bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recommendation for a Therapeutic Reference Range of Cariprazine—A Short Communication
Authors: Sattaf Fabian , Scherf-Clavel Maike , Unterecker Stefan , Reif Andreas , Hahn Martina 
Published: November 2023

Background:
Therapeutic reference ranges are essential for therapeutic drug monitoring to evaluate results and adjust pharmacotherapy. The measured serum concentrations of cariprazine-treated patients have frequently been found to lie beyond the currently used therapeutic reference range; furthermore, reliable data for establishing evidence-based therapeutic ranges are scarce. The current therapeutic reference ranges have only been estimated; however, real-world data on cariprazine are missing. Individual serum concentrations were analyzed, and the validity of the currently used reference ranges was assessed.

Methods:
Serum concentrations of 19 psychiatric patients treated with cariprazine without pharmacokinetic abnormalities were retrospectively analyzed. Only the last measurement per patient was included in the analysis, and patients who underwent a dose adjustment in the subsequent 2 weeks after sampling were excluded (assuming that the target dose and response had been achieved at that time). Serum concentrations were compared with the therapeutic reference range (10–20 ng/mL) of the Arbeitsgemeinschaft für Neuropsychiatrie und Pharmakotherapie consensus guidelines of 2017 and with a recent recommendation for a lower therapeutic reference range (5–15 ng/mL).

Results:
The mean serum concentration was 9.1 ± 4.1 SD ng/mL. A total of 47.4% of the values were within the therapeutic reference range of 10–20 ng/mL, and 78.9% fell within the range of 5–15 ng/mL.

Conclusions:
These results support previous recommendations for lowering the therapeutic reference range to 5–15 ng/mL. The calculated therapeutic reference range was 5.0–13.2 ng/mL. It may even be potentially lower because clinicians may have tried to titrate the dose to a serum concentration within the current therapeutic reference range of 10–20 ng/mL.
Effects of Autologous Serum and Platelet-Rich Plasma on Human Corneal Endothelial Cell Regeneration: A Comparative Study
Authors: Kilic-Toprak Emine , Cort-Donmez Aysegul , Toprak Ibrahim 
Published: November 2023

Objectives:
To investigate the effects of autologous serum (AS) and platelet-rich plasma (PRP) on human corneal endothelial cell (HCEC) proliferation and apoptosis in comparison to Y-27632 as the commonly studied Rho-associated kinase (ROCK) inhibitor.

Methods:
The human corneal endothelial primary cell line was used for this study. As the treatment groups, HCECs were incubated with AS, PRP, and Y-27632, whereas the control group received no treatment. Cell proliferation (measured by 5-bromo-2′-deoxyuridine [BrdU] incorporation) and apoptosis (based on the caspase-3 level) were compared between the control, Y-27632, AS, and PRP groups.

Results:
In the Y-27632, AS, and PRP groups, the ratios of BrdU-incorporated cells were significantly higher (115±0.2%, 125±0.2%, 122±0.4% at 24 hr, and 138±2.4%, 160±0.2%, 142±0.2% at 48 hr, respectively) than in the control group (100±18.4% at 24 hr, 100±1.1% at 48 hr) (P<0.05 for all). Furthermore, AS provided a higher HCEC proliferation ratio compared with the Y-27632 group at 24 and 48 hr (P<0.05 for all). Caspase-3 was significantly lower in the AS group (60.3±3.3%) than in the control (100±2.3%), Y-27632 (101.9±5.2%), and PRP (101±6.8%) groups (P<0.05 for all).

Conclusions:
The results of this study demonstrated for the first time that AS and PRP promoted HCEC proliferation and AS significantly decreased apoptosis in HCECs. A superior effect on HCEC proliferation was also observed with AS compared with Y-27632. Future “autologous” regenerative therapeutic options for corneal endothelial failure may involve the utilization of AS and PRP owing to their accessibility, simplicity in preparation, immunologic compatibility, and donor-free nature.
Modified Magnetic Resonance Imaging Burden of Cerebral Small Vessel Disease and Related Risk Factors in Patients With Thalassemia
Authors: Liu Xiuying , Yang Kunling , Sun Lanfeng , Huang Qi , Long Lianqing , Ou Sijie , Wei Xing , Wu Yuan 
Published: November 2023

Objective:
This study aimed to explore the burden of magnetic resonance imaging (MRI) of cerebral small vessel disease (CSVD) in patients with thalassemia and related risk factors.

