bluuebunny/crossref_metadata_2025_split huggingface dataset:
174 Pseudogout Induced by Vortioxetine
Authors: Batta Priya , Dhillon Davinder , Hirsch Alan R 
Published: June 2018

AbstractStudy ObjectiveVortioxetine induced monoarticular pain has not heretofore been described. Such a case is presented.MethodCase study: A 49 year old right handed female with a past history of multiple hospitalizations for chronic severe migraine, presented with complaints of depression and stress. She has had depression for 20 years, which has been constant and worsened in the past 5 years. As her migraines became more frequent, her depression also worsened. She has never been suicidal, but does endorse sadness, crying spells, fatigue, demotivation, lack of interest, poor concentration, irritability, anger, guilt, hopelessness, helplessness, anorexia, PM insomnia with frequent awakenings, absent libido and racing thoughts.ResultsAbnormalities in her mental status examination: Orientated times 2. Disheveled. Defensive. Motor retardation. Mood: depressed, anxious and irritable with blunted affect. Remote memory: President: Obama,?. Beck Depression Inventory II: 23 (moderate depression). Beck Anxiety Inventory: 25 (moderate anxiety).The patient was begun on 5 mg of vortioxetine every night. Within two days, she developed pain and swelling of the distal interphalangeal joint of the left great toe. The pain was so severe that she demonstrated an antalgic gait. After five days the medication was discontinued and two days later, there was full resolution of the swelling and pain, and ambulation returned to normal.ConclusionsThe mechanism whereby vortioxetine induced this monoarticular pain is unclear. Underlying depression alone can precipitate arthritic exacerbation (Trivedi, 2004). This was unlikely given the long duration of her depression as well as the timing of the precipitant (vortioxetine use) and resolution shortly after the medication was discontinued. Alternatively, in the depressed state, there may be a greater perception of somatic pain, which allowed her to appreciate any arthritic pain which may have pre-existed the use of vortioxetine (Howard, 1991). As such, this may have represented a correspondence bias (Gilbert, 1995). Furthermore, mild new pain is perceived as more intense in those who are depressed (Howard, 1991). Thus, any minimal arthritic injury may be viewed as more intense. Vortioxetine may have paradoxically exacerbated anxiety and anxiety can precipitate pain (Narasimhan & Campbell). Alternatively, vortioxetine could have caused a generalized allergic reaction, which may have initially manifest in the great toe. If the patient continued the medication, she may have developed a generalized systemic reaction including involvement of multiple joints. Another possibility is that it caused an allergic histamine mediated hive like reaction, generalized, as well as on the toe. Continued use of the joint may have caused this to be intensified, with associated swelling, while the general reaction subsided. Inquiry about monoarticular involvement in those taking vortioxetine is warranted.Funding AcknowledgementsSmell & Taste Treatment and Research Foundation
178 Gender Differences in Prodromal Symptoms of Dementia
Authors: Wallis Richard , Bishop Sheryl , Downer Brian , Méndez Thomas , Raji Mukaila , Sapp Aida 
Published: June 2018

AbstractStudy ObjectivesThis study proposed to test the postulate that the anxiety and insomnia symptom cluster (A/I) is a predictor of dementia.MethodsA retrospective data analysis was conducted on the Aging, Demographics, and Memory Study (ADAMS) dataset in order to determine whether A/I symptoms or treatment were associated with subsequent dementia or cognitive impairment (DOCI). The study used logistic regression analysis and comparison of incidence rates on a sample of 249 participants.ResultsThere was a significant relationship between A/I symptoms and subsequent DOCI in the male gender that was not found in the total sample or in females. No association with subsequent DOCI was found for benzodiazepine usage or non-benzodiazepine A/I medication usage.ConclusionsThe gender differences identified suggest prodromal dementia phenotypes that are differentially expressed in males and females. By triangulating the approaches from multiple disciplines—such as neuroimaging and genetics—with prodromalsymptoms, it is possible that reliable early prediction may be accomplished.Funding AcknowledgementsNo funding.
181 Triple Trouble: A Rare Case Report of PCDH19, Autism and Epilepsy in a 7-Year-Old Male Child
Authors: Bysani Sailaja , Kendhari Jusleen , Robert Cale 
Published: June 2018

