bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case series profile of olanzapine post‐injection delirium/sedation syndrome
Authors: Seebaluck Jason , Downes Michael A. , Brown Jared , Harris Keith , Isoardi Katherine Z. , Chan Betty S. 
Published: November 2022

Olanzapine pamoate is an intramuscular depot injection for the treatment of schizophrenia. Approximately 1.4% of patients develop a serious adverse event called post‐injection delirium/sedation syndrome (PDSS), characterised by drowsiness, anticholinergic and extrapyramidal symptoms. The objective is to investigate olanzapine PDSS presentations including clinical features and treatment approach. This is a retrospective review of olanzapine PDSS patients from three toxicology units and the NSW Poisons Information Centre between 2017 and 2022. Adult patients were included if they had intramuscular olanzapine then developed PDSS criteria. Clinical symptoms, treatment, timing and length of symptoms were extracted into a preformatted Excel database. There were 18 patients included in the series, with a median age of 49 years (interquartile range [IQR]: 38–58) and male predominance (89%). Median onset time post injection was 30 min (IQR: 11–38). PDSS symptoms predominate with drowsiness, confusion and dysarthria. Median length of symptoms was 24 h (IQR: 20–54). Most common treatment included supportive care without any pharmacological intervention (n = 10), benzodiazepine (n = 4) and benztropine (n = 3). In one case, bromocriptine and physostigmine followed by oral rivastigmine were given to manage antidopaminergic and anticholinergic symptoms respectively. This proposed treatment combination could potentially alleviate some of the symptoms but needs further studies to validate the findings. In conclusion, this case series supports the characterisation of PDSS symptomology predominantly being anticholinergic with similar onset (<1 h) and duration (<72 h). Bromocriptine is proposed to manage PDSS if patients develop severe dopamine blockade and physostigmine followed by rivastigmine for anticholinergic delirium.
Rewriting the genetic bond: Gene editing and our understanding of genetic parenthood
Authors: Simana Shelly , Ravitsky Vardit 
Published: November 2022

AbstractOne of the most prominent justifications for the use of germline gene editing (GGE) is that it would allow parents to have a “genetically related child” while preventing the transmission of genetic disorders. However, we argue that since future uses of GGE may involve large‐scale genetic modifications, they may affect the genetic relatedness between parents and offspring in a meaningful way: Due to certain genetic modifications, children may inherit much less than 50% of their DNA from each parent. We show that the reduction in genetic relatedness between parents and offspring has three important social and legal implications. First, the desire for a genetically related child may end up not being the strong justification it is currently thought to be for the use of GGE. Second, prospective parents may be reluctant to use GGE because of a potential loss of genetic relatedness. Third, in some jurisdictions, parents who would not pass on “enough” DNA to their child may not be recognized as the child's legal parents. We further argue that the reduction in genetic relatedness challenges current conceptions of genetic parenthood that rely on the quantity of DNA shared with the child or on whether the child was directly derived from the parent's genes. We suggest that genetic parenthood should instead be determined based on the nature of the genetic modifications and whether the child's numerical identity has been preserved after the editing process.
A principle‐based framework for disclosing a psychosis risk diagnosis
Authors: Zhang Oliver Y. , McConnell Doug , Carter Adrian , Pugh Jonathan 
Published: November 2022

