Aims:Research on second-generation antipsychotic drugs (SGAs) has experienced great development in last decades.We did a bibliometric study on the scientific publications on SGAs in Japan.Methods: With theEMBASEandMED...Aims:Research on second-generation antipsychotic drugs (SGAs) has experienced great development in last decades.We did a bibliometric study on the scientific publications on SGAs in Japan.Methods: With theEMBASEandMEDLINEdatabases, we chose papers published from Japan with SGA descriptors. Price’s law and Bradford’s law has been used as bibliometric indicators for quantitating production and dispersion, respectively, of published papers on SGAs. We also calculated the participation index of different countries, and correlated those bibliometric data with some social and health data from Japan (such as totalper capitaexpenditure on health and gross domestic expenditure on research and development). Results: A sum of 669 original documents were published from Japan from 1982 to 2011. Those results fulfilled Price’s law, with scientific production on SGAs showing exponential growth (correlation coefficientr= 0.9261, as against anr= 0.8709 after linear adjustment). The most studied SGAs in Japan wererisperidone (n= 192), aripiprazole (n= 109), and olanzapine (n= 106). Division of documents into Bradford zones yielded a nucleus occupied exclusively by theProgress in Neuro-Psychopharmacology and Biological Psychiatry(49 articles). Those publications were in 157 different journals. Seven of the first 10 frequently used journals had an impact factor of being greater than 3. Conclusions: The SGA publications in Japan have been through exponential growth over the studied period, without evidence of reaching a saturation point.展开更多
Antipsychotic(AP)medications are used to treat schizophrenia and a number off-label conditions.Although effective in reducing psychoses these drugs increase the risk of developing cardiometabolic disease,and are one o...Antipsychotic(AP)medications are used to treat schizophrenia and a number off-label conditions.Although effective in reducing psychoses these drugs increase the risk of developing cardiometabolic disease,and are one of the reasons why individuals with schizophrenia live∼15–20 years less than the general population.While weight gain has traditionally been thought to be the primary culprit linked to increases in rates of cardiometabolic disease,there are weight-gain independent effects of antipsychotics.The purpose of the current review was to highlight the acute metabolic complications of antipsychotics and to address the question:are exercise and targeting“exercise-activated”signaling pathways,a viable approach to offset the metabolic complications of APs?The possibility of fibroblast growth factor 21 being a common factor mediating the protective effects of exercise and certain nutritional approaches against the acute metabolic complications of antipsychotics was also discussed.The research highlighted in this narrative review provides evidence,in preclinical models,that exercise and certain exercise-activated pathways,can protect against acute perturbations in glucose metabolism.While promising,further work is needed to confirm these findings in clinical populations prescribed antipsychotics.展开更多
BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neu...BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neuropsychiatric presentations,such as catatonia.CASE SUMMARY We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium.The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia,which was mitigated by discontinuing olanzapine and supplementing with lorazepam.In this case,whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.CONCLUSION Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.展开更多
BACKGROUND Long-term antipsychotic therapy in psychiatric patients carries significant cardiovascular risks,including QT interval prolongation,myocardial injury,and functional impairment.Guanxinning,a traditional Chin...BACKGROUND Long-term antipsychotic therapy in psychiatric patients carries significant cardiovascular risks,including QT interval prolongation,myocardial injury,and functional impairment.Guanxinning,a traditional Chinese medicine formulation,has demonstrated cardioprotective potential in preclinical studies,but clinical evidence in this population remains limited.AIM To evaluate the cardioprotective effects of Guanxinning against antipsychotic-induced cardiac injury in long-term hospitalized psychiatric patients.METHODS A randomized,double-blind,placebo-controlled trial was conducted with 120 psychiatric inpatients receiving chronic antipsychotic therapy.Participants were allocated to:Intervention group:Conventional antipsychotics+Guanxinning tablets(0.38 g×4 tablets,ter in die);Control group:Conventional antipsychotics+identical placebo;Cardiac assessments at baseline and 12 months included:Electrocardiography(corrected QT interval),echocardiography(left ventricular ejection fraction,left ventricular end-diastolic diameter),serum biomarkers(cardiac troponin I,B-type natriuretic peptide,superoxide dismutase,malondialdehyde,high-sensitivity C-reactive protein).RESULTS Compared to controls,the Guanxinning group showed:Electrophysiological improvement:Corrected QT shortening(438±25 milliseconds vs 465±30 milliseconds,P<0.01).Functional enhancement:Left ventricular ejection fraction increase(58.5%±5.2%vs 53.8%±4.8%,P<0.05),left ventricular end-diastolic diameter reduction(49.8±3.5 mm vs 52.6±3.8 mm,P<0.05),Biochemical modulation:Reduced myocardial injury markers(cardiac troponin I:0.009 ng/mL vs 0.014 ng/mL;B-type natriuretic peptide:52 pg/mL vs 78 pg/mL,P<0.001),improved oxidative stress(superoxide dismutase:↑13.3 U/mL;malondialdehyde:↓0.9 nmol/mL,P<0.001),attenuated inflammation(high-sensitivity C-reactive protein:2.0 mg/L vs 3.2 mg/L,P<0.001).CONCLUSION Guanxinning significantly mitigates antipsychotic-induced cardiac injury in psychiatric patients,demonstrating:Normalization of electrophysiological parameters,Preservation of systolic/diastolic function,suppression of oxidative stress and inflammation.These findings support its clinical application as an adjunctive cardioprotective therapy,potentially through inhibition of myocardial apoptosis and antioxidant upregulation.展开更多
BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Resear...BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Research in developing nations relating to the cost of treatment is scarce when compared with developed countries.Thus,the drug utilization research studies from developing nations are most needed,and their number has been growing.AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia.METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization(WHO)core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators.We also calculated direct medical costs for a period of 6 months.RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia.The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019.The total mean drug cost of our study was 1396 Indian rupees.The total mean cost due to the investigation in our study was 1017.34 Indian rupees.Therefore,the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees.CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.展开更多
