bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kandinsky Clerambault Syndrome Manifesting as Tinnitus
Authors: Sharma Vasudha , Shaaban Luai , Ali Taseen , Hirsch Alan R 
Published: January 2025

IntroductionTinnitus not heretofore been described as the only manifestation of delusional possession in Kandinsky-Clerambault syndrome. Such a case is presented.MethodsCase Report: A 70-year-old left handed (pathological) man, eight years prior to presentation, noted gradual onset of decreased hearing and high- pitched constant tinnitus AU made worse with stress. Initially only present in quiet, it intensified, ultimately present in all situations, even with ambient background noise. He believed that the Devil was inside of his head, had been there for many years, and was making his life unbearable by subjecting him to the tinnitus. Other than the tinnitus, the devil did not cause any other symptoms, nor did it communicate with him in any fashion. In an effort to eliminate the Devil-induced tinnitus, he twice attempted suicide through self-strangulation. The tinnitus persisted despite treatment with mirtazapine and lumateperone.ResultsAbnormalities in physical examination: General: Decreased blink frequency. Continuous fidgeting and generalized tremulousness. Neurological examination: Mental status examination: Hypoverbal. Able to remember 5 digits forwards and 3 digits backwards. Unable to remember any of four objects in 3 minutes with and without reinforcement. Presidents as follows: Biden, Obama, ?. Animal Fluency Test: 7 (Abnormal). Cranial Nerve (CN) Examination: CN I Alcohol Sniff Test: 0 (Anosmia). CN VIII Calibrated Finger Rub Auditory Screening Test: Strong 2 AU. Motor Examination: 1+ cogwheel rigidity in the right upper extremity. Gait Examination: Unstable tandem gait. Reflexes: 1+ throughout. Other: Tinnitus Severity Questionnaire : 38/40 (Severe tinnitus). Tinnitus Handicap Inventory: 94/100 (Grade 5-
Catastrophic handicap).DiscussionWhile Kandinsky Clerambault Syndrome, Delusion of Possession Syndrome is uncommon in the United States (Dimkov, 2020; Enoch, 2020), 46% of Italians believe in the Devil (Marra, 1990) and 0.6% of Canadians believe that they have been possessed by a demon (Ross & Joshi, 1992). Although the most common neurological presentation of Kandinsky Clerambault syndrome is glossolalia, sensory phenomenon of anosmia (Chand et al, 2000; Medeiros De Bustos et al, 2014), ageusia (Chand et al, 2000), kinaesthesia (Gedevani et al, 2022), allochiria (Medeiros De Bustos et al, 2014), synesthetic neuralgia (Medeiros De Bustos et al, 2014), cenesthesia (Medeiros De Bustos et al, 2014), pain (Medeiros De Bustos et al, 2014) and anaesthesia (Yap, 1960) have also been described. While tinnitus has not been reported with Kandinsky Clerambault, it has been noted to occur with depression, anxiety (Zöger et al, 2006; Salviati et al, 2013), and psychosis (Frankenburg & Hegarty, 1994; Jain et al, 2017). Given the widespread belief in the general population of the Devil and possession by external entities, assessment of presence of Kandinsky Clerambault Syndrome in those with intractable tinnitus may be worthwhile.FundingNo Funding
Characteristics and Outcomes of Hospitalized Psychiatric Inpatients Treated with Buprenorphine for Co-occurring OUD
Authors: Sacks Ashley , Gordillo Victor , Lynch Sean , Klepacz Lidia , Ferrando Stephen 
Published: January 2025

