bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial and Ethnic Variation in Genetic Susceptibility: Are Disparities in Infertility Prevalence and Outcomes more than Black and White?
Authors: Morris Jerrine R. , Plowden Torie Comeaux , Green Lisa J. , Edwards Digna R. Velez , Jackson-Bey Tia 
Published: April 2022

AbstractRace, as a social construct without a clear genetic underpinning, is frequently referenced in medicine as predictor of multiple diseases including that of infertility. The authors will discuss how systematic racism can have downstream consequences ranging from overt physician bias to use of medical algorithms that may potentiate the same disparities they attempt to narrow. Then, the authors explore the utility and pragmatic use of genetic ancestry to estimate disease prevalence, instead of racial categories. Finally, the authors explore how health inequities, rooted in systematic racism, can influence disease heritability effectively advocating for research to disentangle the contributions of racism to genetic susceptibility in infertility.
CACA guidelines for holistic integrative management of gastric cancer
Authors:   Society of Gastric Cancer of China Anti-Cancer Association
Published: April 2022

AbstractAccording to statistics, the rates of incidence and death of gastric cancer in China have risen to the fourth worldwide, resulting in huge social burden. Regrettably, international guidelines, such as NCCN or ESMO, could not provide enough consideration to Chinese clinical practice, making it difficult to achieve individual therapy in China. In 2020, China Anti-Cancer Association (CACA) invited domestic multi-disciplinary experts and made the guideline of gastric cancer, involving surgeon, oncologist, pathologist, radiologist, herbalist, physiatrist and psychologist. This gastric cancer guideline recommends comprehensive treatment scheme with high-evidence and well-feasibility, which is mainly based on evidence-based medicine, Chinese experience and expert consensus. We provided MDT to HIM system of “prevention, screening, diagnosis, treatment, rehabilitation” for gastric cancer, which embodied the integration of research evidence, clinical experience and patient needs. The CACA guideline is more suitable for China’s clinical practice, reflecting scientificity, accessibility and Chinese characteristics, highlights the concept of integrated medicine, and has guiding value of clinical practice.
Motor Band Sign in Motor Neuron Disease: A Marker for Upper Motor Neuron Involvement
Authors: Chung Hee Sahng , Melkus Gerd , Bourque Pierre , Chakraborty Santanu 
Published: April 2022

ABSTRACT:Background and Objective:The prevalence and role of the motor band sign (MBS) remain unclear in motor neuron disease. We report the frequency of MBS in amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS), its correlation with clinical upper motor neuron (UMN) signs, and prognostic value in ALS.Methods:We conducted a retrospective study of ALS, PLS, and controls with retrievable MRI between 2010 and 2018. We compared the frequencies of MBS across the three groups, and studied correlation between susceptibility-weighted MRI measurements in primary motor cortices and contralateral UMN features. Clinical outcomes were compared between ALS with and without MBS.Results:Thirteen ALS, 5 PLS, and 10 controls were included (median age 60 years, IQR 54–66 years; 14/28 males). MBS was present in 9/13 (69.2%, 95% CI 38.9–89.6%) and 4/5 (80.0%, 95% CI 29.9–99.0%) of ALS and PLS, respectively, and none in controls. 2/13 (15.4%, 95% CI 2.7–46.3%) ALS and 3/5 (60.0%, 95% CI 17.0–92.7%) PLS had MBS in the absence of corticospinal T2/FLAIR hyperintensity sign. Susceptibility measurements in left motor cortices had a significantly positive correlation with contralateral UMN signs in ALS (τb = 0.628, p = 0.03). Similar but nonsignificant trends was observed for right motor cortices in ALS (τb = 0.516, p = 0.07). There were no significant differences in mRS at last follow-up, mortality, or time from symptom onset to last follow-up between ALS patients with and without MBS.Conclusions:We provide limited evidence that MBS and susceptibility quantification measurements in motor cortices may serve as surrogate markers of UMN involvement in motor neuron disease.
Population genetics reveal multiple independent invasions of Spodoptera frugiperda (Lepidoptera: Noctuidae) in China
Authors: Jiang Yun-Yuan , Zhang Yi-Yin , Zhou Xin-Yu , Hong Xiao-Yue , Chen Lei 
Published: April 2022

