bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescribing clozapine in the UK: Quality improvement issues identified by clinical audit
Authors: Barnes Thomas RE , MacCabe James H , Kane John M , Delgado Oriana , Khan Mareeha , Paton Carol 
Published: June 2022

Introduction: The Prescribing Observatory for Mental Health initiated a quality improvement (QI) programme on clozapine use in UK mental health services. Methods: Clinical audits conducted in 2019 and 2021. Results: Sixty-three participating NHS Trusts/healthcare organisations in 2019, and 61 in 2021, submitted treatment data for 6948 and 8155 patients, respectively. In both audits, high-dose and/or combined antipsychotic medications had been prescribed immediately before initiating clozapine in over a quarter of patients recently started on clozapine. In patients who were tobacco smokers and recently discharged from a smoke-free ward, the impact of the potential change in smoking status had been considered in the care plans of just under one-third in 2019 and just over a half in 2021. For community patients, their Summary Care Records (SCRs) included their clozapine prescriptions in 58% of cases in 2019 and 72% in 2021. Conclusions: Three QI issues were identified. (1) Antipsychotic regimens with limited evidence for efficacy in treatment-resistant schizophrenia were prescribed for over a quarter of cases before starting clozapine. Use of such strategies may delay clozapine treatment, potentially reducing the likelihood of a therapeutic response. (2) While anticipation of the consequences of a change in smoking status on plasma clozapine concentration following discharge from hospital showed improvement over time, even in 2021 it was not evident for nearly a half of relevant cases. (3) While inclusion of clozapine in the SCR also improved over time, even in 2021 it was missing for more than a quarter of community patients.
Effects of acute lysergic acid diethylamide on intermittent ethanol and sucrose drinking and intracranial self-stimulation in C57BL/6 mice
Authors: Elsilä Lauri V , Harkki Juliana , Enberg Emma , Martti Alvar , Linden Anni-Maija , Korpi Esa R 
Published: June 2022

Background: Psychedelics, like lysergic acid diethylamide (LSD), are again being studied as potential therapies for many neuropsychiatric disorders, including addictions. At the same time, the acute effects of psychedelics on rewarding behaviours have been scarcely studied. Aims: The current study aimed to clarify if LSD decreases binge-like ethanol drinking in mice, and whether the observed acute effects on ethanol consumption are generalizable to a natural reinforcer, sucrose, and if the effects resulted from aversive or reward-attenuating effects caused by LSD. Methods: The effects of acute LSD were examined using 2-bottle choice intermittent ethanol (20%) and sucrose drinking (10%), discrete-trial current-intensity threshold method of intracranial self-stimulation and short-term feeding behaviour assay in C57BL/6 male mice. Results: The results showed that acute 0.1 mg/kg, but not 0.05 mg/kg, dose (i.p.) of LSD reduced 2-h intermittent ethanol drinking transiently without any prolonged effects. No effects were seen in intermittent 2-h sucrose drinking. The tested LSD doses had neither effect on the intracranial self-stimulation current-intensity thresholds, nor did LSD affect the threshold-lowering, or rewarding, effects of simultaneous amphetamine treatment. Furthermore, LSD had small, acute diminishing effects on 2-h food and water intake. Conclusions: Based on these results, LSD decreases binge-like ethanol drinking in mice, but only acutely. This effect is not likely to stem from reward-attenuating effects but could be in part due to reduced consummatory behaviour.
Nonlinear hedge fund index clones?
Authors: Walden Mikhail , Lajbcygier Paul 
Published: June 2022

Cloning hedge fund indexes circumvents the many challenges associated with direct hedge fund investment. Theoretically, hedge fund indexes could have nonlinear exposures to the economic risk factors that drive their returns and may require nonlinear clones. By using flexible statistical models, we enable the choice between linear and nonlinear clones. We demonstrate that for certain hedge fund styles, nonlinear index clones are crucial for high fidelity replication. Nonlinear clones both facilitate economic insights to cloning and enhance the best linear clones. JEL classification: G10, G23, C15
A novel 8-genome instability-associated lncRNAs signature predicting prognosis and drug sensitivity in gastric cancer
Authors: Yi Changhong , Zhang Xiulan , Chen Xia , Huang Birun , Song Jing , Ma Minghui , Yuan Xiaolu , Zhang Chaohao 
Published: June 2022