This paper discusses the principle and procedures of the second-generation wavelet transform and its application to the denoising of seismic data. Based on lifting steps, it is a flexible wavelet construction method u...This paper discusses the principle and procedures of the second-generation wavelet transform and its application to the denoising of seismic data. Based on lifting steps, it is a flexible wavelet construction method using linear and nonlinear spatial prediction and operators to implement the wavelet transform and to make it reversible. The lifting scheme transform -includes three steps： split, predict, and update. Deslauriers-Dubuc （4, 2） wavelet transforms are used to process both synthetic and real data in our second-generation wavelet transform. The processing results show that random noise is effectively suppressed and the signal to noise ratio improves remarkably. The lifting wavelet transform is an efficient algorithm.展开更多
AIM To investigate whether differential influence on the QTc interval exists among four second generation antipsychotics(SGAs) in psychosis.METHODS Data were drawn from a pragmatic, randomized headto-head trial of the...AIM To investigate whether differential influence on the QTc interval exists among four second generation antipsychotics(SGAs) in psychosis.METHODS Data were drawn from a pragmatic, randomized headto-head trial of the SGAs risperidone, olanzapine, quetiapine, and ziprasidone in acute admissions patients with psychosis, and with follow-up visits at discharge or maximally 6-9 wk, 3, 6, 12 and 24 mo. Electrocardiograms were recorded on all visits. To mimic clinical shared decision-making, the patients were randomized not to a single drug, but to a sequenceof the SGAs under investigation. The first drug in the sequence defined the randomization group, but the patient and/or clinician could choose an SGA later in the sequence if prior negative experiences with the first one(s) in the sequence had occurred. The study focuses on the time of, and actual use of the SGAs under investigation, that is until treatment discontinuation or change, in order to capture the direct medication effects on the QTc interval. Secondary intention-to-treat(ITT) analyses were also performed. RESULTS A total of 173 patients, with even distribution among the treatment groups, underwent ECG assessments. About 70% were males and 43% had never used antipsychotic drugs before the study. The mean antipsychotic doses in milligrams per day with standard deviations(SD) were 3.4(1.2) for risperidone, 13.9(4.6) for olanzapine, 325.9(185.8) for quetiapine, and 97.2(42.8) for ziprasidone treated groups. The time until discontinuation of the antipsychotic drug used did not differ in a statistically significant way among the groups(Log-Rank test: P = 0.171). The maximum QTc interval recorded during follow-up was 462 ms. Based on linear mixed effects analyses, the QTc interval change per day with standard error was-0.0030(0.0280) for risperidone;-0.0099(0.0108) for olanzapine;-0.0027(0.0170) for quetiapine, and-0.0081(0.0229) for ziprasidone. There were no statistically significant differences among the groups in this regard. LME analyses based on ITT groups(the randomization groups), revealed almost identical slopes with-0.0063(0.0160) for risperidone,-0.0130(0.0126) for olanzapine,-0.0034(0.0168) for quetiapine, and-0.0045(0.0225) for ziprasidone. CONCLUSION None of the SGAs under investigation led to statistically significant QTc prolongation. No statistically significant differences among the SGAs were found.展开更多
Chronic use of antipsychotic medications entails a dilemma between the benefit of alleviating psychotic symptoms and the risk of troubling,sometimes lifeshortening adverse effects.Antipsychotic-induced cardiotoxicity ...Chronic use of antipsychotic medications entails a dilemma between the benefit of alleviating psychotic symptoms and the risk of troubling,sometimes lifeshortening adverse effects.Antipsychotic-induced cardiotoxicity is one of the most life-threatening adverse effects that raises widespread concerns.These cardiotoxic effects range from arrhythmia to heart failure in the clinic,with myocarditis/cardiomyopathy,ischemic injuries,and unexplained cardiac lesions as the pathological bases.Multiple mechanisms have been proposed to underlie antipsychotic cardiotoxicity.This review aims to summarize the clinical signs and pathological changes of antipsychotic cardiotoxicity and introduce recent progress in understanding the underlying mechanisms at both the subcellular organelle level and the molecular level.We also provide an up-to-date perspective on future clinical monitoring and therapeutic strategies for antipsychotic cardiotoxicity.We propose that third-generation antipsychotics or drug adjuvant therapy,such as cannabinoid receptor modulators that confer dual benefits—i.e.,alleviating cardiotoxicity and improving metabolic disorders—deserve further clinical evaluation and marketing.展开更多
AIM To ascertain performance against the standards set by National Institute for Clinical Excellence (NICE) guidelines on physical health monitoring of thirty children and adolescents prescribed antipsychotics in neur...AIM To ascertain performance against the standards set by National Institute for Clinical Excellence (NICE) guidelines on physical health monitoring of thirty children and adolescents prescribed antipsychotics in neurodevelopmental clinics in Northumberland and identifying areas for improvement in practice. METHODS The audit involved a review of recorded documentation pertaining to physical health monitoring in patient electronic records pertaining to children and adolescents attending neurodevelopmental clinics in Northumberland prescribed antipsychotics. Clients were also contacted by telephone if relevant documentation could not be identified or retrieved to confirm the details. 32 case notes were perused of which 2 were excluded as they had refused to have venepuncture which was documented in the electronic records. RESULTS The overall audit results demonstrated partial compliance with NICE guidelines on physical health monitoring in children and adolescents prescribed antipsychotics. Bi-annual recording of height, weight, blood pressure, pulse rate and review of side effects was completed in 100% of subjects. However, annual monitoring for blood tests including liver function, renal function full blood count as well as biannual monitoring of serum prolactin, serum lipid profile was completed only in 56% of subjects. Comparative baseline characteristics between the two groups (compliant and non-compliant with guidelines) found no differences based on any socio-demographic or clinical variables. However, the proportion of patients in the group compliant to guidelines was higher in the age group of 12-17 years as compared to < 12 years (70.58% vs 38.46%), though not statistically significant (χ~2 = 1.236; P = 0.24). CONCLUSION Development of tailored and specific guidelines for physical health monitoring in children and adolescents prescribed antipsychotics taking into consideration clinical effectiveness and safety profile is likely to improve adherence rates.展开更多
Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown...Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown that decreased serum IGF-2 was correlated with the severity of psychopathology in patients with schizophrenia.Here we conducted a prospective observation trial to investigate the effects of atypical antipsychotics on serum IGF-2 level and its relationship with clinical improvements in schizophrenia patients.Thirty-one schizophrenia patients with acute exacerbation and 30 healthy individuals were recruited in this study.Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)and serum IGF-2 levels were determined using ELISA.We found that schizophrenia patients with acute exacerbation had lower serum IGF-2 levels than control individuals at baseline(P<0.05).After 2 months of atypical antipsychotic treatment,a significant improvement in each PANSS subscore and total score was observed in patients(all P<0.01),and the serum IGF-2 levels of patients were significantly increased compared with those at baseline(203.13±64.62 vs.426.99±124.26 ng/mL;t=−5.044,P<0.001).Correlation analysis revealed that the changes of serum IGF-2 levels in patients were significantly correlated with the improvements of negative symptoms(r=−0.522,P=0.006).Collectively,our findings demonstrated changes of serum IGF-2 response to improvements of negative symptoms in schizophrenia patients treated with atypical antipsychotics,suggesting that serum IGF-2 might be a treatment biomarker for schizophrenia.展开更多
Antipsychotic agents are used for various indications in the treatment of psychiatric disorders.Despite their proven roles in multiple conditions,the treatment-emergent side effects of antipsychotic medications,such a...Antipsychotic agents are used for various indications in the treatment of psychiatric disorders.Despite their proven roles in multiple conditions,the treatment-emergent side effects of antipsychotic medications,such as metabolic side effects,are often the limiting factor for their long-term and short-term uses.Moreover,antipsychotic medications are often criticized for being less effective in treating different disabling symptoms such as negative symptoms of schizophrenia.As a result,the search for safer and more efficacious antipsychotic agents is ongoing.Newer antipsychotic agents are gaining attention related to emerging efficacy and tolerability data in treating neuropsychiatric conditions.In this review,we attempt to appraise the scientific data on psychopharmacology,safety profile,and efficacy of the newer additions to the list of second-generation antipsychotics,namely brexpiprazole,cariprazine,and lumateperone.We conducted a selective review utilizing PubMed,clinicaltrials.gov,and Cochrane databases to gather appropriate publications,keeping broad inclusion criteria.There were no restrictions on the age of the study population or the year of publication.We also cross-referenced articles and references to capture all existing studies.Our review of the current literature indicates that all three antipsychotic agents appear to be promising based on their short-term studies,while long-term studies remain limited.There is also a need for a head to head comparison between the newer antipsychotics with the other antipsychotic agents to ascertain if the newer agents are any better than the others.展开更多
Schizophrenia is a group of the most common types of mental illness.Commonly used antischizophrenia drugs all increase mortality to some extent.The increased risk of death in older individuals and patients with dement...Schizophrenia is a group of the most common types of mental illness.Commonly used antischizophrenia drugs all increase mortality to some extent.The increased risk of death in older individuals and patients with dementia using atypical antips-ychotics may be due to myocardial damage,increased mobility and increased risk of stroke.展开更多
Ground-penetrating radar(GPR)is a highly efficient,fast and non-destructive exploration method for shallow surfaces.High-precision numerical simulation method is employed to improve the interpretation precision of det...Ground-penetrating radar(GPR)is a highly efficient,fast and non-destructive exploration method for shallow surfaces.High-precision numerical simulation method is employed to improve the interpretation precision of detection.Second-generation wavelet finite element is introduced into the forward modeling of the GPR.As the finite element basis function,the second-generation wavelet scaling function constructed by the scheme is characterized as having multiple scales and resolutions.The function can change the analytical scale arbitrarily according to actual needs.We can adopt a small analysis scale at a large gradient to improve the precision of analysis while adopting a large analytical scale at a small gradient to improve the efficiency of analysis.This approach is beneficial to capture the local mutation characteristics of the solution and improve the resolution without changing mesh subdivision to realize the efficient solution of the forward GPR problem.The algorithm is applied to the numerical simulation of line current radiation source and tunnel non-dense lining model with analytical solutions.Result show that the solution results of the secondgeneration wavelet finite element are in agreement with the analytical solutions and the conventional finite element solutions,thereby verifying the accuracy of the second-generation wavelet finite element algorithm.Furthermore,the second-generation wavelet finite element algorithm can change the analysis scale arbitrarily according to the actual problem without subdividing grids again.The adaptive algorithm is superior to traditional scheme in grid refinement and basis function order increase,which makes this algorithm suitable for solving complex GPR forward-modeling problems with large gradient and singularity.展开更多
With the emphasis on environmental issues,the recycling of waste concrete,even recycled concrete,has become a hot spot in the field of architecture.But the repeated recycling of waste concrete used in harsh environmen...With the emphasis on environmental issues,the recycling of waste concrete,even recycled concrete,has become a hot spot in the field of architecture.But the repeated recycling of waste concrete used in harsh environments is still a complex problem.This paper discusses the durability and recyclability of recycled aggregate concrete(RAC)as a prefabricated material in the harsh environment,the effect of high-temperature curing(60℃,80℃,and 100℃)on the frost resistance of RAC and physical properties of the second generation recycled coarse aggregate(RCA_(2))of RAC after 300 freeze-thaw cycles were studied.The frost resistance of RAC was characterized by compressive strength,relative dynamic elastic modulus,and mass loss.As the physical properties of RCA_(2),the apparent density,water absorption,and crushing value were measured.And the SEM images of RAC after 300 freeze-thaw cycles were shown.The results indicated that the frost resistance of RAC cured at 80℃ for 7 days was comparable to that cured in the standard condition(cured for 28 days at 20℃±2℃ and 95%humidity),and the RAC cured at 100℃ was slightly worse.However,the frost resistance of RAC cured at 60℃ deteriorated seriously.The RAC cured at 80℃ for 7 days is the best.Whether after the freeze-thaw cycle or not,the RCA that curd at 60℃,80℃,and 100℃ for 7 days can also meet the requirements of Grade III RCA and be used as the aggregate of non-bearing part of prefabricated concrete components.RCA_(2) which is cured at 80℃ for 7 days had the best physical properties.展开更多
