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Background To summarize the current state of knowledge on antipsychotic treatment strategies for the acute phase and treatment resistance in schizophrenia, we conducted a systematic review of guidelines and algorithms. Methods We conducted a systematic literature search to identify clinical guidelines and algorithms on this topic using MEDLINE and Embase. We extracted information on recommendations for antipsychotic treatment strategies, including those for non-response (i.e., increasing antipsychotic dose and switching to another antipsychotic) and treatment resistance. Results We identified a total of 17 guidelines/algorithms in various countries that were published after 2011. With respect to antipsychotic dose, most of the guidelines (N = 10/11) agreed starting with a low dose or the lowest licensed/effective dose and then titrating the dose upwards. Regarding antipsychotic treatment strategies for non-response, all of the guidelines (N = 9/9) recommended increasing antipsychotic dose towards the upper end of its approved dose range. Five guidelines suggested for increasing beyond the therapeutic dose range in exceptional cases, while overall 10 guidelines including them were negative about such strategy. The vast majority of guidelines (N = 16/17) recommended switching to another antipsychotic for non-response; however, some guidelines mentioned the lack of evidence for these strategies other than the use of clozapine. All the guidelines (N = 17/17) endorsed initiating clozapine after failure to respond to 2 different antipsychotics. Four guidelines endorsed an early use of clozapine, yet as the third antipsychotic. Conclusion The currently available guidelines and algorithms recommended increasing antipsychotic dose and switching to another antipsychotic, particularly clozapine for treatment-resistant schizophrenia, during the acute phase of schizophrenia for non-response.

Although antipsychotics are commonly used for delirium, their adverse effects are a serious concern in light of extrapyramidal symptoms and cardiovascular disturbances. In clinical practice, sedative antidepressants are frequently used as an alternative treatment for delirium; however, there is scarce evidence. Thus, we conducted a retrospective chart review to examine the use and effectiveness of trazodone and mianserin for delirium.Patients who were admitted to a university hospital during 4 years and received either trazodone or mianserin on a regular schedule as monotherapy for the treatment of delirium were included. The rates of and times to the improvement of delirium were compared.Among 3971 patients who developed delirium, 379 (9.5%) and 341 (8.6%) patients received trazodone and mianserin on a regular schedule; 52 and 46 patients met the eligibility criteria (ie, monotherapy) for trazodone and mianserin, respectively. The percentages of patients 65 years or older were 86.5% (n = 45) for trazodone and 89.1% (n = 41) for mianserin. The rates of the improvement of delirium were 63.5% for trazodone and 50.0% for mianserin. Times to the improvement of delirium were 5.3 days (95% confidence interval, 3.2-7.4 days) for trazodone and 9.3 days (95% confidence interval, 5.3-13.3 days) for mianserin. There were no significant differences in the primary outcomes between the 2 groups ( P = 0.17 and P = 0.13, respectively).Considering potentially serious, sometimes lethal, adverse effects of antipsychotics, sedative antidepressants such as trazodone and mianserin may be a treatment option for delirium, especially in the elderly.

Background We updated our previous systematic review regarding clinical guidelines and algorithms on antipsychotic treatment in the maintenance phase of schizophrenia (doi: 10.1016/j.schres.2011.11.021) to incorporate and synthesize more recent findings to guide clinical practice. Methods We conducted a systematic literature search to identify clinical guidelines and algorithms describing antipsychotic treatment in the maintenance phase of schizophrenia using MEDLINE and Embase. We assessed overall quality of the guidelines/algorithms according to the AGREE II instrument and extracted information on treatment recommendations. Results We identified 20 guidelines/algorithms from various regions, including 11 updated or newly launched ones after the previous systematic review in 2012. All of the guidelines/algorithms satisfied a certain level of quality. Where mentioned, endorsements were sorted into “recommended”, “partially recommended”, or “not recommended”. As for antipsychotic discontinuation strategy, a majority of guidelines/algorithms that mentioned this strategy did not recommend it for multiple-episode schizophrenia (N = 5/6). On the other hand, the guidelines/algorithms tended to shift from “not recommended” to “partially recommended” both for schizophrenia in general (N = 7/13, N = 7/8 for those published after 2013) and first-episode schizophrenia (N = 10/11, N = 7/7 for those published after 2013) regarding this strategy. All guidelines/algorithms (N = 9/9) converged to discourage antipsychotic intermittent/targeted strategy. Similar to antipsychotic discontinuation strategy, all of the updated or new guidelines/algorithms (N = 6/6) endorsed antipsychotic dose reduction/lower dose strategy. Conclusion Recent clinical guidelines and algorithms on antipsychotic maintenance treatment in schizophrenia shifted more toward a possibility of antipsychotic discontinuation and dose reduction/lower dose strategies. Nonetheless, clinicians need to contemplate on the risk-benefit balance of these strategies for individual patients.