AbstractBackgroundA 7-year-old Caucasian male presented to the emergency department with worsening aggression andbehavioral problems. He was diagnosed with seizure disorder at 9 months old and was started on Keppra. He also had delayed developmental milestones including failure to roll until 6 months, and failure to crawl until after 9 months. At 16 months he was aggressive towards other children including unprovoked attacks of biting and assault. When he was 6yrs old he underwent genetic testing which showed positive for PCDH19 mutation. The most consistent feature of this condition is the early onset ofseizures between 3 months to 3 years of age. He has been on nine anti-seizure medications since his diagnosis. For behavioral problems, he was placed on Focalin, Ritalin, Adderall patch which did not seem to work. He was then on non-stimulants, Zoloft, Prozac, Effexor, Zyprexa and Abilify all with little success.During this admission, patient’s mother described increasing acts of severe physical violence toward multiple people leading to significant bruising. He has a known past psychiatric history of ASD, ADHD,ODD and PCDH19 mutation associated epilepsy. On admission, his medications included Buspirone 5mg BID, Olanzapine 7.5mg BID, Methylphenidate 7.5mg, Ritalin 7.5mg, Zonisamide 150mg qhs, Clonidine 0.1mg qhs. He had significant sensory processing difficulties and lack of communication with peers. He was continued on Clonidine 0.1mg po qhs, Methylphenidate 7.5mg po qam and at noon, Zonisamide 150mg daily. Tapered down Olanzapine and initiated him on Risperidone. His condition improved. He was referred to Thompson center for ABA therapy. He is more interactive and has a smile.DISCUSSIONPCDH19 gene mutations have long since been known to cause epilepsy and behavioral disturbances in females. Males, on the other hand, present as asymptomatic transmitters. PCDH19 is a gene located on Chromosome X and is responsible for the formation of a protein known as protocadherin 19. This protein is especially important as it functions as a Ca2+ dependent cell adhesion in the brain. The PCDH19 mutation, however, impedes protein formation leading to epilepsy and behavioral disturbances. Approximately 90% of symptomatic females possess the mutated gene on one of their X chromosomes. Males similarly carry the mutation on their X chromosome, however are typically asymptomatic. A rare mosaic variant of PCHD19 mutations has been seen in symptomatic males.CONCLUSIONAlthough it is more difficult to think in terms of ASD if a PCDH19 patient has coexisting psychiatric comorbidities like ODD andADHD, clinicians must be keenly aware of other mood disorders. Seizures do not respond well to medications. Family education, psychopharmacological treatment, ABA and CBT were successful in treating the patient. Little is known about the long-term sequela and prognosis of PCDH19 mutation in the male patient population and thus further research is warranted.Funding AcknowledgementsNo funding.
183 AXONA (Caprylidene): Medical Food Therapy For Alzheimer’s Disease
Authors: Shagufta Shanila , Sreeram Venkatesh , Kagadkar Faisal 
Published: June 2018