An effective de-noising method for fiber optic gyroscopes （FOGs） is proposed. This method is based on second-generation Daubechies D4 （DB4） wavelet transform （WT） and level-dependent threshold estimator called S...An effective de-noising method for fiber optic gyroscopes （FOGs） is proposed. This method is based on second-generation Daubechies D4 （DB4） wavelet transform （WT） and level-dependent threshold estimator called Stein＇s unbiased risk estimator （SURE）. The whole approach consists of three critical parts： wavelet decomposition module, parameters estimation module and SURE de-noising module. First, DB4 wavelet is selected as lifting base of the second-generation wavelet in the decomposition module. Second, in the parameters estimation module, maximum likelihood estimation （MLE） is used for stochastic noise parameters estimation. Third, combined with soft threshold de-noising technique, the SURE de-noising module is designed. For comparison, both the traditional universal threshold wavelet and the second-generation Harr wavelet method are also investigated. The experiment results show that the computation cost is 40% less than that of the traditional wavelet method. The standard deviation of de-noised FOG signal is 0.012 and the three noise terms such as angle random walk, bias instability and quantization noise are reduced to 0.007 2°/√h, 0.004 1° / h, and 0.008 1°, respectively.展开更多
English-language literature cited in MEDLINE from January,1980 to October 30,2014 was searched by using terms of antipsychotic,generic and brand names of atypical antipsychotics, ＂bipolar depression/bipolar disorder...English-language literature cited in MEDLINE from January,1980 to October 30,2014 was searched by using terms of antipsychotic,generic and brand names of atypical antipsychotics, ＂bipolar depression/bipolar disorder＂, ＂placebo＂,and ＂trial＂.The parameters of response（≥50%improvement on MADRS,Montgomery-Asberg Depression Rating Scale total score）,remission（either ≤12 or 8 on MADRS total score at endpoint）,discontinuation due to adverse events（DAEs）,somnolence,≥7%weight gain,overall extrapyramidal side-effects（EPSs）,and akathisia,were extracted from originally published primary outcome papers.The number needed to treat to benefit（NNT） for response and remission or harm（NNH） for DAEs or other side effects relative to placebo were estimated and presented with the estimate and 95%confidence interval.Olanzapine monotherapy,olanzapine-fluoxetine combination（OFC）,quetiapine-IR monotherapy,quetiapine-XR monotherapy,lurasidone monotherapy,and lurasidone adjunctive therapy were superior to placebo with NNTs for responses of 11-12,4,7-8,4,4-5,and 7,and NNTs for remission of 11-12,4,5-11,7,6-7,and 6,respectively.There was no significant difference between OFC and lamotrigine,and between aripiprazole or ziprasidone and placebo in response and remission.Olanzapine monotherapy,quetiapine-IR,quetiapine-XR,aripiprazole,and ziprasidone 120-160 mg/day had significantly increased risk for DAEs with NNHs of 24,8-14,9,12,and 10,respectively.For somnolence,quetiapine-XR had the smallest NNH of 4.For ≥7%weight gain,olanzapine monotherapy and OFC had the smallest NNHs with both of 5.For akathisia,aripiprazole had the smallest NNH of 5.These findings suggest that among the FDA-approved agents including OFC,quetiapine-IR and-XR,lurasidone monotherapy and adjunctive therapy to a mood stabilizer,the differences in the NNTs for response and remission are small,but the differences in NNHs for DAEs and common side-effects are large.Therefore,the selection of an FDA-approved atypical antipsychotic for bipolar depression should be based upon safety and tolerability.展开更多
Over the past three decades, concerns about the high prevalence of antipsychotic use in the nursing homes （NHs） for the management of behavioral and psychological symptoms of dementia continue to be emphasized and i...Over the past three decades, concerns about the high prevalence of antipsychotic use in the nursing homes （NHs） for the management of behavioral and psychological symptoms of dementia continue to be emphasized and intervened by many. However, despite the numerous side effects and the recent blackbox warning by the United States Food and Drug Administration about the increased risks for stroke and sudden death associated with the use of antipsychotics in dementia, the preva-lence of antipsychotic use in NHs remains high. While the use of antipsychotics appeared to have modest effcacy in reducing symptoms of aggression and psychosis in dementia, there is insuffcient evidence to routinely rec-ommend the use of alternative psychopharmacological treatments for these symptoms. Hence, clinicians have to balance the safety warnings against the need to treat these symptoms in order to prevent harm to the resident that may result from his/her dangerous behaviors. Although the use of antipsychotics may be warranted in some cases, organizational, resource and training support should be provided to encourage and equip NH staff to participate in interventions so as to minimize inappropriate use of these medicines in NHs. This review will discuss the place in therapy, the trend and appropriateness of antipsychotic use in NHs, as well as the effectiveness of current and future strategies for reducing antipsychotic use in the NHs.展开更多
Alternating-current losses in a two-layer superconducting cable, each layer being composed of 15 closely-spaced rectangular wires made up of second-generation superconductors when the ends of wires are coated by eithe...Alternating-current losses in a two-layer superconducting cable, each layer being composed of 15 closely-spaced rectangular wires made up of second-generation superconductors when the ends of wires are coated by either a non-magnetic or strong ferromagnetic material having a U profile is numerically investigated. Computations are carried out through the finite-element method. The alternating-current losses do not increase significantly if the relative permeability of the coating is increased three orders of magnitude, provided that the current amplitude is less than half of the critical current in a superconducting wire. However, the losses are much higher for ferromagnetic coating if the amplitude of the applied current oscillating at 50 Hz is close to the critical current. The ferromagnetic coating is seen to accumulate the magnetic field lines normally on its surfaces, while the field lines are parallel to the long axes of the wires, leading to more significant flux penetration in the coated regions. This facilitates a uniform low-loss current flow in the uncoated regions of the wires. In contrast, coating with a non-magnetic material gives rise to a considerably smaller current flow in the uncoated regions, whereas the low-loss flow is maintained in the coated regions. Moreover, the current flows in opposite directions in the coated and uncoated regions, where the direction in each region is converse for the two materials.展开更多
Objectives: Atypical antipsychotics are increasingly being prescribed for the treatment of mood disorders, often off-label. This review describes existing published literature on the efficacy and safety of antipsychot...Objectives: Atypical antipsychotics are increasingly being prescribed for the treatment of mood disorders, often off-label. This review describes existing published literature on the efficacy and safety of antipsychotics for the treatment of major depressive disorder (MDD) in adults and adolescents. We discuss current clinical considerations: role as monotherapy, adjunctive, or augmentation therapy, side effect profiles, and optimal dose and duration of therapy. Potential areas for future research and methodological considerations are also highlighted. Method: We conducted a literature search of MEDLINE, EMBASE, PsycINFO, and Cochrane databases. Relevant articles and references were identified. MDD practice guidelines for adolescents and adults were reviewed. Results: Evidence for using atypical antipsychotics to treat MDD is heterogeneous. It is thus difficult to draw firm conclusions regarding their role in therapy. Most current guidelines do not include recommendations for atypical antipsychotics, but off-label use is common in clinical practice. Primary use is adjunct or augmentation therapy for treatment resistant depression. Potential benefits versus side effects must be cautiously considered, especially for children and adolescents. Clinicians must rely on their clinical experience and professional judgment to determine an optimal dose and duration of therapy. Conclusions: There is progressive research to support the use of atypical antipsychotics to treat MDD in adults. However, additional research and well-designed studies are needed to determine the appropriate and safe use of atypical antipsychotics for treating child and adolescent depression. Other subpopulations that may benefit from combination therapy, such as individuals with dual diagnoses, may be identified through future research.展开更多
