bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Excessive Daytime Sleepiness
Authors: O'Malley Mary B. 
Published: August 2016

The most common cause of sleepiness is sleep deprivation, which is often due to behaviorally induced sleep limitations. One method of preventing impaired or shortened sleep is to ensure good sleep hygiene. It is important to review with patients the principles of sleep hygiene so that they can rule out causal behaviors that might be relatively simple to correct. Principles of good sleep hygiene include maintaining a regular sleep/wake schedule, exposure to light in the morning hours, avoiding caffeine and nicotine especially 4–6 hours before bedtime, avoiding alcohol and heavy meals before sleep, regular exercise (vigorous exercise should be avoided 3–4 hours before sleep), limiting time in bed to the time spent sleeping, and allowing sufficient time to get comfortable and relaxed prior to sleep. Even if one can fall asleep after drinking alcohol or caffeine, sleep maintenance can be curtailed. Sensitivity to these stimulants is often apparent in the latter half of the night. People often fail to recognize that vigorous aerobic workouts close to bedtime makes it harder to fall asleep. This is because a revved up metabolism heats the body up, and thereby delays the normal cooling of the core body temperature which triggers the onset of sleep.One study assessed the sleep of 259 subjects using the Multiple Sleep Latency Test (MSLT), an objective measure of daytime sleepiness that assesses how quickly someone can fall asleep in conducive conditions. The results indicated that many people in the general population carry a very heavy burden of sleepiness (Slide 1). Many physicians were shown to carry pathological levels of sleepiness because of their heavy call schedules and their foreshortened sleep on nights that they are not on call. The average adult needs 8.2 hours of sleep per night, and not surprisingly many studies have found that the sleepiest adults spent ≤6 hours in bed. What makes matters worse is that insight into the impairments of sleepiness erodes rapidly, but other cognitive and somatic impairments continue to mount with regular chronic under-sleeping. When sleepiness is due to chronic sleep deprivation, treatment often consists of scheduling enough time in bed to allow for an adequate amount of sleep.
The Spectrum of Recurrent Thoughts and Behaviors in Frontotemporal Dementia
Authors: Mendez Mario F. , Shapira Jill S. 
Published: August 2016

ABSTRACTThis article describes the spectrum of recurrent thoughts and behaviors that can result from frontotemporal dementia (FTD) and its variants. Although repetitive behaviors can result from a range of brain disorders, FTD is the most common neurologic cause of new-onset recurrent thoughts and behaviors in middle or late life. Patients with FTD can manifest typical or bizarre compulsions, hoarding, verbal and motor stereotypies and complex tics; self-injurious acts, perseverations; and fixed, obsessional thoughts. The frequency and variability of these repetitive behaviors suggest a common disturbance of orbitofrontal-basal ganglia circuits involved in response inhibition. The amelioration of these recurrent events with the administration of serotonin selective reuptake inhibitors further suggests a serotonergic deficit.
Prevalence of Bipolar Depression
Authors: Post Robert M. 
Published: August 2016

Recent data indicate that bipolar illness is underdiagnosed and therefore undertreated in the community (Slide 1). A recent survey of >85,000 households in the United States found a 3.7% positive screen for prominent bipolar symptomatology. Using the Mood Disorder Questionnaire, which has good specificity and sensitivity in outpatient clinics, the study also found that the prevalence was higher, 9.3%, among patients 18–24 years of age. However, most disappointing was that only 20% of the positive screens were diagnosed as bipolar, and among those, most were not treated with mood stabilizers. In addition, 31% of patients had been diagnosed with unipolar depression. Several studies have shown that approximately 20% to 40% of presumptively unipolar patients actually have bipolar II or bipolar disorder not otherwise specified. Combined, the data show that bipolar disorder, bipolar depression in particular, is highly prevalent and often misdiagnosed or unrecognized.Two recent studies found virtually the same data showing that depression is the predominant problem in naturalistically treated bipolar outpatients. Judd and colleagues found that depression was three times more prevalent than mania in bipolar patients. This is exactly what was found in the Stanley Foundation bipolar outpatient follow-up study, which rated the study's first 258 patients every day for 1 year (Slide 2). The study found that patients were ill almost 50% of the time; they were depressed 33% of the days in the year, and hypomanic or manic 10.8% of the days. This occurred despite aggressive treatment with a variety of agents, such as mood stabilizers, antidepressants, and benzodiazepines in 50% of the patients, and typical or atypical neuroleptics in almost 50% of the patients. Thus, even bipolar patients who are intensively treated in academic settings have a very substantial degree of morbidity, particularly depression.
Antidepressant Effect of Mood Stabilizers
Authors: Baldassano Claudia F. 
Published: August 2016

