bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Management of Women With Bipolar Disorder During Pregnancy and the Perinatal Period
Authors: Uguz Faruk , Sharma Verinder , Boyce Philip , Clark Crystal T. , Galbally Megan , Koukopoulos Alexia , Marsh Wendy , Stevens Anja , Viguera Adele 
Published: August 2023

AbstractMany women with bipolar disorder experience episodes of illness or relapses over the perinatal period, especially in the immediate postpartum period. Risks associated with treated/untreated psychopathologies and fetal exposure to bipolar medications make the management of bipolar disorder during these periods challenging for clinicians and patients. In light of the available effectiveness and reproductive safety data, the current clinical update based on the opinions of a group of international perinatal psychiatry authors recommends general considerations and specific management strategies for each possible clinical scenario, including mixed features, predominant polarity, diagnosis of subtypes of bipolar disorder, severity of previous episodes, and risk of recurrence of mood episodes.
Clinical Neurology in Practice
Authors: Mathis Stéphane , Solé Guilhem , Damon-Perrière Nathalie , Rouanet-Larrivière Marie , Duval Fanny , Prigent Julia , Nadal Louis , Péréon Yann , Le Masson Gwendal 
Published: August 2023

Background:
The tongue is an essential organ for the development of certain crucial functions such as swallowing and speech. The examination of the tongue can be very useful in neurology, as the various types of lingual alterations can lead to certain specific diagnoses, the tongue being a kind of ‘mirror’ of some neurological function.

Review Summary:
To discuss the elements of clinical examination of the tongue in relation to neurological disorders. After reviewing the different superficial lesions of the tongue, we deal with various movement disorders of the tongue (fasciculations/myokimia, orolingual tremor, choreic movements of the tongue, dystonia of the tongue, lingual myoclonus, and psychogenic movements), disorders of taste and lingual sensitivity and lingual pain.

Conclusions:
Examination of the tongue should not be limited to studying its motility and trophicity. It is equally important to check the sensory function and understand how to interpret abnormal movements involving the tongue. This study also aimed to demonstrate the importance of nonmotor tongue function in neurological practice.
Mental Health Provision in PICU: An Analysis of Referrals to an Embedded Psychologist Over 20 Years at a Single Center*
Authors: Colville Gillian A. 
Published: August 2023

OBJECTIVES:The main aim of this study was to illustrate the type of mental health provision possible on PICU by describing the nature of referrals of child patients and their parents to an embedded psychologist over a 20-year period, adding to the literature on intervention and service development.DESIGN:Retrospective evaluation of anonymized departmental database.SETTING:Twelve-bed PICU at a teaching hospital in a major urban center.PATIENTS:Five hundred forty-five consecutive referrals for support for parent and/or child by PICU staff between 1998 and 2017.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Referrals increased from seven of 288 (2.4%) in 1998 to 85 of 643 (13.2%) in 2017. The majority were for parent support initially (456/545, 84%). Mean (sd) number of contacts was 4.5 (10.2), range 1 to 143, and mode was 1. Patient gender and age typical of the total PICU population, but referrals were more common where children had an oncology or trauma diagnosis (p< 0.001). Comparisons with other inpatient referrals at the same hospital revealed a higher proportion of requests were made for parent support on PICU (456/545 [84%] vs 789/1,997 [40%];p< 0.001) and that nurses were more likely to initiate referrals on PICU than on the other wards (437/543 [80%] vs 1,190/1,993 [60%];p< 0.001). In other respects, the two groups were similar in terms of number of sessions, waiting times, and attendance rates.CONCLUSIONS:Growing appreciation of the psychological impact of a child’s admission to PICU has been associated with increasing referral to an embedded psychologist over a 20-year period, at this center. Clinical and service implications are outlined in the context of the latest research on the mitigation of post-intensive care syndrome in this population.
Successful Transjugular Portosystemic Shunt Treatment of Pediatric Sinusoidal Obstruction: Case Report and Review of Literature
Authors: Ramic Lana , Speckert Matthew , Ramphal Raveena , Ling Simon C. , Temple Michael , Kehar Mohit 
Published: August 2023

Background:
In adults with medically refractory sinusoidal obstruction syndrome (SOS), a transjugular intrahepatic portosystemic shunt (TIPS) has been used successfully to improve portal hypertension and symptoms such as ascites. There is limited data on the use of TIPS for SOS in pediatric patients.

