bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in dose and plasma level of lamotrigine in patients discharged from a mental health trust
Authors: Douglas-Hall Petrina , Dzahini Olubanke , Gaughran Fiona , Bile Ahmed , Taylor David 
Published: October 2016

Background: The objectives of this study were to investigate the dose of lamotrigine when prescribed with an enzyme inhibitor or enzyme inducer in patients discharged from a mental health trust and to determine the corresponding lamotrigine plasma concentrations and the factors that may affect these. Methods: All patients discharged on lamotrigine between October 2007 and September 2012 were identified using the pharmacy dispensing database. We recorded demographic details, lamotrigine dose and plasma levels and coprescribed medication. Results: During the designated period, 187 patients were discharged on lamotrigine of whom 117 had their plasma levels recorded. The mean lamotrigine daily dose was 226.1 mg (range 12.5–800 mg) and the mean plasma level 5.9 mg/l (range 0.8–18.1 mg/l). Gender, ethnicity, diagnosis and smoking status had no significant effect on dose or plasma levels. Patients taking an enzyme-inducing drug ( n = 6) had significantly lower plasma levels [mean (SD) 3.40 (1.54) mg/l] than those not taking enzyme inducers [ n = 111; 6.03 (3.13) mg/l; p = 0.043]. Patients taking an enzyme-inhibiting drug ( n = 23) had significantly higher levels [7.47 (3.99) mg/l] than those not taking an inhibitor [ n = 94; 5.52 (2.75) mg/l; p = 0.035]. No significant difference was found between the doses of lamotrigine in patients taking an enzyme inhibitor and those not taking one ( p = 0.376). No significant difference was found between the doses of lamotrigine in patients taking an enzyme-inducing drug and those not taking any ( p = 0.574). Conclusions: Current dosing recommendations indicate that lamotrigine doses should be halved in individuals taking enzyme inhibitors and doubled in those on enzyme inducers. In our survey these recommendations were rarely followed with the consequence that patients received too high or too low a dose of lamotrigine, respectively.
The effect of long-acting paliperidone palmitate once-monthly on negative and depressive symptoms in patients with schizophrenia switched from previous unsuccessful treatment with oral aripiprazole
Authors: Schreiner Andreas , Bergmans Paul , Cherubin Pierre , Hargarter Ludger 
Published: October 2016

Background: The negative symptoms of schizophrenia are generally harder to recognize, more difficult to treat than positive symptoms, and have a significant impact on patient functioning and overall outcomes. Treatment with aripiprazole may be associated with benefits on negative symptoms and functioning given its partial agonism to the dopamine D2 receptor. The aim of this subanalysis was to explore the impact of flexibly dosed, long-acting paliperidone palmitate once monthly (PP1M) on negative and depressive symptoms, disorganized thoughts, anxiety, extrapyramidal symptoms, and patient functioning in nonacute adult patients with schizophrenia previously unsuccessfully treated with oral aripiprazole monotherapy. Methods: Post-hoc subanalysis of 46 nonacute but symptomatic patients enrolled in a prospective, interventional, single-arm, multicenter, open-label 6-month study. Results: At endpoint, improvements of ⩾ 20% and ⩾ 50% in the Positive and Negative Syndrome Scale (PANSS) total score were observed in 52.2% and 21.7% of patients, respectively. Significant and clinically relevant improvements were observed at endpoint in mean (standard deviation [SD]) PANSS negative subscale score (−3.0 (5.0); p < 0.0001) and in the PANSS Marder factor scores for negative symptoms (−2.9 (5.4); p = 0.0006), disorganized thoughts (−2.8 (4.3); p < 0.0001) and anxiety/depression (−1.8 (3.9); p = 0.0031). Patient functioning assessed by mean (SD) Personal and Social Performance scale score (3.9 (13.2); p = 0.0409), Mini International Classification of Functioning rating for Activity and Participation Disorders in Psychological Illnesses total scores (−2.9 (7.1); p = 0.0079), and Extrapyramidal Symptom Rating Scale scores (−0.6 (3.4); p = 0.0456) improved significantly at endpoint. PP1M was well tolerated with no new safety signals. Conclusions: Six-month treatment with flexibly dosed PP1M was associated with significant and clinically relevant improvements in negative and depressive symptoms, disorganized thoughts, functioning, and extrapyramidal symptoms in nonacute but symptomatic patients with schizophrenia previously unsuccessfully treated with oral aripiprazole.
Predicting ADR from PDR and individual adenoma‐to‐polyp‐detection‐rate ratio for screening and surveillance colonoscopies: A new approach to quality assessment
Authors: Schramm C , Scheller I , Franklin J , Demir M , Kuetting F , Nierhoff D , Goeser T , Toex U , Steffen HM 
Published: October 2016

