Tardive dyskinesia update: the syndrome

SUMMARYTardive dyskinesia is a common iatrogenic neurological and neurobehavioural syndrome associated with the use of antidopaminergic medication, especially antipsychotics. Prior to the introduction of the newer antipsychotics in the 1990s, it was one of the major areas of psychiatric research but interest waned as the new drugs were reputed to have a reduced liability to extrapyramidal adverse effects in general, a claim now discredited by numerous pragmatic research studies. Early small-scale short-term prevalence studies were presented as evidence to support the assumption that patients on the newer drugs did indeed have a lower prevalence of tardive dyskinesia but recent large-scale review of studies with patients exposed for longer suggest that things have not changed. This article presents a clinical overview of a complex and varied syndrome in terms of its phenomenology, epidemiology and risk factors; a companion article will consider treatment. This overview aims to highlight tardive dyskinesia once again, especially to practitioners who have trained in an environment where this was considered mainly in historical terms.LEARNING OBJECTIVES•Understand the complex phenomenology comprising the syndrome of tardive dyskinesia•Appreciate recent data on prevalence and incidence with the newer antipsychotics•Be aware of risk factors when recommending antipsychotic (and other antidopaminergic) drugsDECLARATION OF INTERESTNone.

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Gloxinia—An Open-Source Sensing Platform to Monitor the Dynamic Responses of Plants

Sensors ◽

10.3390/s20113055 ◽

2020 ◽

Vol 20 (11) ◽

pp. 3055

Author(s):

Olivier Pieters ◽

Tom De Swaef ◽

Peter Lootens ◽

Michiel Stock ◽

Isabel Roldán-Ruiz ◽

...

Keyword(s):

Open Source ◽

Large Scale ◽

Environmental Changes ◽

Low Cost ◽

Current Data ◽

Dynamic Responses ◽

Small Scale ◽

Data Logging ◽

Short Term ◽

Sensing Platforms

The study of the dynamic responses of plants to short-term environmental changes is becoming increasingly important in basic plant science, phenotyping, breeding, crop management, and modelling. These short-term variations are crucial in plant adaptation to new environments and, consequently, in plant fitness and productivity. Scalable, versatile, accurate, and low-cost data-logging solutions are necessary to advance these fields and complement existing sensing platforms such as high-throughput phenotyping. However, current data logging and sensing platforms do not meet the requirements to monitor these responses. Therefore, a new modular data logging platform was designed, named Gloxinia. Different sensor boards are interconnected depending upon the needs, with the potential to scale to hundreds of sensors in a distributed sensor system. To demonstrate the architecture, two sensor boards were designed—one for single-ended measurements and one for lock-in amplifier based measurements, named Sylvatica and Planalta, respectively. To evaluate the performance of the system in small setups, a small-scale trial was conducted in a growth chamber. Expected plant dynamics were successfully captured, indicating proper operation of the system. Though a large scale trial was not performed, we expect the system to scale very well to larger setups. Additionally, the platform is open-source, enabling other users to easily build upon our work and perform application-specific optimisations.

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144 A Clinical Practice Assessment In Tardive Dyskinesia: Are Physicians Up-to-Date?

CNS Spectrums ◽

10.1017/s1092852918000391 ◽

2018 ◽

Vol 23 (1) ◽

pp. 89-90

Author(s):

Jovana Lubarda ◽

Stacey Hughes ◽

Christoph U. Correll

Keyword(s):