文摘Aims:Research on second-generation antipsychotic drugs (SGAs) has experienced great development in last decades.We did a bibliometric study on the scientific publications on SGAs in Japan.Methods: With theEMBASEandMEDLINEdatabases, we chose papers published from Japan with SGA descriptors. Price’s law and Bradford’s law has been used as bibliometric indicators for quantitating production and dispersion, respectively, of published papers on SGAs. We also calculated the participation index of different countries, and correlated those bibliometric data with some social and health data from Japan (such as totalper capitaexpenditure on health and gross domestic expenditure on research and development). Results: A sum of 669 original documents were published from Japan from 1982 to 2011. Those results fulfilled Price’s law, with scientific production on SGAs showing exponential growth (correlation coefficientr= 0.9261, as against anr= 0.8709 after linear adjustment). The most studied SGAs in Japan wererisperidone (n= 192), aripiprazole (n= 109), and olanzapine (n= 106). Division of documents into Bradford zones yielded a nucleus occupied exclusively by theProgress in Neuro-Psychopharmacology and Biological Psychiatry(49 articles). Those publications were in 157 different journals. Seven of the first 10 frequently used journals had an impact factor of being greater than 3. Conclusions: The SGA publications in Japan have been through exponential growth over the studied period, without evidence of reaching a saturation point.
文摘Antipsychotic(AP)medications are used to treat schizophrenia and a number off-label conditions.Although effective in reducing psychoses these drugs increase the risk of developing cardiometabolic disease,and are one of the reasons why individuals with schizophrenia live∼15–20 years less than the general population.While weight gain has traditionally been thought to be the primary culprit linked to increases in rates of cardiometabolic disease,there are weight-gain independent effects of antipsychotics.The purpose of the current review was to highlight the acute metabolic complications of antipsychotics and to address the question:are exercise and targeting“exercise-activated”signaling pathways,a viable approach to offset the metabolic complications of APs?The possibility of fibroblast growth factor 21 being a common factor mediating the protective effects of exercise and certain nutritional approaches against the acute metabolic complications of antipsychotics was also discussed.The research highlighted in this narrative review provides evidence,in preclinical models,that exercise and certain exercise-activated pathways,can protect against acute perturbations in glucose metabolism.While promising,further work is needed to confirm these findings in clinical populations prescribed antipsychotics.
基金Supported by STI2030-Major Projects,No.2021ZD0202001Capital Funds for Health Improvement and Research,No.CFH 2022-2-4012.
文摘BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neuropsychiatric presentations,such as catatonia.CASE SUMMARY We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium.The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia,which was mitigated by discontinuing olanzapine and supplementing with lorazepam.In this case,whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.CONCLUSION Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.
基金Supported by the Special Project for Supporting the Development of Biomedicine and Health Industry in Hangzhou City,No.2022WJC123Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2022ZA143.
文摘BACKGROUND Long-term antipsychotic therapy in psychiatric patients carries significant cardiovascular risks,including QT interval prolongation,myocardial injury,and functional impairment.Guanxinning,a traditional Chinese medicine formulation,has demonstrated cardioprotective potential in preclinical studies,but clinical evidence in this population remains limited.AIM To evaluate the cardioprotective effects of Guanxinning against antipsychotic-induced cardiac injury in long-term hospitalized psychiatric patients.METHODS A randomized,double-blind,placebo-controlled trial was conducted with 120 psychiatric inpatients receiving chronic antipsychotic therapy.Participants were allocated to:Intervention group:Conventional antipsychotics+Guanxinning tablets(0.38 g×4 tablets,ter in die);Control group:Conventional antipsychotics+identical placebo;Cardiac assessments at baseline and 12 months included:Electrocardiography(corrected QT interval),echocardiography(left ventricular ejection fraction,left ventricular end-diastolic diameter),serum biomarkers(cardiac troponin I,B-type natriuretic peptide,superoxide dismutase,malondialdehyde,high-sensitivity C-reactive protein).RESULTS Compared to controls,the Guanxinning group showed:Electrophysiological improvement:Corrected QT shortening(438±25 milliseconds vs 465±30 milliseconds,P<0.01).Functional enhancement:Left ventricular ejection fraction increase(58.5%±5.2%vs 53.8%±4.8%,P<0.05),left ventricular end-diastolic diameter reduction(49.8±3.5 mm vs 52.6±3.8 mm,P<0.05),Biochemical modulation:Reduced myocardial injury markers(cardiac troponin I:0.009 ng/mL vs 0.014 ng/mL;B-type natriuretic peptide:52 pg/mL vs 78 pg/mL,P<0.001),improved oxidative stress(superoxide dismutase:↑13.3 U/mL;malondialdehyde:↓0.9 nmol/mL,P<0.001),attenuated inflammation(high-sensitivity C-reactive protein:2.0 mg/L vs 3.2 mg/L,P<0.001).CONCLUSION Guanxinning significantly mitigates antipsychotic-induced cardiac injury in psychiatric patients,demonstrating:Normalization of electrophysiological parameters,Preservation of systolic/diastolic function,suppression of oxidative stress and inflammation.These findings support its clinical application as an adjunctive cardioprotective therapy,potentially through inhibition of myocardial apoptosis and antioxidant upregulation.
文摘BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Research in developing nations relating to the cost of treatment is scarce when compared with developed countries.Thus,the drug utilization research studies from developing nations are most needed,and their number has been growing.AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia.METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization(WHO)core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators.We also calculated direct medical costs for a period of 6 months.RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia.The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019.The total mean drug cost of our study was 1396 Indian rupees.The total mean cost due to the investigation in our study was 1017.34 Indian rupees.Therefore,the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees.CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.
