This article reviews clinical, toxicological, and legal issues related to designer drug abuse, with a focus on synthetic cathinones (bath salts). Synthetic cathinones are amphetamine-type central ...nervous system (CNS) stimulants that produce similar effects to amphetamine. Like amphetamine, synthetic cathinones can also result in neurological and cardiovascular side-effects consistent with sympathomimetic toxicity. The differential for a patient presenting with the signs and symptoms of synthetic cathinone toxicity is broad, and laboratory testing for synthetic cathinones is of limited value in acute management. If a diagnosis of cathinone-induced delirium is suspected, treatment efforts should focus on controlling agitation and then treating medical complications such as metabolic acidosis. Physicians should be aware of these new drugs, not only to optimally treat patients, but also to raise awareness of the dangers of designer drug use through patient counseling and community outreach programs.
ABSTRACT
BACKGROUND
The efficacy of perineal self-acupressure in treating constipation is uncertain.
OBJECTIVE
We aimed to evaluate whether perineal self-acupressure would improve patient reports of ...quality of life and bowel function at 4 weeks after training.
DESIGN
A randomized, parallel group trial was conducted.
SETTING
The study took place at the UCLA Department of Medicine.
PATIENTS
One hundred adult patients who met Rome III criteria for functional constipation participated.
INTERVENTION
The control group received information about standard constipation treatment options, while the treatment group received training in perineal self-acupressure plus standard treatment options.
MEASUREMENTS
Primary outcome was the Patient Assessment of Constipation Quality of Life (PAC-QOL). Secondary outcomes included patient assessments of bowel function (as measured by a modified Bowel Function Index (BFI)), and health and well-being (as measured by the SF-12v2).
RESULTS
The mean PAC-QOL was improved by 0.76 in the treatment group and by 0.17 in the control group (treatment-effect difference, 0.59 95 % CI, 0.37 to 0.81;
p
< 0.01). The mean modified BFI was improved by 18.1 in the treatment group and by 4.2 in the control group (treatment-effect difference, 13.8 95 % CI, 5.1 to 22.5;
p
< 0.01). The mean SF-12v2 Physical Component Score was improved by 2.69 in the treatment group and reduced by 0.36 in the control group (treatment-effect difference, 3.05, 95 % CI, 0.85 to 5.25;
p
< 0.01); and the mean SF-12v2 Mental Component Score was improved by 3.12 in the treatment group and improved by 0.30 in the control group (treatment-effect difference, 2.82, 95 % CI, −0.10 to 5.74;
p
< 0.07).
LIMITATION
The trial was not blinded.
CONCLUSION
Among patients with constipation, perineal self-acupressure improves self-reported assessments of quality of life, bowel function, and health and well-being relative to providing standard constipation treatment options alone.
Recent applications of machine-learned normalizing flows to sampling in lattice field theory suggest that such methods may be able to mitigate critical slowing down and topological freezing. However, ...these demonstrations have been at the scale of toy models, and it remains to be determined whether they can be applied to state-of-the-art lattice quantum chromodynamics calculations. Assessing the viability of sampling algorithms for lattice field theory at scale has traditionally been accomplished using simple cost scaling laws, but as we discuss in this work, their utility is limited for flow-based approaches. We conclude that flow-based approaches to sampling are better thought of as a broad family of algorithms with different scaling properties, and that scalability must be assessed experimentally.
The Laser Inertial Fusion Energy (LIFE) concept is being developed to operate as either a pure fusion or hybrid fusion-fission system. The hybrid version is designed to generate power and burn both ...fertile and fissile nuclear fuel. The fuel blanket is composed of TRISO-based fuel cooled by a molten salt. Low-yield (˜25-40 MJ) targets and a repetition rate of ˜10-15 Hz produce a 300-500 MW fusion source. When this fusion power is coupled to a compact (2-4 m diameter) target chamber, a 14 MeV neutron flux of ˜2 × 10
14
n/cm
2
-s drives fissile production and destruction in the fuel blanket providing an additional energy gain of 4-8, depending on the fuel and design objective.
We employ a methodology using
6
Li as a neutron absorber to generate self-sustaining tritium production for fusion and to maintain constant power over the lifetime of the engine. In a single pass, fertile LIFE blankets achieve uranium and thorium utilization beyond 80% without chemical reprocessing or isotopic enrichment. Fissile blankets destroy more than 90% of the initial load of weapons grade plutonium or highly enriched uranium.
Purpose: Compare 5 dental intraoral scanners by evaluating their precision and truenessMaterials: Mixed material master cast. 5 types of scanners, 5 scans per machine. Compare test scans with master ...scan using software. Statistical analysis determines precision and trueness. Scanners: iTero Element, iTero Element 2, 3Shape TRIOS, 3Shape TRIOS 3, Dentsply Sirona Primescan. Master scanner: GOM ATOS Core 135. Software: GOM Inspect.Results: Posterior Sextant: Primescan had best precision. Anterior Sextant: TRIOS 3 had best trueness and precision. CoCr Crown: Element and Element 2 had best trueness and precision. Full Arch (Telio CAD): TRIOS 3 had best trueness. Cross-Arch distance: Element 2 had best trueness. CoCr crown adjacent to Telio CAD: Primescan had best trueness, Element had best precision. PEEK scanbody adjacent Telio CAD: TRIOS 3 had best trueness.Conclusions: Tested scanners can be appropriate for clinical use. Although clinicians may focus on trueness, bigger differences may be in precision.
Late-life depression (LLD) is a major depressive disorder that affects someone after the age of 60 years. LLD is frequently associated with inadequate response and remission from antidepressants, in ...addition to polypharmacy. Pharmacogenetics offers a promising approach to improve clinical outcomes in LLD via new discoveries determining the genetic basis of response rates and side effects, as well as the development of tailored pharmacogenetic-based decision support tools. This invited review evaluates the LLD pharmacogenetic evidence base and the extent to which this was incorporated into existing commercial decision support tools and clinical pharmacogenetic guidelines.
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