AbstractThe fall armyworm (Spodoptera frugiperda), a destructive pest that originated in South and North America, spread to China in early 2019. Controlling this invasive pest requires an understanding of its population structure and migration patterns, yet the invasion genetics of Chinese S. frugiperda is not clear. Here, using the mitochondrial cytochrome oxidase subunit I (COI) gene, triose phosphate isomerase (Tpi) gene and eight microsatellite loci, we investigated genetic structure and genetic diversity of 16 S. frugiperda populations in China. The Tpi locus identified most S. frugiperda populations as the corn-strains, and a few were heterozygous strains. The microsatellite loci revealed that the genetic diversity of this pest in China was lower than that in South America. Furthermore, we found moderate differentiation among the populations, distinct genetic structures between adjacent populations and abundant genetic resources in the S. frugiperda populations from China sampled across 2 years. The survival rate of S. frugiperda was significantly higher when it was fed on corn leaves than on rice leaves, and the larval stage mortality rate was the highest under both treatments. Our results showed that S. frugiperda probably invaded China via multiple independent introductions and careful pesticide control, continuous monitoring and further studies will be needed to minimize its potential future outbreak.
The alchemy of suffering in the laboratory of the world: Vedāntic Hindu engagements with the affliction of animals
Authors: Gupta Akshay , Barua Ankur 
Published: April 2022

AbstractTraditionally, the problem of evil, in its various formulations, has been one of the strongest objections against perfect being theism. In the voluminous literature on this problem, the motif of evil has usually been discussed with respect to human flourishing. In recent decades more focused attention has been paid to animal suffering and the philosophical problems that such suffering poses for perfect being theists. However, this growing body of literature, in Anglo-American philosophical milieus, is largely aimed at sketching a specifically Christian or Christianity-inflected theodicy that would reconcile animal suffering with the existence of an omni-God. In contrast, there are few, if any, systematic attempts to put forth a Hindu theodicy that aims to offer morally justifiable reasons that God has for allowing animal suffering. In this article, we address this scholarly lacuna by illustrating how a Hindu perfect being theist might respond to the problem of animal suffering.
Language in educational apps for pre-schoolers. A comparison of grammatical constructions and psycholinguistic features in apps, books and child directed speech
Authors: KOLAK Joanna , MONAGHAN Padraic , TAYLOR Gemma 
Published: April 2022

AbstractLanguage in touchscreen apps could be useful as an additional source of children’s language input, alongside child directed speech (CDS) and books. Here we performed the first analysis of language in apps, as compared with books and CDS. We analysed language in 18 of the most popular educational apps targeting pre-schoolers and compared their language content to children’s books and CDS with respect to types of constructions and psycholinguistic features of words. We found that apps contained lower frequency words and had lower lexical diversity compared to CDS, and shorter utterances compared to books. Apps may thus provide an enriched supplementary form of input for young children, due to containing less frequent words. However, apps do not expose children to a high proportion of questions and complex sentences, both of which are crucial for supporting child’s development of structurally rich constructions.
Long-Term Effects of Once-Daily Valbenazine in Older and Younger Adults with Tardive Dyskinesia
Authors: Sajatovic Martha , Farahmand Khody , Shah Chirag , Lundt Leslie 
Published: April 2022