文摘This paper discusses the principle and procedures of the second-generation wavelet transform and its application to the denoising of seismic data. Based on lifting steps, it is a flexible wavelet construction method using linear and nonlinear spatial prediction and operators to implement the wavelet transform and to make it reversible. The lifting scheme transform -includes three steps： split, predict, and update. Deslauriers-Dubuc （4, 2） wavelet transforms are used to process both synthetic and real data in our second-generation wavelet transform. The processing results show that random noise is effectively suppressed and the signal to noise ratio improves remarkably. The lifting wavelet transform is an efficient algorithm.
基金the Division of Psychiatry, Haukeland University Hospital for financial support
文摘AIM To investigate whether differential influence on the QTc interval exists among four second generation antipsychotics(SGAs) in psychosis.METHODS Data were drawn from a pragmatic, randomized headto-head trial of the SGAs risperidone, olanzapine, quetiapine, and ziprasidone in acute admissions patients with psychosis, and with follow-up visits at discharge or maximally 6-9 wk, 3, 6, 12 and 24 mo. Electrocardiograms were recorded on all visits. To mimic clinical shared decision-making, the patients were randomized not to a single drug, but to a sequenceof the SGAs under investigation. The first drug in the sequence defined the randomization group, but the patient and/or clinician could choose an SGA later in the sequence if prior negative experiences with the first one(s) in the sequence had occurred. The study focuses on the time of, and actual use of the SGAs under investigation, that is until treatment discontinuation or change, in order to capture the direct medication effects on the QTc interval. Secondary intention-to-treat(ITT) analyses were also performed. RESULTS A total of 173 patients, with even distribution among the treatment groups, underwent ECG assessments. About 70% were males and 43% had never used antipsychotic drugs before the study. The mean antipsychotic doses in milligrams per day with standard deviations(SD) were 3.4(1.2) for risperidone, 13.9(4.6) for olanzapine, 325.9(185.8) for quetiapine, and 97.2(42.8) for ziprasidone treated groups. The time until discontinuation of the antipsychotic drug used did not differ in a statistically significant way among the groups(Log-Rank test: P = 0.171). The maximum QTc interval recorded during follow-up was 462 ms. Based on linear mixed effects analyses, the QTc interval change per day with standard error was-0.0030(0.0280) for risperidone;-0.0099(0.0108) for olanzapine;-0.0027(0.0170) for quetiapine, and-0.0081(0.0229) for ziprasidone. There were no statistically significant differences among the groups in this regard. LME analyses based on ITT groups(the randomization groups), revealed almost identical slopes with-0.0063(0.0160) for risperidone,-0.0130(0.0126) for olanzapine,-0.0034(0.0168) for quetiapine, and-0.0045(0.0225) for ziprasidone. CONCLUSION None of the SGAs under investigation led to statistically significant QTc prolongation. No statistically significant differences among the SGAs were found.
基金Supported by National Natural Science Foundation of China,No.82070285 and No.81701861.
文摘Chronic use of antipsychotic medications entails a dilemma between the benefit of alleviating psychotic symptoms and the risk of troubling,sometimes lifeshortening adverse effects.Antipsychotic-induced cardiotoxicity is one of the most life-threatening adverse effects that raises widespread concerns.These cardiotoxic effects range from arrhythmia to heart failure in the clinic,with myocarditis/cardiomyopathy,ischemic injuries,and unexplained cardiac lesions as the pathological bases.Multiple mechanisms have been proposed to underlie antipsychotic cardiotoxicity.This review aims to summarize the clinical signs and pathological changes of antipsychotic cardiotoxicity and introduce recent progress in understanding the underlying mechanisms at both the subcellular organelle level and the molecular level.We also provide an up-to-date perspective on future clinical monitoring and therapeutic strategies for antipsychotic cardiotoxicity.We propose that third-generation antipsychotics or drug adjuvant therapy,such as cannabinoid receptor modulators that confer dual benefits—i.e.,alleviating cardiotoxicity and improving metabolic disorders—deserve further clinical evaluation and marketing.
文摘AIM To ascertain performance against the standards set by National Institute for Clinical Excellence (NICE) guidelines on physical health monitoring of thirty children and adolescents prescribed antipsychotics in neurodevelopmental clinics in Northumberland and identifying areas for improvement in practice. METHODS The audit involved a review of recorded documentation pertaining to physical health monitoring in patient electronic records pertaining to children and adolescents attending neurodevelopmental clinics in Northumberland prescribed antipsychotics. Clients were also contacted by telephone if relevant documentation could not be identified or retrieved to confirm the details. 32 case notes were perused of which 2 were excluded as they had refused to have venepuncture which was documented in the electronic records. RESULTS The overall audit results demonstrated partial compliance with NICE guidelines on physical health monitoring in children and adolescents prescribed antipsychotics. Bi-annual recording of height, weight, blood pressure, pulse rate and review of side effects was completed in 100% of subjects. However, annual monitoring for blood tests including liver function, renal function full blood count as well as biannual monitoring of serum prolactin, serum lipid profile was completed only in 56% of subjects. Comparative baseline characteristics between the two groups (compliant and non-compliant with guidelines) found no differences based on any socio-demographic or clinical variables. However, the proportion of patients in the group compliant to guidelines was higher in the age group of 12-17 years as compared to < 12 years (70.58% vs 38.46%), though not statistically significant (χ~2 = 1.236; P = 0.24). CONCLUSION Development of tailored and specific guidelines for physical health monitoring in children and adolescents prescribed antipsychotics taking into consideration clinical effectiveness and safety profile is likely to improve adherence rates.
基金This work was supported by grants from the National Natural Science Foundation of China(No.81760254)the Natural Science Foundation of Fujian Province of China(No.2019J01164)the Scientific Foundation of Quanzhou City for High Level Talents(No.2019C075R).