Background and aimsAdenoma detection rate (ADR) has been established as a quality indicator for screening colonoscopy. Because ADR is cumbersome to obtain in routine practice, polyp detection rate (PDR), polypectomy rate (PR) and adenoma‐to‐polyp‐detection‐rate‐ratio (APDRR) have been proposed to estimate ADR. This study aimed to evaluate APDRR in order to estimate ADR (ADRest ) in different settings.MethodsAverage risk screening and surveillance colonoscopies from a community‐based private practice and a tertiary academic hospital setting were retrospectively evaluated. APDRR was calculated as averaged group APDRR for all study procedures (APDRR) and for the first half of study procedures of each gastroenterologist (APDRRag ) or individually for each gastroenterologist on the basis of his or her first 25, 50 and 100 colonoscopies (APDRRind ). ADRest was determined from PDR by using APDRR, APDRRag, and APDRRind, respectively.ResultsA total of 2717 individuals were analyzed. Using APDRR, significant correlations between ADR and ADRest were observed for the entire (0.944, p  < 0.001), proximal (0.854, p  < 0.001), and distal (0.977, p  < 0.001) colon. These correlations were lost when APDRRag was used to estimate each gastroenterologist’s ADR for the second half of his or her included colonoscopies. However, ADR and ADRest correlated significantly with a root‐mean‐square‐error of 6.8% and 5.8% when APDRRind on the basis of each gastroenterologist’s first 50 and 100 colonoscopies was used for subsequent colonoscopies.ConclusionsADR for subsequent colonoscopies of an individual endoscopist can be reliably estimated from PDR by using an individually calculated APDRR. Prospective studies are needed to verify this promising approach in different practice settings.
The NLRP3 inflammasome functions as a driver of the myelodysplastic syndrome phenotype
Authors: Basiorka Ashley A. , McGraw Kathy L. , Eksioglu Erika A. , Chen Xianghong , Johnson Joseph , Zhang Ling , Zhang Qing , Irvine Brittany A. , Cluzeau Thomas , Sallman David A. , Padron Eric , Komrokji Rami , Sokol Lubomir , Coll Rebecca C. , Robertson Avril A. B. , Cooper Matthew A. , Cleveland John L. , O’Neill Luke A. , Wei Sheng , List Alan F. 
Published: October 2016

Key Points
Key biological features of MDSs are explained by NLRP3 inflammasome activation, which drives pyroptotic cell death and β-catenin activation. Alarmin signals and founder gene mutations license this redox-sensitive inflammasome platform.
MGUS to myeloma: a mysterious gammopathy of underexplored significance
Authors: Dhodapkar Madhav V. 
Published: October 2016

Abstract
All cases of multiple myeloma (MM) are preceded by precursor states termed monoclonal gammopathy of undetermined significance (MGUS) or smoldering myeloma (SMM). Genetic analyses of MGUS cells have provided evidence that it is a genetically advanced lesion, wherein tumor cells carry many of the genetic changes found in MM cells. Intraclonal heterogeneity is also established early during the MGUS phase. Although the genetic features of MGUS or SMM cells at baseline may predict disease risk, transition to MM involves altered growth of preexisting clones. Recent advances in mouse modeling of MGUS suggest that the clinical dormancy of the clone may be regulated in part by growth controls extrinsic to the tumor cells. Interactions of MGUS cells with immune cells, bone cells, and others in the bone marrow niche may be key regulators of malignant transformation. These interactions involve a bidirectional crosstalk leading to both growth-supporting and inhibitory signals. Because MGUS is already a genetically complex lesion, application of new tools for earlier detection should allow delineation of earlier stages, which we term as pre-MGUS. Analyses of populations at increased risk of MGUS also suggest the possible existence of a polyclonal phase preceding the development of MGUS. Monoclonal gammopathy in several patients may have potential clinical significance in spite of low risk of malignancy. Understanding the entire spectrum of these disorders may have broader implications beyond prevention of clinical malignancy.
Imaging for Adults With Seizures and Epilepsy
Authors: Lapalme-Remis Samuel , Cascino Gregory D. 
Published: October 2016

ABSTRACT

Purpose of Review: This article discusses structural and functional neuroimaging findings in patients with seizures and epilepsy. The indications for neuroimaging in these patients and the potential diagnostic utility of these studies are presented.

