bluuebunny/crossref_metadata_2025_split huggingface dataset:
Legal systems
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter begins with an overview of law in society, and then jurisprudence and legal interpretation. It goes on to explain sources of law, and the differences between civil law and common law systems. It goes on to explain the courts and tribunals of the UK, and Scotland. Judicial review, roles within the court, court procedures, and the burdens and standards of proof are all explained, alongside rules of evidence. The court systems within England, Wales, and Northern Ireland, the Republic of Ireland are all outlined, as well as a brief overview of systems in the EU and other countries. Finally, professional regulatory structures, inquests, and inquiries are all included.
The criminal justice system
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter covers the criminal justice system. It outlines social services, police services, the police station, and the handling of vulnerable suspects. Investigative psychology and prison services are both described, along with adolescent secure services. Parole boards, and probations services are included, alongside offender management and managing the restricted patient. Safeguarding, public protection arrangements, the risk management authority are all explained, and the chapter concludes with crime prevention, PREVENT, and homicide and suicide inquiries.
Legal tests relevant to psychiatry
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter provides a general overview of the legal tests relevant to psychiatry. It begins with fitness to plead and fitness to give evidence, and the validity of confessions. Capacity for form intent, automatism, and both voluntary and involuntary intoxication are all covered, as is intoxication and specific defences. The chapter moves on to insanity, diminished responsibility, loss of control and provocation, and duress coercion and necessity in legal defences and forensic psychiatry. Amnesia, aggravating and mitigating factors, and legal tests in personal injury cases are all outlined. Finally, fitness to practice professionally, tests in family law, fitness for work and dismissal, and fitness for extradition and deportation are explained.
Applied ethics and testimony
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter covers applied ethics and supplying testimony in court. It begins with judicial ethics and legal philosophy, and discusses avoiding addressing the ultimate issue in court. It then has an overview of giving expert advice to one side. Tips and tricks on how to convey controversial clinical concepts in court are outlined, and the importance of having opinions in sentencing is covered. The courts’ assessments of dangerousness is explained, and finally bias influencing opinion (including unconscious bias) is covered.
Providing reports
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter provides guides for providing reports in forensic psychiatry. It begins with the aims and methods of report-writing, then goes on to preparation, taking instructions, issues that should be considered before writing the report, and general aspects to do with the task at hand. It provides a suggested outline for report structure, and follow-up actions after writing. The remainder of the chapter provides specific instructions for different types of report: mental health tribunals, criminal cases, parole boards, family courts, civil compensation cases, clinical negligence, professional regulatory cases, employment tribunals, deportation and extradition, and inquests. Finally reporting without giving oral evidence is covered.
Decision-making theories
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán 
Published: June 2023

Abstract
Good, effective, ethical decisions in the assessment, treatment, and management of patients in clinical contexts and defendants or litigants in legal contexts depend upon the strengths and weaknesses of the decision-making process used. Explicit reflection helps good decision-making in any area of medicine (and far beyond medicine), but is particularly necessary in forensic psychiatry and psychology. Before the Enlightenment of the eighteenth century, decision-making rested largely upon the time-worn pillars of faith, hope, and experience. As the Age of Reason progressed, however, scientists, philosophers, and mathematicians, who prided themselves on their rationalism, turned their attention to decision-making, and developed theories that reflected their assumption that it was no more than a purely cognitive reasoning process. This chapter provides an overview of decision-making theories. It includes rational decision-making; nonrational decision-making; dual processes (system 1 and system 2); values at the heart of decision-making; ease, bias, and heuristics; and values-based decision-making.
Ethical cases
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán 
Published: June 2023

Abstract
This chapter covers twenty-four ethical cases with accompanying reflection questions to guide the forensic psychiatrist through difficult ethical issues. It begins with the right or duty to disclose defence reports in a criminal law context, and the right or duty to breach confidence in a civil law context. The duty to supervise a patient in the community is covered, alongside what information to share with patients. Treating the psychiatrist and therapist as an expert witness in criminal trials and civil litigation are both explained, alongside the role professional versus expert witnesses, and professional versus contractual duty and medically relevant but legally inadmissible information. The role of personal values in expert decision-making is discussed, and how to navigate uncertainty about your opinion and resisting legal pressure is explained. Disputes within forensic mental health teams and presenting evidence to a tribunal is related, and what to do when there is a clash between clinician and organisational values is explained. The role of personal values in risk-formulation, monitoring ‘treatment’, assisting police and the prosecution of a patient, measuring ‘good-enough’ treatment outcomes for patient progression, and assisting the detection, prevention, or prosecution of a serious crime are all covered. Professional boundary violations and workplace discrimination, how to weigh the benefits of treatment against detrimental side-effects, and finally what to do when all options present ethical issues are included.
Criminal law cases
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán 
Published: June 2023