文摘Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown that decreased serum IGF-2 was correlated with the severity of psychopathology in patients with schizophrenia.Here we conducted a prospective observation trial to investigate the effects of atypical antipsychotics on serum IGF-2 level and its relationship with clinical improvements in schizophrenia patients.Thirty-one schizophrenia patients with acute exacerbation and 30 healthy individuals were recruited in this study.Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)and serum IGF-2 levels were determined using ELISA.We found that schizophrenia patients with acute exacerbation had lower serum IGF-2 levels than control individuals at baseline(P<0.05).After 2 months of atypical antipsychotic treatment,a significant improvement in each PANSS subscore and total score was observed in patients(all P<0.01),and the serum IGF-2 levels of patients were significantly increased compared with those at baseline(203.13±64.62 vs.426.99±124.26 ng/mL;t=−5.044,P<0.001).Correlation analysis revealed that the changes of serum IGF-2 levels in patients were significantly correlated with the improvements of negative symptoms(r=−0.522,P=0.006).Collectively,our findings demonstrated changes of serum IGF-2 response to improvements of negative symptoms in schizophrenia patients treated with atypical antipsychotics,suggesting that serum IGF-2 might be a treatment biomarker for schizophrenia.
文摘Antipsychotic agents are used for various indications in the treatment of psychiatric disorders.Despite their proven roles in multiple conditions,the treatment-emergent side effects of antipsychotic medications,such as metabolic side effects,are often the limiting factor for their long-term and short-term uses.Moreover,antipsychotic medications are often criticized for being less effective in treating different disabling symptoms such as negative symptoms of schizophrenia.As a result,the search for safer and more efficacious antipsychotic agents is ongoing.Newer antipsychotic agents are gaining attention related to emerging efficacy and tolerability data in treating neuropsychiatric conditions.In this review,we attempt to appraise the scientific data on psychopharmacology,safety profile,and efficacy of the newer additions to the list of second-generation antipsychotics,namely brexpiprazole,cariprazine,and lumateperone.We conducted a selective review utilizing PubMed,clinicaltrials.gov,and Cochrane databases to gather appropriate publications,keeping broad inclusion criteria.There were no restrictions on the age of the study population or the year of publication.We also cross-referenced articles and references to capture all existing studies.Our review of the current literature indicates that all three antipsychotic agents appear to be promising based on their short-term studies,while long-term studies remain limited.There is also a need for a head to head comparison between the newer antipsychotics with the other antipsychotic agents to ascertain if the newer agents are any better than the others.
基金Supported by Curriculum Reform Project of Taizhou University in 2021, No. xkg2021087
文摘Schizophrenia is a group of the most common types of mental illness.Commonly used antischizophrenia drugs all increase mortality to some extent.The increased risk of death in older individuals and patients with dementia using atypical antips-ychotics may be due to myocardial damage,increased mobility and increased risk of stroke.
基金supported by the National Natural Science Foundation of China(Nos.41574116 and 41774132)Hunan Provincial Innovation Foundation for Postgraduate(Grant Nos.CX2017B052)the Fundamental Research Funds for the Central Universities of Central South University(Nos.2018zzts693)。
文摘Ground-penetrating radar(GPR)is a highly efficient,fast and non-destructive exploration method for shallow surfaces.High-precision numerical simulation method is employed to improve the interpretation precision of detection.Second-generation wavelet finite element is introduced into the forward modeling of the GPR.As the finite element basis function,the second-generation wavelet scaling function constructed by the scheme is characterized as having multiple scales and resolutions.The function can change the analytical scale arbitrarily according to actual needs.We can adopt a small analysis scale at a large gradient to improve the precision of analysis while adopting a large analytical scale at a small gradient to improve the efficiency of analysis.This approach is beneficial to capture the local mutation characteristics of the solution and improve the resolution without changing mesh subdivision to realize the efficient solution of the forward GPR problem.The algorithm is applied to the numerical simulation of line current radiation source and tunnel non-dense lining model with analytical solutions.Result show that the solution results of the secondgeneration wavelet finite element are in agreement with the analytical solutions and the conventional finite element solutions,thereby verifying the accuracy of the second-generation wavelet finite element algorithm.Furthermore,the second-generation wavelet finite element algorithm can change the analysis scale arbitrarily according to the actual problem without subdividing grids again.The adaptive algorithm is superior to traditional scheme in grid refinement and basis function order increase,which makes this algorithm suitable for solving complex GPR forward-modeling problems with large gradient and singularity.
基金This research was funded by the National Natural Science Foundation of China(52078068)Practice Innovation Program of Jiangsu Province(KYCX22_3082).
文摘With the emphasis on environmental issues,the recycling of waste concrete,even recycled concrete,has become a hot spot in the field of architecture.But the repeated recycling of waste concrete used in harsh environments is still a complex problem.This paper discusses the durability and recyclability of recycled aggregate concrete(RAC)as a prefabricated material in the harsh environment,the effect of high-temperature curing(60℃,80℃,and 100℃)on the frost resistance of RAC and physical properties of the second generation recycled coarse aggregate(RCA_(2))of RAC after 300 freeze-thaw cycles were studied.The frost resistance of RAC was characterized by compressive strength,relative dynamic elastic modulus,and mass loss.As the physical properties of RCA_(2),the apparent density,water absorption,and crushing value were measured.And the SEM images of RAC after 300 freeze-thaw cycles were shown.The results indicated that the frost resistance of RAC cured at 80℃ for 7 days was comparable to that cured in the standard condition(cured for 28 days at 20℃±2℃ and 95%humidity),and the RAC cured at 100℃ was slightly worse.However,the frost resistance of RAC cured at 60℃ deteriorated seriously.The RAC cured at 80℃ for 7 days is the best.Whether after the freeze-thaw cycle or not,the RCA that curd at 60℃,80℃,and 100℃ for 7 days can also meet the requirements of Grade III RCA and be used as the aggregate of non-bearing part of prefabricated concrete components.RCA_(2) which is cured at 80℃ for 7 days had the best physical properties.
基金Supported by the Aerospace Science and Technology Innovation Foundation of China (2006)
文摘An effective de-noising method for fiber optic gyroscopes （FOGs） is proposed. This method is based on second-generation Daubechies D4 （DB4） wavelet transform （WT） and level-dependent threshold estimator called Stein＇s unbiased risk estimator （SURE）. The whole approach consists of three critical parts： wavelet decomposition module, parameters estimation module and SURE de-noising module. First, DB4 wavelet is selected as lifting base of the second-generation wavelet in the decomposition module. Second, in the parameters estimation module, maximum likelihood estimation （MLE） is used for stochastic noise parameters estimation. Third, combined with soft threshold de-noising technique, the SURE de-noising module is designed. For comparison, both the traditional universal threshold wavelet and the second-generation Harr wavelet method are also investigated. The experiment results show that the computation cost is 40% less than that of the traditional wavelet method. The standard deviation of de-noised FOG signal is 0.012 and the three noise terms such as angle random walk, bias instability and quantization noise are reduced to 0.007 2°/√h, 0.004 1° / h, and 0.008 1°, respectively.