Recent Findings: Patients presenting with new seizures typically require urgent imaging to rule out a critical underlying cause. MRI is the structural neuroimaging procedure of choice in individuals with epilepsy. Specific epilepsy protocols should be considered to increase the diagnostic yield of neuroimaging in patients with structural lesions associated with focal or generalized seizures. Common epileptogenic pathologic processes include mesial temporal sclerosis, malformations of cortical development, focal encephalomacia, primary brain tumors, vascular malformations, and neurocysticercosis. Functional neuroimaging studies are usually restricted to the evaluation of patients with drug-resistant focal epilepsy who are being considered for surgical treatment.

Summary: The role of neuroimaging in epilepsy depends on the appropriate clinical indication. In patients without known epilepsy presenting with acute seizures, structural imaging is essential to rule out an underlying etiology (eg, subdural hematoma) that may require a specific therapeutic intervention. In individuals with new or previously uninvestigated epilepsy, MRI serves multiple purposes, including identifying a causative focal lesion and helping to diagnose the epilepsy type. In a significant number of patients with epilepsy, the MRI results are normal or reveal indeterminate findings. For patients with drug-resistant focal epilepsy, functional neuroimaging techniques, such as fludeoxyglucose-positron emission tomography (FDG-PET), ictal single-photon emission computed tomography (SPECT), or functional MRI (fMRI), may assist in surgical planning, especially in patients with MRI-negative epilepsy, whose prognosis for a seizure-free outcome after surgery is worse than for patients with an epileptogenic lesion on structural MRI.
Potential Safety Issues Related to the Use of Gadolinium-based Contrast Agents
Authors: Pinter Nandor K. , Klein Joshua P. , Mechtler Laszlo L. 
Published: October 2016

ABSTRACT

Purpose of Review: This article reviews recent research on gadolinium deposit formation in the brain linked to contrast-enhanced MRI studies.

Recent Findings: Human and animal studies have confirmed the presence of gadolinium in the brain following the serial administration of gadolinium-based contrast agents. This is a relatively new and growing field of research primarily driven by concerns regarding unknown and potentially harmful side effects of gadolinium-based contrast agents. Retrospective observational in vivo studies in humans demonstrated T1 shortening effects in the brain parenchyma resulting from gadolinium exposure. These studies were followed by postmortem human and animal studies. Evidence exists that gadolinium may cause deposits in the brain and that this may occur independently of impaired renal function and in the presence of an intact blood-brain barrier. Gadolinium deposition has been linked primarily with the use of linear, rather than macrocyclic, gadolinium-based contrast agents.

Summary: The formation of gadolinium deposits and its implications have been the focus of only a small number of research groups. The currently available data must be verified, and the potential factors that may be linked to this phenomenon and the clinical significance must be explored. Depending on future findings, changes in the clinical application of gadolinium-based contrast agents may be expected.
Imaging of Pituitary and Parasellar Disorders
Authors: Fenstermaker Robert , Abad Ajay 
Published: October 2016

ABSTRACT

Purpose of Review: This article reviews sellar and parasellar anatomy and the appearance of normal bone and soft tissue components on both CT and MRI. Pituitary gland structure and function are discussed with respect to hormone secretion, along with clinical syndromes caused by perturbations in hormone levels. Syndromes and specific diseases in the sellar and parasellar regions are discussed along with characteristic clinical features and imaging findings.

Recent Findings: Bone and calcifications are best visualized with CT scans, while soft tissues are better defined using MRI. Some lesions have characteristic enhancement patterns with contrast; the presence of delayed contrast uptake further narrows the differential.