IntroductionDespite being the gold standard for long term treatment and mortality reduction, medications for opioid use disorder (mOUD) are under utilized despite ongoing efforts to reduce barriers to access, with only 18% of qualifying patients undergoing treatment. Approximately 38% of patients nationally with an opioid use disorder (OUD) have a co-occurring psychiatric diagnosis; however, treatment for these co-occurring illnesses frequently do not occur simultaneously, especially among acutely psychiatrically ill patients. Inpatient psychiatric units often do not initiate patients on mOUD, such as buprenorphine, possibly due to lack of national policy encouraging expanded access. This study involves a pilot mOUD consultation service for patients admitted to inpatient psychiatric units, and aimed to characterize the patients involved, and compare certain variables (such as length of stay (LOS)) to inpatients without an OUD.MethodsThis IRB-approved retrospective single-site (level 1 trauma in academic hospital just outside New York City) study examined the medical records of patients who received consultations from our service between January 1st 2018 and August 15th 2020. Demographic and clinical information was collected and analyzed for descriptive statistics. There were no interventions; the primary outcome gathered was average length of stay for patients consulted.Results123 patients received consultations during this time period. Patients had an average age of 37 years, identified predominantly as male, and were mostly White. About one third of the population was undomiciled, and almost three quarters were unemployed. Over half of the patients had prior treatment with buprenorphine. The most common primary psychiatric diagnosis was depression (over 50%), followed by bipolar disorders and schizophrenia spectrum illness. About 40% of patients had co-occurring stimulant use, followed by about 30% with marijuana use, and 16% with benzodiazepine use. The average LOS among patients treated with mOUD was not significantly longer than the average LOS for the inpatient units overall. Over half of the patients were established with outpatient or inpatient substance use treatment following discharge from psychiatry.ConclusionsOur data supports initiating patients with co-occurring OUD and psychiatric illness on mOUD, regardless of severity of acute psychiatric symptoms. Our study did not find that initiating substance use treatment prolonged LOS. Initiating treatment on the psychiatric unit may have increased engagement in outpatient addiction services. Further studies are required to characterize potential benefits.FundingNo Funding
Diagnostic Challenges of Late-Onset Mania versus Dementia with Behavioral Disturbances: A Case Report
Authors: Zhang Yuxi , Ballone Nina 
Published: January 2025

IntroductionLate-onset mania presents as a diagnostic challenge given the interplay between psychiatry and neurology. Neurocognitive disorders, especially the behavioral subtype of Frontotemporal Dementia (FTD), are among one of the differential diagnoses in patients presenting later in life with manic-like symptoms. Here we discuss a case of new-onset manic symptoms in an elderly patient with no prior history of bipolar disorder and conduct a comprehensive literature review to assist with the diagnostic challenges of late-onset mania and dementia with behavioral disturbances.CaseMrs. X is a 67-year-old female with bipolar disorder diagnosed 2 months prior to admission who presented to the hospital after a mechanical fall and witnessed seizure-like activity thought to be due to benzodiazepine withdrawal. She was found to have new atrial fibrillation that was stabilized, and clonazepam was resumed. Psychiatry was consulted to assist with manic behaviors. On initial evaluation, Mrs. X presented as anxious, distractible, tangential with pressured speech, increased psychomotor activity, and paranoid towards her husband. She was treated for a urinary tract infection but otherwise workup was unremarkable. Head imaging demonstrated gray matter volume loss that appeared more prominent in the temporal and frontal lobes. Once transferred to the inpatient psychiatry unit, she presented with elevated mood, excessive jocularity, disinhibition, and poor insight. SLUMS of 18 noted poor attention, processing, and short-term recall. She was started on divalproex sodium titrated to 1500 mg daily (VPA level 108 mcg/mL) and olanzapine 25 mg daily. Observations throughout this time included minimal change in affect, elevated mood, memory deficits and social disinhibition. She did have less aggression, minimal paranoia towards her husband and circumstantial thought process although noted with confabulation.MethodsWe completed a comprehensive literature review utilizing PubMed and Google Scholar. Search terms included combinations of “late-onset”, “bipolar disorder”, “mania”, “neurocognitive disorder”, “dementia”, “frontotemporal”, “behavioral disturbances”.DiscussionOnce Mrs. X’s initial delirium resolved, she remained with manic-like symptoms. Collateral, brain imaging of reduced gray matter volume in the frontal and temporal lobes, and lack of response to high doses of a mood stabilizer and antipsychotic favor a probable neurocognitive disorder with behavioral disturbances. Literature reviewed helped to narrow down the differential diagnosis for Mrs. X and allowed for a more comprehensive treatment plan.ConclusionDiagnostic elucidation of late-onset mania relies on a comprehensive investigation into psychiatric and non-psychiatric etiologies, a detailed collateral history, and a neuropsychiatric lens. Neurocognitive disorders remain an important differential diagnosis.FundingNo Funding
Top-Line Results from Phase 3 PALISADE-2 Trial of Fasedienol (PH94B) Nasal Spray in Social Anxiety Disorder (SAD)
Authors: Liebowitz Michael R. , Salmán Ester , Hanover Rita , Reed Brittany , Baker Ross A. , Monti Louis 
Published: January 2025