OBJECTIVESEvaluate the current novel food therapy for Alzheimer and its adverse effects. What is the response to Axona (Capylidene) in different ethnicities and determine the generalizability of the drug use in diverse populations.What genes are linked with positive responses? What are the implications of its use in high risk populations? Its role in early detection of Alzheimer’s and the arrest of the neurodegeneration in APO E4 (-) patients.METHODPubMed was queried with the search terms ‘Axona’ OR ‘Caprylidene’ and the following articles were collected and reviewed.RESULTSAmong the articles collected and reviewed, two studies extensively evaluated the safety and efficacy of using Medium Chain Triglycerides (MCT) in Alzheimer’s disease. These studies genotyped patients for APO E4 status (positive/negative). According to the Reger et al. study in 2002, treatment of APOE4 (-ve) patients with MCTs reported a considerable improvement in comparison to placebo-treated patients (P=0.04). The second study by Henderson et al. in 2009 demonstrated an improvement in cognitive functioning determined by Alzheimer’s disease Assessment Scale- cognitive subscale (ADAS-Cog) scores in those treated with MCTs versus placebo in APOE4 -ve patients. An open label Japanese pilot study also showed improvement in cognitive functioning with Caprylidene in APOE4 (-ve) patients with Mini Mental Status Exam (MMSE) score>14.DISCUSSIONThe FDA approved treatment options in Alzheimer’s disease include acetylcholinesterase inhibitors (Rivastigmine, Donepezil and Galantamine), NMDA receptor antagonist (Memantine). These drugs only delay the progression of the disease in these patients.MCTs are classified as medical foods, which are defined as substances that provide a specific nutritional need in a patient that cannot be satisfied by modification of a normal diet alone The FDA approved Axona as medicalfood for specific dietary management of the disease in 2009. Early metabolic changes in Alzheimer’s Diseaseprior to cognitive decline and plaque deposition can possibly be prevented by early intervention with Axona, especially in high risk population (APOE4 (þ), Downs syndrome).These trials highlight the benefits of MCT in a discrete group, and the importance of routine genomic testing in Alzheimer patients in clinical settings. A better understanding into Caprylidene’s pharmacokinetics and pharmacodynamics will help us in the prevention and intervention of patients based on their genetic profiles.Funding AcknowledgementsNo funding.
197 Guanfacine and Impulsivity – Review of Literature
Authors: Vargas William Donovan , Radonjic Nevena V. 
Published: June 2018

AbstractPrefrontal cortex (PFC) represents one of the most evolved regions of primate brain that is thought to regulate human specific features such as cognition, emotion and behavior (Arnsten and Jin, 2012). PFC is a site of action of guanfacine, an agonist of alpha 2 adrenergic receptors. Compared to clonidine, another alpha adrenergic drug, guanfacine is more selective for α2A adrenergic receptor subtype (van Zwieten et al., 1994; Uhlen at al., 1995) and is weaker in producing hypotension andsedation (Jurado at al., 1998) resulting in better tolerability of the medication. Studies have shown that endogenous noradrenergic stimulation of alpha2A receptors is essential for PFC regulation of behavior, thought and emotion as blockade ofα2A receptors in the monkey dorsolateral PFC significantly impairs working memory (Li and Mei, 1994) and behavioral inhibition (Ma et al., 2003; Ma et al., 2003). So far FDA has approved guanfacine in treatment of attention deficit hyperactivity disorder in children but the medication is used off label for treatment of oppositional defiant disorder, conduct disorder, pervasive developmental disorders, motor tics and Tourette’s syndrome as well. Impulsivity as used in clinical terms is very broadly defined and encompasses personality traits as well as cognitive functions such as emotion regulation and behavioral inhibition. Numerous studies have shown effectiveness of extended release guanfacine in reducing impulsiveness in children with ADHD and recently in autism spectrum disorder (Scahill et al., 2015), however limited data is available on use of guanfacine in treatment of impulse control and aggression in adults.Funding AcknowledgementsNo funding.
Evaluation of the Resistance of a Polypropylene Geotextile Against Ultraviolet Radiation
Authors: Carneiro José Ricardo , Almeida Paulo Joaquim , Lopes Maria de Lurdes 
Published: June 2018

AbstractThe exposure to solar radiation (mainly due to the action of ultraviolet radiation) is one of the main causes for the premature failure of many polymeric materials, including the geotextiles. In this work, a nonwoven polypropylene geotextile (stabilized with a known amount of a hindered amine light stabilizer) was exposed to ultraviolet-aging tests, both in the laboratory (accelerated conditions) and outdoors (natural conditions). The damage occurred in the geotextile (caused by the ultraviolet-aging tests) was evaluated quantitatively (by monitoring changes in its mass per unit area, thickness, and tensile properties) and qualitatively (by scanning electron microscopy). The results, among other findings, showed that: (1) the ultraviolet-aging tests (both in the laboratory and outdoors) induced relevant damage in the polypropylene fibers of the geotextile (transverse cracks), leading to the deterioration of its tensile behavior, (2) the amount of degradation increased with the increase of the ultraviolet radiant energy, (3) the laboratory tests caused a faster deterioration of the polypropylene fibers than the outdoor tests, and (4) the degradation found by scanning electron microscopy in the polypropylene fibers correlated well with the deterioration occurred in the tensile behavior of the geotextile.
Comparative analysis of health system performance in Montreal and New York: the importance of context for interpreting indicators
Authors: Gusmano Michael K. , Strumpf Erin , Fiset-Laniel Julie , Weisz Daniel , Rodwin Victor G. 
Published: June 2018

