Probable effects of polypharmacy and equivalent doses of psychotropic drugs on prevalence of adverse drug events among psychiatric inpatients in a general hospital in Japan.

OBJECTIVE: In psychiatry, polypharmacy or high psychotropic drug doses increase adverse drug event (ADE) prevalence. However, the full relationship between polypharmacy and ADEs is unclear, and few studies have evaluated dose equivalents for psychotropic drugs for ADEs. Thus, we conducted a retrospective analysis to clarify the effects of polypharmacy and chlorpromazine (CP)-, diazepam (DAP)-, and imipramine- equivalent doses on all ADEs in inpatients. METHODS: Psychiatric inpatients in a Japanese hospital from April 1, 2016 to March 31, 2018, were enrolled. ADE severity and causality were assessed. Multiple logistic regression analyses were performed to evaluate ADE risk factors. RESULTS: Among 462 patients analyzed, out of 471 patients enrolled, 145 (31.4%) experienced ADEs. The causality assessment determined that "possible" was 96.5%. The most common ADEs were nervous system disorders (35%). Multiple logistic regression analyses indicated an increase in ADE prevalence with the number of drugs used (≥5; p = 0.026); CP-equivalent dose (p = 0.048); and endocrine, nutritional, and metabolic disorders (p = 0.045). DAP-equivalent dose; infectious and parasitic diseases; and injury, poisoning, and consequences of other external causes decreased ADE prevalence (p = 0.047, 0.022, and 0.021, respectively). CONCLUSIONS: Avoiding polypharmacy in psychiatric inpatients and adjusting drug regimens to safe equivalent doses could reduce ADEs during hospitalization.

In Situ Observation of the Movement of Magnetic Particles in Polyurethane Elastomer Densely Packed Magnetic Particles Using Synchrotron Radiation X-ray Computed Tomography.

In situ observation of the migration and structure formation of magnetic particles in polyurethane elastomers was carried out by X-ray computed tomography using synchrotron radiation. The mean diameter of the magnetic particles was 7.0 µm, and the volume fraction was ϕ= 0.24 at its maximum. The exposure time was 100 ms/frame, and the pixel size was 0.458 µm/pixel. The orientation angle and the volume fraction of the maximum aggregate were analyzed using commercial software for image analysis. The orientation angle for magnetic elastomers with ϕ = 0.24 was approximately 55° at 0 mT and decreased remarkably with the magnetic field. At magnetic fields above 150 mT, the orientation angle gradually decreased with the field and showed a constant value of 38° at 300 mT, suggesting that magnetic particles move and form a chain-like structure although the chains do not align perfectly in the direction of the magnetic field. On the other hand, the volume fraction of the maximum aggregate was constant at magnetic fields below 100 mT, and it significantly increased with the field, indicating that magnetic particles were connected to each other and developed into a macroscopic structure with anisotropy. Dynamic viscoelastic measurements revealed that the storage modulus of the magnetic elastomers cannot be simply scaled by the orientation angle. It was also found that the volume fraction of the maximum aggregate is a good parameter for explaining the huge increase in the storage modulus. The dynamic movement of magnetic particles when a magnetic field of 300 mT was switched on and off was also successfully observed. When the field was switched on, magnetic particles connected instantly and their aggregates were rapidly elongated in the direction of the magnetic field. When the field was switched off, some of the connections between aggregates were broken; however, most of the aggregates did not return to the original position even 5 min after being switched off.

Particle Size in Secondary Particle and Magnetic Response for Carrageenan Magnetic Hydrogels.

The relation between the number of magnetic particles and the change in storage modulus induced by a magnetic field was investigated for weak hydrogels containing carbonyl iron, iron oxide, and barium ferrite particles with different diameters in primary particles while maintaining the magnetization of magnetic particles. The change in storage modulus exhibited a power dependency against the number of magnetic particles, which was nearly independent of the magnetic particles. The change in storage modulus was successfully scaled by the reduced number of magnetic particles using the diameter of secondary particles. Microphotographs revealed that iron oxide and barium ferrite particles form aggregations while carbonyl iron particles are well dispersed in carrageenan gels. The diameter of secondary particles determined by a relation between the change in storage modulus and the reduced number of magnetic particles showed similar values with those observed in microphotographs.