Background Genome instability lncRNA (GILnc) is prevalently related with gastric cancer (GC) pathophysiology. However, the study on the relationship GILnc and prognosis and drug sensitivity of GC remains scarce. Method We extracted expression data of 375 GC patients from TCGA cohort and 205 GC patients from GSE26942 cohort. Then, lncRNA was separated from expression data, and systematically characterized the 8 marker lncRNAs using the LASSO method. Next, we constructed a GILnc model (GILnc score) to quantify the GILnc index of each GC patient. Finally, we analyzed the relationship between GILnc score and clinical traits including survival outcomes, TP53, and drug sensitivity of GC. Results Based on a computational frame, 205 GILncs in GC has been identified. Then, a 8 GILncs was successfully established to predict overall survival in GC patients based on LASSO analysis, divided GC samples into high GILnc score and low GILnc score groups with significantly different outcome and was validated in multiple independent patient cohorts. Furthermore, GILnc model is better than the prediction performance of two recently published lncRNA signatures, and the high GILnc score group was more sensitive to mitomycin. Besides, the GILnc score has greater prognostic significance than TP53 mutation status alone and is capable of identifying intermediate subtype group existing with partial TP53 functionality in TP53 wild-type patients. Finally, GILnc signature as verified in GSE26942. Conclusion We applied bioinformatics approaches to suggest that a 8 GILnc signature could serve as prognostic biomarkers, and provide a novel direction to explore the pathogenesis of GC.
Influence of scanning strategies on microstructure, residual stress, and corrosion behavior of 17-4 PH stainless steel fabricated by selective laser melting
Authors: Kartikeya Sarma I. , Selvaraj N. , Kumar Adepu 
Published: June 2022

In the present study, the effect of hexagonal (inside out and outside in), rectangular (horizontal, vertical, alternate, and both), and strip (horizontal, vertical, alternate, and both) scan strategies on the microstructure, residual stresses, and the corrosion behavior of 17-4 PH stainless steel samples fabricated by selective laser melting were investigated. The results indicate that through hexagonal inside-out scanning strategy, the sample density and hardness are double than that of wrought and cast alloys. Microstructure consists of small and large molten pools on the side and front surface of each sample generated using a different scan strategy. Austenite phase and ferrite peak at the highest intensity were observed by X-ray diffraction for hexagonal inside-out sample. Electron back scattered diffraction (EBSD) orientation maps showed a high-density of ɣ-austenite phase (43%) in the finer grain size area of the hexagonal inside-out scan strategy sample. Low residual stresses and high corrosion resistance (<0.5 mpy) were obtained for the hexagonal inside-out scan strategy sample compared to other two strategies because of lower defects, lower thermal gradient, and smaller scan tracks.
The effectiveness and safety of acupuncture/electroacupuncture for chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis
Authors: Pei Li-Xia , Yi Yue , Guo Jing , Chen Lu , Zhou Jin-Yong , Wu Xiao-Liang , Sun Jian-Hua , Chen Hao 
Published: June 2022

Objective: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting adverse eﬀect of anticancer agents with virtually no effective treatment. Safe and effective therapies are needed urgently. Acupuncture shows therapeutic possibilities in this regard but needs to be further evaluated. Methods: A systematic search was conducted in seven databases from their inception to April 2020. Randomized controlled trials (RCTs) focused on acupuncture/electroacupuncture (EA) for the treatment of CIPN were included. Revman 5.3 software was used for meta-analysis if there was no significant heterogeneity. Otherwise, qualitative analysis was utilized. Results: Nine studies involving 582 patients were included in this review. Most of the studies exhibited unclear risk of bias because some details were not mentioned. As the clinical heterogeneity was significant, qualitative analysis was performed to describe nerve conduction velocity, effective rate for motor neuropathy, pain scores, quality of life and adverse events. Meta-analysis was performed on four studies to analyze the effective rate for sensory neuropathy due to inconspicuous heterogeneity. The results indicated that acupuncture may generate a better effect on sensory neuropathy than vitamin B (risk ratio = 1.60, 95% confidence interval = 1.31–1.95, I2 = 0%, p < 0.00001). The efficacy of EA plus glutathione (GSH) appeared to be better than that of GSH alone in alleviating sensory neurotoxicity and in improving nerve conduction velocity. Acupuncture plus methylcobalamin showed more favorable effects than methylcobalamin alone in relieving neuralgia, restoring nerve conduction velocity and improving quality of life. In terms of pain relief and improved CIPN-specific quality of life, acupuncture plus standard care was better than standard care alone. In terms of pain relief, EA was more effective than usual care. Conclusion: Acupuncture may be effective and safe in the treatment of CIPN according to the analyzed studies. However, more studies with higher methodological quality are warranted in order to be able to draw firmer conclusions. Future rigorous RCTs will be necessary to confirm the effectiveness and safety of acupuncture for CIPN.
Intestinal Pathology in Patients With Pathogenic ACTG2-Variant Visceral Myopathy: 16 Patients From 12 Families and Review of the Literature
Authors: Kapur Raj P. , Goldstein Allan M. , Loeff Deborah S. , Myers Candace T. , Paschal Cate R. 
Published: June 2022