Risk Factors ◽

Medical Education ◽

Clinical Practice ◽

Tardive Dyskinesia ◽

Continuing Medical Education ◽

Educational Activity ◽

List Type ◽

Current Guideline ◽

Emerging Treatments ◽

Practice Assessment

AbstractStudy ObjectivesTo assess physicians’ current knowledge, skills, competence, and practice barriers regarding tardive dyskinesia (TD) and assess continuing medical education (CME) needs.Assessment MethodsA 29-question clinical practice assessment survey instrument consisting of multiple-choice knowledge and case-based questions was administered online to gather abaseline “snapshot” of knowledge, skills, attitudes, and competence on TD epidemiology, risk factors, diagnosis, current guideline-based management, and emerging management strategiesThe survey launched online on a website dedicated to continuous professional development on July 25, 2016, and was made available to healthcare providers without monetary compensation or charge. Data were collected through August 28, 2016Confidentiality was maintained and responses were de-identified and aggregated prior to analysesResultsData were collected for the 1157 psychiatrists and 177 neurologists who responded to all survey questions during the study period. The findings were:∙Epidemiology: 62% of psychiatrists and 68% of neurologists were aware that TD affects approximately 20% of patients treated with neuroleptic agents∙Risk factors: 63% of psychiatrists and 67% of neurologists were aware of risk factors for TD, such as older age∙Diagnosis: 93% of psychiatrists and 71% of neurologists were aware that Abnormal Involuntary Movement Scale (AIMS) can be used to support diagnosis of TD∙Guidelines: 21% of psychiatrists and 11% of neurologists were aware of the American Psychiatric Association guidelines for monitoring of TD, and 56% of psychiatrists and 42% of neurologists were aware of the American Academy of Neurology guidelines on treatment of TDNew/emerging treatments: 24% of psychiatrists and 34% of neurologists were aware of the mechanisms of action of new/emerging treatments for TD, and 54% and 44%, respectively, were aware of the clinical data for valbenazineConclusionsThis educational research yielded important insights into clinical practice gaps in TD, indicating that both psychiatrists and neurologists would benefit from continuing medical education on epidemiology, risk factors, diagnosis, guideline-based care, and information on how to incorporate new/emerging treatments for TD into practice.Funding AcknowledgementsThe educational activity and outcomes measurement were funded through an independent educational grant from Neurocrine Biosciences, Inc.

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Population signatures of large-scale, long-term disjunction and small-scale, short-term habitat fragmentation in an Afromontane forest bird

Heredity ◽

10.1038/hdy.2014.15 ◽

2014 ◽

Vol 113 (3) ◽

pp. 205-214 ◽

Cited By ~ 14

Author(s):

J C Habel ◽

R K Mulwa ◽

F Gassert ◽

D Rödder ◽

W Ulrich ◽

...

Keyword(s):

Habitat Fragmentation ◽

Large Scale ◽

Small Scale ◽

Short Term ◽

Forest Bird ◽

Afromontane Forest

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From Small Scale, Short Term to Large Scale, Long Term: Integrating ‘Sustainability’ into Engineering Education

European Journal of Engineering Education ◽

10.1080/03043799608923423 ◽

1996 ◽

Vol 21 (4) ◽

pp. 353-386 ◽

Cited By ~ 10

Author(s):

S. M LEMKOWITZ ◽

B. H BIBO ◽

G. H LAMERIS ◽

J. A. B. A. F. BONNET

Keyword(s):

Engineering Education ◽

Large Scale ◽

Small Scale ◽

Short Term

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Scalable and selective deuteration of (hetero)arenes

Nature Chemistry ◽

10.1038/s41557-021-00846-4 ◽

2022 ◽

Author(s):

Wu Li ◽

Jabor Rabeah ◽

Florian Bourriquen ◽

Dali Yang ◽

Carsten Kreyenschulte ◽

...

Keyword(s):

Large Scale ◽

Hydrogen Pressure ◽

Active Drug ◽

Iron Catalyst ◽

New Drugs ◽

Small Scale ◽

Straightforward Manner ◽

Iron Salts ◽

Selective Deuteration ◽

Scalable Methods

AbstractIsotope labelling, particularly deuteration, is an important tool for the development of new drugs, specifically for identification and quantification of metabolites. For this purpose, many efficient methodologies have been developed that allow for the small-scale synthesis of selectively deuterated compounds. Due to the development of deuterated compounds as active drug ingredients, there is a growing interest in scalable methods for deuteration. The development of methodologies for large-scale deuterium labelling in industrial settings requires technologies that are reliable, robust and scalable. Here we show that a nanostructured iron catalyst, prepared by combining cellulose with abundant iron salts, permits the selective deuteration of (hetero)arenes including anilines, phenols, indoles and other heterocycles, using inexpensive D2O under hydrogen pressure. This methodology represents an easily scalable deuteration (demonstrated by the synthesis of deuterium-containing products on the kilogram scale) and the air- and water-stable catalyst enables efficient labelling in a straightforward manner with high quality control.

