bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychomotor Side Effects of Carbamazepine in an Elderly Patient With Bipolar Disorder and Cognitive Impairment
Authors: Compaired Alejandro , Torres Javier 
Published: April 2023

AbstractIntroductionThe management of elderly bipolar patients can become very complex due to higher prevalence of medical comorbidities and sensitivity to treatment-related adverse effects. One of the antiepileptic drugs used for their treatment, carbamazepine, has had a number of cognitive and psychomotor effects linked to it: deterioration in measures of information processing speed, and attention and faster motor skills after discontinuation, among others. The literature concerning them is quite sparse.MethodologyWe report the case of a 75-year-old woman with bipolar disorder and unspecified cognitive impairment who was brought to the emergency department by her family due to global functional decline dating 3 weeks back.ResultsThe patient had been diagnosed and in treatment with bipolar disorder for 40 years. About 2 months before the current episode, because of the presence of tremor and family reports of marked functional decline (from being independent for daily life activities to being bound to a wheelchair and with worsening cognitive symptoms), the psychiatrist opted for a gradual switch from valproate to carbamazepine. During our interview, her husband pointed to the complete dose of 100 mg of carbamazepine 3 weeks ago as the onset of her current symptoms. The patient demonstrated clear psychomotor inhibition, with an absence of spontaneous movement and sporadic, almost monosyllabic, responses to only the simplest questions. Although aware that she was in a hospital, she could not recall its name and was completely disoriented in regards to time. Barely capable of emoting with her facial muscles, she denied feeling depressed and only acknowledged a stomachache. After spending the night in observation, and the suspension of carbamazepine, the patient experienced an improvement of her cognitive functions: although still not fully oriented in space and time, she could now speak in sentences and answer most of our questions. Even though she still maintained not being depressed, when pressed about any weird sensations she admitted to the feeling of being dead inside. The decision was made to transfer her to the psychogeriatric hospitalization unit.DiscussionThe initial assessment of the patient was complicated due to a variety of factors. Beyond the physical comorbidities, the psychomotor inhibition impeded a thorough examination of her emotional state. Only the suppression of her evening dose of carbamazepine allowed for the diagnosis of Cotard-like major depressive symptoms. Even though the cognitive impairment was apparent before, the state of the patient was markedly improved with just the removal of carbamazepine and was confirmed by her family to be a lot closer to her base state of more than a month ago.ConclusionThe use of anticonvulsant therapy in elderly bipolar patients with cognitive impairment can have important side effects. Further evidence of the prevalence and specific nature and frequency of its side effects is needed.FundingNo Funding
Pure Verbal Autopalinacousis
Authors: Trinh Alisa , Hirsch Alan 
Published: April 2023

AbstractIntroductionPalinacousis, the phenomenon in which sounds are internally perseverated or repeated has not heretofore been reported occurring exclusively to an individual’s own voice.MethodsA 52-year-old woman started to experience auditory hallucinations of her voice at 3 years old when she began talking out loud. The auditory hallucinations of her own voice, yclept autopalinacousis, consisting of one to three words, were affectively neutral, rarely disruptive, and unchanged by psychiatric medications. During these palinacoustic phenomena, she would hear the last few words she had spoken out loud repeat inside her head in both ears. When the autopalinacousis occurred, the words were repeated just once. Sound quality was an exact replication of how it was originally spoken. She only experienced the palinacousis to her own voice and never to any other sounds. For the palinacousis to occur, she had to verbally state the words loud enough for her to hear. If she spoke out loud but could not hear her own voice, via occlusion of her external auditory canal or presence of loud noise, the internal auditory repetition would not occur. However, after the auditory stimulus was sensed, nothing could reduce the palinacousis. The palinacousis could occur if she read out loud, but not if she read silently. The frequency of the autopalinacousis ranged from a few times a week to several times a day and was associated with reduced sleep, but unaffected by mood, psychiatric medications, or headaches. Five months prior to her psychiatric hospitalization, she began to experience paranoid delusions, decreased sleep, increased activity, rapid speech, and auditory hallucinations of one male and two female voices. In contrast to autopalinacousis, these auditory hallucinations consisted of full phrases or sentences, were affectively charged, intrusive, and diminished by psychiatric medications. No palinacousis occurred with the hallucinated voices.ResultsAbnormalities: Mental Status Examination: Speech: pressured. Oriented x2. Memory: ability to remember 5 digits forwards and 2 digits backwards. She is not able to spell with word “world.” Calculation ability: poor. MRI of brain with and without contrast: normal.DiscussionIn cases where patients with psychotic illness experience palinacousis, the palinacousis always appear after the psychotic illness has already manifested, anywhere from less than a year to 15 years later. Our patient’s palinacousis presented almost 5 decades before the onset of her auditory hallucinations and paranoid delusions. Furthermore, her palinacousis only occurred to her own spoken voice and never to any other voices. In those who present with auditory hallucinations, query as to the presence and characteristics of palinacousis is warranted.FundingNo Funding
Review of the Trace Amine-Associated Receptor 1 (TAAR1) Agonist Ulotaront: Part II—Summary of Initial Clinical Efficacy/Safety Results
Authors: Hopkins Seth C. , Dworak Heather , Zeni Courtney , Koblan Kenneth S. 
Published: April 2023