Methods:
The clinical data and MRI of patients with thalassemia were retrospectively analyzed, and non-thalassemia controls with matched sex and age were selected. The modified MRI burden of CSVD included recent small subcortical infarct, presumed vasogenic white matter hyperintensity, presumed vasogenic lacunae, perivascular space (PVS), and brain atrophy.

Results:
This study included 110 patients in each of the thalassemia and control groups. There was no significant difference in sex, age, and common cerebrovascular disease risk factors between the 2 groups. The patients with thalassemia had a higher red blood cell count and lower content of hemoglobin. The PVS and modified MRI burden scores in the thalassemia group were higher than in the control group. With the increase in age, patients with thalassemia have a more severe CSVD burden.

Conclusion:
Patients with thalassemia have a heavier modified MRI burden of CSVD than non-thalassemia patients, particularly PVS, and aging is an important risk factor for CSVD changes.
Mechanical Thrombectomy in Anticoagulated Patients With Acute Ischemic Stroke
Authors: Zhang HaoLiang , Chen Shiqin , Zhu QianYuan , Li ZongShan , Lv Tian , Liu Chengjiang 
Published: November 2023

Background:
According to a previous studies, mechanical thrombectomy(MT) is safe for anticoagulated patients. However, the safety and prognosis of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKA) have not been compared with those of MT.This meta-analysis aimed at determining the efficacy of DOACs or VKA for patients after MT.

Review Summary:
We searched PubMed, Embase, Web of Science databases, and Cochrane from their inception to Aug 2022. Revman 5.3 served for the meta-analysis. The meta-analysis included 12 studies that covered 3571 patients, finding that after MT treatment, DOACs significantly decreased the symptomatic intracerebral hemorrhage [odd ratio (OR)=0.49, 95% CI 0.30-0.80, P=0.004] and mortality (OR=0.63, 95% CI 0.48-0.83, P=0.001) compared with VKA. Meanwhile, no obvious differences were found between DOACs and VKA after MT treatment in terms of in any hemorrhagic transformation (OR=1.07, 95% CI 0.84-1.37, P=0.59), good functional outcome (OR=1.06, 95% CI 0.88-1.27, P=0.53), and successful arterial recanalization (OR=1.24, 95% CI 1.00-1.53, P=0.05).

Conclusions:
This meta-analysis demonstrates that the application of DOACs in MT treatment for anticoagulated patients with acute ischemic stroke is safer than that in the VKA group. However, further studies are necessary to confirm these results.
Noninvasive Neurally Adjusted Ventilatory Assist in Infants With Bronchiolitis: Respiratory Outcomes in a Single-Center, Retrospective Cohort, 2016–2018*
Authors: Lepage-Farrell Alex , Tabone Laurence , Plante Virginie , Kawaguchi Atsushi , Feder Joshua , Al Omar Sally , Emeriaud Guillaume 
Published: November 2023

OBJECTIVES:
To describe our experience of using noninvasive neurally adjusted ventilatory assist (NIV-NAVA) in infants with bronchiolitis, its association with the evolution of respiratory effort, and PICU outcomes.

DESIGN:
Retrospective analysis of a prospectively curated, high-frequency electronic database.

SETTING:
A PICU in a university-affiliated maternal-child health center in Canada.

PATIENTS:
Patients younger than 2 years old who were admitted with a diagnosis of acute bronchiolitis and treated with NIV-NAVA from October 2016 to June 2018.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Patient characteristics, as well as respiratory and physiologic parameters, including electrical diaphragmatic activity (Edi), were extracted from the electronic database. Respiratory effort was estimated using the modified Wood Clinical Asthma Score (mWCAS) and the inspiratory Edi. A comparison in the respiratory effort data was made between the 2 hours before and 2 hours after starting NIV-NAVA. In the two seasons, 64 of 205 bronchiolitis patients were supported with NIV-NAVA. These 64 patients had a median (interquartile range [IQR]) age of 52 days (32–92 d), and there were 36 of 64 males. Treatment with NIV-NAVA was used after failure of first-tier noninvasive respiratory support; 25 of 64 patients (39%) had at least one medical comorbidity. NIV-NAVA initiation was associated with a moderate decrease in mWCAS from 3.0 (IQR, 2.5–3.5) to 2.5 (IQR, 2.0–3.0; p < 0.001). NIV-NAVA initiation was also associated with a statistically significant decrease in Edi (p < 0.01). However, this decrease was only clinically relevant in infants with a 2-hour baseline Edi greater than 20 μV; here, the before and after Edi was 44 μV (IQR, 33–54 μV) compared with 27 μV (IQR, 21–36 μV), respectively (p < 0.001). Overall, six of 64 patients (9%) required endotracheal intubation.