Bipolar depression certainly poses the greatest challenge to clinicians treating bipolar patients. Having a widespread disability associated with it, bipolar depression is often chronic, is less responsive to medication treatment, and has a particularly high rate of suicide. There are currently no drugs approved by the Food and Drug Administration for the treatment of bipolar depression, although full trials have been conducted with lithium, the antipsychotic olan-zapine, and the antiepileptic (AED) lamotrigine. Data for the other AEDs are quite limited and not controlled. The American Psychiatric Association guidelines recommends maximizing the dose in patients who are already on a mood stabilizer and initiating lithium or lamotrigine in patients who are not on a mood stabilizer.Zornberg and Pope reviewed nine studies comparing lithium to placebo in bipolar depression. Among the 145 patients in these studies, there was detectable response in 79% and an unequivocal response in 36%. Although the studies varied in their methodological design and rigor, they argue quite strongly that lithium is an effective anti-depressant. In addition, six of the seven pre1990 studies evaluating lithium for bipolar depression indicated that the drug had significant antidepressant effects.The most recent study of lithium for bipolar depression randomly assigned 117 outpatients with acute bipolar depression to treatment with either placebo, Imipramine, or paroxetine. At the 10-week study endpoint, lithium monotherapy was as effective as the addition of an antidepressant, suggesting lithium's antidepressant properties.
Aspetti psicosociali delle condotte suicidarie in Italia. Un'analisi trasversale e multivariata su dati aggregati
Authors: Crepet Paolo , Micciolo Rocco 
Published: August 2016

SummaryObjective- To analyse suicide trends in Italy and to correlate suicide rates with psychosocial indicators.Design- Cross-sectional analysis of aggregate data at national level (1960-1990).Setting- Italy.Main outcome measures- Mortality rates (deaths for suicide, mental disorders and homicide), hospital admission rates (for schizophrenia, neurosis and affective psychosis), unemployment rates, alcohol consumption. Principal components of the correlation matrix calculated on the psychosocial indicators.Results- The study indicates that a slight increate in suicide rates has been recorded among males (+10,7%) but not among females. The regions with the highest suicide rate are the Northern ones (up to twice the national average). The age groups with the highest suicide risk are those over 70 years. In females and males over 65 between 1974 and 1989 the suicide rate rose by 70% and 77% respectively. Between 1978 and 1989, the suicide rate among the people in search of a first job rose by 25%, among the employed it rose by 35%, while among the people in search of a new job it rose by 594%. Correlation between admission and suicide rates shows negative figure both for affective psychosis and neurosis, wherelse the correlation with schizophrenia is positive. The correlation with death both by mental disorders and homicide is positive. The correlation with death both by mental disorders and homicide is positive. The correlation between suicide and alcohol consumption is negative, while that with unemployment is positive. Principal components analysis showed a first component, wich explained more then 60% of the general variation, highly correlated with suicide rates.
Interventi psicoterapici nei dipartimenti di salute mentale di Napoli: un'indagine sulle scelte e sulla qualificazione degli operatori
Authors: Morlino Massimo , Martucci Giuseppe , Amendola Davide , Muscettola Giovanni 
Published: August 2016