IntroductionFasedienol (PH94B; 3β-androsta-4,16-dien-3-ol) is a synthetic neuroactive nasal spray from the androstane family of pherines. Intranasal fasedienol activates receptors in peripheral nasal chemosensory neurons connected to subsets of neurons in the olfactory bulbs that in turn are neurally connected to neurons in the limbic amygdala involved in the pathophysiology of SAD and potentially other anxiety and mood disorders. Fasedienol is locally metabolized in the olfactory mucosa without systemic uptake or binding to CNS receptors. The objective of the present study was to compare fasedienol vs. placebo during a public speaking challenge in subjects with SAD.MethodsThis was a multi-center, double-blind, randomized, placebo-controlled study (NCT05011396). After screening (Visit 1), all subjects completed Visit 2 (V2, Baseline, placebo nasal spray administered to all subjects) and participated in a 5-minute public speaking challenge (PSC) during which Subjective Units of Distress Scores (SUDS) were recorded. Subjects with SUDS >= to 70 were invited back a week later for the Visit 3 (V3) treatment visit and randomly allocated to receive either fasedienol (3.2 μg intranasally) or placebo, then undergo a second 5-minute PSC, with SUDS scores recorded. After the V3 PSC, subjects completed a Patient Global Impression of Change (PGI-C) and trained raters completed a Clinical Global Impression of Improvement (CGI-I). CGI-I responders were defined as those assigned scores of 1 (very much improved) or 2 (much improved); PGI-C responders reported scores of 1 (very much less anxious) or 2 (much less anxious). ANCOVA with baseline SUDS as a covariate was used to compare change in mean SUDS from V2 to V3 for the subjects administered fasedienol at V3 vs those who received placebo at V3.ResultsFasedienol-treated patients (n=70) demonstrated a statistically significant greater change in mean SUDS score (least-squares (LS) mean = -13.8) compared with placebo (n=71, LS mean = -8.0), for a difference between groups of -5.8 (p=0.015). The proportion of CGI-I responders was higher in the fasedienol group 37.7% vs. placebo 21.4% (p=0.033), as was the proportion of PGI-C responders: fasedienol 40.6% vs. placebo 18.6% (p=0.003). Fasedienol was well-tolerated with no treatment-emergent adverse events above 1.5% occurrence.ConclusionThe Phase 3 PALISADE-2 trial results demonstrated that a single dose of fasedienol prior to a stressful PSC produced efficacy on patient-rated SUDS and PGI-C, as well as the clinician-rated CGI-I. The results also confirmed the nasal-amygdala neural circuits as a new portal for administration of pharmaceuticals. The data support continued development of fasedienol as a first-in-class, rapid-onset, well-tolerated treatment option for SAD without addictive properties.FundingVistagen Therapeutics
A Veteran with PTSD and Bipolar Disorder Type I with Psychotic Features
Authors: Becker Ryan , Billakanti Rohit , Guillermo Chrisalbeth 
Published: January 2025

This case discusses a 33-year-old transgender Army Veteran, diagnosed with co-occurring Bipolar Disorder Type 1 (Bipolar I) and Post-Traumatic Stress Disorder (PTSD), both with psychotic features. The patient exhibited recurrent mood swings, delusions, auditory hallucinations, and passive suicidal thoughts. Concurrent symptoms, such as disrupted sleep, irritability, and intrusive thoughts, complicated diagnosis and treatment. The patient’s medical history included migraines, chronic pain, medication-induced seizures, traumatic brain injury (TBI), and Borderline Personality Disorder.During the assessment, the patient displayed mood fluctuations, cognitive issues, and intermittent tearfulness. They were averse to sedative medications and preferred non-pharmacological approaches. The Alpha-Stim (Cranial Electrical Stimulator – CES) was recommended for anxiety, depression, insomnia, and chronic pain.Medication options (Aripiprazole, Lurasidone, and Risperidone) were discussed, and the patient chose Aripiprazole. The treatment plan included Dialectical Behavior Therapy for Borderline Personality Disorder and potential polysomnography to evaluate sleep disorders.This case underscores the management challenges of co-occurring Bipolar I and PTSD with psychotic features, emphasizing the need for further research on their interplay, impact on functioning, and optimal treatments. It also explores CES as a potential intervention for psychosis during mood episodes.FundingNo Funding
Service evaluation of ‘GP at Door’ of accident and emergency services in Eastern England
Authors: Brainard Julii , Rice Aiden , Hughes Gareth , Everden Paul 
Published: January 2025

Abstract

Aim:
We describe activity, outcomes, and benefits after streaming low urgency attenders to General practice services at Door of Accident and Emergency departments (GDAE).