CONCLUSIONS:
In this single-center retrospective cohort, in infants with bronchiolitis who were considered to have failed first-tier noninvasive respiratory support, the use of NIV-NAVA was associated with a rapid decrease in respiratory effort and a 9% intubation rate.
Sudden Unexplained Death in Childhood
Authors: Wojcik Monica H. , Krous Henry F. , Goldstein Richard D. 
Published: November 2023

Abstract
Sudden unexplained death in childhood is a term that encompasses apparently natural deaths in children aged older than 1 year with no discernible cause despite a thorough assessment. Definitive underlying causes vary but most cases remain largely unexplained. Research has furthered the view that sudden unexplained death in childhood is not an accident, but rather a sentinel medical event for which a thorough postmortem investigation is indicated. Emerging evidence in genetics, neurology, and neuropathology point to heterogeneous causes that in some cases share features of recognized diseases.
Management of severe congenital femoral deficiency: Does surgical intervention enhance prosthetic function?
Authors: Calder Peter , Elsheikh Ahmed , Cross George , Thornton Matt , Wright Jonathan , Eastwood Deborah , Sedki Imad 
Published: November 2023

Background & Objective:
The purpose of this study was to evaluate prosthetic outcome in patients with severe congenital femoral deficiency and the potential benefits of surgical intervention on prosthetic fitting and gait.

Methods:
A retrospective review identified 26 active case records with a proximal femoral focal deficiency using a prosthesis. Validated outcome measures evaluated comfort, function, and prosthetic use and quality-of-life assessment. Outcome compared age groups and surgical intervention. Gait analysis performed in 7 patients further evaluated hip and knee function.

Results:
Eleven male patients and 15 female patients, including 13 children (mean age 10 years, range 5–16) and 13 adults (mean age 36 years, range 23–63) were evaluated. Better prosthetic function and PedsQL scores were recorded in the pediatric group. There was a trend for better scores after surgery. Gait analysis demonstrated reduced hip extension compensated by knee flexion in 3 patients, 2 patients had hip extension with near normal kinematics, 1 untreated patient walked with an unsteady gait, and the remaining walked well using an ischial-bearing prosthesis with pelvic compensatory movements.

Conclusion:
The management strategy in severe proximal femoral focal deficiency remains a major challenge. Hip reconstruction seems to improve functional scores. Overall, the scores seem to decline into adulthood but not significantly. Gait analysis before further surgical intervention is recommended because compensatory knee flexion may improve step length in terminal stance. Limited numbers, with short follow-up, prevents clear guidance on the benefit of surgery.
Assessing the Impact of Non-Pharmaceutical Interventions on COVID-19: A Combined CCE and Quantile Regression Approach
Authors: Mishra Kaibalyapati 
Published: November 2023

