bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolic Flexibility: Hibernation, Torpor, and Estivation
Authors: Staples James F. 
Published: March 2016

ABSTRACTMany environmental conditions can constrain the ability of animals to obtain sufficient food energy, or transform that food energy into useful chemical forms. To survive extended periods under such conditions animals must suppress metabolic rate to conserve energy, water, or oxygen. Amongst small endotherms, this metabolic suppression is accompanied by and, in some cases, facilitated by a decrease in core body temperature—hibernation or daily torpor—though significant metabolic suppression can be achieved even with only modest cooling. Within some ectotherms, winter metabolic suppression exceeds the passive effects of cooling. During dry seasons, estivating ectotherms can reduce metabolism without changes in body temperature, conserving energy reserves, and reducing gas exchange and its inevitable loss of water vapor. This overview explores the similarities and differences of metabolic suppression among these states within adult animals (excluding developmental diapause), and integrates levels of organization from the whole animal to the genome, where possible. Several similarities among these states are highlighted, including patterns and regulation of metabolic balance, fuel use, and mitochondrial metabolism. Differences among models are also apparent, particularly in whether the metabolic suppression is intrinsic to the tissue or depends on the whole‐animal response. While in these hypometabolic states, tissues from many animals are tolerant of hypoxia/anoxia, ischemia/reperfusion, and disuse. These natural models may, therefore, serve as valuable and instructive models for biomedical research. © 2016 American Physiological Society.Compr Physiol6:737‐7771, 2016.
PTH and Vitamin D
Authors: Khundmiri Syed Jalal , Murray Rebecca D. , Lederer Eleanor 
Published: March 2016

ABSTRACTPTH and Vitamin D are two major regulators of mineral metabolism. They play critical roles in the maintenance of calcium and phosphate homeostasis as well as the development and maintenance of bone health. PTH and Vitamin D form a tightly controlled feedback cycle, PTH being a major stimulator of vitamin D synthesis in the kidney while vitamin D exerts negative feedback on PTH secretion. The major function of PTH and major physiologic regulator is circulating ionized calcium. The effects of PTH on gut, kidney, and bone serve to maintain serum calcium within a tight range. PTH has a reciprocal effect on phosphate metabolism. In contrast, vitamin D has a stimulatory effect on both calcium and phosphate homeostasis, playing a key role in providing adequate mineral for normal bone formation. Both hormones act in concert with the more recently discovered FGF23 and klotho, hormones involved predominantly in phosphate metabolism, which also participate in this closely knit feedback circuit. Of great interest are recent studies demonstrating effects of both PTH and vitamin D on the cardiovascular system. Hyperparathyroidism and vitamin D deficiency have been implicated in a variety of cardiovascular disorders including hypertension, atherosclerosis, vascular calcification, and kidney failure. Both hormones have direct effects on the endothelium, heart, and other vascular structures. How these effects of PTH and vitamin D interface with the regulation of bone formation are the subject of intense investigation. © 2016 American Physiological Society.Compr Physiol6:561‐601, 2016.
Development of human white matter fiber pathways: From newborn to adult ages
Authors: Cohen Andrew H. , Wang Rongpin , Wilkinson Molly , MacDonald Patrick , Lim Ashley R. , Takahashi Emi 
Published: March 2016