AbstractIn recent decades, researchers have attempted to prospectively identify individuals at high risk of developing psychosis in the hope of delaying or preventing psychosis onset. These psychosis risk individuals are identified as being in an ‘At‐Risk Mental State’ (ARMS) through a standardised psychometric interview. However, disclosure of ARMS status has attracted criticism due to concerns about the risk–benefit ratio of disclosure to patients. Only approximately one quarter of ARMS patients develop psychosis after three years, raising concerns about the unnecessary harm associated with such ‘false‐positive’ results. These harms are especially pertinent when identifying psychosis risk individuals due to potential stigma and discrimination in a young clinical population. A dearth of high‐quality evidence supporting interventions for ARMS patients raises further doubts about the benefit accompanying an ARMS disclosure. Despite ongoing discussion in the bioethical literature, these concerns over the ethical justification of disclosure to ARMS patients are not directly addressed in clinical guidelines. In this paper, we aim to provide a unified disclosure strategy grounded in principle‐based analysis for ARMS clinicians. After considering the ethical values at stake in ARMS disclosure, and their normative significance, we argue that full disclosure of the ARMS label is favoured in the vast majority of clinical situations due to the strong normative significance of enhancing patients' understanding. We then compare our framework with other approaches to ARMS disclosure and outline its limitations.
Exploring the risks and benefits of flexibility in biodiversity offset location in a case study of migratory shorebirds
Authors: Shumway Nicole , Saunders Megan I. , Nicol Sam , Fuller Richard A. , Ben‐Moshe Noam , Iwamura Takuya , Kim Sun W. , Murray Nicholas J. , Watson James E. M. , Maron Martine 
Published: November 2022

AbstractBiodiversity offsets aim to counterbalance the residual impacts of development on species and ecosystems. Guidance documents explicitly recommend that biodiversity offset actions be located close to the location of impact because of higher potential for similar ecological conditions, but allowing greater spatial flexibility has been proposed. We examined the circumstances under which offsets distant from the impact location could be more likely to achieve no net loss or provide better ecological outcomes than offsets close to the impact area. We applied a graphical model for migratory shorebirds in the East Asian–Australasian Flyway as a case study to explore the problems that arise when incorporating spatial flexibility into offset planning. Spatially flexible offsets may alleviate impacts more effectively than local offsets; however, the risks involved can be substantial. For our case study, there were inadequate data to make robust conclusions about the effectiveness and equivalence of distant habitat‐based offsets for migratory shorebirds. Decisions around offset placement should be driven by the potential to achieve equivalent ecological outcomes; however, when considering more distant offsets, there is a need to evaluate the likely increased risks alongside the potential benefits. Although spatially flexible offsets have the potential to provide more cost‐effective biodiversity outcomes and more cobenefits, our case study showed the difficulty of demonstrating these benefits in practice and the potential risks that need to be considered to ensure effective offset placement.
School committee composition: Exploring the role of parental and female representation in India
Authors: Guha Panchali 
Published: November 2022

SummaryMotivationThe adoption of school‐based management (SBM) reforms has led to the formation of local‐level school committees in many low‐ and middle‐income countries. These committees are usually created with the stated aim of giving parents or local community members a greater say in school management. Various studies have, however, highlighted difficulties with parental and female participation, casting doubt on the extent to which greater community representation improves school management.PurposeThe article examines empirically whether greater parental and female representation in Indian school management committees (SMCs) is associated with school improvement as measured by increases in the school‐level provision of basic infrastructure and services.Methods and approachFixed‐effects regression models are estimated using school‐level panel data.FindingsI find that increased parental representation is not associated with improvements in school infrastructure/service provision. Rather, what contributes strongly to improved outcomes is increased representation of elected local authority members. Overall, schools with female‐majority SMCs also perform better.Policy implicationsWhile the requirement for Indian SMCs to include representation from local government appears to be an effective feature of their composition, there is a need for capacity‐building efforts to ensure that parent members also contribute effectively to school management. SMCs should also be encouraged to meet the female representation quota, as the analysis suggests a positive association between female representation and school outcomes.
Dumbbell in the atrium: A rare case report of biatrial myxoma that crosses atrial septum diagnosed by multimodal echocardiography
Authors: Song Wenjuan , Wang Yu , Ma Xuejuan , Liu Liping , Gu Ying , Sun Yue , Zhao Yue , Ye Yujia , Zhang Ying 
Published: November 2022