AbstractThis paper tries to quantify the impact of government policy intervention on the death due to COVID-19 in India. I use the Oxford COVID-19 Government Response Tracker (OxCGRT), a longitudinal database of daily government response from Jan 28th, 2020, when the first COVID case was diagnosed in India till December 31st, 2022. Here government responses are captured in form of,stringencymeasures,containmentmeasures,economic supportmeasures, and theoverall government support, providing a holistic assessment of the government’s efforts in mitigating the virus’s incidence. I quantify both the average relation and causality at the to understand the impacts of NPIs with COVID-19 incidence in terms of deaths and infections due to COVID-19. Short-term analysis reveals a significant relationship between various non-pharmaceutical interventions (NPIs) and the logarithmic change in COVID-19 deaths. Higher infection rates are strongly associated with increased deaths, with positive coefficients. Stringent measures, containment actions, and economic support show negative coefficients, indicating that these interventions effectively reduce deaths in the short term. The overall government support, which aggregates all three NPIs, also demonstrates a significant negative effect on deaths, highlighting the importance of stringent and immediate measures in controlling the death toll early in the pandemic. In the long term, the analysis continues to emphasize the importance of infection rates and NPIs. Long-term coefficients for infection rates and various NPIs are consistently significant and negative, indicating that sustained interventions significantly reduce mortality over time. Specific measures like stringency, containment, and economic support show substantial negative impacts underscoring the long-term benefits of maintaining rigorous public health measures. Further, causality analysis confirms that relationship among government interventions and COVID-19 incidences were mostly bidirectional, meaning more deaths (or infections) leads to stricter interventions that in turn further reduce deaths.JELC23, C54, I18, I38
In-bore MRI-compatible Transrectal Ultrasound and Photoacoustic Imaging
Authors: Murakami Ryo , Wang Yang , Lesniak Wojciech G. , Tsumura Ryosuke , Tang Yichuan , Tsunoi Yasuyuki , Nycz Christopher J. , Pomper Martin G. , Fischer Gregory S. , Zhang Haichong K. 
Published: November 2023

AbstractProstate cancer (PCa) is known as one of the most prevalent and fatal cancer types. This report describes an MRI-compatible photoacoustic/ultrasound (PA/US) imaging platform to improve the diagnosis of PCa. In the proposed solution, PA imaging, which offers real-time, non-ionizing imaging with high sensitivity and specificity, is combined with MRI, aiming to overcome PA’s limited field of view (FOV) and make PA scalable for translation to clinical settings. Central to the design of the system is a reflector-based transrectal probing mechanism composed of MRI-compatible materials. The linear transducer with a center hole for optical fiber delivery can be mechanically actuated to form a multi-angled scan, allowing PA/US imaging from varied cross-sectional views. Performance assessment was carried out in phantom and ex-vivo settings. We confirmed the MRI compatibility of the system and demonstrated the feasibility of its tri-modal imaging capability by visualizing a tubing phantom containing contrast agents. The ex-vivo evaluation of targeted tumor imaging capability was performed with a mouse liver sample expressing PSMA-positive tumors, affirming the system’s compatibility in spectroscopic PA (sPA) imaging with biological tissue. These results support the feasibility of the in-bore MRI-compatible transrectal PA and US and the potential clinical adaptability.
Delayed cortical engagement associated with balance dysfunction after stroke
Authors: Palmer Jacqueline A. , Payne Aiden M. , Mirdamadi Jasmine L. , Ting Lena H. , Borich Michael R. 
Published: November 2023

AbstractCortical resources are typically engaged for balance and mobility in older adults, but these resources are impaired post-stroke. Although slowed balance and mobility after stroke have been well-characterized, the effects of unilateral cortical lesions due to stroke on neuromechanical control of balance is poorly understood. Our central hypothesis is that stroke impairs the ability to rapidly and effectively engage the cerebral cortex during balance and mobility behaviors, resulting in asymmetrical contributions of each limb to balance control. Using electroencephalography (EEG), we assessed cortical N1 responses evoked over fronto-midline regions (Cz) during balance recovery in response to backward support-surface perturbations loading both legs, as well as posterior-lateral directions that preferentially load the paretic or nonparetic leg. Cortical N1 responses were smaller and delayed in the stroke group. While older adults exhibited weak or absent relationships between cortical responses and clinical function, stroke survivors exhibited strong associations between slower N1 latencies and slower walking, lower clinical mobility, and lower balance function. We further assessed kinetics of balance recovery during perturbations using center of pressure rate of rise. During backward support-surface perturbations that loaded the legs bilaterally, balance recovery kinetics were not different between stroke and control groups and were not associated with cortical response latency. However, lateralized perturbations revealed slower kinetic reactions during paretic loading compared to controls, and to non-paretic loading within stroke participants. Individuals post stroke had similar nonparetic-loaded kinetic reactions to controls implicating that they effectively compensate for impaired paretic leg kinetics when relying on the non-paretic leg. In contrast, paretic-loaded balance recovery revealed time-synchronized associations between slower cortical responses and slower kinetic reactions only in the stroke group, potentially reflecting the limits of cortical engagement for balance recovery revealed within the behavioral context of paretic motor capacity. Overall, our results implicate individuals after stroke may be uniquely limited in their balance ability by the slowed speed of their cortical engagement, particularly under challenging balance conditions that rely on the paretic leg. We expect this neuromechanical insight will enable progress toward an individualized framework for the assessment and treatment of balance impairments based on the interaction between neuropathology and behavioral context.
Unveiling Vulnerabilities in Maternal-Child Health amidst COVID-19: A Cross-Sectional Study on Food Insecurity and Socio-Demographic Disparities in the U.S.
Authors: Henkes Zoe , Romo-Palafox Maria J. 
Published: November 2023

