bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-lasting leukocytosis in patients with schizophrenia treated with clozapine after electroconvulsive therapy
Authors: Sugita Kotaro , Mori Yasuhiro , Kanemoto Kousuke , Sugita Sotaro 
Published: August 2022

Introduction The present study was conducted to investigate the possible hematologic impact of long-term electroconvulsive therapy (ECT) in patients with drug-resistant schizophrenia and receiving clozapine therapy. Subjects and Methods In this retrospective study, clinical charts of 57 hospitalized patients with schizophrenia who required clozapine therapy because of active psychotic symptoms resistant to other antipsychotics were examined. For 18 who underwent ECT, the first assessment was conducted at the end of that therapy (average two months after start, 7.68 sessions) and the second two months later. As for the 39 patients who did not undergo ECT, the first and second assessment points were at two and four months, respectively, after a randomly chosen time point. Results Multiple regression analysis revealed that modified ECT (m-ECT) (ß = 0.346, p = 0.005), gender (males showed greater increase) (ß = 0.273, p = 0.023), and disease duration (longer associated with greater increase) (ß = 0.258, p = 0.033) were correlated with a change in white blood cell (WBC) count (ΔR2 = 0.277, p < 0.001) at the first assessment point. At the second assessment point, multiple regression analysis showed that m-ECT (ß = 0.262, p = 0.039), gender (males showed greater increase) (ß = 0.264, p = 0.036), and disease duration (longer associated with greater increase) (ß = 0.234, p = 0.068) were again correlated with changed WBC count (ΔR2 = 0.203, p < 0.007). Discussion An increase in leukocytes may have a protective influence against the adverse myelosuppressive effects of clozapine. However, a simple mobilization of leukocytes from bone marrow to peripheral circulation may not enhance the immune system, leading to only a masking of the effects of a potential immuno-insufficient state in the treated patient. In either case, should leukocytosis be induced and then remain for an extended period, hematologists, as well as psychiatrists involved in electroconvulsive intervention for clozapine-treated patients, must keep this factor in mind.
Relationship between change in social evaluation learning and mood in early antidepressant treatment: A prospective cohort study in primary care
Authors: Hobbs Catherine , Beck Milly , Denham Faye , Pettitt Laura , Faraway Julian , Munafò Marcus R , Sui Jie , Kessler David , Button Katherine S 
Published: August 2022

Background: Antidepressants are proposed to work by increasing sensitivity to positive versus negative information. Increasing positive affective learning within social contexts may help remediate negative self-schema. We investigated the association between change in biased learning of social evaluations about the self and others, and mood during early antidepressant treatment. Method: Prospective cohort assessing patients recruited from primary care in South West England at four timepoints over the first 8 weeks of antidepressant treatment ( n = 29). At each timepoint, participants completed self-report measures of depression (Beck Depression Inventory II (BDI-II) and Patient Health Questionnaire 9 (PHQ-9)), anxiety (Generalised Anxiety Disorder Questionnaire 7 (GAD-7)), and a computerised task measuring learning of social evaluations about the self, a friend and a stranger. Results: We did not find evidence that learning about the self was associated with a reduction in PHQ-9 ( b = 0.08, 95% CI: −0.05, 0.20, p = 0.239) or BDI-II scores ( b = 0.10, 95% CI: −0.18, 0.38, p = 0.469). We found some weak evidence that increased positive learning about the friend was associated with a reduction in BDI-II scores ( b = 0.30, 95% CI: −0.02, 0.62, p = 0.069). However, exploratory analyses indicated stronger evidence that increased positive learning about the self ( b = 0.18, 95% CI: 0.07, 0.28, p = 0.002) and a friend ( b = 0.22, 95% CI: 0.10, 0.35, p = 0.001) was associated with reductions in anxiety. Conclusions: Change in social evaluation learning was associated with a reduction in anxiety but not depression. Antidepressants may treat anxiety symptoms by remediating negative affective biases towards socially threatening information directed towards the self and close others. However, our findings are based on exploratory analyses within a small sample without a control group and are therefore at risk of type 1 errors and order effects. Further research with larger samples is required.
A simple technique to repair distal and mid-shaft hypospadias using a de-epithelialized Byars’ flap
Authors: Li Jiaqiang , Li Shoulin , Yang Zhilin , Ke Zhicong , Zhang Tiejun , Yin Jianchun 
Published: August 2022