SummaryObjective - To survey and analyse the extent of utilization of «Non Pharmacological Interventions» (NPI) in the public mental health services of a large city. Setting - Inteview of the entire medical staff employed in 1991 in 10 Departments of Mental Health in the urban area of Naples, Italy. Main measures - A «ad hoc» questionnaire was prepared to gather informations on prevalence of use on NPI in different therapeutic settings, the selected technique according to the different diagnostic categories and the degree of professional training of the interviewed medical personnel. Result - The NPI, as the only treatment, was preferred by the large majority (86%) of the medical staff. The patients treated with NPI was double in outpatient than in inpatient. Although the medical staff did not use the same diagnostic criteria (ICD-9, DSM-III, others) anxiety (49%) and personality disorders (14,3%) were the diagnostic categories most commonly selected for NPI. At the time of the survey 24% of the patients were treated with psychotherapy. Support psychoterapy, psychoanalysis, family therapy were the most frequently employed. The support psychotherapy was mainly used in treatment of schizophrenia. Near to 50% of the medical staff reported a combined use of up to five different NPI. By and large choice of NPI was found dependent on the type of training and inversly correlated with the degree of seniority. Conclusions - The data obteined from the present survey show the large use and variability in NPI employed in public mental health services. The analysis of psycotherapy used suggests a different approach between public and private sector.
Prevalenza dei disturbi affettivi (DSM-IIIR) nei pazienti di un reparto di medicina geriatrica. Uno studio epidemiologico con controlli della popolazione generale
Authors: Turrina Cesare , Steinmayr Maria , Piasere Orazio , Siciliani Orazio 
Published: August 2016

SummaryObjective - To investigate the rate of DSM-IIIR main affective disorders in a sample (52) of elderly medical patients consecutively admitted to a geriatric ward; to look for risk factors associated with depression; to compare the rate of depression with the one detected in community controls (117 subjects). Design - All consecutive patients admitted during January-February 1990 were assessed with a standardized psychiatric interview (Geriatric Mental State Examination) and with the Mini-Mental State Examination. Setting - The IV Geriatric Division (ward and day-hospital), Ospedale Civile Maggiore of Verona, which cares for elderly affected by medical illnesses. Main outcome measures - Depression was diagnosed according to the main DSM-IIIR categories for mood disorders. Results - Overall, an affective disorder was diagnose in 25% of the subjects (major depression 5,7%, dysthymic disorder 3,8%, n.o.s. depression 13,4%, adjustment disorder with depressive mood 1,9%). This rate was significantly higher when compared with the prevalence detected in community controls (25% vs. 11,1%). Older age, female sex, physical disability and distressing events were not associated with affective illness, while the lack of social support was significantly associated with depression. Conclusions - Elderly medical patients turned out to be an high risk group for depression, which deserves psychiatric screening and specific treatment.
Epidemiologia e psichiatria: considerazioni di metodo
Authors: Vineis Paolo 
Published: August 2016

SummaryPsychiatry has been, among medical disciplines, the one showing the highest conflict between a «positivist» model and the «hermeneutic» tradition. In particular, in recent years several authors have suggested that both the scientific method and a scientific mentality should be introduced in psychiatric practice and research. They claim that criteria like a strong correlation among clearly defined signs and symptoms, a high predictive value towards the outcome and therapeutical response, and a clearly defined relationship between the symptoms and etiology are necessary to accept a diagnositc entity. Since in the case of e.g. schizofrenia such requirements are not met, some authors even suggest that the concept of schizofrenia should be abandoned. The present paper aims to show that such problems are not unique to mental disease, but are common to several branches of medicine. For example, the definition and classification of cancer follow a «polythetic» criterion which is similar to the concept of «family resemblances». Also, diagnostic reproducibility is often low in other medical disciplines. The paper examines how such methodological problems could be dealt with using the tools of epidemiology.
Beurteilung von Kindern und Jugendlichen in Erziehungshilfen mit dem Kompetenzanalyseverfahren (KANN)
Authors: Suing Martina , Brochhagen-Beier Birgit Maria , Gollan Tobias , Petermann Franz , Waldmann Hans-Christian , Schmidt Martin H. , Sinzig Judith 
Published: August 2016