AbstractObjectiveEarly infancy is a critical time of development when stresses, nutritional deficiencies, and other challenges have lifelong consequences. Social distancing regulations due to the COVID-19 pandemic in 2020 led to abrupt changes in work status, childcare accessibility, and food availability.DesignThis cross-sectional study assessed responses regarding experiences during the COVID-19 pandemic, including food insecurity (validated two-question screener), WIC use, and changes in childcare accessibility and work status. Data were assessed using logistic regressions while controlling for sociodemographic factors.SettingNational U.S. online survey in July–August 2020.ParticipantsU.S. mothers (n=1861) with infants ≤12 months old.ResultsWe detected a 34% increase in perceived food insecurity during July–August 2020 compared to that before the pandemic. Hispanic mothers had 74% higher odds of becoming food insecure than non-Hispanic White mothers. Mothers with infants <9 weeks old had a 7% increase in WIC utilization, although no overall increase in WIC usage was detected. Most mothers (71%) reported moderate or extreme impacts from the pandemic, with higher odds associated with childcare interruptions, working from home, and identifying as Hispanic or non-Hispanic Black.ConclusionsOur findings reveal specific sociodemographic groups of mothers with infants who were especially vulnerable during the COVID-19 pandemic. These insights hold significant value for tailoring supportive programs, equipping these groups for potential socioeconomic upheavals, and aiding their transition into the post-pandemic world.
Maternal Controlling Parenting and Child-Perceived Mother-Child Attachment Mediate the Association between Maternal Adverse Childhood Experiences and Adolescent Behavioural Difficulties
Authors: Shi Yuze , Xie Shuya , MacBeth Angus 
Published: November 2023

AbstractBackgroundMaternal adverse childhood experiences (ACEs) are risk factors for increased mental health difficulties. However, the intergenerational transmission mechanisms between maternal ACEs and adolescent behavioural difficulties are poorly understood. The current study modelled the mediating effects of maternal controlling parenting and child-perceived mother-child attachment on the association between maternal ACEs and behavioural difficulties.MethodsData were obtained from Growing Up in Scotland, a nationally representative prospective probability cohort study of Scottish adolescents (N= 2223), followed up at 14-15 years of age. Hierarchical multivariate linear regression analyses were used to examine the strength of predictors (maternal ACEs, maternal controlling parenting, child-perceived mother-child attachment) on levels of adolescent behavioural difficulties. Mediation analyses were used to examine the serial mediating effects of maternal controlling parenting and child-perceived mother-child attachment.ResultsRegression analysis results indicated maternal ACEs were associated with adolescent behavioural difficulties. Serial mediation results indicated a significant indirect effect of maternal ACEs on adolescent mental health outcomes, through maternal controlling parenting and child-perceived mother-child attachment.ConclusionThe study indicates that maternal controlling parenting and child-perceived mother-child attachment are mechanisms mediating the effect of maternal ACEs on adolescent behavioural difficulties. Consequently, attending to the impact of both maternal and children’s factors may improve policy programming to ameliorate the intergenerational impact of maternal ACEs on adolescent young peoples’ mental health.Key pointsResearch suggests maternal adverse childhood experiences have intergenerational impacts on children.Maternal controlling parenting and child-perceived mother-child attachment potentially mediate the intergenerational link between maternal ACEs and behavioural difficulties of young people.There is a lack of research examining these mechanisms in adolescence.Maternal controlling parenting and child-perceived mother-child attachment mediate the link between maternal ACEs and adolescent internalizing behaviours, externalizing behaviours, and anxiety; with a small but significant serial mediating path through these two mediators.Policy programming should incorporate both consideration of maternal and child factors in adolescent mental health.