Objective To describe standard and modified de-epithelialized Byars’ flap techniques in tubularized incised plate urethroplasty and evaluate postoperative outcomes. Methods We retrospectively evaluated data for 404 primary hypospadias repair patients who underwent standard (Group A) or modified (Group B) urethroplasty between January 2016 and 2021. Group B’s data were analyzed to evaluate whether our modified technique was effective for all hypospadias types. Results There was no difference in the ratio of different hypospadias types between Groups A (n = 145) and B (n = 259). Median follow-up duration was 35 months. Fistula occurred in 19 patients in Group A and 12 in Group B (statistically significant difference). The total complication rate was statistically significantly different between the groups. In Group B, 3/142 patients with distal hypospadias developed urethrocutaneous fistula vs 4/95 with mid-shaft hypospadias and 5/22 with proximal hypospadias. No difference was noted between the distal and mid-shaft groups. Significant differences were observed when comparing distal and mid-shaft groups with the proximal group; total complication rates were similar. Glans dehiscence and meatal stenosis rates were similar between Groups A and B, and among the hypospadias phenotypes. Conclusion Our modified procedure is simple to perform and yields excellent results in distal and mid-shaft hypospadias repair.
Expression of HER2/NEU in newly diagnosed metastatic carcinoma prostate on TRUS biopsy specimen and its clinical correlation and progression
Authors: Abhishek Anand , Sarkar Debansu , Kumar Pal Dilip 
Published: August 2022

Background: Prostate cancer development and progression to androgen-independent disease is correlated with increased expression of growth factors and receptors capable of establishing autocrine and/or paracrine growth-stimulatory loops. Overexpression of the Her2/neu receptor tyrosine kinase has been associated with the progression to androgen independence in prostate cancer cells. Objective: Our primary aim was to investigate the frequency of HER2/neu amplification in prostate biopsy specimens in newly diagnosed metastatic carcinoma prostate and its correlation to progression of androgen independent carcinoma. Materials and Methods: In our study, expression of HER2/neu was carried out by immunohistochemical analysis in TRUS biopsy specimen of newly diagnosed metastatic carcinoma prostate. Results: Out of 36 patients, seven (19.4%) showed her2neu overexpression on immunohistochemical staining. Five out of seven (71%) were associated with higher histological grade >7 at diagnosis ( p < 0.05). Her2neu overexpression was not significantly associated with age and serum PSA at diagnosis. However progression to castration resistant stage was not dependant on Her2/neu status ( p > 0.05). Conclusion: Overexpression of her2/neu was associated with high grade carcinoma prostate at diagnosis, however progression to castration resistant stage was not related with her2neu expression.
Pediatric Headache Experience During the COVID-19 Pandemic
Authors: DiSabella Marc , Pierce Emily , McCracken Emily , Ratnaseelan Aarane , Vilardo Lauren , Borner Kelsey , Langdon Raquel , Fletcher Angela A. 
Published: August 2022