Methods:
The index case was reviewed retrospectively. PubMed and Medline databases were searched to identify other cases.

Results:
A 4-year-old male with high-risk neuroblastoma, developed SOS after tandem autologous stem cell transplant. He was medically managed with defibrotide, diuretics, and peritoneal drainage, but, due to refractoriness, he underwent TIPS day +54 following bone marrow transplant. Hepatic venous pressure gradient improved from 17 to 8 mm Hg following TIPS placement with significant improvement in the patient’s clinical status and ascites. However, 15 months later, his shunt remained patent, and he remains clinically well with stable liver enzymes. A literature review identified 13 pediatric cases of TIPS for SOS due to varied causes. TIPS caused a median hepatic venous pressure gradient of 9 mmHg (range, 2–38 mm Hg). The mortality following the procedure was 15%, with 2 cases who died at 2- and 11-days post-TIPS. At the time of the last follow-up (range 8–25 months), 5 patients were alive, and 8 were lost to follow-up.

Conclusion:
We present here a pediatric case of SOS due to stem cell transplant treated successfully with TIPS with a review of the literature. A timely, individualized application of TIPS can be effective in treating children with medication-refractory SOS.
Anatomic Study of Petrous Bone and Its Surrounding Structures in the Extended Anterior Transpetrosal Approach
Authors: Cheng Ye , Cao Jun , Chen Zhenlin , Geng Homing , Wu Xiaolong , Zhang Lei , Bai Jie , Xiao Xinru 
Published: August 2023

Extended anterior transpetrosal approach (ATPA) includes drilling the petrous bone to achieve maximal exposure of the petroclival region. Injuring of surrounding neurovascular structures, such as the internal carotid artery (ICA), during the procedure may result in severe complications. In this study, we aimed to use computer topographic images to provide comprehensive anatomic information on the petrous bone and surrounding structures to help surgeons during the extended ATPA. Computer topographic angiography images of 110 individuals were reviewed, and measurements were performed on coronal, sagittal, and axial planes following multiplanar reformation. The petrous apex and sagittal midline were used to locate the anterior, middle, and posterior parts of the petrous bone and petrosal segment of the ICA during the ATPA. The thicknesses of the petrous bone were 3.28±0.71, 3.53±0.88, and 7.02±1.11 mm at the petrous apex, trigeminal impression, and internal opening of internal auditory canal (IAC) positions, respectively. The distances between the petrous apex to the trigeminal impression, internal opening of the IAC, auris interna, and labyrinth were 7.39±1.62, 15.95±2.48, 17.39±2.39, and 29.00±3.18 mm, respectively. Furthermore, the petrosal segment of the ICA was located at the above landmarks on the petrous bone. Our findings provide anatomic information on the petrous bone and surrounding structures during the extended ATPA procedure based on fixed anatomic landmarks so as to achieve maximal exposure and reduce the number of complications.
Impact of Neighborhood Disadvantage on High-Risk Oncotype DX Recurrence Scores and Breast Cancer Survival
Authors: Goel Neha , Hernandez Alexandra , Kwon Deukwoo , Antoni Michael H. , Cole Steve 
Published: August 2023

Objective:
Evaluate the association between neighborhood disadvantage and Oncotype DX score, a surrogate for tumor biology, among a national cohort.

Summary Background Data:
Women living in disadvantaged neighborhoods have shorter breast cancer (BC) survival, even after accounting for individual-level, tumor, and treatment characteristics. This suggests unaccounted social and biological mechanisms by which neighborhood disadvantage may impact BC survival.

Methods:
This cross-sectional study included Stage I and II, ER+ /HER2- BC patients with Oncotype DX score data from the National Cancer Database from 2004-2019. Multivariate regression models tested the association of neighborhood-level income on Oncotype DX score controlling for age, race/ethnicity, insurance, clinical stage, and education. Cox regression assessed overall survival.

Results:
Of the 294,283 total BC patients selected, the majority were non-Hispanic White (n=237,197, 80.6%) with 7.6% non-Hispanic Black (n=22,495) and 4.5% Other (n=13,383). 27.1% (n=79,7254) of the population lived in the most disadvantaged neighborhoods with an annual neighborhood-level income of <$48,000 while 59.62% (n=175,305) lived in neighborhoods with a median-level income of >$48,000. On multivariate analysis controlling for age, race/ethnicity, insurance status, neighborhood-level education, and pathologic stage, patients in disadvantaged neighborhoods had a greater risk of high- versus low-risk Oncotype DX scores compared to those in advantaged neighborhoods [OR=1.04 (1.01-1.07), P=0.0067].