AbstractIntroductionUlotaront is a trace amine-associated receptor 1 (TAAR1) agonist with serotonin 5-HT1A agonist activity that has received FDA Breakthrough Therapy Designation for the treatment of schizophrenia. Here we summarize ongoing clinical research characterizing the efficacy and safety of ulotaront as a member of the novel trace amine-associated receptor 1 (TAAR1) agonist class.MethodsSummarized are results from a double-blind, placebo-controlled study to evaluate the efficacy and safety of ulotaront (50 mg or 75 mg) in an acute exacerbation of schizophrenia, and a 6-month, open-label follow-up study. Also summarized are post-hoc analyses evaluating negative symptom efficacy, and key safety and adverse event (AE) outcomes.ResultsIn the short-term study, treatment with ulotaront was associated with significant (p<0.001) endpoint improvement in the PANSS total score (effect size [ES]: 0.45), the CGI-Severity score (ES: 0.52) and the Brief Negative Symptom Scale total score (ES: 0.48). The incidence of any AE was lower on ulotaront versus placebo (45.8% vs. 50.4%), and the number needed to harm (NNH) for individual AEs on ulotaront were all >40. Ulotaront was associated with lower risk for antipsychotic class-related AEs (extrapyramidal symptoms, akathisia, somnolence, nausea/vomiting, increased weight/metabolic labs, prolactinemia). The 6-month study demonstrated further improvement, with a completion rate (67%) that was higher than reported for current dopamine D2 antipsychotics.ConclusionsThe emerging profile of ulotaront is characterized by significant improvement in positive and negative symptoms of schizophrenia. The safety and tolerability profile of ulotaront is markedly different with respect to antipsychotic class-related AEs. The benefit-risk profile of ulotaront, as a member of a novel TAAR1 agonist class, is distinguished from antipsychotics by lack of AEs related to D2 and serotonin 5-HT2A receptor blockade.FundingSunovion Pharmaceuticals, Inc., and Otsuka Pharmaceutical Development & Commercialization, Inc.
Clinical Determinants, Patterns, and Outcomes of Antipsychotic Medication Prescribing in the Treatment of Schizophrenia and Schizoaffective Disorder: A Naturalistic Cohort Study
Authors: Groenendaal Emily , Lynch Sean , Dornbush Rhea , Klepacz Lidia , Ferrando Stephen 
Published: April 2023