Objective Headache disorders are exceedingly common in children and adolescents. The association between headaches, emotional stress, and disruptions in daily routines are well established. The goal of this study is to compare the experiences of patients with a preexisting diagnosis of a primary headache disorder in terms of headache frequency and severity, lifestyle techniques for headache prevention, screen use, and mood from before and after the onset of the COVID-19 pandemic. Methods Patients evaluated by the Headache Clinic at Children’s National Hospital between Summer 2020 and Winter 2021 were enrolled in a patient registry. Patients completed a questionnaire examining changes in headache characteristics and lifestyle factors since the onset of the COVID-19 pandemic. Results A total of 107 patients completed the survey. Since the pandemic’s onset, patients reported decreased physical activity (n = 59, 55%), increased frequency of chronic headaches from 40% (N = 42) to 50% (N = 54), and increased constant daily headaches from 22% (n = 24) to 36% (n = 38). Patients reported worsened anxiety (n = 58, 54%), mood (n = 50, 47%), and workload (n = 49, 46%). Sixty-one percent (n = 65) of patients reported using screens for school for more than 6 hours per day. The majority (n = 67, 63%) of patients indicated that they would prefer attending in-person school, with 14% (n = 15) responding that they preferred online school. Conclusion Since the COVID-19 pandemic’s onset, pediatric headache patients have experienced increasing headache frequency, worsening anxiety and mood, decreased physical activity, and increased screen usage. Although this study is limited by sample size and observational design, future population-based studies will further elucidate the impact of this pandemic on pediatric headache.
Minimally Invasive Chevron-Akin for Correction of Moderate and Severe Hallux Valgus Deformities: Clinical and Radiologic Outcomes With a Minimum 2-Year Follow-up
Authors: de Carvalho Kepler Alencar Mendes , Baptista Andre Donato , de Cesar Netto Cesar , Johnson Anne H. , Dalmau-Pastor Miki 
Published: August 2022

Background: The minimally invasive chevron-Akin (MICA) technique has already demonstrated efficacy compared with other known surgical treatments for mild to moderate hallux valgus (HV). MICA combines percutaneous osteotomies with the benefits of modern, rigid internal fixation. The aim of study was to evaluate the radiographic parameters, clinical improvement, and potential complications in moderate to severe HV cases, operated using the MICA technique. Methods: Retrospective study including 70 feet with HV operated using the MICA technique. The AOFAS hallux MTP-IP score and radiographics for HV evaluation were applied preoperatively, and after 6 months, 1 year, and 2 years of follow-up. The following radiographic parameters were measured: metatarsophalangeal hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), interphalangeal angle (IPA), and intermetatarsal angle (IMA). Results: The average preoperative VAS pain score was 8.2 ± 1.5, which improved to 1.2 ± 2.2 at 24 months. The mean preoperative IMA was 14.8 ± 3.6 degrees compared with a mean of 7.5 ± 2.1 degrees ( P < .01) at 24 months. The preoperative HVA value averaged 30.4 ± 9.8 degrees and at 6 months postoperatively 11.1 ± 6.8 degrees ( P < .01), which remained stable until measured at 24 months. The mean preoperative DMAA was 16.3 ± 8.6 degrees and at the 6-month follow-up was 7.8 ± 5.4 degrees ( P < .01). The mean preoperative IPA was 7.63 ± 4.4 degrees compared with a mean of 6.28 ± 3.5 degrees ( P > .05) at 24 months. Complications included painful hardware (14.28%), neuropathic pain (2.85%), and loss of correction (4.28%). Conclusion: In this retrospective review from a single center, we found the MICA technique to be an effective procedure for correcting moderate to severe HV, with a low rate of recurrence and an acceptable rate of complications. Patients undergoing the surgical procedure in our series showed a significant reduction in radiographic parameters and a significant improvement in clinical scores, maintaining these results over time. Level of Evidence: Level IV, retrospective study.
Elevated transaminases and development of cardiomyopathy in a 32-year-old woman with metastatic breast cancer after treatment with ribociclib followed by palbociclib
Authors: Watts Christina , Nadori Karin 
Published: August 2022