AbstractMajor long‐range white matter pathways (cingulum, fornix, uncinate fasciculus [UF], inferior fronto‐occipital fasciculus [IFOF], inferior longitudinal fasciculus [ILF], thalamocortical [TC], and corpus callosal [CC] pathways) were identified in eighty‐three healthy humans ranging from newborn to adult ages. We tracked developmental changes using high‐angular resolution diffusion MR tractography. Fractional anisotropy (FA), apparent diffusion coefficient, number, length, and volume were measured in pathways in each subject. Newborns had fewer, and more sparse, pathways than those of the older subjects. FA, number, length, and volume of pathways gradually increased with age and reached a plateau between 3 and 5 years of age. Data were further analyzed by normalizing with mean adult values as well as with each subject's whole brain values. Comparing subjects of 3 years old and under to those over 3 years old, the studied pathways showed differential growth patterns. The CC, bilateral cingulum, bilateral TC, and the left IFOF pathways showed significant growth both in volume and length, while the bilateral fornix, bilateral ILF and bilateral UF showed significant growth only in volume. The TC and CC took similar growth patterns with the whole brain. FA values of the cingulum and IFOF, and the length of ILF showed leftward asymmetry. The fornix, ILF and UF occupied decreased space compared to the whole brain during development with higher FA values, likely corresponding to extensive maturation of the pathways compared to the mean whole brain maturation. We believe that the outcome of this study will provide an important database for future reference.
Ethical challenges in preclinical Alzheimer's disease observational studies and trials: Results of the Barcelona summit
Authors: Molinuevo José L. , Cami Jordi , Carné Xavier , Carrillo Maria C. , Georges Jean , Isaac Maria B. , Khachaturian Zaven , Kim Scott Y.H. , Morris John C. , Pasquier Florence , Ritchie Craig , Sperling Reisa , Karlawish Jason 
Published: March 2016

AbstractAlzheimer's disease (AD) is among the most significant health care burdens. Disappointing results from clinical trials in late‐stage AD persons combined with hopeful results from trials in persons with early‐stage suggest that research in the preclinical stage of AD is necessary to define an optimal therapeutic success window. We review the justification for conducting trials in the preclinical stage and highlight novel ethical challenges that arise and are related to determining appropriate risk‐benefit ratios and disclosing individuals' biomarker status. We propose that to conduct clinical trials with these participants, we need to improve public understanding of AD using unified vocabulary, resolve the acceptable risk‐benefit ratio in asymptomatic participants, and disclose or not biomarker status with attention to study type (observational studies vs clinical trials). Overcoming these challenges will justify clinical trials in preclinical AD at the societal level and aid to the development of societal and legal support for trial participants.
Resolution of a warfarin and dabigatran‐resistant left atrial appendage thrombus with apixaban
Authors: Miwa Yosuke , Minamishima Toshinori , Sato Toshiaki , Sakata Konomi , Yoshino Hideaki , Soejima Kyoko 
Published: March 2016

AbstractThe majority of embolisms associated with atrial fibrillation (AF) are from the left atrial appendage (LAA). To treat the existing thrombus, warfarin and novel anticoagulants have been used. However, there has been no clinical information regarding the difference of the effects of congealing the fibrinogenolysis system among these oral anticoagulants. Here, we report a case of persistent AF, in whom apixaban, factor Xa inhibitor resolved an LAA clot refractory to warfarin and direct thrombin inhibition. Factor Xa inhibitor, apixaban, could resolve the left appendage thrombosis refractory to warfarin and dabigatran.
Clinical and genetic features of Australian families with long QT syndrome: A registry‐based study
Authors: Burns Charlotte , Ingles Jodie , Davis Andrew M. , Connell Vanessa , Gray Belinda , Hunt Lauren , McGaughran Julie , Semsarian Christopher 
Published: March 2016