AbstractAlthough eliminating financial barriers to care is a necessary condition for improving access to health services, it is not sufficient. Given the contrasting health systems with regard to financing and organization of health insurance in the United States and Canada, there is a long history of comparing these countries. We extend the empirical studies on the Canadian and US health systems by comparing access to ambulatory care as measured by hospitalization rates for ambulatory care sensitive conditions (ACSC) in Montreal and New York City. We find that, in New York, ACSC rates were more than twice as high (12.6 per 1000 population) as in Montreal (4.8 per 1000 population). After controlling for age, sex, and number of diagnoses, significant differences in ACSC rates are present in both cities, but are more pronounced in New York. Our findings are consistent with the hypothesis that universal, first-dollar health insurance coverage has contributed to lower ACSC rates in Montreal than New York. However, Montreal’s surprisingly low ACSC rate calls for further research.
Eccentricity‐Paced Southern Hemisphere Glacial‐Interglacial Cyclicity Preceding the Middle Miocene Climatic Transition
Authors: Ohneiser C. , Wilson G. S. 
Published: June 2018

AbstractWe present new paleoclimate proxy data from the Southwest Pacific spanning the middle Miocene climatic transition (circa 16.2–13.5 Ma), which indicate a dynamic South Pacific Oceanic system with two periods of increasing and decreasing current strength in response to orbitally paced ice volume variations. A magneto‐biostratigraphic age model provides age control for magnetic susceptibility and Anisotropy of Magnetic Susceptibility data from a mudstone succession in Western Southland, New Zealand. Magnetic susceptibility in this succession reflects changes in carbonate content, which we suggest is proxy for ocean productivity or sea level variations and therefore a proxy for ice volume variations. The Anisotropy of Magnetic Susceptibility data carry a record of deep current strength in response to ice volume changes. Our data show that periods of increased ice volume resulted in the northward migration of erosive currents in this sector of the Pacific and that large, dynamic ice sheets may have persisted in Antarctic during the middle Miocene climatic optimum.
The Effect of Neutral Density Estimation Errors on Satellite Conjunction Serious Event Rates
Authors: Hejduk M. D. , Snow D. E. 
Published: June 2018

AbstractWhile past studies have investigated the effect of neutral atmospheric density mismodeling on satellite conjunction assessment (CA), none has focused their investigation specifically on serious (high‐risk) conjunction events, which are the event types that drive both risk and workload for CA operations. The present study seeks to do this by reprocessing chosen groups of archived actual conjunction events, artificially introducing atmospheric density error to these events, and then examining the effect of these introduced errors on the probability of collision (Pc) calculation, which is the principal parameter used to assess collision risk. These reprocessed calculations are executed both with the satellites' covariances unaltered and with a covariance modification that accounts for the induced atmospheric density error. The results indicate that the situation is greatly aided by an a priori knowledge of the approximate density estimation error, even if the model itself is unaltered—missed detections due to density estimation uncertainty are notably reduced when the density model prediction error is characterized and can be included in the satellite covariance and thus Pc calculation. Overall improvements in density model predictive performance, in situations of both low and high solar activity, substantially benefit the CA enterprise, especially for false alarm reduction; but model enhancements that include a robust, in‐model error analysis offer the most significant improvements overall.
Multidisciplinary Constraints on the Abundance of Diamond and Eclogite in the Cratonic Lithosphere
Authors: Garber Joshua M. , Maurya Satish , Hernandez Jean‐Alexis , Duncan Megan S. , Zeng Li , Zhang Hongluo L. , Faul Ulrich , McCammon Catherine , Montagner Jean‐Paul , Moresi Louis , Romanowicz Barbara A. , Rudnick Roberta L. , Stixrude Lars 
Published: June 2018