AbstractWe reported a very rare case, a 59‐year‐old female whose heart myxoma was present in both atrium, the mass in biatrial was connected to each other at the oval foramen, resembling “dumbbell‐like.” By means of multimodality echocardiography techniques such as transthoracic echocardiography (TTE), contrast enhanced ultrasound (CEUS), and Real‐time three‐dimensional transesophageal echocardiography (RT‐3D TEE), we have clarified the diagnosis. The patient underwent open‐heart surgery to remove the biatrial myxoma which adhered to the oval fossa, with a slightly wider base and smooth lobulated surface. This case demonstrates the importance of multimodality echocardiography in the diagnosis of atypical myxomas.
Sex differences in imaging and clinical characteristics of patients from the WAKE‐UP trial
Authors: Wouters Anke , Scheldeman Lauranne , Liessens Hannelore , Dupont Patrick , Boutitie Florent , Cheng Bastian , Ebinger Martin , Endres Matthias , Fiebach Jochen B. , Gerloff Christian , Muir Keith W. , Nighoghossian Norbert , Pedraza Salvador , Simonsen Claus Z. , Thijs Vincent , Thomalla Götz , Lemmens Robin 
Published: November 2022

AbstractBackground and purposeSex‐based differences in acute ischemic stroke are a well‐known phenomenon. We aimed to explore these differences between women and men in the Efficacy and Safety of MRI‐Based Thrombolysis in Wake‐Up Stroke (WAKE‐UP) trial.MethodsWe compared baseline demographic and imaging characteristics (visual fluid‐attenuated inversion recovery [FLAIR] positivity, relative FLAIR signal intensity, collateral status) between women and men in all screened patients. In randomized patients (i.e., those with diffusion‐weighted imaging (DWI)–FLAIR mismatch), we evaluated a modifying role of sex on the treatment effect of alteplase in multivariable logistic regression, with treatment adjusted for National Institute of Health Stroke Scale (NIHSS) score and age. Dependent variables were modified Rankin Scale (mRS) score of 0–1 at 90 days and distribution of mRS scores at 90 days.ResultsOf 1362 screened patients, 529 (38.8%) were women. Women were older than men, had higher baseline NIHSS scores and smoked less frequently. FLAIR positivity of the DWI lesion was equally present in women (174/529, 33.1%) and men (273/833, 33.3%; p = 1.00) and other imaging variables also did not differ between the sexes. In a total of 503 randomized patients, of whom 178 were women (35.4%), sex did not modify the treatment effect of alteplase on mRS score 0–1 or on the total distribution of mRS scores.ConclusionAs in many other stroke trials, more men than women were included in the WAKE‐UP trial, but the presence of a visual DWI–FLAIR mismatch and the relative FLAIR signal intensity did not differ between the sexes. The treatment effect of alteplase was not modified by sex.
The impact of remineralization agents on dental bleaching efficacy and mineral loss in bleached enamel
Authors: Misilli Tuğba , Çarıkçıoğlu Burak , Deniz Yeşim , Aktaş Çağatay 
Published: November 2022

AbstractThis study evaluated the effect of remineralization agents on bleaching efficiency, enamel mineral changes, and post‐bleaching color stability. A total of 112 enamel‐dentin blocks were prepared from bovine teeth. Following initial color measurements, separate treatment regimens were carried out as follows: negative control (no treatment); positive control (bleaching only); bleaching, then NaF; bleaching + NaF (mix); bleaching, then CPP‐ACPF; bleaching + CPP‐ACPF (mix); bleaching, then nHAP+F; bleaching + nHAP+F (mix). Color measurements were repeated after immersion in distilled water for 7 days, and again after staining with coffee solution for 14 days. The CIELAB‐based whiteness index was used to evaluate bleaching efficiency, and the CIEDE2000 color difference formula for color stability. Chemical investigation was performed using scanning electron microscopy with energy dispersive spectroscopy and X‐ray diffraction analyses. The experimental groups showed significant increases in whiteness compared to the negative control, and the staining after bleaching did not result in statistically significant differences between the groups. Energy dispersive spectroscopic analysis revealed that bleaching protocols had no impact on elemental levels as well as the ratio of Ca/P. The combined use of bleaching agents with remineralization agents did not affect bleaching effectiveness but also did not provide an additional contribution.
Reflections on the place of criminal law in the European construction
Authors: Monar Jörg 
Published: November 2022

