Use of olanzapine compared with clozapine for treatment-resistant schizophrenia in a real-world setting: nationwide register-based study.

BACKGROUND: Clozapine is generally considered as the treatment of choice for patients with treatment-resistant schizophrenia (TRS). However, its superiority has recently been questioned because olanzapine has been suggested as non-inferior to clozapine in its effectiveness. AIMS: We aimed to investigate the current status of clozapine prescriptions to identify any disparity between clinical guidelines and real-world practices. METHOD: In this study, we utilised the Health Insurance Review Agency database in the Republic of Korea to investigate the real-world effectiveness of clozapine for patients with TRS. We compared differences in patient variables before and after clozapine administration, and we also performed survival analyses for both psychiatric admissions and emergency room visits among patients who used clozapine or olanzapine. RESULTS: This study investigated an incident cohort of 64 442 patients, and 2338 patients have been prescribed clozapine. Of these, 998 patients had TRS. In survival analysis, clozapine showed a worse survival rate for psychiatric admissions than olanzapine (hazard ratio 0.615). We also identified that clinicians tended to try a number of antipsychotics, as recommended, before starting patients on clozapine. CONCLUSIONS: In conclusion, we found that olanzapine led to higher survival rates for psychiatric admissions than clozapine. Thus, considering the risk of serious adverse effects, clozapine may be used conservatively. Considering several studies advocating superior efficacy of clozapine, further studies with extensive data are recommended.

Effects of comorbid alcohol use disorder on the clinical outcomes of first-episode schizophrenia: a nationwide population-based study.

BACKGROUND: Alcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia, associated with poor clinical outcomes and medication noncompliance. Most previous studies on the effect of alcohol use in patients with schizophrenia had limitations of small sample size or a cross-sectional design. Therefore, we used a nationwide population database to investigate the impact of AUD on clinical outcomes of schizophrenia. METHODS: Data from the Health Insurance Review Agency database in South Korea from January 1, 2007 to December 31, 2016 were used. Among 64,442 patients with first-episode schizophrenia, 1598 patients with comorbid AUD were selected based on the diagnostic code F10. We performed between- and within-group analyses to compare the rates of psychiatric admissions and emergency room (ER) visits, and medication possession ratio (MPR) between the patients with comorbid AUD and control patients matched for the onset age, sex, and observation period. RESULTS: The rates of psychiatric admissions and ER visits in both groups decreased after the time point of diagnosis of AUD; however, the decrease was significantly greater in the patients with comorbid AUD compared to the control patients. While the comorbid AUD group showed an increase in MPR after the diagnosis of AUD, MPR decreased in the control group. The rates of psychiatric admissions, ER visits, and MPR were worse in the comorbid AUD group both before and after the diagnosis of AUD. CONCLUSIONS: The results emphasize an importance of psychiatric comorbidities, especially AUD, in first-episode schizophrenia and the necessity of further research for confirmative findings of the association of AUD with clinical outcomes of schizophrenia.

A Study on Focused Ion Beam (FIB) Milling Machining and Fabrication Technology of Nano-Scale Diamond Tool for Machining Fine-Patterns in a Free-Form Surfaces.

Recently, the technology of the industry has been increasing for diffractive optical elements, holograms, optical components, and next-generation display components. The advanced high value-added industry is designing fine patterns on ultra-precision optical components and applying them to various industries. In the case of the ultra-fine pattern, a contact-type machining technique is required because it requires a precise pattern in nano-scale units. In this paper, the fabrication technology of ultra-precision diamond which is essential in the ultra-precision processing technology was suggested. The material used in the experiment was a single-crystal diamond tool (SCD), and the equipment for machining the SCD used a focused ion beam (FEI COMPANY, system Nova 600) equipment. The back fire method was applied without metal coating in order to carry out the process study and the focused beam of 30 keV Ga+ ions were carried out processing for various fabrication of diamond cutting tools. As a result of applying the backfire method through the process experiment, the cutting edge width of the ultra-precision diamond tool was verified 275 nm.

Efficient Training of Machine Learning Potentials by a Randomized Atomic-System Generator.

Machine learning potentials provide an efficient and comprehensive tool to simulate large-scale systems inaccessible by conventional first-principles methods still in a similar level of accuracy. One critical issue in constructing machine learning potentials is to build training data sets cost-effectively that can represent the potential energy surface in a wide range of configurations. We develop a scheme named randomized atomic-system generator (RAG) to produce the training sets that widely cover the potential energy surface by combining the random sampling and structural optimization. We apply the scheme to construct the machine learning potentials for simulation of chalcogen-based phase change materials. Constructed machine learning potentials successfully simulate the dynamics of melting and crystallization processes of binary GeTe at a level comparable to first-principles simulations. The visual analysis shows that the RAG-generated training set represents the crystallization process including the amorphous phases. From the velocity autocorrelation function obtained from the molecular dynamics simulations, we calculate the phonon density of states to analyze the vibrational properties during crystallization.

Publisher Correction: A mountable toilet system for personalized health monitoring via the analysis of excreta.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

A mountable toilet system for personalized health monitoring via the analysis of excreta.

Technologies for the longitudinal monitoring of a person's health are poorly integrated with clinical workflows, and have rarely produced actionable biometric data for healthcare providers. Here, we describe easily deployable hardware and software for the long-term analysis of a user's excreta through data collection and models of human health. The 'smart' toilet, which is self-contained and operates autonomously by leveraging pressure and motion sensors, analyses the user's urine using a standard-of-care colorimetric assay that traces red-green-blue values from images of urinalysis strips, calculates the flow rate and volume of urine using computer vision as a uroflowmeter, and classifies stool according to the Bristol stool form scale using deep learning, with performance that is comparable to the performance of trained medical personnel. Each user of the toilet is identified through their fingerprint and the distinctive features of their anoderm, and the data are securely stored and analysed in an encrypted cloud server. The toilet may find uses in the screening, diagnosis and longitudinal monitoring of specific patient populations.

Inhibitory effects of heartwood extracts of Broussonetia kazinoki Sieb on the development of atopic dermatitis in NC/Nga mice.

We investigated the effects of a topically applied extract of the heartwood of Broussonetia kazinoki Sieb (B. kazinoki) on atopic dermatitis (AD)-like skin lesions induced by an extract of the house-dust mite Dermatophagoides farina in NC/Nga mice. We found that topically applied B. kazinoki extract suppressed the histological manifestations of AD-like skin lesions, and decreased the levels of plasma immunoglobulin E (IgE) and interleukin-4 (IL-4) in the mice. Moreover, B. kazinoki inhibited the induction of thymus-and-activation-regulated chemokine (TARC/CCL17), macrophage-derived chemokine (MDC/CCL22), and regulated-on-activation-normal T cell-expressed-and-secreted chemokine (RANTES/CCL5) in HaCaT cells activated by tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma). In conclusion, our results suggest that B. kazinoki extract has therapeutic advantages in the treatment of AD.

Synthesis and evaluation of new antimalarial analogues of quinoline alkaloids derived from Cinchona ledgeriana Moens ex Trimen.

In the course of attempts to develop antimalarial drugs, we have designed and synthesized a series of quinoline alkaloide derivatives. Three of them, N-(4-methoxy-3,5-di-tert-butylbenzyl)cinchonidinium bromide (OSL-5), O-benzyl-N-(3,5-di-tert-butyl-4-methoxybenzyl)cinchonidinium bromide (OSL-7), and N-(3,5-di-tert-butyl-4-methoxybenzyl)quininium bromide (OSL-14) show potent activity against Plasmodium falciparum.