Chain Structure in a Cross-Linked Polyurethane Magnetic Elastomer Under a Magnetic Field.

The morphology of magnetic particles with a size of 7.0 µm was observed for magnetic elastomers with a concentration of magnetic particles of 70 wt% using an X-ray microscope remolded into high resolution. Computed tomography images revealed that magnetic particles were distributed isotopically in the absence of a magnetic field, but they formed a chain structure in the polyurethane network under a magnetic field of 270 mT. It was also established, by image analysis, that magnetic elastomers had an anisotropic structure under the magnetic field.

Effect of Sonication Time on Magnetorheological Effect for Monomodal Magnetic Elastomers.

The effect of sonication time on the storage modulus and particle morphology for magnetic elastomers was investigated by dynamic viscoelastic measurements and morphological studies. An ultrasonic wave using a homogenizer was irradiated to magnetic liquids containing 70 wt % carbonyl iron, for up to 30 min before cure. SEM photographs revealed that magnetic particles were randomly dispersed in the polyurethane matrix for magnetic elastomers with sonication. A parameter showing nonlinear viscoelasticity for magnetic elastomers with sonication decreased from 0.75 to 0.4, indicating that the aggregations of magnetic particles had been destroyed by the sonication. The storage modulus at 500 mT at the linear viscoelastic regime significantly increased with the irradiation time, reaching saturation after 10 min; this suggests an increase in the number of chains of magnetic particles by sonication, due to the random dispersion of magnetic particles. At high strains, the storage modulus at 500 mT increased by 8.9 kPa by sonication, indicating the number of chains of magnetic particles which were not destroyed by increased sonication. It was also found that the storage modulus for polyurethane elastomers without magnetic particles was not varied by sonication, suggesting that the polyurethane network was not broken. The effect of sonication time on the viscoelastic properties, and on the magnetorheological response for magnetic elastomers, is discussed.

Anomalous conformational change in 1-butyl-3-methylimidazolium tetrafluoroborate-D2O mixtures.

We have investigated the effect of deuterated water on the conformational equilibrium between the gauche and trans conformers of the [bmim] cation in mixtures of water and 1-butyl-3-methylimidazolium tetrafluoroborate ([bmim][BF(4)]), an ionic liquid, at room temperature. A comparison of the results obtained from solutions made with H(2)O and with D(2)O highlights an anomalous conformational change in the D(2)O solution showing an extended N-shaped behavior. The gauche conformer of the [bmim] cation in D(2)O increased up to x = ~50 (D(2)O mol %); however, it decreased up to higher water concentrations of x = ~85 before again increasing drastically toward x = ~100. We provide spectroscopic evidence that the anomalous conformational dynamics of the [bmim] cation in D(2)O is directly related to the H/D exchange reaction of the C-H group at position 2 of the imidazolium ring.

Factors associated with late post-partum depression in Japan.

AIM: Postnatal depression is one of the life-threatening events faced by women. As the factors associated with postnatal depression have not been investigated fully in Japan, we studied the factors associated with postnatal depression. METHODS: One-hundred-and-sixty-nine women who visited the health center of a city in Aomori Prefecture, Japan, at 4 months after childbirth for regular examination fulfilled the selection criteria and completed self-reporting questionnaires on postnatal depression using the Edinburgh Postnatal Depression Scale (EPDS) and a life and social events scale. RESULTS: The primiparas showed a significantly higher EPDS score than the multiparas. The EPDS score decreased with the frequency of delivery in the groups of mothers in their twenties and thirties. For the multiparas, the number of participants who suffered obstetric events was lower, the number of participants who went back to their home was higher, and the number of participants who were taken care of by their mother was lower than for the primiparas. General health abnormalities, sociability, and worries about baby care were significantly associated with the EPDS for both the primiparas and multiparas. The cooperation of the husband was associated with a decreased EPDS score, both for the primiparas and multiparas, irrespective of the family structure. CONCLUSION: The EPDS score decreased with an increased frequency of delivery, suggesting that the experience of delivery would impact on postnatal depression, partly because of decreased obstetric events. However, a social assistance system is needed for women with general health abnormalities, less sociability, worries about baby care, and limited cooperation of the husband for both primiparas and multiparas.