Conclusion and Relevance:
This study takes a translational epidemiologic approach to identify that women living in the most disadvantaged neighborhoods have more aggressive tumor biology, as determined by the Oncotype DX score.
Development and Internal Validation of a Questionnaire Assessing Predisposition to Nonadherence to Immunosuppressive Medication in Kidney Pretransplant Patients
Authors: Oliveira Luana Cristina Lins de Medeiros , Tavares Raquel Padilha Martins , Moreira Francisca Sueli Monte , Nóbrega Ítala Morgânia Farias da , Nogueira Telma Cristiane Cavalcanti , Oliveira Alene Barros de , Batista Lorena de Medeiros , Martins Rand Randall , Oliveira Antonio Gouveia 
Published: August 2023

Background.
After kidney transplant, nonadherence to immunosuppressive therapy is the main cause of impaired kidney function and graft loss. The objective of this study was the development and internal validation of a clinical questionnaire for assessing the predisposition to adherence to immunosuppressive therapy in kidney pretransplant patients.

Methods.
Multicenter prospective study conducted in 7 kidney hemodialysis and 6 kidney transplant centers of 3 Brazilian state capitals. Kidney transplant candidate patients of both sexes and >18-y-old were included. Retransplanted patients were excluded. A 72-item pilot version of the questionnaire, created through literature review complemented with a focus group of 8 kidney pretransplant patients, was administered to 541 kidney transplant candidate patients. Factor analysis with varimax rotation was used for questionnaire development. Internal validity evaluation used Cronbach’s alpha and test–retest reliability. Construct validity was assessed by differentiation by known groups.

Results.
The final questionnaire, named Kidney AlloTransplant Immunosuppressive Therapy Adherence (KATITA) Questionnaire, consisting of 25 items in 3 dimensions, presented good internal consistency reliability (Cronbach’s alpha 0.81). The 3 dimensions and respective Cronbach’s alpha were “Carelessness” (14 items, 0.81), “Skepticism” (6 items, 0.57), and “Concern” (5 items, 0.62). The interdimension correlation matrix showed low correlation coefficients (<0.35). Test–retest reliability, evaluated with 154 patients, showed an intraclass correlation coefficient of 0.62 (moderate agreement). The scale showed construct validity.

Conclusions.
The KATITA-25 questionnaire is the first psychometric instrument for evaluation of predisposition to nonadherence to immunosuppressive medication in candidate patients for kidney transplant in the pretransplant setting.
Current avenues of gene therapy in Pompe disease
Authors: Leon-Astudillo Carmen , Trivedi Prasad D. , Sun Ramon C. , Gentry Matthew , Byrne Barry J. , Corti Manuela 
Published: August 2023

Purpose of the review
Pompe disease is a rare, inherited, devastating condition that causes progressive weakness, cardiomyopathy and neuromotor disease due to the accumulation of glycogen in striated and smooth muscle, as well as neurons. While enzyme replacement therapy has dramatically changed the outcome of patients with the disease, this strategy has several limitations. Gene therapy in Pompe disease constitutes an attractive approach due to the multisystem aspects of the disease and need to address the central nervous system manifestations. This review highlights the recent work in this field, including methods, progress, shortcomings, and future directions.

Recent findings
Recombinant adeno-associated virus (rAAV) and lentiviral vectors (LV) are well studied platforms for gene therapy in Pompe disease. These products can be further adapted for safe and efficient administration with concomitant immunosuppression, with the modification of specific receptors or codon optimization. rAAV has been studied in multiple clinical trials demonstrating safety and tolerability.

Summary
Gene therapy for the treatment of patients with Pompe disease is feasible and offers an opportunity to fully correct the principal pathology leading to cellular glycogen accumulation. Further work is needed to overcome the limitations related to vector production, immunologic reactions and redosing.
Thymectomy in myasthenia gravis
Authors: Rath Jakob , Moser Bernhard , Zimprich Fritz 
Published: August 2023

Purpose of review
Thymectomy has long been used in the treatment of patients with myasthenia gravis and antibodies against the acetylcholine receptor. However, its effectiveness has only been proven a few years ago in a randomized controlled trial in patients under the age of 65. Here, we review the current literature focusing on patient subgroups, potential biomarkers for outcome prediction and the choice of surgical approach.

