signals need to be recorded, but this is still very challenging. Herein, micrometer‐ to nanometer‐sized SERS optophysiological probes were created to determine both the CO32− concentration and the pH in live brains and neurons because both species play important roles in regulating the acid–base balance in the brain. A ratiometric SERS microarray of eight microprobes with tip sizes of 5 μm was established and used for the first time for real‐time mapping and simultaneous quantification of CO32− and pH in a live brain. We found that both the CO32− concentration and the pH value dramatically decreased under ischemic conditions. The present SERS technique can be combined with electrophysiology without cross‐talk to record both electrical and chemical signals in brains. To deepen our understanding of the mechanism of ischemia on the single‐cell level, a SERS nanoprobe with a tip size of 200 nm was developed for use in a single neuron.
Harnessing Intramolecular Rotation To Enhance Two‐photon Imaging of Aβ Plaques through Minimizing Background Fluorescence
Authors: Shin Jinwoo , Verwilst Peter , Choi Hayoung , Kang Sangrim , Han Jiyou , Kim Na Hee , Choi Jin Gyu , Oh Myung Sook , Hwang Ji Sun , Kim Dokyoung , Mook‐Jung Inhee , Kim Jong Seung 
Published: February 2019

AbstractThe aggregation of amyloid beta (Aβ) proteins in senile plaques is a critical event during the development of Alzheimer's disease, and the postmortem detection of Aβ‐rich proteinaceous deposits through fluorescent staining remains one of the most robust diagnostic tools. In animal models, fluorescence imaging can be employed to follow the progression of the disease, and among the different imaging methods, two‐photon microscopy (TPM) has emerged as one of the most powerful. To date, several near‐infrared‐emissive two‐photon dyes with a high affinity for Aβ fibrils have been developed, but there has often been a tradeoff between excellent two‐photon cross‐sections and large fluorescence signal‐to‐background ratios. In the current work, we introduced a twisted intramolecular charge state (TICT)‐based de‐excitation pathway, which results in a remarkable fluorescence increase of around 167‐fold in the presence of Aβ fibrils, while maintaining an excellent two‐photon cross section, thereby enabling high‐contrast ex vivo and in vivo TPM imaging. Overall, the results suggest that adopting TICT de‐excitation in two‐photon fluorophores may represent a general method to overcome the tradeoff between probe brightness and signal‐to‐background ratio.
Effects of the matrix crystallinity, dispersed phase, and processing type on the morphological, thermal, and mechanical properties of polylactide‐based binary blends with poly[(butylene adipate)‐co‐terephthalate] and poly[(butylene succinate)‐co‐adipate]
Authors: Nofar Mohammadreza , Oguz Hazal , Ovalı Didem 
Published: February 2019

ABSTRACTIn this study, we prepared immiscible blends of 75 wt % polylactide (PLA) with 25 wt % poly[(butylene adipate)‐co‐terephthalate] (PBAT) through an injection‐molding (IM) process and a twin‐screw extruder (TSE) followed by IM. An amorphous polylactide (A‐PLA) and a semicrystalline polylactide (SC‐PLA) were used as the matrixes to investigate the matrix crystallization effect on the morphology and property development of the blends with only IM. A blend of A‐PLA with 25 wt % poly[(butylene succinate)‐co‐adipate] (PBSA) was also prepared through IM to compare its properties with those of the A‐PLA–PBAT blends. The morphological, thermal, solid viscoelastic, tensile, and flexural properties of the blends were compared, and their dependency on the evolution of the blend morphology was analyzed. The tensile results show that when IM was used as the sole processing technique, the ductility and toughness were significantly improved only when SC‐PLA was used as the matrix. Preprocessing through TSE also resulted in the enhancement of the blend ductility. In A‐PLA–PBSA, the vitrification of PLA hindered the crystallization of PBSA to very low temperatures (<0°C) and resulted in a very nonuniform structure with weak intermolecular bonding between phases. © 2019 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2019, 136, 47636.