AbstractIntroductionOlder patients taking a dopamine receptor blocking agent (eg, first- or second-generation antipsychotic) have an increased risk for tardive dyskinesia (TD), a persistent and potentially disabling movement disorder. Valbenazine, a selective and potent vesicular monoamine transporter 2 inhibitor, is approved for once-daily treatment of TD with no dosing adjustments required for older patients. This analysis of valbenazine clinical trial data, which is the first to evaluate an approved TD medication in a population ≥65 years, was conducted to better understand treatment outcomes in older patients.MethodsData from two 48-week long-term studies (KINECT 3-extension, KINECT 4) were pooled and analyzed in older (≥65 years) and younger (<65 years) participants. Analyses based on the Abnormal Involuntary Movement Scale (AIMS) total score included: mean change from baseline (BL); clinically meaningful response (≥30% improvement from BL [AIMS-30%]); and protocol-defined response (≥50% improvement from BL [AIMS-50%]). Additional analyses included response thresholds for Clinical Global Improvement-Tardive Dyskinesia and Patient Global Impression of Change as follows: rating of “minimally improved” or better (score ≤3) at week 48 (CGI-TD≤3, PGIC≤3); rating of “much improved” or “very much improved” (score ≤2) at week 48 (CGI-TD≤2, PGIC≤2).ResultsAIMS outcomes in the older subgroup were generally comparable to (or better than) outcomes in the younger subgroup and overall study populations. In participants ≥65 years, pooled AIMS results indicated substantial improvements in TD movements with valbenazine 40 mg (n = 8) and 80 mg (n = 20): mean change from BL (−6.4 and −9.8 [for 40 and 80 mg, respectively]); AIMS-30% (75% and 95%); AIMS-50% (75% and 85%). CGI-TD and PGIC response rates indicated that clinician- and patient-reported global improvements were also substantial in the older subgroup: CGI-TD = 3 (88% and 100% [for 40 and 80 mg, respectively]); CGI-TD = 2 (88% and 95%); PGIC = 3 (88% and 100%); PGIC = 2 (75% and 90%).ConclusionsThese analyses, which are the first to evaluate long-term valbenazine effects in patients ≥65 years, indicate that older study participants had clinically meaningful and substantial improvements in TD that were comparable to (or better than) those in younger participants.FundingNeurocrine Biosciences, Inc.
Planned Deprescribing to Protect Health Systems in Pandemics and Other Disasters: A Scoping Review
Authors: Black James E. 
Published: April 2022

AbstractBackgroundHow can psychiatrists best provide care in complex, sometimes overwhelming disasters? COVID-19 strained every aspect of health care to the breaking point, from finances to pharmaceutical supply lines. We can expect more challenges to prescribing in the future, as shown by recent hurricanes in Puerto Rico, fires in California, and ice storms in Texas. When medications become scarce or inaccessible, then clinicians need to make difficult prescribing decisions. We suggest that a culture of deprescribing, a systematic approach to reducing or simplifying medications, could be applied to a wide variety of crises. Deprescribing is defined as the planned reduction of medications to improve patient health or to reduce side effects (see deprescribing.org). It has been used to reduce polypharmacy in geriatric and other complex populations. It provides evidence-based guidance for phasing out many classes of medications. It is part of the larger program to reduce waste in health care and to make pharmacy more rational. Disasters and resource scarcity, however, require a different approach. In contrast to routine care focused on individual patients, crisis standards of care (CSC) shift the clinical focus to the community. Instead of deprescribing guidelines for individual clinicians, CSC deprescribing would be national policies addressing shortages of important medications. We did a scoping review looking for studies of deprescribing in a crisis.Methods/ResultsWe extracted 1340 references in Google Scholar 2016 to 2021 using (deprescribing) AND (disaster OR crisis OR climate OR pandemic OR supply lines ). A scan of texts found 160 references matching our criteria, and only 19 of them addressed deprescribing as a strategy to strengthen health systems or providers in an emergency. Most of those were related to scarce supplies during COVID, and a few addressed the carbon impact of medications. We also reviewed related literatures on medication supply chain vulnerabilities, WHO Essential Medicines, and healthcare rationing.ImplicationsDeprescribing gained attention during the COVID pandemic, responding to both disrupted supply lines and improving patient safety. Writers concerned with climate change support deprescribing to reduce the carbon impact of medications. Deprescribing as crisis policy could help streamline national stockpiles, supply chains, and manufacturing. Education could make deprescribing second nature for clinicians, potentially decreasing stress and increasing flexibility in future emergencies. Barriers to deprescribing generally include cultural inertia, industry lobbyists, education, and malpractice fears. In a crisis, deprescribing guidelines could provide clinicians with confidence and flexibility while conserving scarce resources. Research is needed to evaluate deprescribing guidelines for crises, especially ensuring equity in how they reduce polypharmacy and save money.FundingNo funding
Weight Gain and Comorbidities Associated with Oral Second-Generation Antipsychotics: Analysis of Patients with Bipolar I Disorder or Schizophrenia
Authors: Meyer Jonathan M. , Bessonova Leona , Friedler Haley S. , Mortimer Kathleen M. , Cheng Harry , Brecht Thomas , O’Sullivan Amy K. , Cummings Hannah , McDonnell David , Doane Michael J. 
Published: April 2022