Recent findings
Long-term follow-up studies after thymectomy confirmed that the benefits regarding clinical outcome parameters and a reduced need for immunosuppressive treatment persist. Nevertheless, a substantial proportion of patients in real-world cohorts do not reach complete stable remission after thymectomy indicating that the underlying autoimmune process is sustained in the periphery. Our understanding of the responsible mechanisms has improved with recent studies. Presently, outcome data after thymectomy in several patient subgroups, such as those aged over 50 years, those with juvenile onset or those with purely ocular symptoms are limited and have been the focus of recent research activities. Similarly, biomarkers guiding an appropriate patient selection for thymectomy are under investigation. A number of cohort studies demonstrated that minimal invasive surgical techniques such as extended robotic thymectomy lead to similar positive outcomes as a transsternal approach with potentially fewer short-term adverse effects.

Summary
Thymectomy is an effective treatment option in adult patients with early onset acetylcholine-receptor positive myasthenia gravis but uncertainty remains with regard to certain patient subgroups.
Advanced brain imaging for the diagnosis of Alzheimer disease
Authors: Wang Yi-Ting Tina , Rosa-Neto Pedro , Gauthier Serge 
Published: August 2023

Purpose of review
The purpose is to review the latest advances of brain imaging for the diagnosis of Alzheimer disease (AD).

Recent findings
Brain imaging techniques provide valuable and complementary information to support the diagnosis of Alzheimer disease in clinical and research settings. The recent FDA accelerated approvals of aducanumab, lecanemab and donanemab made amyloid-PET critical in helping determine the optimal window for anti-amyloid therapeutic interventions. Tau-PET, on the other hand, is considered of key importance for the tracking of disease progression and for monitoring therapeutic interventions in clinical trials. PET imaging for microglial activation, astrocyte reactivity and synaptic degeneration are still new techniques only used in the research field, and more studies are needed to validate their use in the clinical diagnosis of AD. Finally, artificial intelligence has opened new prospective in the early detection of AD using MRI modalities.

Summary
Brain imaging techniques using PET improve our understanding of the different AD-related pathologies and their relationship with each other along the course of disease. With more robust validation, machine learning and deep learning algorithms could be integrated with neuroimaging modalities to serve as valuable tools for clinicians to make early diagnosis and prognosis of AD.
A patient with neuropathy and ataxia: what do I have to consider?
Authors: Roberts Leslie J. , Szmulewicz David J. 
Published: August 2023

Purpose of review
An increasing number of peripheral neuro(no)pathies are identified as involving other components of the neurological system, particularly those that further impair balance. Here we aim to outline an evidence-based approach to the diagnosis of patients who present with a somatosensory disorder which also involves at least one other area of neurological impairment such as the vestibular, auditory, or cerebellar systems.

Recent findings
Detailed objective investigation of patients who present with sensory impairment, particularly where the degree of imbalance is greater than would be expected, aids the accurate diagnosis of genetic, autoimmune, metabolic, and toxic neurological disease.

Summary
Diagnosis and management of complex somatosensory disorders benefit from investigation which extends beyond the presenting sensory impairment.
Performance of ChatGPT in Diagnosis of Corneal Eye Diseases
Authors: Delsoz Mohammad , Madadi Yeganeh , Munir Wuqaas M , Tamm Brendan , Mehravaran Shiva , Soleimani Mohammad , Djalilian Ali , Yousefi Siamak 
Published: August 2023