AbstractAlthough the place of EU criminal law in the European construction has become incontestable today, it has historically been a far from obvious one. In its origins and development, two different rationales can be distinguished: a functional one aimed at using criminal law instruments to address specific cross‐border crime challenges generated or enhanced by the progress of EU integration in other fields, and a constitutional one implying the use of criminal law also to further enhance the respect and promotion of EU common values. While the first rationale has been dominant from the outset, the second has emerged only gradually. For the sake of effectiveness, legitimacy and mutual trust, both rationales should equally drive the further development of EU criminal law. Yet prospects for a stronger affirmation of the constitutional rationale are weakened by current EU rule of law and democratic leadership challenges.
Gender‐responsive budgeting for public value creation: Insights from higher education
Authors: Oppi Chiara , Galizzi Giovanna 
Published: November 2022

AbstractThis study explores how managers and officials enable public value (PV) creation through accounting practices in higher education institutions (HEIs). Adopting a narrow perspective related to gender accounting, this paper presents a comparative case study of three HEIs based in Italy that have been implementing gender‐responsive budgeting (GRB) in the last few years. Interviews are conducted with managers and officials involved in GRB processes. The results are analyzed on the basis of Moore's strategic triangle and the strategic alignment among its dimensions. Scarce integration within HEI strategies and low involvement of internal and external stakeholders in iterative processes for strategy definition are identified. Furthermore, the GRB is a standalone gender accounting practice and has limited capability of assessing gender equality outcomes. These results are among the main factors limiting the capability of HEIs to deliver PV through GRB.
Conserved GTPase mechanism in bacterial FtsZ and archaeal tubulin filaments
Authors: Andreu José M. , Ruiz Federico M. , Fernández‐Tornero Carlos 
Published: November 2022

Self‐assembling protein filaments are at the heart of cell function. Among them, tubulin‐like proteins are essential for cell division, DNA segregation and cytoskeletal functions across the domains of life. FtsZ and tubulin share their core structures, a characteristic nucleotide‐binding pocket and similar protofilament architecture. GTP hydrolysis between consecutive subunits drives their assembly dynamics. Two recent studies provide previously missing, filament atomic structures of bacterial FtsZ and a recently discovered archaeal tubulin in their nucleotide triphosphate‐bound states. Both filament structures reveal strikingly conserved interfacial GTPase active sites, with Mg2+ and K+/Na+ cations and an NxDxxD/E triad of catalytic residues, probably inherited from the common ancestor of FtsZs and tubulins. Moreover, both proteins exhibit nucleotide‐regulated subunit association mediated by interfacial water bridges, as well as polymerization‐induced structural changes, likely enabling related dynamic assembly mechanisms.
A method for estimating fish density through the catches of gillnets
Authors: Lobyrev Feodor , Hoffman Matthew J. 
Published: November 2022