Objective To compare efficacy and safety of single daily dosing (Single-DD) vs multiple daily dosing (Multiple-DD) regimens of psychotropic drugs, the authors conducted a systematic review and meta-analysis. Data sources A systematic literature search of MEDLINE and Embase was conducted with keywords related to dosing regimens and psychotropic drugs (last search: December 30, 2019). Study selection Randomized controlled trials comparing clinical outcomes between Single-DD and Multiple-DD of the same formulation of the same psychotropic drugs in patients with psychiatric disorders were included. Data extraction Data on study discontinuation, psychopathology, and treatment-emergent adverse events (TEAEs) were extracted. Results A total of 32 studies with 34 paired comparisons involving 3,142 patients met the eligibility criteria and were included in the meta-analysis. Various types of psychotropic drugs were examined: antidepressants (22 comparisons), antipsychotics (7 comparisons), benzodiazepines (2 comparisons), mood stabilizers (2 comparisons), and antidepressant-benzodiazepine combination (1 comparison). There was no significant difference in study discontinuation due to all causes (30 comparisons, N = 2,883, risk ratio [RR] = 1.01, 95% CI = 0.94 to 1.09, P = .77), lack of efficacy (22 comparisons, N = 2,307, RR = 1.06, 95% CI = 0.84 to 1.33, P = .62), or adverse events (25 comparisons, N = 2,571, RR = 0.93, 95% CI = 0.75 to 1.14, P = .47) between the Single-DD and Multiple-DD groups. No significant difference was found in changes in psychopathology (8 comparisons, N = 1,337, standardized mean difference = 0.00, 95% CI = -0.11 to 0.11, P = .99) between the 2 groups. These results were also true for any type of psychotropic drugs. In terms of TEAEs, however, there were significant differences in anxiety (4 comparisons, N = 347, RR = 0.53, 95% CI = 0.33 to 0.84, P = .007) and sleepiness (3 comparisons, N = 934, RR = 0.82, 95% CI = 0.68 to 0.99, P = .04) in favor of the Single-DD group. Conclusions The findings suggest Single-DD can be clinically adopted regardless of type of psychotropic drugs in patients with psychiatric disorders in general.

The nonlinear optical response of monolayer transition-metal dichalcogenides $T{X}_{2}\phantom{\rule{0.28em}{0ex}}(T=\mathrm{Mo},\mathrm{W};\phantom{\rule{0.28em}{0ex}}X=\mathrm{S},\phantom{\rule{0.28em}{0ex}}\mathrm{Se})$ on ${\mathrm{SiO}}_{2}/\mathrm{Si}(001)$ substrates was examined using second-harmonic generation (SHG) spectroscopy in combination with differential reflectance (DR) spectroscopy. In the SHG spectroscopy, the second-harmonic intensity corrected by a crystalline quartz reference was obtained for the wavelength of the incident femtosecond laser varied from 750 to 1040 nm. The SHG spectra of all the four ${TX}_{2}$ were dominated by two-photon resonance around the C peaks in the DR spectra that was previously assigned to interband transitions at critical points formed as a result of band nesting. Multiple peaks were observed in each resonance spectrum, which was then decomposed into a few components. The overall feature of the main components---denoted as $\overline{\mathrm{C}1}$ and $\overline{\mathrm{C}2}$---was common among the four ${TX}_{2}$ materials. The optical transitions contributing to these components were concluded to occur at different $k$ points in a ring-shaped area around the \cyrchar\CYRG{} point with the aid of the published results of optical spectrum calculations and the SHG spectrum of bilayer ${\mathrm{MoS}}_{2}$. In addition, one-photon resonance at the $A$ exciton and two-photon resonance at the ${A}^{\ensuremath{'}}$ exciton were observed in ${\mathrm{MoSe}}_{2}$ and ${\mathrm{WSe}}_{2}$, respectively, and their intensities were proven to be significantly lower than those of the resonances around the C peaks.

International audience; The performances of Solid Oxide Fuel Cells (SOFC) are strongly related to the catalytic/conductive properties of cathode materials, which are temperature dependent. The optimal temperature in operating conditions implies a tradeoff between high efficiency at high temperatures and improved lifetime at Intermediate Temperatures (IT). Among the candidates, Pr2NiO4 presents attractive functional properties but is susceptible to decompose into Pr4Ni3O10 under IT-SOFC conditions. In this contribution, a deposition process to obtain Pr4Ni3O10 phase were directly targeted as a potential alternative to the integration of Pr2NiO4 in IT-SOFC. Pr4Ni3O10 thin films have been deposited on Y-stabilized Zirconia substrates through a two-step process: (i) room temperature co-sputtering of metallic Ni and Pr targets, (ii) ex-situ annealing under O2 flux. The composition of thin films were adjusted by changing the power applied to each target and confirmed by Energy Dispersive Spectroscopy. X-Ray Diffraction analyses as a function of temperature were made to identify the temperature window to stabilize the desired phase. The structural and morphological features of polycrystalline Pr4Ni3O10 thin films were analyzed by Transmission Electron Microscopy and Scanning Electron Microscopy. Electrical resistivity of ~6.5.10−3 Ω cm and Seebeck coefficient of ~ – 23 μV K−1 at 150 °C highlight the synthesis of Pr4Ni3O10 continuous coatings representing a promising candidate for cathodes in IT-SOFC.

Industrially alcohol dehydration is carried out by a distillation process, thereby requiring a large amount of energy. In an IPA/water system, since producing an azeotrope, two more distillation towers should be added. Therefore, a large amount of energy saving will be expected when the IPA concentration by applying vapor permeation (VP) with membrane becomes possible. Recently, zeolite membrane separation has been attracting much interest in terms of lower energy consumption and higher separation performance. In this study, a composite type of NaY (Faujasite) zeolite membrane with high dehydration performance was synthesized, and VP tests were carried out for IPA/water mixtures. Furthermore, a continuous recycled VP (CVP) apparatus was set up and operated to analyze the enriching process of IPA. As a result, a two-step method, where two membranes with different performances are exchanged along the concentrating way, or operation temperature or feed rate was increased stepwise, was proposed. It was shown that such a new operation method could shorten the time of concentrating IPA.