AbstractObjectiveClinically significant weight gain (CSWG) is associated with increased morbidity and mortality. This study describes CSWG and comorbidities observed in patients with bipolar I disorder (BD-I) and schizophrenia (SZ) after initiating select second-generation antipsychotics (SGAs).MethodsPercent change in weight, CSWG (=7% weight increase), and incident comorbidities within 12 months of treatment were assessed among patients initiating oral SGAs of moderate-to-high weight gain risk using medical records/claims (OM1 Real-World Data Cloud; January 2013-February 2020). Oral SGAs included clozapine (SZ), iloperidone (SZ), paliperidone (SZ), olanzapine, olanzapine/fluoxetine (BD-I), quetiapine, and risperidone. Outcomes were stratified by baseline body mass index and reported descriptively.ResultsAmong patients with BD-I (N = 9142) and SZ (N = 8174), approximately three-quarters were overweight/obese at baseline. During treatment (mean duration = 30 weeks), average percent weight increase was 3.7% (BD-I) and 3.3% (SZ). Average percent weight increase was highest for underweight/normal weight patients (BD-I = 5.5%; SZ = 4.8%), followed by overweight (BD-I = 3.8%; SZ = 3.4%) and obese patients (BD-I = 2.7%; SZ = 2.3%). Within 3 months of treatment, 12% of all patients experienced CSWG. A total of 11.3% (BD-I) and 14.7% (SZ) of patients developed coronary artery disease, hypertension, dyslipidemia, or type 2 diabetes within 12 months of treatment; development of comorbidities was highest among overweight/obese patients and those with CSWG.ConclusionsPatients who were underweight/normal weight at baseline had the greatest percent change in weight during treatment. Increased comorbidities were observed within 12 months of treatment, specifically among overweight/obese patients and those with CSWG. The magnitude of weight gain and development of comorbidities were similar for patients with BD-I and SZ.FundingAlkermes, Inc.
Timely Depression, Suicide Screening, and Transition of Care Coordination in an Addiction Treatment Setting
Authors: Weston Kristin , Jolles Diana 
Published: April 2022

AbstractBackgroundPeople with substance use disorders (SUDs) experience higher rates of depression and suicide and lack primary care providers (PCP).Local ProblemTwenty chart audits at the St. Lawrence Addiction Treatment Center (SLATC) showed 65% (n = 11) of SUD patients lacked a PCP. Standardized screening tools and timely appointments were lacking. The aim was to increase timely scheduled psychiatric appointments for SUD patients at discharge by 80% within 90 days.MethodsA 90-day rapid cycle improvement project with plan-do-study-act was the process for improvement. Data were collected with four interventions from screening, checklist, patient, and team engagement concurrently. Run charts, spreadsheets, and aggregate data were interpreted for timely care. Interventions: Screening tools evaluated risks for depression and suicide. If patients screened positive, a decision aid was used for patient education. Discharge Care Coordination Checklist was used as a quality tool tracking all patients. The Project Briefing Tool and team engagement activities were used to improve participation.ResultsScreening tools were spread with 125 screenings showing 53 positives for depression and four positives for suicide. After using the decision aid, 24 (45.2%) chose depression medications, 29 (52.8%) chose complementary alternative medicine, and one patient chose neither. Of the 125 patients on the Discharge Care Coordination Checklist, 43.2% (n = 54) were scheduled with appointments, The Project Briefing Tool improved participation.ConclusionStandardized screening tools, CAM, and co-creation activities improved timeliness of care. A further study for the impact of mental health services for relapse prevention was recommended.FundingNo funding
Pharmacokinetic-Pharmacodynamic Analysis of Concentration-Response Relationship in Schizophrenia Patients Treated with Olanzapine or OLZ/SAM
Authors: Sun Lei , Mills Richard , Sadler Brian M. , Rege Bhaskar 
Published: April 2022