Summary: Lesions that commonly occur in the sellar and parasellar region include benign and malignant tumors, cysts, vascular pathology, inflammatory processes, and abscesses. Knowledge of sellar and parasellar anatomy and attention to the use and interpretation of various imaging modalities can be of great assistance to the clinician when formulating a differential diagnosis for lesions in this region.
LUBRICANT TEMPERATURE INFLUENCE UPON PULSE HYDROPNEUMATIC DRIVE OPERATION
Authors: Калашникова Наталия , Kalashnikova Nataliya , Грядунова Елена , Gryadunova Elena , Журавлева Анжелика , Zhuravleva Anzhelika , Горина Мария , Gorina Mariya , Горин Андрей , Gorin Andrey 
Published: October 2016

A pulse hydropneumatic drive can make a percussive effect up to 15,000 J. A head carrying out a pulse effect (a blow) on an object is cocked in an operation position by liquid. At the same time occurs a compression of a working body (gas) in a gas accumulator. The pulse influence occurs because of head acceleration at the expense of a working body in a pneumatic accumulator.
The operation of a pulse hydropneumatic drive depends on a number of parameters: viscosity and temperature of operating fluid, pressure of pneumatic accumulator initial charge and others. In the course of work oil becomes warm because of a high rate of travel in control equipment of a pulse drive in hydromains that results in changes in blow energy.
A simulator describing stages and acceleration of the head of a pulse hydro-pneumatic drive. As a result of a numerical experiment carried out in the en-vironments of Mathcad and Matlab there are obtained dependences of blow energy upon working liquid tem-perature.
To investigate the influence of different parameters of a pulse hydro-pneumatic drive upon its operation was designed and carried out a test bench which allows changing different parameters of a drive in a wide range. The experimental dependences of blow energy upon temperature of a working body and the dependences of blow energy upon working liquid viscosity are obtained. A comparative analysis of theoretical and experimental results which has given good convergence is carried out.
The conclusions obtained: the operation of a pulse hydro-pneumatic drive is effected greatly both by the viscosity of a working body, and its temperature; the best values of head energy correspond to the mean viscosity of working liquid; to obtain a constant of blow energy it is necessary to use working liquids with stable viscosity at high tempera-tures: it is expedient that different additives should be used in working liquid to reduce a constant of friction and wear-resistance increase.
DYNAMIC ANALYSIS PECULIARITIES OF SUSPENSION TRUCK TRAVEL IN BRIDGE CRANE WITH LINEAR DRIVE
Authors: Денисов Илья , Denisov Ilya , Гончаров Кирилл , Goncharov Kirill , Ильин Евгений , Ilin Evgeniy 
Published: October 2016

The paper reports the results of a dynamic analysis of suspension truck travel in a bridge crane with a linear drive. As compared with the existing designs this drive possesses a number of advantages and distinguishing capacities which should be taken into account at the formation of dynamic models. So, the interaction force between the elements of an electric motor affects the resistance value to a truck travel of friction forces.
A nominal operating rate of linear electric motors exceeds 1 m/sec. The operating rates of the travel of most loadlifting machines and their separate elements are within the bounds of 0.1 – 1 m/sec. It is evident that even to maintain the same rate of travel the introduction of a control system is necessary. On the other hand, linear electric motors with the control systems possess high dynamic characteristics and may be used to reduce load oscillations on a flexible suspension which is particularly significant for technological cranes.
A dynamic analysis is carried out for a singlemass and doublemass models. The results of computations confirmed a necessity for the drive control to obtain a working speed of movement and also to reduce load oscillations and dynamic loads upon mechanisms and a metal structure of a loadlifting machine. The analysis has also shown that a singlemass model does not give a complete comprehension of changes in a speed of a mechanism at acceleration and it should not be used at the design computations of movement mechanisms of this type.
EXPERIMENTAL INVESTIGATION OF QUALITY METRICS FORMATION PROCESS DURING PLASTIC MILLING
Authors: Черданцев Павел , Cherdantsev Pavel , Марков Андрей , Markov Andrey , Катаева Софья , Kataeva Sofya , Гайст Сергей , Gayst Sergey , Лапенков Евгений , Lapenkov Evgeniy 
Published: October 2016