AbstractBackgroundFamilial long QT syndrome (LQTS) is a primary arrhythmogenic disorder caused by mutations in ion channel genes. The phenotype ranges from asymptomatic individuals to sudden cardiac arrest and death. LQTS is a rare but significant health problem for which global data should exist. This study sought to provide the first clinical and genetic description of Australian families with LQTS.MethodsWe performed a cross‐sectional study to evaluate clinical and genetic features of families with LQTS. We recruited individuals from the Australian Genetic Heart Disease Registry and Genetic Heart Disease Clinic, in Sydney, Australia, and included those with a diagnosis of LQTS according to the most recent consensus statement.ResultsAmong 108 families with LQTS, 173 individuals were affected. Twenty‐five (32%) probands had a sudden cardiac death (SCD) event (including appropriate implantable cardioverter defibrillator [ICD] therapy, or resuscitated cardiac arrest). There were 64 (82%) probands who underwent genetic testing, and 34 (53%) had a pathogenic or likely pathogenic mutation in. Having a family history of LQTS was significantly associated with identification of a pathogenic result (79% versus 14%, p<0.0001). There were 16 (9%) participants who experienced delay to diagnosis of at least 12 months.ConclusionsThis is the first clinical and genetic study in a large cohort of Australian families with LQTS. Findings from this study suggest that the clinical and genetic features in this population are not dissimilar to those described in North American, European, and Asian cohorts. Global‐scale information about families with LQTS is an important initiative to ensure diagnostic and management approaches are applicable to different populations and ethnicities.
Hypothyroidism in patients treated with radiotherapy for head and neck carcinoma: standardised long-term follow-up study
Authors: Alba J R , Basterra J , Ferrer J C , Santonja F , Zapater E 
Published: March 2016

AbstractObjective:Hypothyroidism is a common complication when radiotherapy is part of the treatment for head and neck tumours. This study aimed to show the incidence of hypothyroidism and possible risk factors in these patients.Methods:Factors related to the population, tumour, treatment and occurrence of hypothyroidism were analysed in 241 patients diagnosed with head and neck carcinoma.Results:Approximately 53 per cent of patients were diagnosed with radiation-induced hypothyroidism. Its occurrence was related to: tumour location, laryngeal surgery type, neck dissection type, post-operative complications, cervical radiotherapy and radiotherapy unit type (linear particle accelerator or telecobalt therapy technology).Conclusion:Control of thyroid function should be standardised for several years after treatment, particularly in patients with risk factors, such as those treated with telecobalt therapy, those with post-operative complications and for whom the thyroid parenchyma is included in the irradiated area (laryngeal or pharyngeal location and bilateral cervical radiation).
Depressive vulnerability, stressful life events and episode onset of major depression: a longitudinal model
Authors: Kendler K. S. , Gardner C. O. 
Published: March 2016

BackgroundThe nature of the relationship between depressive vulnerability (DV) and acute adversity in the etiology of major depression (MD) remains poorly understood.MethodStressful life events (SLEs) and MD onsets in the last year were assessed at four waves in cohort 1 (females) and at two waves in cohort 2 (males and females) from the Virginia Adult Twin Study. Structural equation modeling was conducted in Mplus.ResultsIn cohort 1, DV was strongly indexed by depressive episodes over the four waves (paths from +0.72 to 0.79) and predicted by SLEs in the month of their occurrence (+0.31 to 0.36). Wave-specific DV was associated both with stable DV (+0.29 to 0.33) and by forward transmission of DV from the preceding wave (+0.33 to 0.36). SLEs were predicted by stable DV (+0.29) and from SLEs in the preceding month (+0.06). As the cohort aged, MD onsets were better indexed by DV and more poorly predicted by SLEs. Parameter estimates were similar in males and females from cohort 2. In individuals with prior depressive episodes, the association between MD onset and SLEs was weakened while the prediction of SLEs from DV was substantially strengthened. We found no evidence for ‘reverse causation’ from MD episodes to SLEs.ConclusionThe interrelationship between DV and acute adversity in the etiology of MD is complex and temporally dynamic. DV impacts on MD risk both directly and indirectly through selection into high stress environments. Over time, depressive episodes become more autonomous. Both DV and SLEs transmit forward over time and therefore form clear targets for intervention.
Canopy gaps do not help establish pioneer species in a South Florida dry forest
Authors: Diamond Joshua M. , Ross Michael S. 
Published: March 2016