AbstractBackgroundSchizophrenia affects individuals, families, and systems, with treatment primarily being antipsychotic medications. Long-acting injectable (LAI) antipsychotics are increasingly being used. This study sought to identify predictors of antipsychotic choice, in terms of formulation (LAI vs oral) and class (FGA vs SGA), and clinical outcomes.Methods123 patients who received LAI antipsychotics were diagnosis-matched to patients who received oral antipsychotics. Sociodemographic and clinical factors were extracted from the medical record, including indicators of illness severity. Groups were compared with Chi-Square and t-tests, and logistic regression models were used to identify independent predictors of antipsychotic choice.ResultsPatients that received LAIs had longer admissions, more complex discharges, and greater illness severity; however, there were no differences in readmission rates. Independent predictors of LAIs included younger age, being single, and longer admission. Patients who received FGA LAIs were more likely to use substances and be undomiciled compared to SGA LAIs, with the only predictor being older age. Oral FGAs were more likely than oral SGAs to be prescribed to older and female patients, as well as those with co-occurring substance use, complex discharges, and longer admissions.ConclusionsIllness severity and duration of illness appear to drive choice of LAI vs. oral antipsychotic medication and FGA vs. SGA. While LAIs were prescribed to patients with greater illness severity, readmission rates were equivalent to those receiving oral medication, supporting the use of LAI in patients with greater illness severity. Rationales for prescribing LAIs to younger patients and FGAs to older patients are discussed.FundingNo Funding
Dissociative Identity Disorder in an Inpatient Setting
Authors: Martin Samantha Ongchuan 
Published: April 2023

AbstractDespite recognition in current and past versions of DSM, dissociative identity disorder (DID) remains a controversial psychiatric disorder which hampers its diagnosis and treatment. Factors that lead misdiagnosing of DID are the unfamiliarity with spectrum of dissociative disorders, the existence of feigned DID, the reluctance of individuals with DID to present their dissociative symptoms, and lack of knowledge and appreciation of its epidemiology which is shown to have 1.5% lifetime prevalence. An accurate diagnosis allows the appropriate interventions leading to fewer hospitalizations.KC is 28 y.o. female with a psychiatric history significant for polysubstance use, PTSD, and GAD, who presented to the ED due concern for DID per mother. Prior to presentation, she had thrashed her mother’s home of which she denies recollection. She has a history of early sexual trauma by her own family. She screened 44 on the Dissociative Experiences Scale (DES). Throughout her hospitalization, she exhibited questionable lapses of disassociation, although there were no noted changes of posture, dress, speech, or acknowledgement of alters. She was discharged on Remeron 15 mg, Risperdal 2 mg, and Prazosin 2 mg with outpatient resources for trauma-based therapy.DID is characterized by two or more distinct identities or personality that coincide with fluctuating states of consciousness and changing access to autobiographical memory. The neurological similarities between personality states in DID and PTSD subtypes support a trauma-related etiology of DID. Although there are many interviewing tools, the DES has been the most widely used clinically. Although collateral information, detailed history, and DES were concerning for DID, observation did not show distinct dissociative episodes as discussed by collateral (alter described as destructive and cold towards her own infant) although the hospital environment may not have provided enough stress for patient to transition from one personality to another.The International Society for the Study of Trauma and Dissociation proposes a phase-oriented treatment approach: 1) establishing safety, stabilization, and symptom reduction; 2) confronting, working through and integrating traumatic memories; 3) identity integration and rehabilitation. From inpatient standpoint, phase 1 and 2 may be promptly addressed. Besides initiation of Remeron and Risperdal (consistent with treatment of DID in two prior case reports), implement grounding techniques and coping mechanisms against triggers for dissociative episodes. Inpatient screening can facilitate earlier accurate diagnosis, faster and more targeted interventions, prevent unnecessary direct and indirect societal costs, and, most importantly, improve quality of life for those with the disorder.FundingNo Funding
Improvement in Anxiety Symptoms in Depressed Patients Treated With AXS-05 (DEXTROMETHORPHAN-BUPROPION): Results From the Evolve Open-Label, Long-Term Study
Authors: Jones Amanda , Streicher Caroline , Alter Shawn , Thomas Zachariah , Tabuteau Herriot 
Published: April 2023

