Field measurements of N2O emissions from soils are limited for cropping systems in the semiarid northern Great Plains (NGP). The objectives were to develop N2O emission-time profiles for cropping ...systems in the semiarid NGP, define important periods of loss, determine the impact of best management practices on N2O losses, and estimate direct N fertilizer-induced emissions (FIE). No-till (NT) wheat (Triticum Aestivum L.)-fallow, wheat-wheat, and wheat-pea (Pisum sativum), and conventional till (CT) wheat-fallow, all with three N regimes (200 and 100 kg N ha-1 available N, unfertilized control); plus a perennial grass-alfalfa (Medicago sativa L.) system were sampled over 2 yr using vented chambers. Cumulative 2-yr N2O emissions were modest in contrast to reports from more humid regions. Greatest N2O flux activity occurred following urea-N fertilization (10-wk) and during freeze-thaw cycles. Together these periods comprised up to 84% of the 2-yr total. Nitrification was probably the dominant process responsible for N2O emissions during the post-N fertilization period, while denitrification was more important during freeze-thaw cycles. Cumulative 2-yr N2O-N losses from fertilized regimes were greater for wheat-wheat (1.31 kg N ha-1) than wheat-fallow (CT and NT) (0.48 kg N ha-1), and wheat-pea (0.71 kg N ha-1) due to an additional N fertilization event. Cumulative losses from unfertilized cropping systems were not different from perennial grass-alfalfa (0.28 kg N ha-1). Tillage did not affect N2O losses for the wheat-fallow systems. Mean FIE level was equivalent to 0.26% of applied N, and considerably below the Intergovernmental Panel on Climate Change mean default value (1.25%).
Background
Antipsychotic drugs are the core treatment for schizophrenia. Treatment guidelines state that there is no difference in efficacy between any other antipsychotic compounds, however, ...low‐potency antipsychotic drugs are often perceived as less efficacious than high‐potency compounds by clinicians, and they also seem to differ in their side effects. This review examined the effects of the high‐potency antipsychotic fluphenazine compared to those of low‐potency antipsychotics.
Objectives
To review the effects of fluphenazine and low‐potency antipsychotics for people with schizophrenia.
Search methods
We searched the Cochrane Schizophrenia Group Trials Register (November 2010).
Selection criteria
We included all randomised controlled trials (RCTs) comparing fluphenazine with first‐generation low‐potency antipsychotic drugs for people with schizophrenia or schizophrenia‐like psychosis.
Data collection and analysis
We extracted data independently. For dichotomous data we calculated risk ratios (RR) and their 95% confidence intervals (CI) on an intention‐to‐treat basis based on a random‐effects model.
Main results
The review currently includes seven randomised trials and 1567 participants that compared fluphenazine with low‐potency antipsychotic drugs. The size of the included studies was between 40 and 438 participants. Overall, sequence generation, allocation procedures and blinding were poorly reported. Fluphenazine was not significantly different from low‐potency antipsychotic drugs in terms of response to treatment (fluphenazine 55%, low‐potency drug 55%, 2 RCTs, n = 105, RR 1.06 CI 0.75 to 1.50, moderate quality evidence). There was also no significant difference in acceptability of treatment with equivocal numbers of participants leaving the studies early due to any reason (fluphenazine 36%, low‐potency antipsychotics 36%, 6 RCTs, n = 1532, RR 1.00 CI 0.88 to 1.14, moderate quality evidence). There was no significant difference between fluphenazine and low‐potency antipsychotics for numbers experiencing at least one adverse effect (fluphenazine 70%, low‐potency antipsychotics 88%, 1 RCT, n = 65, RR 0.79 CI 0.58 to 1.07, moderate quality evidence). However, at least one movement disorder occurred significantly more frequently in the fluphenazine group (fluphenazine 15%, low‐potency antipsychotics 10%, 3 RCTs, n = 971, RR 2.11 CI 1.41 to 3.15, low quality of evidence). In contrast, low‐potency antipsychotics produced significantly more sedation (fluphenazine 20%, low‐potency antipsychotics 64%, 1 RCT, n = 65, RR 0.31 CI 0.13 to 0.77, high quality evidence). No data were available for the outcomes of death and quality of life. The results of the primary outcome were robust in a number of subgroup and sensitivity analyses.
Adverse effects such as akathisia (fluphenazine 15%, low‐potency antipsychotics 6%, 5 RCTs, n = 1209, RR 2.28 CI 1.58 to 3.28); dystonia (fluphenazine 5%, low‐potency antipsychotics 2%, 4 RCTs, n = 1309, RR 2.66 CI 1.25 to 5.64); loss of associated movement (fluphenazine 20%, low‐potency antipsychotics 2%, 1 RCT, n = 338, RR 11.15 CI 3.95 to 31.47); rigor (fluphenazine 27%, low‐potency antipsychotics 12%, 2 RCTs, n = 403, RR 2.18 CI 1.20 to 3.97); and tremor (fluphenazine 15%, low‐potency antipsychotics 6%, 2 RCTs, n = 403, RR 2.53 CI 1.37 to 4.68) occurred significantly more frequently in the fluphenazine group.