AbstractWe propose a new method for estimating fish density using catches obtained by gillnets of given mesh size. This method builds on work for estimating the number of fish approaching a gillnet by modelling the fish movement that leads to a gillnet encounter. The theoretical framework is developed, and the method is tested on catch data for cod Gadus morhua and Dolly Varden Salvelinus malma to demonstrate how the method can be applied. The method relies on knowledge of geometric properties of the net, and morphological and behavioural properties of the fish, so we explore the sensitivity of the estimates to some of these parameters. Estimates are most sensitive to the morphological parameter of the angle the mouth is open while swimming and largely invariant to estimates of uncertain parameters like maximum number of fish that can be caught by the particular net.
Late diagnosis of HIV: An updated consensus definition
Authors: Croxford Sara , Stengaard Annemarie Rinder , Brännström Johanna , Combs Lauren , Dedes Nikos , Girardi Enrico , Grabar Sophie , Kirk Ole , Kuchukhidze Giorgi , Lazarus Jeffrey V. , Noori Teymur , Pharris Anastasia , Raben Dorthe , Rockstroh Jürgen K. , Simões Daniel , Sullivan Ann K. , Van Beckhoven Dominique , Delpech Valerie C. ,   The EuroTEST HIV Late Diagnosis Definition Working Group
Published: November 2022

AbstractIntroductionIn recent years, HIV testing frequency has increased, resulting in more people being diagnosed during seroconversion with a temporarily low CD4 count. Using the current consensus definition of late HIV presentation ('presenting for care with a CD4 count < 350 cells/μL or an AIDS‐defining event, regardless of CD4 count') these individuals would be incorrectly assigned as being diagnosed late.MethodsIn spring 2022, a European expert group convened to revise the current late HIV presentation consensus definition. A survey on data availability to apply this revised definition was sent to nominated European focal points responsible for HIV surveillance (n = 53).ResultsExperts agreed that the updated definition should refer to late HIV diagnosis rather than presentation and include the following addition: People with evidence of recent infection should be reclassified as 'not late', with evidence of recent infection considered hierarchically. The individual must have: (i) laboratory evidence of recent infection; (ii) a last negative HIV test within 12 months of diagnosis; or (iii) clinical evidence of acute infection. People with evidence of being previously diagnosed abroad should be excluded. A total of 18 countries responded to the survey; 83% reported capturing CD4 count and/or AIDS at diagnosis through national surveillance, 67% captured last negative test and/or previous HIV diagnosis, 61% captured seroconversion illness at diagnosis and 28% captured incident antibody results.ConclusionsAccurate data on late diagnosis are important to describe the effects of testing programmes. Reclassification of individuals with recent infection will help to better identify populations most at risk of poor HIV outcomes and areas for intervention.
Key data from AIDS 2022
Authors: Owen Rhiannon , Maan Irfaan , Waters Laura 
Published: November 2022

AbstractWe report on the highlights ofthe 24th International AIDS Conference, held in Montreal in 2022. We address three main themes: human immunodeficiency virus (HIV) targets and cascades, HIV and sexually transmitted infection prophylaxis, and HIV treatment, including the use of antiretroviral therapy in pregnancy.
DECIDING WHEN TO DECIDE: COLLECTIVE DELIBERATION AND OBSTRUCTION
Authors: Anesi Vincent , Safronov Mikhail 
Published: November 2022

AbstractWe study the impact of deliberation rules on collective learning and decision making in committees. In contrast to much of the existing literature, this article makes a distinction between the final votes over policy proposals and the cloture votes that bring them about. We show how deliberation rules can cause Pareto‐inefficient outcomes and failures to bring good proposals to a final vote, and how they affect the distribution of power among committee members in the deliberative process. We further show that deliberation rules are dynamically stable, even when they generate Pareto‐inefficient outcomes.
DIRECTED SEARCH WITH PHANTOM VACANCIES
Authors: Albrecht James , Decreuse Bruno , Vroman Susan 
Published: November 2022

AbstractWhen vacancies are filled, the job ads often remain, creating phantom vacancies. Older listings more likely represent phantoms. We assume job seekers direct their search based on listing age. Forming a match with an age‐a vacancy creates an age‐a phantom with probability β and generates an externality affecting vacancies aged a and older. Thus, the externality decreases with the match's listing age. Relative to efficient behavior, job seekers overapply to younger listings. We calibrate using U.S. data. The contribution of phantoms to inefficiency is large, but, given their existence, the planner cannot improve much on the directed search allocation.