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Radar based rainfall forecast for sewage systems control

Water Science & Technology ◽

10.2166/wst.2001.0256 ◽

2001 ◽

Vol 43 (5) ◽

pp. 79-86 ◽

Cited By ~ 1

Author(s):

H. Aspegren ◽

C. Bailly ◽

A. Mpé ◽

N. Bazzurro ◽

A. Morgavi ◽

...

Keyword(s):

Urban Areas ◽

Large Scale ◽

Cross Correlation ◽

Small Scale ◽

Water Industry ◽

Short Term ◽

Radar Images ◽

Rainfall Forecast ◽

Increasing Demand ◽

Sewage Systems

There has been an increasing demand for accurate rainfall forecast in urban areas from the water industry. Current forecasting systems provided mainly by meteorological offices are based on large-scale prediction and are not well suited for this application. In order to devise a system especially designed for the dynamic management of a sewerage system the “RADAR” project was launched. The idea of this project was to provide a short-term small-scale prediction of rain based on radar images. The prediction methodology combines two methods. An extrapolation method based on a sophisticated cross correlation of images is optimised by a neural network technique. Three different application sites in Europe have been used to validate the system.

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Cattle

BSAP Occasional Publication ◽

10.1017/s0263967x00000999 ◽

1984 ◽

Vol 8 ◽

pp. 83-89

Author(s):

Ian B. Howie

Keyword(s):

Large Scale ◽

Production Systems ◽

Farming System ◽

Small Scale ◽

Market Forces ◽

Poultry Production ◽

Short Term ◽

Fully Integrated ◽

Beef Producers ◽

The Many

Matching production to the markets for meat makes the assumption that individual producers can have an influence on market forces. This may well apply nowadays to some of the very large scale poultry production units but, individually, beef producers can have little if any influence on the marketing scene. Although there are farmers who produce several hundred fat cattle a year, the bulk of the beef produced comes from fairly small scale producers. Much of beef production is on a fairly haphazard basis with little or no recording or budgeting.Nevertheless, small scale producers and feeders who move in and out of the market can exploit local or short-term, favourable, market fluctuations and, with skilful buying and selling, make good profits on a quick turnover. Larger scale producers who have pre-planned fully integrated production systems cannot react as quickly to any great extent to short-term marketing opportunities. I regard marketing as only one of the many variable factors to be taken into account when planning a beef enterprise within a whole farming system, in which it is likely to be one of a number of enterprises which have to be kept in balance.

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Identifying stationary phases in multivariate time-series for highlighting behavioural modes and home range settlements

10.1101/444794 ◽

2018 ◽

Cited By ~ 1

Author(s):

Rémi Patin ◽

Marie-Pierre Étienne ◽

Émilie Lebarbier ◽

Simon Chamaillé-Jammes ◽

Simon Benhamou

Keyword(s):

Time Series ◽

Home Range ◽

Large Scale ◽

Stationary Phases ◽

Activity Level ◽

Range Shifts ◽

Small Scale ◽

Minimum Length ◽

List Type ◽

Ancillary Data

AbstractRecent advances in bio-logging open promising perspectives in the study animal movements at numerous scales. It is now possible to record time-series of animal locations and ancillary data (e.g. activity level derived from on-board accelerometers) over extended areas and long durations with a high spatial and temporal resolution. Such time-series are often piecewise stationary, as the animal may alternate between different stationary phases (i.e. characterised by a specific mean and variance of some key parameter for limited periods). Identifying when these phases start and end is a critical first step to understand the dynamics of the underlying movement processes.We introduce a new segmentation-clustering method we called segclust2d. It can segment bi-(or more generally multi-) variate time-series and possibly cluster the various segments obtained, corresponding to phases assumed to be stationary. It is easy to use, as it only requires specifying the minimum length of a segment (to prevent over-segmentation) based on biological considerations.Although this method can be applied to time-series of any nature, we focus here on two-dimensional piecewise time-series whose phases correspond at small scale to the expressions of different behavioural modes such as transit, feeding and resting, as characterised by two joint metrics such as speed and turning angles or, at larger scale, to temporary home ranges, characterised by stationary distributions of bivariate coordinates.Using computer simulations, we show that segcust2d can rival and even outperform previous, more complex methods, which were specifically developed to highlight changes in movement modes or home range shifts (based on Hidden Markov or Ornstein-Uhlenbeck modelling, respectively), which, contrary to our method, require truly informative initial guesses to be efficient. Furthermore we demonstrate it on actual examples involving a zebra’s small scale movements and an elephant’s large scale movements, to illustrate the identification of various movement modes and of home range shifts, respectively.