Abstract
In this chapter thirty-one cases provide examples of criminal law, along with guided questions to help the forensic psychiatrist navigate the patient under criminal charges. The chapter begins with the preparation of an expert report on a vulnerable defendant, and how to perform an assessment for suggestibility and compliance on the patient. Next it covers fitness to plead in circumstances of intellectual disability and psychosis, and how to use psychological test results. Diminished responsibility is discussed with cases that include psychosis, neurotic illness, personality disorders, recognised medical conditions, and substance dependence and intoxication. It then covers the difference between loss of control and diminished responsibility, the concept of ‘slow burn’, and woundability and malingering, and joint enterprise and the role of encouraging or assisting a crime. Cases in the capacity to form specific intent in the presence of intoxication, intent to kill in the presence of drugs and alcohol, and the capacity to reform when there is the potential for the death sentence to be carried out are then included. Insanity as an appeal against verdict, and infanticide by an adolescent are both covered. Duress using drug importation is included, alongside vulnerability short of duress in the presence of personality disorder, and self-defence in attempted murder are all included. Cases on automatism in intoxication, brain injury, and dissociation; amnesia, dementia, and retracted confession in intellectual disability; and reliability of witness evidence, extradition and autism, appeal against murder convictions in emerging psychotic depression, and requests to alter court reports for sentencing.
A case study of critiquing clinical decision-making within multiple paradigms
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán 
Published: June 2023

Abstract
The well-known case of a higher trainee paediatrician Dr Bawa-Garba, who was convicted of manslaughter as a result of her role in the death of a young boy with Down’s syndrome, illustrates the differences of process and outcome between prosecution for gross negligence manslaughter, civil legal negligence, professional regulatory proceedings, and internal service inquiries. All the material given in the description that follows is in the public domain, released by the inquiries concerned. This chapter provides a real-world case of critiquing clinical decision-making in a manslaughter trial. It presents the clinical case, the legal case, and reflections on how the case was handled.
Randomized controlled trials
Authors: Cook Jonathan A. 
Published: June 2023

Abstract
Randomized controlled trials (RCTs) are the preferred study design for assessing efficacy in clinical trials. This chapter describes the standard (two arm parallel-group) RCT design. In this chapter, why RCTs are considered the ‘gold’ standard design for comparing medical treatments is reviewed. The benefits of random allocation of treatments are considered. What is meant by random allocation, along with different methods of randomization (simple, random permuted blocks, stratification, minimization, and outcome-adaptive) are described. How randomization can be carried out in a clinical trial is also considered, and guidance on how to choose the randomisation method for a trial is given.
Choosing the sample size for a clinical trial
Authors: Cook Jonathan A. 
Published: June 2023

Abstract
Getting the sample size right is crucial for ensuring the clinical trial can meet its objectives. It also has practical, financial, and ethical considerations. Why getting the sample size right matters is addressed in this chapter. The chapter explains the purpose of the sample size calculation, and to how to determine the required sample size for binary, continuous and time-to-event outcomes. The inputs needed for each are covered along with what values to use, and worked example calculations are used. Different approaches to sample size determination when assessing safety is the main focus, or a precision-based or Bayesian approach are also described.
Reporting and disseminating the findings of a clinical trial
Authors: Cook Jonathan A. 
Published: June 2023

Abstract
The findings of a clinical trial need to be reported and disseminated so that they can be used by others and improve clinical practice. Why the quality of study reporting matters and the consequences of poor reporting are addressed in this chapter. Common limitations in reporting are considered along with potential remedies. The vital role of reporting guidelines in facilitating good reporting in journal articles is reviewed. The many possible audiences who might be interested in trial results and means of dissemination that can reach them are addressed, as is how to communicate to them. Sharing trial data and the related challenges are also considered.
A Denial a Day Keeps the Doctor Away
Authors: Dunn Abe , Gottlieb Joshua D , Shapiro Adam Hale , Sonnenstuhl Daniel J , Tebaldi Pietro 
Published: June 2023

Abstract
Who bears the consequences of administrative problems in health care? We use data on repeated interactions between a large sample of U.S. physicians and many different insurers to document the complexity of health care billing, and estimate its economic costs for doctors and consequences for patients. Observing the back-and-forth sequences of claim denials and resubmissions for past visits, we can estimate physicians’ costs of haggling with insurers to collect payments. Combining these costs with the revenue never collected, we estimate that physicians lose 18% of Medicaid revenue to billing problems, compared with 4.7% for Medicare and 2.4% for commercial insurers. Identifying off of physician movers and practices that span state boundaries, we find that physicians respond to billing problems by refusing to accept Medicaid patients in states with more severe billing hurdles. These hurdles are quantitatively just as important as payment rates for explaining variation in physicians’ willingness to treat Medicaid patients. We conclude that administrative frictions have first-order costs for doctors, patients, and equality of access to health care. We quantify the potential economic gains—in terms of reduced public spending or increased access to physicians—if these frictions could be reduced and find them to be sizable.
Radiotherapy Infrastructure Shielding Calculations: software development for shielding calculations in a linear accelerator radiotherapy room
Authors: Ganou Charalampia , Ganos Aristotelis , Papatheodorou Spiridon , Metaxas Vasileios , Dimitroukas Christos , Panayiotakis George 
Published: June 2023