AbstractBackgroundA combination of olanzapine and samidorphan (OLZ/SAM) that provides the efficacy of olanzapine while mitigating weight gain was recently approved by the Food and Drug Administration for the treatment of schizophrenia and bipolar I disorder. This exploratory population pharmacokinetic-pharmacodynamic analysis evaluated potential relationships between drug exposure and treatment effects.MethodsPositive and Negative Syndrome Scale (PANSS) total score and/or bodyweight data from efficacy studies served as pharmacodynamic endpoints. Pharmacokinetic input came from predicted plasma drug concentrations using a population pharmacokinetic model for the corresponding studies. Regression and box plots were generated to investigate potential pharmacokinetic-pharmacodynamic relationships.ResultsPANSS total score and/or bodyweight records were paired with olanzapine and/or samidorphan concentrations from 1464 patients with schizophrenia. Within the clinical dose range for olanzapine (10-20 mg/day) and samidorphan (5-20 mg/day), no significant correlation was noted between (a) olanzapine concentrations and change in PANSS total score, or % change in body weight, in patients treated with OLZ/SAM or olanzapine, and (b) samidorphan concentration or samidorphan-to-olanzapine concentration ratio and % change in body weight. No meaningful difference in olanzapine and samidorphan concentrations or samidorphan-to-olanzapine concentration ratios was observed between patients with <10% and ≥10% weight gain.ConclusionsThe antipsychotic efficacy of olanzapine was not affected by samidorphan at any concentration of olanzapine. Furthermore, olanzapine-associated weight gain did not correlate with olanzapine dose or plasma concentration. Finally, the effect of OLZ/SAM on mitigation of olanzapine-associated weight gain was not affected by intersubject variability in olanzapine and/or samidorphan plasma concentrations.FundingAlkermes, Inc.
Psychosocial Stressors and Phase of Life Problems as a Cause of Somatic Symptom Disorder in Healthy Patients: Case Report
Authors: Bhimanadham Narmada Neerja , Ali Ornela , Hossain Asghar 
Published: April 2022

AbstractKnowledge about the aging process and in particular changes affecting mental health in the elderly has been gradually acquired as more research studies focus on this topic. However, as the majority of studies are geared toward more commonly encountered mental health disorders such as depression and anxiety, there is less data for conditions that are encountered less frequently such as somatoform disorder. We present the case of a 62-year-old male who presents with idiopathic physical symptoms not explained by any medical conditions except somatic symptom disorder. A comprehensive review of the literature using databases, such as PubMed, NCBI, and Google Scholar was conducted to gain a better understanding of this specific disorder and to rule out similar conditions that present in a similar way. The purpose of this case report is to emphasize the fact that social stressors and phase of life problems could trigger somatic symptom disorder in otherwise healthy individuals.FundingNo funding
Psychiatric Manifestations of Huntington’s Disease Case Report
Authors: Kukaj Pajtesa , Corzo Krysten 
Published: April 2022

AbstractHuntington’s disease is a rare autosomal dominant disease with an estimated incidence of approximately 4-6.1/100,000 people within the United States. Often recognized for its progressive motor symptoms and cognitive decline, its psychiatric symptoms can be underrepresented. It is only within the past few years that we have come to appreciate the range and prevalence of neuropsychiatric symptoms that plague patients with chronic degenerative disease. Still, some patients’ neuropsychiatric symptoms may be misinterpreted as part of other psychiatric conditions. Specifically, prodromal phase symptoms such as agitation, impulsivity, depression, and more may present similarly to purely psychiatric disorders. This may complicate patient’s clinical picture consequently leading to delays in diagnosis and in treatment. Such delays can worsen prognosis and a patient’s quality of life. Here, we describe a multifaceted case of a patient who exhibited striking psychiatric symptoms as her primary presentation. This case helps highlight the importance of recognizing psychiatric symptoms including irritability, depression, as well as the less common psychotic features as early warning signs of impending progression of a neurodegenerative disorder such as Huntington’s disease.FundingNo funding