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Leveraging the Potential of Crowdfunding for Financing Renewable Energy

10.33116/br.002 ◽

2021 ◽

Author(s):

Massita Ayu Cindy Putriastuti ◽

◽

Vivi Fitriyanti ◽

Muhammad Razin Abdullah

Keyword(s):

Renewable Energy ◽

Interest Rates ◽

Financial Literacy ◽

Large Scale ◽

Third Parties ◽

Small Scale ◽

Short Term ◽

P2p Lending ◽

Small Medium Enterprises ◽

Medium Enterprises

• Renewable energy (RE) projects in Indonesia usually have IRR between 10% and 15% and PP around 6 to 30 years • Attractive return usually could be found in large scale RE projects, although there are numerous other factors involved including technology developments, capacity scale, power purchasing price agreements, project locations, as well as interest rates and applied incentives. • Crowdfunding (CF) has big potential to contribute to the financing of RE projects especially financing small scale RE projects. • P2P lending usually targeted short-term loans with high interest rates. Therefore, it cannot be employed as an alternative financing for RE projects in Indonesia. • Three types of CF that can be employed as an alternative for RE project funding in Indonesia. Namely, securities, reward, and donation-based CF. In addition, hybrid models such as securities-reward and reward-donation could also be explored according to the project profitability. • Several benefits offer by securities crowdfunding (SCF) compared to conventional banking and P2P lending, as follows: (1) issuer do not need to pledge assets as collateral; (2) do not require to pay instalment each month; (3) issuer share risks with investors with no obligation to cover the investor’s loss; (4) applicable for micro, small, medium, enterprises (MSMEs) with no complex requirements; and (5) there is possibility to attract investors with bring specific value. • Several challenges that need to be tackled such as the uncertainty of RE regulations; (1) issuer’s inability in managing the system and business; (2) the absence of third parties in bridging between CF platform and potential issuer from RE project owner; (3) the lack of financial literacy of the potential funders; and (4) lastly the inadequacy of study regarding potential funders in escalating the RE utilisation in Indonesia.

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Cost-Effectiveness of Dementia Prevention Interventions

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2020.71 ◽

2020 ◽

pp. 1-8

Author(s):

I. McRae ◽

L. Zheng ◽

S. Bourke ◽

N. Cherbuin ◽

K.J. Anstey

Keyword(s):

Risk Factors ◽

Cost Effectiveness ◽

Cost Effective ◽

Risk Groups ◽

Sensitivity Analyses ◽

Small Scale ◽

Prevention Measures ◽

Short Term ◽

Dementia Prevention ◽

The Impact

Background: Assessment of cost-effectiveness of interventions to address modifiable risk factors associated with dementia requires estimates of long-term impacts of these interventions which are rarely directly available and must be estimated using a range of assumptions. OBJECTIVES: To test the cost-effectiveness of dementia prevention measures using a methodology which transparently addresses the many assumptions required to use data from short-term studies, and which readily incorporates sensitivity analyses. DESIGN: We explore an approach to estimating cost-effective prices which uses aggregate data including estimated lifetime costs of dementia, both financial and quality of life, and incorporates a range of assumptions regarding sustainability of short- term gains and other parameters. SETTING: The approach is addressed in the context of the theoretical reduction in a range of risk factors, and in the context of a specific small-scale trial of an internet-based intervention augmented with diet and physical activity consultations. MEASUREMENTS: The principal outcomes were prices per unit of interventions at which interventions were cost-effective or cost-saving. RESULTS: Taking a societal perspective, a notional intervention reducing a range of dementia risk-factors by 5% was cost-effective at $A460 per person with higher risk groups at $2,148 per person. The on-line program costing $825 per person was cost-effective at $1,850 per person even if program effect diminished by 75% over time. CONCLUSIONS: Interventions to address risk factors for dementia are likely to be cost-effective if appropriately designed, but confirmation of this conclusion requires longer term follow-up of trials to measure the impact and sustainability of short-term gains.

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