Abstract
This work aimed to develop and validate software that calculates the shielding thickness required for a radiotherapy room with a linear accelerator utilising geometric and dosimetric data. The software “Radiotherapy Infrastructure Shielding Calculations” (RISC) was developed using MATLAB programming. It does not require the installation of the MATLAB platform, and the user only needs to download and install the application, which displays a graphical user interface (GUI). The GUI includes empty cells to insert numerical values for several parameters to calculate the proper shielding thickness. The GUI comprises two main interfaces, one for the primary and one for the secondary barrier calculation. The interface of the primary barrier is divided into four tabs: (a) primary radiation, (b) patient scattered and leakage radiation, (c) IMRT techniques and (d) the shielding cost calculations. The interface of the secondary barrier includes three tabs: (a) patient scattered and leakage radiation, (b) IMRT techniques and (c) the shielding cost calculations. Each tab consists of two sections: one for input and one for output of the necessary data. The RISC is based on the methods and formulae of the NCRP 151 and calculates the primary and secondary barrier thickness for ordinary concrete with a density of 2.35 g/cm3 and the cost for a radiotherapy room with a linear accelerator that performs conventional or IMRT techniques. Calculations can be performed for photon energies of 4, 6, 10, 15, 18, 20, 25 and 30 MV of a dual-energy linear accelerator, while instantaneous dose rate (IDR) calculations are also performed. The RISC has been validated using all comparative examples of NCRP 151 and the calculations from shielding reports of the Varian IX linear accelerator at Methodist Hospital of Willowbrook and Elekta Infinity at the University Hospital of Patras. The RISC is accompanied by two text files: (a) “Terminology,” extensively describing all parameters, and (b) “User’s Manual,” providing useful instructions to the user. The RISC is user-friendly, simple, fast and precise, providing accurate shielding calculations and quickly and easily reproducing different shielding scenarios for a radiotherapy room with a linear accelerator. Additionally, it could be used during the educational process of shielding calculations by graduate students or trainee medical physicists. As a future work, the RISC will be updated with new features such as skyshine radiation, door shielding, and other types of machines and shielding materials.
Identification of Bone Morphometric Protein-Related Hub Genes and Construction of a Transcriptional Regulatory Network in Patients With Ossification of the Ligamentum Flavum
Authors: Tuo YiFan , Hu Lihong , Gu Wenbo , Yuan Xiaoya , Ma Da , Wu Jide , Luo Di , Zhang Xiao , Li Xusheng , Yang Shengsen , Yuan Haifeng 
Published: June 2023

Study Design:
Basic science laboratory study.

Objective:
To identify hub genes related to bone morphogenetic proteins (BMP) in ossification of the ligamentum flavum (OLF) and analyze their functional characteristics.

Summary of Background Data:
The exact etiology and pathological mechanism of OLF remain unclear. BMPs are pleiotropic osteoinductive proteins that may play a critical role in this condition.

Methods:
The GSE106253 and GSE106256 datasets were downloaded from the Gene Expression Omnibus database. The mRNA and lncRNA expression profiles were obtained from GSE106253. The miRNA expression profiles were obtained from GSE106256. Differentially expressed genes (DEGs) were identified between OLF and non-OLF groups and then intersected with BMP-related genes to obtain differentially expressed BMP-related genes (DEBRGs). The least absolute shrinkage selection operator (LASSO) and support vector machine recursive feature elimination (SVM-RFE) were used to screen hub genes. Furthermore, a competing endogenous RNA (ceRNA) network was constructed to explain the expression regulation of the hub genes in OLF. Finally, the protein and mRNA expression levels of the hub genes were verified using western blot and real-time polymerase chain reaction (RT-PCR), respectively.

Results:
We identified 671 DEGs and 32 DEBRGs. Hub genes ADIPOQ, SCD, SCX, RPS18, WDR82, and SPON1, identified via LASSO and SVM-RFE analyses, showed high diagnostic values for OLF. Furthermore, the ceRNA network revealed the regulatory mechanisms of the hub genes. RT-PCR showed that the mRNA expression of the hub genes was significantly downregulated in the OLF group compared with the non-OLF group. Western blot showed that the protein levels of ADIPOQ, SCD, WDR82, and SPON1 were significantly downregulated, whereas those of SCX and RPS18 were significantly upregulated in the OLF group compared with the non-OLF group.