AbstractBackgroundInnovative therapies to treat individuals with MDD, especially those with comorbid anxiety, are urgently needed.AXS-05 (dextromethorphan HBr 45 mg-bupropion HCl 105 mg) is a novel, oral, investigational NMDA receptor antagonist with multimodal activity. The dextromethorphan component of AXS-05 is an NMDA receptor antagonist and a sigma-1 receptor agonist. The bupropion component of AXS-05 serves primarily to increase the bioavailability of dextromethorphan.ObjectiveTo evaluate the effects of AXS-05 on anxiety in MDD.MethodsEVOLVE was an open-label study, in which patients were treated with AXS-05 twice daily for up to 15 months. Subjects had either rolled in after a prior AXS-05 study or were directly enrolled and had a DSM-5 diagnosis of MDD, a MADRS score of ≥25, and had been treated with ≥ 1 antidepressant in the current major depressive episode. A total of 186 patients were enrolled. Efficacy endpoints included MADRS and HAM-A. Here we present the results for the directly enrolled patients (n =146).ResultsMean baseline HAM-A scores were 15.6. Reductions from baseline to Weeks 1, 2, and 6 were 3.4±5.34 (p< 0.001), 5.5±5.81 (p< 0.001), and 8.6±5.75 (p< 0.001), respectively. Improvements on the HAM-A were durable through Month 12 (-10.2±6.33; p< 0.001). Remission (HAM-A ≤7) rates on the HAM-A at Weeks 1, 2, and 6 were 19.9%, 36.0%, and 58.1%, respectively. Remission at Month 12 was 78.3%.Long-term treatment with AXS-05 was generally well tolerated. The most commonly reported adverse events were COVID-19 infection (8.9%), nausea (8.9%), headache (7.5%), dry mouth (6.2%), insomnia (5.5%), and dizziness (5.5%).ConclusionsThese data support the use of AXS-05 in patients with comorbid depression and anxiety.FundingAxsome Therapeutics
Race Differentials in the Credit Market Experiences of Small Business Owners
Authors: Kim Jeonghun 
Published: April 2023

AbstractSmall businesses employ more than half of the entire workforce, account for more than sixty percent of new jobs created in the United States, and are responsible for about fifty percent of private domestic gross product. It is noteworthy, however, that small business owners in credit markets, in particular minority owners, have difficulty in securing sources of capital for their business operation. The literature on credit market discrimination shows consistent results that can be interpreted as evidence that minority owners are discriminated against compared to their counterparts (i.e., White owners) in obtaining loans, which may be caused by lenders’ discrimination, although such behavior is prohibited under current fair-lending laws. This paper uses pooled cross-sectional data from the Survey of Small Business Finances (1993, 1998, and 2003) and a bivariate probit model based on James J. Heckman’s approach to deal with sample selection bias for those choosing to apply for loans. Those who didn’t apply for loans have been ignored in analyses of credit markets for small business owners. This paper adds to the small business lending market literature by 1) combining cross sectional data from the Survey of Small Business Finances (SSBF) for 1993, 1998, and 2003 to get more precise estimates and test statistics with more power; 2) conducting regression analyses with different model specifications to show the robustness of the empirical results; and 3) dealing directly with problems of sample selection based on Heckman’s approach with particular attention to the assumptions required to justify the identification of the effect (i.e., exclusion restrictions).The analysis confirms previous results, suggesting that minority owners are discriminated against in credit markets. These conclusions are supported in a variety of model specifications.
The Predatory Rhetorics of Urban Development
Authors: Clay Kevin L. , Hill Jasmine D. 
Published: April 2023

AbstractIn this article, we reflect on the pernicious nature of rhetoric aimed at soliciting Black community support for predatory urban development schemes. Highlighting recent examples of Urban One Casino + Resort’s development campaign in Richmond, Virginia, and the messaging leveraged by political leaders on behalf of SoFi stadium and the Intuit Dome in Inglewood, California, we find that discursive moves made by public and private stakeholders reflect what we call the “predatory rhetorics of urban development.” We argue that these rhetorics intend to enlist divested Black communities as supporters of development projects that concentrate wealth and power in the hands of economic and political elites. They do so by playing on Black desires for social and economic inclusion into American middle-class community life. Four common threads of predatory rhetoric appear across both contexts. They are 1) seizing the real needs and concerns of stigmatized places, 2) relying on representational politics to mitigate issues of trust, 3) the neoliberal framing of American internal colonization as a problem that requires extractive private development solutions and, finally, 4) dissimulating intra-community class interests to consolidate “Black needs.” We reflect on the outcomes supported by these rhetorics across both development projects and raise several points of further consideration as we hope for more organized responses to such rhetorics in the future.
Effects of the Horizontal Scales of the Cloud‐Resolving Model on Tropical Cyclones in the Superparameterized Community Atmosphere Model
Authors: Kuo Kuan‐Ting , Wu Chien‐Ming , Chen Wei‐Ting 
Published: April 2023