文摘English-language literature cited in MEDLINE from January,1980 to October 30,2014 was searched by using terms of antipsychotic,generic and brand names of atypical antipsychotics, ＂bipolar depression/bipolar disorder＂, ＂placebo＂,and ＂trial＂.The parameters of response（≥50%improvement on MADRS,Montgomery-Asberg Depression Rating Scale total score）,remission（either ≤12 or 8 on MADRS total score at endpoint）,discontinuation due to adverse events（DAEs）,somnolence,≥7%weight gain,overall extrapyramidal side-effects（EPSs）,and akathisia,were extracted from originally published primary outcome papers.The number needed to treat to benefit（NNT） for response and remission or harm（NNH） for DAEs or other side effects relative to placebo were estimated and presented with the estimate and 95%confidence interval.Olanzapine monotherapy,olanzapine-fluoxetine combination（OFC）,quetiapine-IR monotherapy,quetiapine-XR monotherapy,lurasidone monotherapy,and lurasidone adjunctive therapy were superior to placebo with NNTs for responses of 11-12,4,7-8,4,4-5,and 7,and NNTs for remission of 11-12,4,5-11,7,6-7,and 6,respectively.There was no significant difference between OFC and lamotrigine,and between aripiprazole or ziprasidone and placebo in response and remission.Olanzapine monotherapy,quetiapine-IR,quetiapine-XR,aripiprazole,and ziprasidone 120-160 mg/day had significantly increased risk for DAEs with NNHs of 24,8-14,9,12,and 10,respectively.For somnolence,quetiapine-XR had the smallest NNH of 4.For ≥7%weight gain,olanzapine monotherapy and OFC had the smallest NNHs with both of 5.For akathisia,aripiprazole had the smallest NNH of 5.These findings suggest that among the FDA-approved agents including OFC,quetiapine-IR and-XR,lurasidone monotherapy and adjunctive therapy to a mood stabilizer,the differences in the NNTs for response and remission are small,but the differences in NNHs for DAEs and common side-effects are large.Therefore,the selection of an FDA-approved atypical antipsychotic for bipolar depression should be based upon safety and tolerability.
文摘Over the past three decades, concerns about the high prevalence of antipsychotic use in the nursing homes （NHs） for the management of behavioral and psychological symptoms of dementia continue to be emphasized and intervened by many. However, despite the numerous side effects and the recent blackbox warning by the United States Food and Drug Administration about the increased risks for stroke and sudden death associated with the use of antipsychotics in dementia, the preva-lence of antipsychotic use in NHs remains high. While the use of antipsychotics appeared to have modest effcacy in reducing symptoms of aggression and psychosis in dementia, there is insuffcient evidence to routinely rec-ommend the use of alternative psychopharmacological treatments for these symptoms. Hence, clinicians have to balance the safety warnings against the need to treat these symptoms in order to prevent harm to the resident that may result from his/her dangerous behaviors. Although the use of antipsychotics may be warranted in some cases, organizational, resource and training support should be provided to encourage and equip NH staff to participate in interventions so as to minimize inappropriate use of these medicines in NHs. This review will discuss the place in therapy, the trend and appropriateness of antipsychotic use in NHs, as well as the effectiveness of current and future strategies for reducing antipsychotic use in the NHs.
基金Project supported by the Fund from the Scientific and Technological Research Council of Turkey(TüB˙ITAK)(Grant No.110T876)
文摘Alternating-current losses in a two-layer superconducting cable, each layer being composed of 15 closely-spaced rectangular wires made up of second-generation superconductors when the ends of wires are coated by either a non-magnetic or strong ferromagnetic material having a U profile is numerically investigated. Computations are carried out through the finite-element method. The alternating-current losses do not increase significantly if the relative permeability of the coating is increased three orders of magnitude, provided that the current amplitude is less than half of the critical current in a superconducting wire. However, the losses are much higher for ferromagnetic coating if the amplitude of the applied current oscillating at 50 Hz is close to the critical current. The ferromagnetic coating is seen to accumulate the magnetic field lines normally on its surfaces, while the field lines are parallel to the long axes of the wires, leading to more significant flux penetration in the coated regions. This facilitates a uniform low-loss current flow in the uncoated regions of the wires. In contrast, coating with a non-magnetic material gives rise to a considerably smaller current flow in the uncoated regions, whereas the low-loss flow is maintained in the coated regions. Moreover, the current flows in opposite directions in the coated and uncoated regions, where the direction in each region is converse for the two materials.
文摘Objectives: Atypical antipsychotics are increasingly being prescribed for the treatment of mood disorders, often off-label. This review describes existing published literature on the efficacy and safety of antipsychotics for the treatment of major depressive disorder (MDD) in adults and adolescents. We discuss current clinical considerations: role as monotherapy, adjunctive, or augmentation therapy, side effect profiles, and optimal dose and duration of therapy. Potential areas for future research and methodological considerations are also highlighted. Method: We conducted a literature search of MEDLINE, EMBASE, PsycINFO, and Cochrane databases. Relevant articles and references were identified. MDD practice guidelines for adolescents and adults were reviewed. Results: Evidence for using atypical antipsychotics to treat MDD is heterogeneous. It is thus difficult to draw firm conclusions regarding their role in therapy. Most current guidelines do not include recommendations for atypical antipsychotics, but off-label use is common in clinical practice. Primary use is adjunct or augmentation therapy for treatment resistant depression. Potential benefits versus side effects must be cautiously considered, especially for children and adolescents. Clinicians must rely on their clinical experience and professional judgment to determine an optimal dose and duration of therapy. Conclusions: There is progressive research to support the use of atypical antipsychotics to treat MDD in adults. However, additional research and well-designed studies are needed to determine the appropriate and safe use of atypical antipsychotics for treating child and adolescent depression. Other subpopulations that may benefit from combination therapy, such as individuals with dual diagnoses, may be identified through future research.