Introduction Cyclin-dependent kinase 4 and 6 inhibitors, ribociclib and palbociclib, are associated with reports of transaminitis and adverse cardiac events. Case report The patient is a previously healthy 32-year-old female diagnosed with estrogen receptor-positive, progesterone receptor-positive, and human epidermal growth factor 2 negative metastatic breast cancer. From July to September 2021, the patient was initiated on ribociclib followed by palbociclib for metastatic breast cancer. She subsequently experienced two episodes of transaminitis and was diagnosed with cardiomyopathy. Management and outcome The patient experienced transaminitis 2 weeks after the initiation of ribociclib resulting in discontinuation. When rechallenged with palbociclib, the patient experienced transaminitis within 1 week of initiation, which resulted in discontinuation. Approximately 1 month after palbociclib discontinuation, the patient was diagnosed with congestive heart failure with a left ventricular ejection fraction of 24%. Discussion To our knowledge, there are few case studies investigating cyclin-dependent kinase 4 and 6 inhibitor rechallenge following transaminitis. Prior literature suggests that transaminitis with cyclin-dependent kinase 4 and 6 inhibitors is not a class effect, but this case report suggests otherwise. This report presents a rare case of cardiomyopathy and transaminitis following the administration of cyclin-dependent kinase 4 and 6 inhibitors, ribociclib and palbociclib.
Effects of the tip structure of temporary indwelling catheters on blood recirculation at various blood flow rates and diameters of the mock blood vessel
Authors: Sato Yukihiro , Yanagisawa Katsuya , Hachitani Yusuke , Ueki Shunichi , Kurihara Yoshitaka , Kobayashi Kozue , Kokubo Kenichi 
Published: August 2022

Aims: The aim of the present study was to determine the effects of the tip structure of the catheters used for hemodialysis on blood recirculation at varying blood flow rates and diameters of the mock blood vessel in a well-defined in vitro experimental system, focusing on reverse connection mode. Methods: A mock circulatory circuit was created with silicon tubing (15 or 20 mm), a circulatory pump, connected through the catheter to dialysis circuit and dialyzer attached to dialysis machine. The tip of the inserted catheter was fixed to the center of the silicone tube, and 3 L of pig blood was poured into the blood side of the dialyzer and the recirculation rates were measured at blood flow rates of 100, 150, and 200 mL/min. Five types of commercially available catheters were used: (A) Argyle™, (B) Gentle Cath™ (Hardness gradient type), (C) Gentle Cath™, (D) Niagara™, and (E) Power-Trialysis®. Results: In the case of reverse connection mode, (1) the recirculation rates were lower in the catheter with a relatively large side hole (catheter C, 17%), catheters with a greater distance between the end hole and side hole (catheters C and D, 25%), and catheter with a symmetrical tip structure (catheter E, 10%) as compared with those in catheters A and B (40% and 25%); (2) increase of the blood flow rate in the dialysis machine was associated with a reduced recirculation rate; and (3) a wider inner diameter of the mock blood vessel and faster flow rate in the vessel were associated with a reduced recirculation rate. Conclusion: The lowest recirculation was observed with the catheter with symmetrical holes, which produces a helical blood flow line that does not intersect with the blood streamline flowing out to the blood supply hole.
Autistic experiences of applied behavior analysis
Authors: Anderson Laura K 
Published: August 2022

Autism spectrum disorder is a developmental disability affecting individuals across their entire lifespan. Autistic individuals have differences from nonautistic people (sometimes called allistic or neurotypical people) in social skills, communication, and atypical interests and/or repetitive behaviors. Approximately 1 in 59 children are born autistic, leading to over 3.5 million autistic Americans. Applied behavior analysis is one of the first and most common interventions recommended for autistic children. However, autistic self-advocates argue that applied behavior analysis damages their mental health and treats them as though they are a problem to be fixed. This phenomenological qualitative study examined seven autistic individuals who received applied behavior analysis interventions as children to understand what autistic adults perceive as the costs and benefits of applied behavior analysis interventions, how they feel about the applied behavior analysis interventions they received, and what recommendations autistic adults have for the future of applied behavior analysis. The findings include: Autistic adults remember traumatic events from applied behavior analysis, do not believe that they should be made to behave like their peers, gained some benefits but suffered significant negative long-term consequences, believe that applied behavior analysis is an unethical intervention, and recommend that applied behavior analysis practitioners listen to autistic people and consider using interventions in place of applied behavior analysis. Lay Abstract Autism spectrum disorder is a developmental disability affecting individuals across their entire lifespan. Autistic individuals have differences from nonautistic people (sometimes called allistic or neurotypical people) in social skills, communication, and atypical interests and/or repetitive behaviors. Applied behavior analysis is one of the first and most common interventions recommended for autistic children. However, autistic individuals argue that applied behavior analysis damages their mental health and treats them as though they are a problem to be fixed. This study examined the experiences of seven autistic individuals who received applied behavior analysis interventions as children to understand what autistic adults think about their applied behavior analysis interventions, how they feel about the applied behavior analysis interventions they received, and what recommendations autistic adults have for the future of applied behavior analysis. The findings include: Autistic adults remember traumatic events from applied behavior analysis, do not believe that they should be made to behave like their peers, gained some benefits but suffered significant negative long-term consequences, believe that applied behavior analysis is an unethical intervention, and recommend that applied behavior analysis practitioners listen to autistic people and consider using interventions in place of applied behavior analysis.
Asserting the right to care – Birth parents’ arguments in newborn care orders
Authors: Juhasz Ida Benedicte 
Published: August 2022

