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Background: Schizophrenia is a complex psychiatric disorder characterized by hallucinations, delusions, and cognitive deficits, often leading to functional decline. Pharmacotherapy has long played a central role in schizophrenia management with our evolving understanding shaping the treatment. Current Concepts: Antipsychotic agents are the mainstay of the pharmacological treatment of schizophrenia. Although second-generation antipsychotics (atypical) reduce extrapyramidal side effects, they give rise to metabolic concerns. Personalized treatment, guided by the response and side effects of the patient, determines suitable medications and dosages. Long-acting injectable antipsychotics have enhanced medication adherence, and the consideration of clozapine is warranted for treatment-resistant cases. In addition, potential combination therapies with other psychotropic medications could be explored to address specific symptoms or comorbidities. Discussion and Conclusion: Antipsychotics are pivotal in acute intervention and schizophrenia treatment maintenance. Individualized plans, accounting for drug response, side effects, and adherence, are essential when selecting specific antipsychotic agents. Long-acting injectables and clozapine with combination therapies for treatment resistance offer effective and tolerable management. Ongoing studies and novel antipsychotic development hold promise for improving schizophrenia treatment and patient life quality. [ABSTRACT FROM AUTHOR]

As demands for health and wellbeing in the ageing society have grown, complex problems involving diverse stakeholders arise in the healthcare environment. The objective of this study is to identify roles and abilities of designers in a healthcare setting where professionals from different disciplines collaborate to achieve a common goal. Case studies on healthcare design projects adapting interdisciplinary approach were explored to find which methods and processes were implemented effectively. Results are based on three research questions that lead to analyzing multifaceted roles of designers regarding process facilitation, manage relations, visualization, and imagination. [ABSTRACT FROM AUTHOR]

For a pair (E,P) of an elliptic curve E/Q and a nontorsion point P Ⲉ E(Q), the sequence of elliptic Fermat numbers is defined by taking quotients of terms in the corresponding elliptic divisibility sequence (Dn)nⲉN with index powers of two, i.e. D1, D2/D1, D4/D2, etc. Elliptic Fermat numbers share many properties with the classical Fermat numbers, Fk = 2²k + 1. In the present paper, we show that for magnified elliptic Fermat sequences, only finitely many terms are prime. We also define generalized elliptic Fermat numbers by taking quotients of terms in elliptic divisibility sequences that correspond to powers of any odd positive integer m, and show that many of the classical properties of Fermat numbers, including coprimality, order universality, and compositeness, still hold. [ABSTRACT FROM AUTHOR]

Latissimus dorsi muscle flap is a commonly used reconstructive method on chest wall reconstruction. But meeting patient with absence of latissimus dorsi muscle on intra-operatively is very rare and embarrassing experience. A 73-year-old woman visited our clinic with radiation induced chronic ulceration on the right chest. In the presented case, the patient had received modified radical mastectomy with radiation therapy 36 years ago and lymphatic edema of the upper extremity lasting for 30 years. The ulceration was developed 6 weeks ago and accompanied by profound erythema and abscess pocket. The presence of right thoracodorsal artery in the computed tomography taken before surgery was confirmed and we planned to reconstruct the defect using latissimus dorsi muscle flap. When the authors dissected the skin paddle to elevate the flap, we found that there was no latissimus dorsi muscle. So, we decided to cover the defect by free style perforator flaps. We describe our experience of reconstructing radiation induced chest wall ulceration with intercostal and thoracodorsal artery perforator flaps on latissimus dorsi muscle absence patient. We recommend that the presence of latissimus dorsi muscle be confirmed by imaging before surgery if the patient has a long history of previous breast cancer surgery or lymphatic edema. [ABSTRACT FROM AUTHOR]

Background Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers. Methods This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10). Initial surgical debridement and secondary surgical procedures such as a split-thickness skin graft, primary closure, or local flap were performed. Between the initial surgical debridement and secondary surgical procedures, 0.9% normal saline (3 mL) or PDRN was injected for 2 weeks by the intramuscular (1 ampule, 3 mL, 5.625 mg, 5 days per week) and perilesional routes (1 ampule, 3 mL, 5.625 mg, 2 days per week). Transcutaneous oxygen tension (TcPO2) was evaluated using the Periflux System 5000 with TcPO2/CO2 unit 5040 before the injections and on days 1, 3, 7, 14, and 28 after the start of the injections. A pathologic review (hematoxylin and eosin stain) of the debrided specimens was conducted by a pathologist, and vessel density (average number of vessels per visual field) was calculated. Results Compared with the control group, the PDRN-treated group showed improvements in peripheral tissue oxygenation on day 7 (P<0.01), day 14 (P<0.001), and day 28 (P<0.001). The pathologic review of the specimens from the PDRN group showed increased angiogenesis and improved inflammation compared with the control group. No statistically significant difference was found between the control group and the PDRN group in terms of vessel density (P=0.094). Complete healing was achieved in every patient. Conclusions In this study, PDRN improved peripheral tissue oxygenation. Moreover, PDRN is thought to be effective in improving inflammation and angiogenesis in diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Special investment vehicles (SIVs), extremely popular financial structures for the creation of highly-rated tranched securities, experienced spectacular demise in the 2007-2008 financial crisis. These financial vehicles epitomize the shadow banking sector, characterized by high leverage, undiversified asset pools, and long-dated assets supported by short-term debt, thus bearing material rollover risk on their liabilities which led to defeasance. This paper models these vehicles, and shows that imposing leverage risk control triggers can be optimal for all capital providers, though they may not always be appropriate. The efficacy of these risk controls varies depending on anticipated asset volatility and fire-sale discounts on defeasance. Despite risk management controls, we show that a high failure rate is inherent in the design of these vehicles, and may be mitigated to some extent by including contingent capital provisions in the ex-ante covenants. Post the recent subprime financial crisis, we inform the creation of safer SIVs in structured finance, and propose avenues of mitigating risks faced by senior debt through deleveraging policies in the form of leverage risk controls and contingent capital. [ABSTRACT FROM AUTHOR]