Background Dominant gamma-smooth muscle actin gene ( ACTG2) variants cause clinically diverse forms of visceral myopathy. Many patients undergo intestinal resection or biopsy before identification of their genetic defect. The pathology of ACTG2-variant visceral myopathy has not been evaluated systematically. Methods Glass slides, ultrastructural images, molecular genetic reports, and clinical records from 16 patients with pathogenic (15) or likely pathogenic (1) ACTG2 variants were reviewed and compared with surgical specimens from controls (no evidence of a primary myopathy or pseudo-obstruction due to Hirschsprung disease) and published descriptions. Results The variable clinical manifestations in our cohort matched those in the literature. Only non-specific light and electron microscopic findings observed in non-myopathic controls were encountered in 13 of 16 patients. The remaining 3 patients harbored hyalinized cytoplasmic inclusions in smooth muscle cells and 1 of them had polyglucosan bodies in the muscularis propria. Conclusions Apart from hyalinized inclusions, which were only observed in 3/16 patients, intestinal pathology in the majority of patients with ACTG2 variants is not indicative of an underlying visceral myopathy. Molecular testing should be considered even when no diagnostic intestinal pathology is identified.
Acute myocardial infarction risk in multiple sclerosis and neuromyelitis optica spectrum disorder: A nationwide cohort study in South Korea
Authors: Cho Eun Bin , Yeo Yohwan , Jung Jin-Hyung , Jeong Su-Min , Han Kyungdo , Yang Jeong Hoon , Shin Dong Wook , Min Ju-Hong 
Published: June 2022

Background: The link between neuromyelitis optica spectrum disorder (NMOSD) and cardiovascular disease is currently unclear. Objective: To determine the acute myocardial infarction (MI) risk in patients with MS and NMOSD. Methods: This study analyzed the Korean National Health Insurance Service database between January 2010 and December 2017. The included patients comprised 1503/1675 adults with MS/NMOSD who had not experienced ischemic heart disease or ischemic stroke at the index date. Matched controls were selected based on age, sex, and the presence of hypertension, diabetes mellitus (DM), and dyslipidemia. Results: The risks of developing MI were 2.61 (hazard ratio (HR), 95% confidence interval (CI) 1.73–3.95) and 1.95 (95% CI = 1.18–3.22) times higher in MS and NMOSD compared with the control populations. Patients with NMOSD had a similar MI risk compared with patients with MS, after adjusting for age, sex, income, hypertension, DM, and dyslipidemia (HR = 0.59, 95% CI = 0.34–1.02, p = 0.059). Among each patient group, the MI risk did not differ significantly with age (20–39, 40–64 or ⩾65 years), sex, or the presence of hypertension, DM, or dyslipidemia. Conclusion: The MI risk increased in MS and NMOSD and seemed to be comparable between NMOSD and MS.
Parental perspectives on attention-deficit/hyperactivity disorder treatments for children
Authors: Vitulano Lawrence A , Mitchell John T , Vitulano Michael L , Leckman James F , Saunders David , Davis Naomi , Woodward Diana , Goodhue Bethany , Artukoglu Bekir , Kober Hedy 
Published: June 2022