Abstract:Canopy gaps create a temporary spatial heterogeneity, often allowing pioneer species to establish and grow in mature forests. In this study, we asked whether the above model holds for tropical dry forests in the Florida Keys. Six hundred and forty-eight canopy gaps in an extensive Key Largo forest were identified with a LiDAR digital canopy model. The structure and composition of juvenile trees were examined in 45 selected gaps in three stands of known age, and weighted averaging calibration and regression were applied to the data to determine the successional age optimum for each tree species, and the inferred age for each gap based on its sapling composition. Less than 1% of the forest area was recorded as canopy gaps in the LiDAR model. The inferred stand ages were about 70 y greater in canopy gaps in young forest than in the surrounding, unimpacted forest. This suggested that gap formation advanced succession rather than reversing or resetting it. The apparent lack of recruitment by early-successional species may be due to the small size of canopy gaps in this forest, and the minimal contrast between gap and understorey environments; light and water conditions in the small gaps may favour late-successional rather than pioneer species. Establishment of pioneer species may not take place without intense, large-scale disturbances such as fires and hurricanes that remove the entire canopy and consume or erode soils.
Factors that influence patients' attitudes to antipsychotic medication
Authors: Haq Farhan , Behan Caragh , McGlade Nicola , Mulkerrin Una , O'Callaghan Eadbhard , Kinsella Anthony , Corvin Aiden , Donohoe Gary , Gill Michael 
Published: March 2016

AbstractObjective: The aim of this study was to investigate the attitudes to medication in relation to insight, purpose in life, symptoms and sociodemographic factors among a cohort of stable patients with a diagnosis of schizophrenia and schizoaffective disorder.Method: We included 70 patients with a diagnosis of schizophrenia and schizoaffective disorder attending a Dublin suburban mental health service. All participants were 18 years or older and were excluded if they had a learning disability, acquired brain injury resulting in unconsciousness, and psychosis secondary to a general medical condition or illicit substance misuse. All participants were given self report questionnaires which included Drug Attitude Inventory (DAI-30), Birchwood Insight Scale, and Purpose in Life test. Symptoms were assessed using the Scale for Assessment of Positive and Negative symptoms. All data was analysed using the Statistical Package for the Social Sciences.Results: We found that 86% (n = 60) of the participants had positive attitudes to medication, and 82% (n = 58) had good insight into their illness. Only 27% (n = 19) were found to have a definite purpose in life. There was a significant negative relationship between attitudes to medication and delusions (r = -0.25, n = 70, p < 0.05) and a significant positive relationship between insight and attitudes to medication (r = 0.0.28, n = 70, p < 0.05).Conclusion: Many factors are involved in the multifaceted issue of attitudes to medication. Researchers must realise that these factors do not remain constant and may change with time and over the course of illness and treatment.
Psychiatric illness and driving: Irish psychiatrists' documentation practices
Authors: Langan Camilla 
Published: March 2016

AbstractObjective: Psychiatric illness and the use of psychotropic medication are recognised as factors that may impair driving ability. Clinicians in the UK have a legal duty to advise patients on the effects of illness and prescribed medication on driving ability. Although clinicians in Ireland have no equivalent legal obligations, good medical practice suggests that doctors should be aware of whether patients are active drivers, and issue appropriate advice, supported by adequate documentation in clinical notes.Method: The initial phase of the study analysed 44 outpatient records and 48 discharge records to ascertain the level of documentation regarding driving status, and advice given to patients regarding the effect of illness or medication on driving ability. The second phase involved distribution of an anonymous questionnaire to 18 psychiatrists employed in the acute psychiatric unit setting.Results: Although there was minimal documentation regarding the potential effect of illness on driving ability, more than 50% of case notes revealed documented advice to patients regarding side-effects of medication and driving ability. Over 50% of case notes contained advice about medication compliance, but none contained cautionary advice about operating machinery. All psychiatrists admitted not being aware of the driving status of every patient they reviewed. Over 50% admitted to advising patients of the effect of illness or medication on driving ability, but fewer reported documenting this advice on every occasion. All psychiatrists reported that they would benefit from training in this area.Conclusion: This study suggests that there is underdocumentation of advice given to patients regarding the effect of their symptoms or medication on driving ability. Clinicians need to improve their awareness of patients' driving status, in addition to receiving training on what their responsibilities are in this regard.
Competency based training in Irish psychiatry
Authors: Nwachukwu Izu 
Published: March 2016