The authors present a liability-directed investment (LDI) rebalancing framework that is based on expected shortfall (ES), denoted as LDI-ES, to prescribe remedies for an underfunded portfolio. Investors endowed with some current wealth optimize their target wealth at the end of N periods, subject to their tolerance for shortfalls from that target wealth. The authors contrast LDI-ES rebalancing with fixed-proportions rebalancing, in which portfolio allocations are rebalanced to ratios, such as 60:40, at the beginning of each of N periods. They consider critical issues of underfunding, in which no portfolio can meet the shortfall constraint, as well as the effectiveness of portfolio infusions in resolving underfunded situations relative to other measures, such as increasing risk, cutting back on target liabilities or goals, and extending the portfolio horizon. [ABSTRACT FROM AUTHOR]

Background: Evaluation of skin sensitization potential is an important part of the safety assessment of cosmetic ingredients and topical drugs. Recently, evaluation of changes in surface marker expression induced in dendritic cells (DC) or DC surrogate cell lines following exposure to chemicals represents one approach for in vitro test methods. Objective: The study aimed to test the change of expression patterns of surface markers on THP-1 cells by chemicals as a predictive in vitro method for contact sensitization. Methods: We investigated the expression of CD54, CD86, CD83, CD80, and CD40 after a 1-day exposure to sensitizers (1-chloro-2,4-dinitrobenzene; 2,4-dinitrofluorobenzene; benzocaine; 5-chloro-2-methyl-4-isothiazolin-3-one; hexyl cinnamic aldehyde; eugenol; nickel sulfate hexahydrate; potassium dichromate; cobalt sulfate; 2-mercaptobenzothiazole; and ammonium tetrachloroplatinate) and non-sensitizers (sodium lauryl sulfate, benzalkonium chloride, lactic acid, salicylic acid, isopropanol, and dimethyl sulphoxide). The test concentrations were 0.1×, 0.5×, and 1× of the 50% inhibitory concentration, and the relative fluorescence intensity was used as an expression indicator. Result and Conclusion: By evaluating the expression patterns of CD54, CD86, and CD40, we could classify the chemicals as sensitizers or non-sensitizers, but CD80 and CD83 showed non-specific patterns of expression. These data suggest that the THP-1 cells are good model for screening contact sensitizers and CD40 could be a useful marker complementary to CD54 and CD86. [ABSTRACT FROM AUTHOR]

We examine the long-run return performance of over 1,600 firms with reverse stock splits. These stocks record statistically significant negative abnormal returns over the three-year period following the month of the reverse split. The sample firms experience poor operating performances over the four years that include and follow the year of the reverse split, which suggests informational inefficiencies. Because these stocks have unique financial characteristics, we also show that they would be very difficult to sell short. Thus, arbitrageurs would be restricted in their ability to earn abnormal profits, even if they correctly anticipated a price decline. [ABSTRACT FROM AUTHOR]

Background: While early intervention shows a better outcome in patients with schizophrenia, the benefit of early administration of long-acting injectable antipsychotics (LAI) in schizophrenia is not well-studied. Paliperidone Palmitate is one of the most frequently used LAI, and it is usually administered in the later stage of the illness than oral medication. In this study, the difference in clinical and functional improvement by illness duration after the administration of Paliperidone LAI was evaluated. Methods: Patients with schizophrenia who planned to switch their antipsychotic treatment from oral ones to once-monthly Paliperidone LAI were recruited from hospitals in South Korea from 26 July 2010 to 25 July 2017. The clinical and functional change was measured every 4 weeks with Clinical Global Impression Severity (CGI-S) scale and Personal and Social Performance (PSP) scale for 6 months after initiation of Paliperidone LAI. Compared to baseline, improvements after switching to Paliperidone LAI were analyzed based on the duration of illness (DI) (less than 3 years, 3 to 10 years, over 10 years). Results: 1166 participants (DI≤3 years, N=240; 310 years, N=484) were enrolled. The change in CGI-S score was significantly different according to the DI and those with DI less than 3 years showed the most improvement in the aspect of clinical symptoms (DI, p<0.001; week, p<0.001; DI*week, p=0.013). All three groups showed significant improvements in PSP scores after the treatment with Paliperidone LAI and patients with DI less than 3 years demonstrated the highest PSP scores (DI, p<0.001; DI*week, p=0.436; week, p<0.001). Discussion: Switching to Paliperidone LAI showed significantly better outcomes in schizophrenia patients especially with those with shorter DI. This result suggests that earlier administration of LAI in schizophrenia might lead to better clinical and functional outcomes. [ABSTRACT FROM AUTHOR]