This study investigated parental perspectives and experiences on the evaluation and treatment process associated with attention-deficit/hyperactivity disorder (ADHD). Five hundred sixty-eight parents of youth 2-28 years-old (M = 9.37; SD = 4.11) diagnosed with ADHD responded to a 14-item online survey about their child’s diagnosis and treatment. Parents reported that they had tried an average of 4.49 interventions (SD = 2.63). Parents further shared factors in treatment selection, most helpful parenting strategies, and preferences for types of treatments and treatment targets. A majority of parents reported incorporating many non-traditional strategies (e.g., exercise, healthy eating, outdoor activities) with goals of improving their child’s coping skills, study habits, and anger management. The findings show that treatment choices were often selected based on trust in the provider, research support, and the child’s preference. Given parental preferences for non-traditional strategies, treatment development efforts should consider these strategies as a component of a broader multimodal treatment approach to ADHD.
Post-traumatic Lemierres Syndrome: A rare presentation secondary to mandibular fracture
Authors: Kaplan Saul , Grobler Ruan , Chetty Sean 
Published: June 2022

Lemierre’s Syndrome is a rare phenomenon with a low prevalence and is characteristically seen in patients with an oropharyngeal infection that is complicated by thrombophlebitis of the internal jugular vein and secondary septic emboli. We present the case of a 16 year old previously well male who was diagnosed with a rare case of Lemierre’s syndrome secondary to a mandibular fracture. Blood tests and radiological imaging confirmed the diagnosis, with CT scan of the patients head and neck revealing a right mandibular fracture with abscess formation, bilateral parapharyngeal abscesses, bilateral internal jugular vein thromboses, left sigmoid sinus thrombosis, cavernous sinus thrombosis, post septal orbital cellulitis with enhancing infraorbital collections and a subdural empyema overlying the left tentorium cerebelli. The treatment is usually non-operative with antibiotics and in some instances surgical drainage. In this case a combination of surgical drainage for source control and antibiotics were used. Unfortunately, despite an initial improvement in the patient’s clinical status the patient died. This is the first case of Lemierre’s syndrome secondary to blunt facial trauma reported in the scientific literature. This case highlights the importance of clinicians having a high degree of suspicion of Lemierre’s syndrome when a patient presents with typical clinical features following facial trauma.
Long-term Survival, Tolerability, and Safety of First-Line Bevacizumab and FOLFIRI in Combination With Ginsenoside-Modified Nanostructured Lipid Carrier Containing Curcumin in Patients With Unresectable Metastatic Colorectal Cancer
Authors: Jeon Youngbae , Sym Sun Jin , Yoo Bong Kyu , Baek Jeong-Heum 
Published: June 2022

Background: Colorectal cancer is the third most common malignant disease and the second leading cause of death worldwide. Previous studies showed improved bioavailability and cytotoxicity of ginsenoside-modified nanostructured lipid carrier containing curcumin (G-NLC) in human colon cancer cell lines. This study aimed to evaluate the safety and tolerability with long-term survival rates in patients with colorectal cancer with unresectable metastases after treatment with first-line bevacizumab/FOLFIRI (folinic acid, bolus/continuous fluorouracil, and irinotecan) in combination with a dietary supplement of G-NLC. Methods: This study was a prospective, observational, single-group analysis. The enrolled patients had colorectal cancer with unresectable metastases and were administered bevacizumab and FOLFIRI in combination with daily oral G-NLC as first-line treatment. Overall survival, progression-free survival, tumor response, and adverse events were evaluated. Results: A total of 44 patients were enrolled between 2015 and 2019. The median age was 65 (range 45-81) years and the sex ratio was 31:13 (male:female). The primary tumor locations were the colon (31 patients) and rectum (13 patients). The metastatic sites included, liver only (n = 20), lung only (n = 6), both liver and lung (n = 12), and others (n = 6). The median duration of curcumin supply was 7.9 (range 0.9-16.6) months. The most common grade 3 or higher adverse events were neutropenia (n = 15, 34.1%), followed by nausea (n = 4, 9.1%) and vomiting (n = 4, 9.1%). Within the median follow-up period of 22.8 months, the median overall survival was 30.7 months, and the median progression-free survival was 12.8 months. None of the patients achieved complete response (CR); however, 9 patients showed partial response (PR), and 3 patients underwent conversion surgery. Conclusions: Bevacizumab/FOLFIRI with G-NLC as first-line chemotherapy in patients with colorectal cancer with unresectable metastases presented comparable long-term survival outcomes with acceptable toxicity outcomes. Additional randomized controlled studies are needed to establish definitive conclusions regarding this new regimen for metastatic colorectal cancer.
A Cadaveric Comparison of Approaches for Exposure of the Volar Distal Radius: Is There a Utilitarian Approach?
Authors: Warrender William J. , Wagner Daniel J. , Hoyer Reed W. , Merrell Gregory A. , Kleinman William B. , Smetana Brandon S. 
Published: June 2022