For other adverse effects such as dizziness (fluphenazine 8%, low‐potency antipsychotics 17%, 4 RCTs, n = 1051, RR 0.49 CI 0.32 to 0.73); drowsiness (fluphenazine 18%, low‐potency antipsychotics 25%, 3 RCTs, n = 986, RR 0.67 CI 0.53 to 0.86); dry mouth (fluphenazine 11%, low‐potency antipsychotics 18%, 4 RCTs, n = 1051, RR 0.63 CI 0.45 to 0.89); nausea (fluphenazine 4%, low‐potency antipsychotics 15%, 3 RCTs, n = 986, RR 0.25 CI 0.14 to 0.45); and vomiting (fluphenazine 3%, low‐potency antipsychotics 8%, 3 RCTs, n = 986, RR 0.36 CI 0.18 to 0.72) results favoured fluphenazine with significantly more events occurring in the low‐potency antipsychotic group for these outcomes.
Authors' conclusions
The results do not show a clear difference in efficacy between fluphenazine and low‐potency antipsychotics. The number of included studies was low and their quality moderate. Therefore, further studies would be needed to draw firm conclusions about the relative effects of fluphenazine and low‐potency antipsychotics.
We present a combined TEVA-DGA chromatography chemistry to purify single-element fractions of Pu, Am, and Np from bulk (mg-level) U materials. Plutonium and Np are first sorbed onto TEVA resin using ...a 4 + redox adjustment with a hydroxylamine hydrochloride and sodium nitrite treatment, with U + Am eluting directly onto DGA resin. Americium is then purified from U on DGA using 0.1 M HNO
3
as a U eluent. A subsequent TEVA column is used to separate Pu from Np using hydrogen peroxide to oxidize Np into the 5 + oxidation state for elution through TEVA. Our presented TEVA-DGA method is able to produce high-purity, single-element fractions of Pu (90% recovery), Am (98% recovery), and Np (62% recovery) from mg-levels of U, and does so in three days of column chemistry.
Abstract
Objectives
Successful treatment of delirium depends on the detection of the reversible contributors. Drugs with delirogenic properties are the most prevalent reversible cause of delirium.
...Methods
This observational study is based on data from Arzneimittelsicherheit in der Psychiatrie, a multicenter drug surveillance program in German-speaking countries recording severe adverse drug reactions (ADRs) in psychiatric inpatients. The present study analyzes drug-induced delirium (DID) during treatment with antidepressants and antipsychotics.
Results
A total of 436 565 psychiatric inpatients were treated with antidepressants and/or antipsychotics during the observation period from 1993 to 2016 in the participating 110 hospitals. Overall, 254 cases (0.06% of all patients treated with antidepressants and/or antipsychotics) of DID were detected. Implicated either in combination or alone (multiple drugs were implicated in 70.1% of DID), clomipramine (0.24%), amitriptyline (0.21%), and clozapine (0.18%) showed the highest incidence rates of DID. When implicated alone (98 cases overall), clozapine (0.11%) followed by amitriptyline (0.05%) were most likely causally associated with the occurrence of DID. Drugs with strong antimuscarinic properties generally exhibited higher risk of DID.
Conclusions
With an incidence rate of <0.1%, the use of antidepressants and antipsychotics was rarely associated with DID within the Arzneimittelsicherheit in der Psychiatrie program. Tricyclic antidepressants and clozapine were the most commonly implicated psychotropic drugs. These data support the specific role of antimuscarinic properties in DID.
Galactorrhea is a well-known adverse drug reaction (ADR) of numerous antipsychotic drugs (APD) and is often distressing for those affected. Methodological problems in the existing literature make it ...difficult to determine the prevalence of symptomatic hyperprolactinemia in persons treated with APDs. Consequently, a large sample of patients exposed to APDs is needed for more extensive evaluation. Data on APD utilization and reports of galactorrhea caused by APDs were analyzed using data from an observational pharmacovigilance program in German-speaking countries—Arzneimittelsicherheit in der Psychiatrie (AMSP)—from 1993 to 2015. 320,383 patients (175,884 female inpatients) under surveillance were treated with APDs for schizophrenia and other indications. A total of 170 events of galactorrhea caused by APDs were identified (0.97 cases in 1000 female inpatient admissions). Most cases occurred during the reproductive age with the highest incidence among patients between 16 and 30 years (3.81 cases in 1000 inpatients). The APDs that were most frequently imputed alone for inducing galactorrhea were risperidone (52 cases and 0.19% of all exposed inpatients), amisulpride (30 resp. 0.48%), and olanzapine (13 resp. 0.05%). In three cases, quetiapine had a prominent role as a probable cause for galactorrhea. High dosages of the imputed APDs correlated with higher rates of galactorrhea. Galactorrhea is a severe and underestimated condition in psychopharmacology. While some APDs are more likely to cause galactorrhea, we identified a few unusual cases. This highlights the importance of alertness in clinical practice and of taking a patient’s individual situation into consideration.