Zusammenfassung. Das Kompetenzanalyseverfahren (KANN) ist ein Fremdbeurteilungsverfahren für Eltern und pädagogische Fachkräfte zur Beurteilung beobachtbarer Kompetenzen von Kindern und Jugendlichen. In der Studie wird untersucht, ob, und wenn ja, inwiefern sich die Unterschiede zwischen den zwei Normstichproben (Schulnorm/Elternurteil vs. Kinder- und Jugendhilfe-Norm/Urteil pädagogischer Fachkräfte) durch (1) die Reliabilität des Messinstruments, (2) systematische Beurteilertendenzen und/oder (3) Kompetenzdefizite von Kindern und Jugendlichen in Erziehungshilfen erklären lassen. Hierzu wurden die Intra-/Interrater-Reliabilität und -Übereinstimmung an vier Stichproben aus dem Bereich der Erziehungshilfen analysiert: (A) Pädagoge/-in A – A (Test-Retest), n = 153; (B) Pädagoge/-in A – B, n = 169; (C) Mutter–Vater, n = 26 und (D) Pädagoge/-in – Elternteil, n = 136. Die Ergebnisse weisen auf eine gute Intra-/Interrater-Reliabilität und eine akzeptable Übereinstimmung im Urteil pädagogischer Fachkräfte hin. Zwischen unterschiedlichen Beurteilertypen (Pädagoge/-in – Elternteil), lässt sich eine deutlich niedrigere Interrater-Reliabilität und -Übereinstimmung feststellen. Der Vergleich des Elternurteils mit den beiden Normstichproben verdeutlicht die unterdurchschnittlichen KANN-Werte von Kindern und Jugendlichen in Erziehungshilfen. Eine Überschätzungstendenz der Eltern ist wahrscheinlich.
Konzentrationsdiagnostik bei Grundschulkindern
Authors: Brunnemann Nicole , Sparfeldt Jörn R. 
Published: August 2016

Zusammenfassung. Konzentration gilt als bedeutsames Korrelat und als Prädiktor erfolgreichen Lern- und Arbeitsverhaltens. Insbesondere bei Grundschulkindern wurde wiederholt die Güte entsprechender Testverfahren bezweifelt. Zur psychometrischen Prüfung bearbeiteten Viertklässlerinnen und Viertklässler (N = 530) drei Testverfahren: (a) die Testreihe zur Prüfung der Konzentrationsfähigkeit (TPK; Kurth & Büttner, 1999 ) mit schulnäheren Aufgaben (Abschreibtext, einfache Rechenaufgaben, Merkaufgabe) sowie – mit schulferneren Aufgaben – (b) den Aufmerksamkeits- und Konzentrationstest (d2-R; Brickenkamp, Schmidt-Atzert & Liepmann, 2010 ), einen Durchstreichtest, und (c) den Zahlen-Verbindungs-Test (ZVT; Oswald & Roth, 1978 ). Zusätzlich schätzten Klassenlehrkräfte (N = 31) die Konzentrationsleistung der Kinder ein. Die psychometrischen Manualkennwerte wurden weitgehend repliziert. Konzentrationsleistungskennwerte innerhalb und zwischen Tests korrelierten moderat, konfirmatorisch zeigte ein Generalfaktor eine gute Modellpassung. Die von den Lehrkräften und Schulkindern eingeschätzten Konzentrationsleistungen korrelierten moderat mit der Testleistung in schulnäheren und niedriger in schulferneren Aufgaben. Die Befunde werden vor dem Hintergrund einer konstruktvaliden Konzentrationsdiagnostik diskutiert.
Metal stressors consistently modulate bacterial conjugal plasmid uptake potential in a phylogenetically conserved manner
Authors: Klümper Uli , Dechesne Arnaud , Riber Leise , Brandt Kristian K , Gülay Arda , Sørensen Søren J , Smets Barth F 
Published: August 2016

Abstract
The environmental stimulants and inhibitors of conjugal plasmid transfer in microbial communities are poorly understood. Specifically, it is not known whether exposure to stressors may cause a community to alter its plasmid uptake ability. We assessed whether metals (Cu, Cd, Ni, Zn) and one metalloid (As), at concentrations causing partial growth inhibition, modulate community permissiveness (that is, uptake ability) against a broad-host-range IncP-type plasmid (pKJK5). Cells were extracted from an agricultural soil as recipient community and a cultivation-minimal filter mating assay was conducted with an exogenous E. coli donor strain. The donor hosted a gfp-tagged pKJK5 derivative from which conjugation events could be microscopically quantified and transconjugants isolated and phylogenetically described at high resolution via FACS and 16S rRNA amplicon sequencing. Metal stress consistently decreased plasmid transfer frequencies to the community, while the transconjugal pool richness remained unaffected with OTUs belonging to 12 bacterial phyla. The taxonomic composition of the transconjugal pools was distinct from their respective recipient communities and clustered dependent on the stress type and dose. However, for certain OTUs, stress increased or decreased permissiveness by more than 1000-fold and this response was typically correlated across different metals and doses. The response to some stresses was, in addition, phylogenetically conserved. This is the first demonstration that community permissiveness is sensitive to metal(loid) stress in a manner that is both partially consistent across stressors and phylogenetically conserved.
Identification of disease-specific motifs in the antibody specificity repertoire via next-generation sequencing
Authors: Pantazes Robert J. , Reifert Jack , Bozekowski Joel , Ibsen Kelly N. , Murray Joseph A. , Daugherty Patrick S. 
Published: August 2016