Background: It remains unclear whether exposure for planned fixation of distal radius fractrues is superior with any given approach, and whether a single utilitarian approach exists that permits reliable complete exposure of the volar distal radius. Methods: A cadaveric study was performed using 10 matched specimens. Group 1 consisted of 3 radially based approaches (standard flexor carpi radialis [FCR], standard FCR with radial retraction of FCR and flexor pollicis longus [FPL] tendons, extended FCR). Group 2 consisted of 2 ulnarly based approaches (volar ulnar, extended carpal tunnel). The primary outcome was total width of exposed distal radius at the watershed line. Mann-Whitney U and Wilcoxon rank testing was used to identify differences. Results: The standard FCR approach exposed 29 mm (90%), leaving on average 3 mm (10%) of the ulnar corner unexposed. Retracting the FCR and FPL tendons radially allows for an extra 1 mm of volar ulnar corner exposure. Finally, converting to an extended FCR approach provided 100% exposure in all specimens. The volar ulnar exposure however provided exposure to only 9 mm (37%), leaving 20 mm (62.5%) left unexposed radially. The extended carpal tunnel provided exposure to 21 mm (65%), leaving 11 mm (35%) radially unexposed. Differences between each group were statistically significant ( P < .05). Conclusions: The extended FCR approach exposed 100% of the volar distal radius in our study and may serve as a utilitarian volar surgical approach for exposure and fixation of distal radius fractures. Additional knowledge of the limitations of alternative approaches can be helpful in surgical planning.
Craniocervical Junction Visualization and Radiation Dose Consideration Utilizing Cone Beam Computed Tomography for Upper Cervical Chiropractic Clinical Application a Literature Review
Authors: DeNunzio Greg , Evans Tyler , Beebe Mychal E , Browning Jaime , Koivisto Juha 
Published: June 2022

Objectives To highlight the detail obtained on a Cone Beam Computed Tomography (CBCT) scan of the craniocervical junction and its usefulness to Chiropractors who specialize in the upper cervical spine. A review of the dose considerations to patients vs radiography in a chiropractic clinical setting and to review the effective radiation dose to the patient. Methods A review of studies discussing cervical biomechanics, neurovascular structures, and abnormal radiographic findings, was discussed in relation to chiropractic clinical relevance. Further studies were evaluated demonstrating radiation dose to the patient from radiographs compared to CBCT. Results Incidental and abnormal findings of the craniocervical junction were shown to have superior visualization with CBCT compared to radiography. The radiation dose to the patient for similar imaging protocols to the craniocervical junction and cervical spine was equal or less utilizing CBCT when compared to radiographs. Conclusions The use of CBCT for visualization of the craniocervical junction and cervical spine in the chiropractic clinical setting allows for adjunctive visualization of the osseous structures which is germane to clinical protocol. Further with CBCT the effective dose to the patient is equal or less than similar imaging protocols utilizing radiographs to evaluate the craniocervical junction.
Comparisons of Fifth-, Sixth-, and Seventh-Generation Continuous Glucose Monitoring Systems
Authors: Welsh John B. , Psavko Simon , Zhang Xiaohe , Gao Peggy , Balo Andrew K. 
Published: June 2022

Background: Between-system differences for continuous glucose monitoring (CGM) devices have important clinical consequences. Purpose: Here we review attributes of Dexcom’s fifth-, sixth-, and seventh-generation (G5, G6, and G7) CGM systems. Methods: Accuracy metrics were derived from preapproval trials of the three systems and compared after propensity score adjustments were used to balance baseline demographic characteristics. Metrics included mean absolute relative differences (MARD) between CGM and YSI values and the proportion of CGM values within 20% or 20 mg/dL of the YSI values (“%20/20”). Ease-of-use was evaluated by formal task analysis. Conclusions: Adjusted MARD and %20/20 agreement rates were 9.0%/93.1% (abdomen-placed G5), 9.9%/92.3% (abdomen-placed G6), 9.1%/93.2% (abdomen-placed G7), and 8.2%/95.3% (arm-placed G7). Task analysis favored G7 over earlier systems. Favorable clinical outcomes such as hemoglobin A1c reduction and hypoglycemia avoidance seen with G5 and G6 are anticipated with G7 use.