Composite materials are widely used in mechanical engineering, but at edge cutting machining, in particular, during milling these materials a number of peculiarities arise which must be taken into account at the definition of cutting modes and design-geometrical parameters of cutters. Besides, new composite materials machining does not allow using effectively the recommendations developed earlier. In such a way, to solve such a problem it is necessary to carry out experimental investigations on the analysis of the influence of milling mode characteristics and design-geometrical of a tool upon values of roughness of a surface processed and tool wear. As a cutter for investigations there were taken hardmetal endmilling cutters of TC-8 (tungstencobalt) type, the experimental samples – pipes made of composite material with oblique longi-tudinal-transverse fiber winding (OLTFW). As varied parameters were adopted cutting modes: cutting speed V, m/min, feed S, mm/tooth and milling depth t, mm. During the experiments were controlled the following parameters: tool wear Δ, mkm, roughness of the surface Ra, mkm and a depth of a faulty layer h, mkm.
To carry out the experiments there was offered an original design of an assembly milling cutter which allows defining in an experimental way optimum geo-metrical parameters of a tools to achieve output milling parameters specified. On the basis of experiments data there are obtained dependences allowing the estimate of parameter modes influence upon the period of cutter duration at the same time a temperature is affected mostly by a milling depth and a feed on a tooth affects the wear of an end flank.
OPTICAL CIRCUITS OF HOLOGRAPHIC CONTROL PLANT OF MICRORELIEF FORMATION PROCESS
Authors: Поярков Вячеслав , Poyarkov Vyacheslav , Белкин Евгений , Belkin Evgeniy , Марков Олег , Markov Oleg 
Published: October 2016

One of the ways allowing the increase of accuracy and control devices potentialities consists in the use of system complexes investigating a holographic image of an object under control.
The design peculiarities of system complexes of this set allow using module-geometrical approach for the simulation of a surface investigated.
The modulegeometrical approach allows, in its turn, obtaining the topography of a microrelief with an analytical description and conservation of a natural surface curvature and also a threedimensional model of an aerohydrodynamic surface with a complex shape which is a smooth module connection having also an analytical presentation.
To obtain a holographic image of an object which allows fixing geometrical characteristics in a nanointerval are used the circuits of image recording through Leight-Upatnieks method.
There is developed and approbated an optical circuit of a profilograph scanning a holographic image of an object in a visible interval of electro-magnetic waves and allowing the reception of surface characteristic for structuring its threedimensional model on the basis of a modulegeometrical approach.
The circuit of a roentgenoprofilograph for active control of microrelief formation is developed.
INFLUENCE OF USE COMPLETENESS OF ENGINEERING SYSTEM MODEL UPON ACCURACY AND ADEQUACY OF RELIABILITY ASSESSMENT
Authors: Елисеева Татьяна , Eliseeva Tatyana 
Published: October 2016

An overall purpose of researches – improvement of assessment methods of engineering systems reliability at the stage of design.
To achieve the end specified within the bounds of the investigation there was established that one of the most significant factors defining the effectiveness of the reliability assessment at the stage of designing is the completeness of a model used. For the assessment of model completeness by the example of a failure tree it was offered to determine a correlation between levels of a logical model of reliability and kinds of engineering consistency regulated by RSS 30709-2002 “Engineering Consistency. Terms and Definitions”. Within the bounds of the paper there is analyzed a minimum set of the sorts engineering consistency (dimensional consistency of system elements, compatibility of ele-ments according to reliability, interoperability) the account of which requires various degrees of detailed elaboration of a model and supposes the existence of corresponding source data including those established at the identification of logic connections between failures and the analysis of possible failures caused by a common reason.
For the systematization of research results there is developed a matrix of correlation of analyzed kinds of engineering consistency with the levels of a failure tree and the values of the assessment of a quadratic means of deviation (QMD) of expected results. The mathematical dependences allowing the definition of QMD values at every level of the logic model of relia-bility are developed. To account for the progressive-ness of a QMD value at the decrease of assessment reliability by analogy with Taguchi function of losses it is offered to use a parabolic dependence. The approach offered is particularly urgent for methods where the accuracy of results obtained determines the degree of a risk of manufacturers caused by wrong or untimely management or technical decision-makings. The trend of risk changes for manufacturers depending on QMD of a resultant value allows explaining diagrams presented in the paper.
The results obtained explain the dependence of accuracy and reliability of a reliability assessment on the completeness of use of the model and show a trend of the influence of parameters pointed out upon risk probability of manufacturers at the decisionmaking at the stage of designing.