Oral miltefosine was administered to 39 human immunodeficiency virus (HIV)-infected patients with leishmaniasis for whom standard leishmaniasis treatment had failed. Initial response was achieved in ...25 patients (64%), including 16 patients (43%) with initial parasitological cure. Repeated responses after relapse and tolerability of long courses of treatment indicate the potential for development of optimized dosage schemes.
Background
Antipsychotic drugs are the core treatment for schizophrenia. Treatment guidelines state that there is no difference in efficacy between any other antipsychotic compounds, however, ...low‐potency antipsychotic drugs are often perceived as less efficacious than high‐potency compounds by clinicians, and they also seem to differ in their side‐effects.
Objectives
To review the effects in response to treatment of trifluoperazine and low‐potency antipsychotics for people with schizophrenia.
Search methods
We searched the Cochrane Schizophrenia Group's Trials Register (November 2010).
Selection criteria
We included all randomised trials comparing trifluoperazine with first‐generation low‐potency antipsychotic drugs for people with schizophrenia or schizophrenia‐like psychosis.
Data collection and analysis
We extracted data independently. For dichotomous data we calculated risk ratios (RR) and their 95% confidence intervals (CI) on an intention‐to‐treat basis based on a random‐effects model.
Main results
The review currently includes seven randomised trials involving 422 participants that compared trifluoperazine with low‐potency antipsychotic drugs. The size of the included studies was between 20 and 157 participants with a study length between four and 52 weeks. Overall, sequence generation, allocation procedures and blinding were poorly reported.
Trifluoperazine was not significantly different from low‐potency antipsychotic drugs in terms of response to treatment (trifluoperazine 26%, low‐potency drug 27%, 3 RCTs, n = 120, RR 0.96 CI 0.59 to 1.56, moderate quality evidence). There was also no significant difference in acceptability of treatment with equivocal number of participants leaving the studies early due to any reason (trifluoperazine 20%, low‐potency antipsychotics 16%, 3 RCTs, n = 239, RR 1.25, CI 0.72 to 2.17,low quality evidence). There was no significant difference in numbers with at least one adverse effect (trifluoperazine 60%, low‐potency antipsychotics 38%, 1 RCT, n = 60, RR 1.60, CI 0.94 to 2.74, moderate quality evidence). However, at least one movement disorder was significantly more frequent in the trifluoperazine group (trifluoperazine 23%, low‐potency antipsychotics 13%, 2 RCTs, n = 123, RR 2.08 CI 0.78 to 5.55, very low quality evidence) as well as incoordination (trifluoperazine 20%, low‐potency antipsychotics 5%, 1 RCT, n = 60, RR 7.00, CI 1.60 to 30.66) and rigor (trifluoperazine 45%, low‐potency antipsychotics 10%, 1 RCT, n = 60, RR 4.50, CI 1.58 to 12.84). No data were available for other outcomes of interest death, sedation and quality of life.
Authors' conclusions
The results did not show a difference in efficacy between trifluoperazine and low‐potency antipsychotics. Trifluoperazine produced more movement disorders. The number of randomised studies as well as their quality is low, the quality of evidence for outcomes of interest ranged from moderate to very low quality, so more, newer studies would be needed for conclusions about the relative effects of trifluoperazine and low‐potency antipsychotics.
Evidence of ferroelasticity in a non-planar organic molecular crystal is presented for 4,4′-dicarboxydiphenyl ether. Ferroelasticity has been demonstrated by the micro- and macroscopic mechanical ...characterization of single crystals, including recording of a full hysteretic stress–strain cycle. The underlying mechanism involves the partial flipping of phenyl rings.
Objectives: The aim of this study was to systematically integrate the available evidence on response prediction to prophylactic lithium based on clinical factors.
Methods: Each clinical variable ...that was related to lithium response in at least one prior study was examined with respect to response prediction. If several studies were located for the same variable, results were integrated using the meta‐analytic approach as suggested by DerSimonian and Laird which was developed for substantial heterogeneity in primary studies.
Results: Of 42 potential clinical predictors investigated, five variables were identified as possible response predictors of prophylactic lithium: 1 An episodic pattern of mania‐depression‐interval, and 2 a high age of illness onset were identified as potentially protective against a recurrence under lithium. 3 A high number of previous hospitalizations, 4 an episodic pattern of depression‐mania‐interval, and 5 continuous cycling were identified as potential risk factors. Six further variables were found to be significantly related to lithium response, though calculation of fail‐safe numbers indicates that current evidence is not sufficient to hold these variables as reliable predictors of lithium response. All effect‐sizes relating clinical predictors to response were small to moderate.
Conclusions: Although a few variables are quite robustly supported as response‐predictors in this review, a more in‐depth analysis of each potential predictor is needed. As none of the potential predictors had a very strong impact on response, prediction of lithium response should be based on a multitude of variables.
It is shown that a continuous-time observer, which comprises two standard nth order observers and a delay D, can observe the state of an nth order linear system in finite time D exactly. In ...particular, (almost) any convergence time D can be assigned, independent of the observer eigenvalues.
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