AbstractDisease-specific antibodies can serve as highly effective biomarkers but have been identified for only a relatively small number of autoimmune diseases. A method was developed to identify disease-specific binding motifs through integration of bacterial display peptide library screening, next-generation sequencing (NGS) and computational analysis. Antibody specificity repertoires were determined by identifying bound peptide library members for each specimen using cell sorting and performing NGS. A computational algorithm, termed Identifying Motifs Using Next- generation sequencing Experiments (IMUNE), was developed and applied to discover disease- and healthy control-specific motifs. IMUNE performs comprehensive pattern searches, identifies patterns statistically enriched in the disease or control groups and clusters the patterns to generate motifs. Using celiac disease sera as a discovery set, IMUNE identified a consensus motif (QPEQPF[PS]E) with high diagnostic sensitivity and specificity in a validation sera set, in addition to novel motifs. Peptide display and sequencing (Display-Seq) coupled with IMUNE analysis may thus be useful to characterize antibody repertoires and identify disease-specific antibody epitopes and biomarkers.
Comparison of CT and MRI in Diagnosis of Laryngeal Carcinoma with Anterior Vocal Commissure Involvement
Authors: Wu Jian-hui , Zhao Jing , Li Zeng-hong , Yang Wei-qiang , Liu Qi-hong , Yang Zhi-yun , Liao Bing , Li Xiao-ling , Wang Bin , Qin Hao , Luo Jie , Lv Ke-xing , Wen Wei-ping , Lei Wen-bin 
Published: August 2016

AbstractThis study aimed to compare the accuracy of CT and MRI in determining the invasion of thyroid cartilage by and the T staging of laryngeal carcinoma with anterior vocal commissure (AVC) involvement. A total of 26 cases of laryngeal carcinomas with AVC involvement from May 2012 to January 2014 underwent enhanced CT and MRI scan, out of whom 6 patients also underwent diffusion-weighted magnetic resonance imaging(DWI). T staging and thyroid cartilage involvement were evaluated. All the surgical specimens underwent serial section and were reviewed by two senior pathologists independently. When compared with pathologic staging, the accuracy was 88.46% (23/26) of MRI scan (with a 95% confidence interval 37~77%) and 57.69% (15/26) of CT scan (with a 95% confidence interval 70~98%), respectively (P < 0.01). We also reported three cases who were misdiagnosed on CT or MRI about either the thyroid cartilage was involved or not, and one case of preliminary study of DWI. Compared to CT, MRI exhibited a higher accuracy rate on T staging of laryngeal carcinomas with AVC involvement. Combined utility of CT and MRI could help improve the accuracy of assessment of thyroid cartilage involvement and T staging of laryngeal carcinomas with AVC involvement.
CCN concentrations and BC warming influenced by maritime ship emitted aerosol plumes over southern Bay of Bengal
Authors: Ramana M. V. , Devi Archana 
Published: August 2016

AbstractSignificant quantities of carbon soot aerosols are emitted into pristine parts of the atmosphere by marine shipping. Soot impacts the radiative balance of the Earth-atmosphere system by absorbing solar-terrestrial radiation and modifies the microphysical properties of clouds. Here we examined the impact of black carbon (BC) on net warming during monsoon season over southern Bay-of-Bengal, using surface and satellite measurements of aerosol plumes from shipping. Shipping plumes had enhanced the BC concentrations by a factor of four around the shipping lane and exerted a strong positive influence on net warming. Compiling all the data, we show that BC atmospheric heating rates for relatively-clean and polluted-shipping corridor locations to be 0.06 and 0.16 K/day respectively within the surface layer. Emissions from maritime ships had directly heated the lower troposphere by two-and-half times and created a gradient of around 0.1 K/day on either side of the shipping corridor. Furthermore, we show that ship emitted aerosol plumes were responsible for increase in the concentration of cloud condensation nuclei (CCN) by an order of magnitude that of clean air. The effects seen here may have significant impact on the monsoonal activity over Bay-of-Bengal and implications for climate change mitigation strategies.