AbstractSome seismic models derived from tomographic studies indicate elevated shear‐wave velocities (≥4.7 km/s) around 120–150 km depth in cratonic lithospheric mantle. These velocities are higher than those of cratonic peridotites, even assuming a cold cratonic geotherm (i.e., 35 mW/m2 surface heat flux) and accounting for compositional heterogeneity in cratonic peridotite xenoliths and the effects of anelasticity. We reviewed various geophysical and petrologic constraints on the nature of cratonic roots (seismic velocities, lithology/mineralogy, electrical conductivity, and gravity) and explored a range of permissible rock and mineral assemblages that can explain the high seismic velocities. These constraints suggest that diamond and eclogite are the most likely high‐Vs candidates to explain the observed velocities, but matching the high shear‐wave velocities requires either a large proportion of eclogite (>50 vol.%) or the presence of up to 3 vol.% diamond, with the exact values depending on peridotite and eclogite compositions and the geotherm. Both of these estimates are higher than predicted by observations made on natural samples from kimberlites. However, a combination of ≤20 vol.% eclogite and ~2 vol.% diamond may account for high shear‐wave velocities, in proportions consistent with multiple geophysical observables, data from natural samples, and within mass balance constraints for global carbon. Our results further show that cratonic thermal structure need not be significantly cooler than determined from xenolith thermobarometry.
Validating GIC Models With Measurements in Austria: Evaluation of Accuracy and Sensitivity to Input Parameters
Authors: Bailey R. L. , Halbedl T. S. , Schattauer I. , Achleitner G. , Leonhardt R. 
Published: June 2018

AbstractSpace weather events can cause geomagnetically induced currents (GICs) in power transmission networks. Over the past years, these currents have been measured in multiple substations in Austria, and the measurements have been tested against a model of local GIC with the aim of producing an optimized model, which can be developed through evaluation of various input parameters. We show the impact the choice of the local resistivity, in particular the surface conductivity in thin‐sheet modeling, and the source of geomagnetic variations has on GIC modeling. In addition, the sensitivity of the model to the accuracy of the network configuration is also investigated. This encompasses the inclusion of power grids outside of Austria in the model as well as the consequences of removal of a substation either through transformer failure or active disconnection. Results show that a detailed surface conductivity model brings benefits to areas with large lateral conductivity variations and that there are certain substations that lead to increases and decreases of GIC in the rest of the network when removed. The importance of regionally representative geomagnetic field measurements is also highlighted and shown to impact model accuracy. This study concentrates on regional effects, but the results are also valid for large‐scale studies elsewhere.
Towards femtosecond on-chip electronics based on plasmonic hot electron nano-emitters
Authors: Karnetzky Christoph , Zimmermann Philipp , Trummer Christopher , Duque Sierra Carolina , Wörle Martin , Kienberger Reinhard , Holleitner Alexander 
Published: June 2018

AbstractTo combine the advantages of ultrafast femtosecond nano-optics with an on-chip communication scheme, optical signals with a frequency of several hundreds of THz need to be down-converted to coherent electronic signals propagating on-chip. So far, this has not been achieved because of the overall slow response time of nanoscale electronic circuits. Here, we demonstrate that 14 fs optical pulses in the near-infrared can drive electronic on-chip circuits with a prospective bandwidth up to 10 THz. The corresponding electronic pulses propagate in macroscopic striplines on a millimeter scale. We exploit femtosecond photoswitches based on asymmetric, nanoscale metal junctions to drive the pulses. The non-linear ultrafast response is based on a plasmonically enhanced, multiphoton absorption resulting in a field emission of ballistic hot electrons propagating across the nanoscale junctions. Our results pave the way towards femtosecond electronics integrated in wafer-scale THz circuits.