Background:
Many attendances to A&Es are for non-urgent health problems that could be better met by primary care rather than urgent care clinicians. It is valuable to monitor service activity, outcomes, service user demographics, and potential benefits when primary care is co-located with A&E departments.

Methods:
As a service evaluation, we describe and analyse GDAE users, reasons for presentation, wait times, outcomes, and co-located A&E wait times at two hospitals in eastern England. Distributions of outcomes, wait times, reasons for attendance, deprivation, and age groups were compared for GDAE and usual A&E attenders at each site using Pearson chi-square tests and accelerated time failure modelling. Performance in a four-hour key performance indicator was descriptively compared for co-located and similar emergency departments.

Findings:
Each GDAE saw about 1025 patients per month. Wait times for usual accident and emergency (A&E) care are relatively short at only one site. Reattendances were common (about 11% of unique patients), 75% of GDAE attenders were seen within 1 hour of arrival, 7% of patients initially allocated to GDAE were referred back to A&E for further investigations, and 59% of GDAE patients were treated and discharged with no further treatment or referral required. Pain, injury, infection, or feeling generally unwell each comprised > 10% of primary reasons for attendance. At James Paget University Hospital, 4.3%, and at Queen Elizabeth Hospital, 16.1% of GDAE attendances led to referral to specialist health services. GDAE attenders were younger and more socially deprived than attenders to co-located A&Es. Patients were seen quickly at both GDAE sites, but there were differences in counts of specialist referrals and wait times. Process evaluation could illuminate reasons for differences between study sites.
Constitutional ImagiNations: on the Imaginal Foundations of the Indian Constitution
Authors: Suresh Sabarish 
Published: January 2025

Abstract
Even after seven decades since it came into force, examinations of the Indian Constitution remain partial and incomplete. It is not widely known that the original ratified copy of the Constitution also makes a visual argument through the opening pages of every part. These elaborately crafted artworks, which are entirely negated in Indian scholarship, are structured in the form of a teleological and linear narrative, encompassing a claim of an unbroken link to an immemorial civilisation. Based on archival research and a hermeneutic that combines imaginal analysis, literary theory, historical scholarship and constitutional jurisprudence, this article will demonstrate that these constitutive images are the aesthetic foundation that imaginally binds the constitutional subject and the collective citizenry, and this article will show how its negation is closely tied to a foundational ambivalence that endures in constitutional law.
Poetics and Performance: Fanfa Bands and the Semiotic Landscape in Northern Haiti
Authors: Yarrington Jonna 
Published: January 2025

Abstract
This paper examines the poetics and cultural significance of fanfa youth band performances in the rural commune of Limonade in northern Haiti. Drawing on observations during fieldwork in 2010 and 2016, it analyzes how fanfa bands, directed by maestros, create complex sign systems through music, movement, and materialities. Utilizing Roman Jakobson’s semiotic theory and Linda Waugh’s expansion of poetic function, the study explores the interpretive relations between these components and their role in constituting a unique cultural soundscape. By examining the selection and combination of musical pieces, routes, and accompanying elements, the research highlights the dynamic interaction between fanfa bands and their social environment. This semiotic analysis offers insights into the broader implications of cultural landscapes and the poetics of performance in Haiti.
Reflexivity as a transformative capacity for sustainability science: introducing a critical systems approach
Authors: Lazurko Anita , Moore Michele-Lee , Haider L. Jamila , West Simon , McCarthy Daniel D. P. 
Published: January 2025

Abstract

Non-technical summary
Transdisciplinary sustainability scientists work with many different actors in pursuit of change. In so doing they make choices about why and how to engage with different perspectives in their research. Reflexivity – active individual and collective critical reflection – is considered an important capacity for researchers to address the resulting ethical and practical challenges. We developed a framework for reflexivity as a transformative capacity in sustainability science through a critical systems approach, which helps make any decisions that influence which perspectives are included or excluded in research explicit. We suggest that transdisciplinary sustainability research can become more transformative by nurturing reflexivity.