AbstractIn this study, the Superparameterized Community Atmosphere Model (SPCAM) is used to simulate tropical cyclones (TCs) using the hindcast approach. Three hindcast experiments are conducted with 32‐km (D32), 128‐km (D128), and 1,024‐km (D1024) horizontal scales in the sub‐grid cloud‐resolving models (CRMs). The results show that D1024 produces reasonable TCs compared with the reanalysis data. It is 3.42 TCs per 10 days for the reanalysis data, while there are 8.07, 4.88, and 3.73 for D32, D128, and D1024. The bias of overestimating TC numbers grows with decreasing CRM scale. The D32 experiment also produces stronger TCs with a higher precipitation rate and wind speed. The bias is highly related to the efficiency of adjusting convective instability in CRMs. The D32 exhibits higher column‐integrated water vapor under warm conditions compared with D1024, indicating its inefficiency in removing water vapor by the weaker convective mass fluxes in the small CRM scale. That is, the vertical transport of convection in a smaller horizontal scale will be restricted by stronger subsidence because CRM columns for compensating are limited. The distribution of accumulated convective instability is broader and more frequent in D32. As a result, large‐scale precipitating systems tend to develop in D32, leading to a higher probability of TC genesis. This study highlights the importance of sub‐grid configuration when estimating TC activities using SPCAM.
Late Holocene Cliff Retreat in Del Mar, CA, Revealed From Shore Platform 10Be Concentrations and Numerical Modeling
Authors: Clow T. , Willenbring J. K. , Young A. P. , Matsumoto H. , Hidy A. J. , Shadrick J. R. 
Published: April 2023

AbstractRocky coast cliff retreat presents a hazard to coastal communities and infrastructure that is potentially amplified under rising sea level conditions, among other factors. Unfortunately, constraints on retreat rates are typically limited to those derived from imagery and maps spanning the last ∼100 years. Here, we use a newly developed coupled model of shore platform profile evolution and cosmogenic radionuclide production that considers the influence of relative sea level (RSL) rise, weathering, material resistance, and wave height decay to model cliff retreat over millennial timescales and its potential drivers in Del Mar, California. We demonstrate the ability to use topographic and bathymetric measurements from a narrow shore platform along with a limited data set of nine cosmogenic 10Be concentrations extending ∼125 m from the cliff base to obtain modeled cliff retreat rates that steadily range from 5.0 to 12.5 cm yr−1 over the last two millennia until 100 years before present. These rates are consistent with modern retreat rates of about 2–19 cm yr−1 here. RSL rise in Southern California remained relatively constant during the late Holocene, potentially explaining the relatively stable modeled cliff retreat rate over this time. We also explore the relative influence of weathering, material resistance, and wave erosion efficacy and find that both weathering and wave‐driven erosion are necessary to replicate the measured data at this location, with the latter exerting a stronger control on model acceptance, suggesting that waves may provide a possible mechanism by which RSL rise may influence coastal cliff erosion in southern California.
The Role of Weathering on Morphology and Rates of Escarpment Retreat of the Rift Margin of Madagascar
Authors: Wang Yanyan , Willett Sean D. , Wu Datian 
Published: April 2023

AbstractA great escarpment at a rift margin can correspond directly to a major water divide, but at many margins, including in Madagascar, the escarpment often appears as a steep knickzone on rivers that have their main water divides into the interior of the high plateau. We hypothesize that this variability in morphology is a reflection of the frequency and size of the drainage area captured from the high plateau over the escarpment. To test this hypothesis, we document morphological features and weathering conditions of river sediment in Madagascar. We propose that the existence of a weathered, weak surface layer of crystalline bedrock encourages river reversal and large river captures from the upper plateau, leading to a high frequency of knickpoint‐type rivers. We demonstrate that this is feasible using 2D landscape evolution models and show that an easily eroded surface layer is prone to fast divide migration through frequent river capture and reversal. A positive scaling relationship between the captured area and escarpment retreat rate is found from the models. We demonstrate that this scaling is also observed in the great escarpments of Madagascar and India. This divide migration mechanism provides a new explanation for the morphology of river profiles and great escarpments.