ABSTRACTIntroductionAssessing the capabilities of ChatGPT-4.0 and ChatGPT-3.5 for diagnosing corneal eye diseases based on case reports and compare with human experts.MethodsWe randomly selected 20 cases of corneal diseases including corneal infections, dystrophies, degenerations, and injuries from a publicly accessible online database from the University of Iowa. We then input the text of each case description into ChatGPT-4.0 and ChatGPT3.5 and asked for a provisional diagnosis. We finally evaluated the responses based on the correct diagnoses then compared with the diagnoses of three cornea specialists (Human experts) and evaluated interobserver agreements.ResultsThe provisional diagnosis accuracy based on ChatGPT-4.0 was 85% (17 correct out of 20 cases) while the accuracy of ChatGPT-3.5 was 60% (12 correct cases out of 20). The accuracy of three cornea specialists were 100% (20 cases), 90% (18 cases), and 90% (18 cases), respectively. The interobserver agreement between ChatGPT-4.0 and ChatGPT-3.5 was 65% (13 cases) while the interobserver agreement between ChatGPT-4.0 and three cornea specialists were 85% (17 cases), 80% (16 cases), and 75% (15 cases), respectively. However, the interobserver agreement between ChatGPT-3.5 and each of three cornea specialists was 60% (12 cases).ConclusionsThe accuracy of ChatGPT-4.0 in diagnosing patients with various corneal conditions was markedly improved than ChatGPT-3.5 and promising for potential clinical integration.Key summary points-The aim of this work was to evaluate the performance of ChatGPT-4 and ChatGPT-3.5 for providing the provisional diagnosis of different corneal eye diseases based on case descriptions and compared them with three cornea specialists.-The accuracy of ChatGPT-4.0 in diagnosing patients with various corneal conditions was significantly better than ChatGPT-3.5 based on the specific cases.-The interobserver agreement between ChatGPT-4.0 and ChatGPT-3.5 was 65% while the interobserver agreement between ChatGPT-4.0 and three cornea specialists were 85%, 80%, and 75%, respectively.
Retrieval induced forgetting in a non-monotonic hippocampal model
Authors: Midler Benjamin , McClelland James 
Published: August 2023

AbstractRetrieval induced forgetting (RIF) occurs when the retrieval of one item negatively impacts the recall probability of related items stored in memory (Anderson et al., 1994). Recently, Ritvo et al. (2023) demonstrated RIF emerges in a neural network model equipped with non-monotonic plasticity. Their finding supports the non-monotonic plasticity hypothesis (NMPH; Ritvo et al., 2019): the theory that connection changes in the brain follow a “U” shaped function of post-synaptic stimulation. Here, we apply a unique implementation of non-monotonic plasticity to a neural network model of an idealized hippocampus (HPC) and evaluate it with an adaptation of a classic RIF task. The model evidences the behavioral and representational characteristics of RIF, replicating Ritvo et al. (2023). As a monotonic baseline model failed these tests, we provide evidence of non-monotonic plasticity’s sufficiency for RIF. In addition to demonstrating the NMPH is robust to multiple implementations and evaluative paradigms, we conduct additional analysis to provide a mechanistic explanation for how non-monotonic plasticity brings about RIF. Lastly, we evaluate the model with an expansion of RIF: reverse RIF. The model fails this final test, raising questions for future research on the necessary parameters of non-monotonic plasticity and whether it must pair with complementary processes in the brain.
Structural Determinants of Tendon Function During Development and Their Sensitivity to Mechanical Stimulation
Authors: Peterson Benjamin E. , Canonicco Castro Maria L. , McCarthy Helen , Buckley Niamh , Dunne Nicholas , Rolfe Rebecca , Murphy Paula , Szczesny Spencer E. 
Published: August 2023

AbstractThe load-bearing capabilities of tendon are acquired during neonatal stages of development, characterized by an abrupt increase in multiscale mechanical properties. While prior work has identified numerous changes within the collagenous structure during these developmental periods, the primary structural elements that give rise to this abrupt mechanical functionality, and their mechanobiological sensitivity, remains unclear. To address this gap in knowledge, we leveraged a combination of ultrastructural imaging, biochemical/thermodynamic assays, multiscale mechanical testing, and shear lag modeling to probe the dynamic structure-function relationships and establish their sensitivity to mechanical stimulation during tenogenesis. Mechanical testing and modeling suggested that the rapid increase in multiscale mechanics can be explained by a increasing fibril length and intrafibrillar crosslinking. To test this, we inhibited collagen crosslinking during development and observed a drastic reduction in multiscale mechanical capabilities that was explained by a reduction in both fibril modulus and length. Using muscle paralysis to investigate mechanosensitivity, we observed a significantly impaired multiscale mechanical response despite small changes in fibril diameter and fibril area fraction. While there was no change in crosslinking density, there was a decrease in thermal stability with flaccid paralysis, and our shear-lag model suggested that flaccid paralysis produces a reduction in fibril length and intrafibrillar crosslinking. Together, these data suggest that both intrafibrillar crosslink formation and fibril elongation are critical to the formation of load-bearing capabilities in tenogenesis and are sensitive to musculoskeletal activity. These findings provide critical insights into the biological mechanisms that give rise to load-bearing soft tissue.