AbstractThe goal of undertaking postgraduate training in psychiatry is to become a competent specialist, and the educational model under which one is trained and assessed is crucial in achieving this goal. Over the years, traditional training models have emphasised what trainees know, over a given period of time, with outcomes assessed mainly by simple recall of knowledge. While these traditional approaches have met with varying levels of success, they are less than optimal when the goal is to train individuals to perform specific, job-related skills. This recognition has led to a global move towards competency based training models where the focus of training and assessment is the mastery of specific knowledge and skills as well as the conduct of the doctor in day-to-day clinical situations. In this article, a general overview of competency-based training in psychiatry is followed by a review of recent developments in Ireland in a global context.
Dialectical behaviour therapy in an Irish community mental health setting
Authors: Blennerhassett Richard , Bamford Lindsay , Whelan Anthony , Jamieson Sarah , Wilson O'Raghaillaigh Jennifer 
Published: March 2016

AbstractObjectives:Dialectical behaviour therapy (DBT) is a recommended treatment of patients with borderline personality disorder, yet there are few descriptions of the approach in public community mental health settings where the majority of such patients present. This study describes the development and evaluation of a DBT programme in an Irish setting.Methods:The DBT programme was run over a six month period. Participants were assessed at baseline and post intervention with the following instruments: The Structured Clinical Interview for DSM III R personality disorders (SCID II), the clinical Outcomes in Routine Evaluation (CORE) and the symptom checklist 90 Revised (SCL-90-Revised). Inpatient bed usage was determined from case note review.Results:Outcome data was available for eight subjects. Significant improvement (p < 0.005) was seen on all CORE subscales. SCL-90-R showed significant improvement (p < 0.05) on the global severity index and on the positive symptom distress index. A decrease in self harming behaviour was found. Subjects' inpatient bed days dropped from a mean of 58 in the year pre intervention to a mean of four days in the year post intervention. A novel finding was that 43% of subjects who originally fulfilled criteria for avoidant personality disorder no longer did so post intervention.Conclusions:The study found that DBT can be applied in a community mental health setting with benefits similar to more specialist settings. Significant difficulties were encountered in implementing the programme. The clinical implications are that specialist psychotherapy services need to be an integral part of psychiatric services to achieve better outcomes for patients with borderline personality disorder.
Barriers to care in the mental health service: who gets in – who gets out?
Authors: Doherty Anne 
Published: March 2016

“People with mental health problems are particularly vulnerable to social exclusion” – Vision for Change.People with mental health problems are very vulnerable. However those with mental health problems who have additional social problems are even more vulnerable.Currently psychiatric services in Ireland are provided on a ‘catchment area’ basis, with a consultant psychiatrist leading a multi-disciplinary team providing a service to the population of a defined geographical area. These services comprise both outpatient and inpatient care, and there is significant regional variation in terms of both bed availability and multidisciplinary team staffing. Sub-specialities, with the exception of child psychiatry and psychiatry of old age, are often unavailable, particularly outside Dublin. In such cases, some additional duties (eg. liaison, rehabilitation, perinatal) are assumed by the local general adult services.However, the overall distribution of services is uneven. Instead of services being concentrated upon those areas of greatest need, the opposite is often the case, with the most deprived areas having the least services in terms of acute beds and community mental health teams per thousand people. These areas also have less psychological services and specialist services despite increased levels of mental illness.Within this vulnerable population there are a number of sub-groups who are even further marginalised, and for whom there are significant barriers both at point of contact with services and with accessing appropriate follow up services. These include the homeless, the ever-increasing cohort of migrants to this country, those in prison and children and adolescents. Stigma and discrimination are the greatest barriers to social inclusion, quality of life and recovery for people with mental illness.