Technical summary
Transdisciplinary sustainability science is increasingly applied to study transformative change. Yet, transdisciplinary research involves diverse actors who hold contrasting and sometimes conflicting perspectives and worldviews. Reflexivity is cited as a crucial capacity for navigating the resulting challenges, yet notions of reflexivity are often focused on individual researcher reflections that lack explicit links to the collective transdisciplinary research process and predominant modes of inquiry in the field. This gap presents the risk that reflexivity remains on the periphery of sustainability science and becomes ‘unreflexive’, as crucial dimensions are left unacknowledged. Our objective was to establish a framework for reflexivity as a transformative capacity in sustainability science through a critical systems approach. We developed and refined the framework through a rapid scoping review of literature on transdisciplinarity, transformation, and reflexivity, and reflection on a scenario study in the Red River Basin (US, Canada). The framework characterizes reflexivity as the capacity to nurture a dynamic, embedded, and collective process of self-scrutiny and mutual learning in service of transformative change, which manifests through interacting boundary processes – boundary delineation, interaction, and transformation. The case study reflection suggests how embedding this framework in research can expose boundary processes that block transformation and nurture more reflexive and transformative research.

Social media summary
Transdisciplinary sustainability research may become more transformative by nurturing reflexivity as a dynamic, embedded, and collective learning process.
Medication use is associated with distinct microbial features in anxiety and depression
Authors: Dilmore Amanda Hazel , Kuplicki Rayus , McDonald Daniel , Kumar Megha , Estaki Mehrbod , Youngblut Nicholas , Tyakht Alexander , Ackermann Gail , Blach Colette , MahmoudianDehkordi Siamak , Dunlop Boadie W. , Bhattacharyya Sudeepa , Guinjoan Salvador , Mandaviya Pooja , Ley Ruth E. , Kaddaruh-Dauok Rima , Paulus Martin P. , Knight Rob ,   on behalf of Alzheimer Gut Microbiome Project Consortium
Published: January 2025

AbstractThis study investigated the relationship between gut microbiota and neuropsychiatric disorders (NPDs), specifically anxiety disorder (ANXD) and/or major depressive disorder (MDD), as defined by Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV or V criteria. The study also examined the influence of medication use, particularly antidepressants and/or anxiolytics, classified through the Anatomical Therapeutic Chemical (ATC) Classification System, on the gut microbiota. Both 16S rRNA gene amplicon sequencing (16S) and shallow shotgun sequencing (WGS) were performed on DNA extracted from 666 fecal samples from the Tulsa-1000 and Neurocomputational Mechanisms of Affiliation and Personality Study Center for Biomedical Research Excellence (NeuroMAP CoBRE) cohorts. The results highlight the significant influence of medication use; antidepressant use is associated with significant differences in gut microbiota beta diversity and has a larger effect size than NPD diagnosis. Next, specific microbes were associated with ANXD and MDD, highlighting their potential for non-pharmacological intervention. Finally, the study demonstrated the capability of Random Forest classifiers to predict diagnoses of NPD and medication use from microbial profiles, suggesting a promising direction for the use of gut microbiota as biomarkers for NPD. Though the effect sizes were larger in females than males, similar trends emerged for both sexes. These findings encourage future research on the gut microbiota’s role in NPD and its interactions with pharmacological treatments.
PSMA2 promotes chemo- and radioresistance of oral squamous cell carcinoma by modulating mitophagy pathway
Authors: Wang Chun-I , Chen Cheng-Yi , Chen Ting-Wen , Cheng Chun-Chia , Hong Shu-Wen , Tsai Tsung-You , Chang Kai-Ping 
Published: January 2025

AbstractOral cavity squamous cell carcinoma (OSCC) represents the most prevalent malignancy among head and neck squamous cell carcinomas (HNSCCs). Standard treatment modalities include surgical resection combined with radiation and chemotherapy. However, locoregional failure remains a critical issue affecting the prognosis of OSCC patients, largely due to tumor resistance against radiation or chemotherapy. In this study, we established a gene database related to OSCC recurrence and identified PSMA2 as a novel molecule influencing prognosis in OSCC patients. An independent Taiwanese cohort confirmed that elevated PSMA2 transcript levels were associated with poorer prognosis and contributed to the chemo- and radioresistance phenotype in OSCC. Furthermore, we confirmed that PSMA2 regulates cell cycle, mitochondrial dysfunction, and mitophagy, thereby contributing to carcinogenesis and resistance. Notably, mitophagy inducer exhibit antitumor effects in PSMA2-overexpressing OSCC xenograft mouse model. Collectively, our results provide a mechanistic understanding of the atypical function of PSMA2 in promoting OSCC recurrence.