Removing a newborn from his or her birth parents’ care is arguably a stark display of state power into the family. This study explores birth parents’ engagement with care proceedings in all ( N = 177) newborn care orders in Norway between 2012 and 2016. The study asks which arguments parents use to assert their care rights, their focus, and whether arguments differ depending on the parents’ risks. Applying the defence dichotomy and seeing arguments as accounts, the analysis revealed parents primarily both justifying and excusing risks, and in two-thirds of cases rationalizing their care rights. Parents primarily denied harm and pinpointed (failed) service provision efforts, as well as excused their situation by claiming sufficient change and placing blame on i.e. child welfare services. Rationalizations did not defend parenting as such, but claimed normalcy and deservingness, as well as echoing concerns raised. Arguments were primarily parent- and service-focused. Parents with substance use risks blamed significantly less than parents with personality risks, and parents with intellectual disability risks demanded significantly more leeway as ‘new parents’ than parents with personality risks. The study reflects how a marginalized demographic similarly, comprehensively, and most often unsuccessfully, engages with the child welfare system. The arguments reveal both alignment and misalignment in understandings of acceptable state intervention and responsibilities. It points to the dire need for knowledge about parents’ actual understanding of child welfare services, as well as clear communication and feedback between parents, their legal counsel, and social workers in assessments and service provision.
Importance of patient engagement in the conduct of pragmatic multicenter randomized controlled trials: The ADAPTABLE experience
Authors: Marquis-Gravel Guillaume , Faulkner Madelaine , Merritt Greg , Farrehi Peter , Zemon Nadine , Robertson Holly R , Jones W Schuyler , Kraschnewski Jennifer 
Published: August 2022

Background/Aims Actively engaging patient partners in the conduct of trials is crucial to ensure the studies answer genuine, patient-centered, unmet clinical needs, and to facilitate participant recruitment and retention. The aim of this article is to demonstrate the feasibility of patient engagement within a large pragmatic multicenter randomized controlled trial, specifically for the purposes of dissemination of study information/updates and to favorize recruitment and retention. Methods In the patient-centric, pragmatic ADAPTABLE randomized trial, transparent and timely dissemination of information on the study updates to the trial participants was undertaken to create meaningful engagement and to facilitate retention. A national panel of patient partners, the Adaptors, were directly involved in this information dissemination strategy, and study participants were engaged both nationally and locally to design recruitment methods iteratively during the conduct of the trial. All Adaptors had a lived experience with cardiovascular disease. Results Adaptors attended bi-weekly meetings facilitated by the director of the study’s patient-powered research network. They drafted and/or edited newsletters and ad hoc educational information written in a lay-friendly manner for study participants, which were regularly distributed to the ADAPTABLE community, in addition to online forums where participants could share their experience of their involvement in ADAPTABLE. To spur recruitment, a patient-driven initiative was to draft letters sharing their story, which were distributed by the local study teams. Patient partners thought that using patients’ voice to provide their perspectives on why they believed this project was important would be more engaging for prospective participants than traditional approaches. Conclusions ADAPTABLE’s experience has demonstrated the feasibility of engaging patients as partners in the conduct of a large-scale, multi-center, pragmatic randomized controlled trial. Future trials should embrace and iteratively improve this model by engaging patient partners as early as study protocol development and funding applications, and quantify its impact on the effectiveness and value of the trial.