Conclusion:
This study is the first to identify BMP-related genes in OLF pathogenesis through bioinformatics analysis. ADIPOQ, SCD, SCX, RPS18, WDR82, and SPON1 were identified as hub genes for OLF. The identified genes may serve as potential therapeutic targets for treating patients with OLF.
Novel agents for treating IgA nephropathy
Authors: Kunter Uta , Seikrit Claudia , Floege Jürgen 
Published: June 2023

Purpose of review
In the past, the treatment of IgA nephropathy (IgAN), which is the most common glomerulonephritis worldwide, mostly relied on blockade of the renin–angiotensin system as a central component of so-called supportive therapy as well as on high-dose systemic corticosteroid therapy.

Recent findings
The supportive treatment arm has been expanded by the addition of sodium-glucose cotransporter-2 inhibitors, hydroxychloroquine, and, most recently, endothelin A receptor blockers. Treatment with high-dose systemic corticosteroids has become more controversial, with some studies observing no benefit and others documenting the protection of kidney function. However, all recent studies on systemic corticosteroids consistently found significant toxicity. An important novel approach to IgAN, therefore, is therapy with a targeted release formulation of budesonide with preferential release in the distal small intestine, given the mounting evidence for a gut–kidney axis in the pathophysiology of IgAN. In addition, emerging new therapeutic options include a variety of complement inhibitors as well as agents targeting B-cell proliferation and differentiation.

Summary
In recent years, IgAN has become the focus of a considerable number of clinical studies that will significantly advance the development of new therapy strategies.
The Limit Is Zero: A Prospective Evaluation of Ketorolac in Patients Undergoing Primary Palatoplasty to Reduce Narcotic Utilization
Authors: Cepeda Alfredo , Johnson Madysen L. , Kelagere Kavya , Obinero Chioma G. , Nguyen Phuong D. , Greives Matthew R. 
Published: June 2023

Background:
Patients undergoing primary palatoplasty rely on narcotics for pain control, but narcotics can lead to sedation and respiratory depression. Recent research into Enhanced Recovery After Surgery (ERAS) pathways utilizing multimodal pain therapy has yielded promising results for patients undergoing palatoplasty in terms of decreased hospital length of stay (LOS), increased oral intake, and decreased narcotic usage. Despite the potential benefit of ketorolac after palatoplasty, there is a paucity of data regarding its use.

Methods:
A single-center cohort study of patients undergoing primary palatoplasty was performed using 2 cohorts: a retrospective cohort treated with our institution’s prior ERAS protocol from 2016 to 2018 and a prospective group of patients who also received ketorolac (ERAS+K) postoperatively from 2020 to 2022.

Results:
A total of 85 patients (57 ERAS and 28 ERAS+K) were included. Compared with the ERAS group, the ERAS+K cohort had significantly decreased LOS (31.8 versus 55 h, P=0.02), decreased morphine milligram equivalents administered at 24 hours (1.5 versus 2.5, P=0.003), 48 hours (0 versus 1.5, P<0.001), and total inpatient morphine milligram equivalents (1.9 versus 3.8, P=0.001). The ERAS+K group also had a significant decrease in the prescribed narcotic rate (32.1% versus 61.4%, P=0.006). No bleeding issues, blood transfusions, or reoperations were noted in either cohort.

Conclusions:
This study illustrates many potential benefits of using ketorolac as a pain management adjunct in combination with a multimodal pain regimen. Our results demonstrated favorable outcomes, including decreased narcotic usage and LOS as well as increased hourly oral intake, without increasing bleeding complications.
New developments in diagnostics and treatment of adult-onset focal dystonia
Authors: Centen Liesanne M. , van Egmond Martje E. , Tijssen Marina A.J. 
Published: June 2023

Purpose of review
The aim of this review is to showcase the recent developments in the field of diagnosis and treatment of adult-onset focal dystonia.

Recent findings
Accurate phenotyping of focal dystonia is essential in the process of finding an underlying cause, including acquired, genetic, and idiopathic causes. Motor symptoms as well as the associated nonmotor symptoms and their detrimental impact on quality of life have received increased interest over the last years. The diagnostic process is complicated by the steadily increasing numbers of newly discovered genes associated with dystonia. Recent efforts have been aimed at further developing recommendations and algorithms to aid in diagnosis and in navigating the use of diagnostic tools. In terms of treatment, research on DBS is advancing towards a better understanding of the most effective stimulation locations within the globus pallidus. Moreover, with the introduction of the LFP-recording devices, the search continues for an accurate electrophysiological biomarker for dystonia.

Summary
Accurate phenotyping and (sub)classification of patients with dystonia is important for improving diagnosis, subsequent treatment effect and population-based study outcomes in research. Medical practitioners should be attentive to the presence of nonmotor symptoms in dystonia.