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Reflections on the Lack of Consideration of Ethnic Ancestry to Stratify Clozapine Dosing
Jose de Leon(Jose de Leon ) 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.3
This review article argues against trusting standard clozapine references, including the US package insert, because they do not include advances in the sciences of pharmacokinetics and pharmacovigilance and ignore the effects of ethnic ancestry on therapeutic dosing. The minimum therapeutic dose leading to the minimum therapeutic concentration of 350 ng/mL in serum/plasma can be used to compare individuals/groups with treatment-resistant schizophrenia. The US clozapine package insert recommends targeting doses of 300-450 mg/day and, subsequently, increments of up to 100 mg with a maximum dose of 900 mg/day. Ethnic ancestry is defined by DNA ancestry group. Asians (people with ancestry ranging from Pakistan to Japan) and Indigenous Americans are similar in clozapine dosing; their average clozapine minimum therapeutic dose ranged from 166 mg/day (female non-smokers) to 270 mg/day (male smokers). For those with European ancestry, average clozapine minimum therapeutic doses ranged from 236 mg/day (female non-smokers) to 368 mg/day (male smokers). Based on limited studies, Black (African sub-Saharan ancestry) patients may be treated with typical US doses (300-600 mg/day), assuming no poor metabolism (PM) status. Ancestry’s impact on clozapine lethality in four countries is discussed (two countries with highly homogenous populations, Denmark and Japan, and two countries with increasingly heterogenous populations due to immigration, Australia and the UK). An international guideline with 104 authors from 50 countries/regions was recently published, providing 6 personalized clozapine titration schedules for adult inpatients (3 ancestry groups and PM/non-PM schedules) and recommending c-reactive protein monitoring at baseline and weekly for 4 weeks.
Situational Philosophy : Towards a theory of philosophical practice
( Leon De Haas ) 한국철학상담치료학회 2012 철학 실천과 상담 Vol.3 No.-
This essay is a revised and expanded version of the text which was the basis for the author’s Masterclass at the 11th International Conference on Philosophical Practice (ICPP), the 18th of July 2012 at the Humanities Institute, Kangwon National University in Chuncheon, Republic of Korea. The main goal of the essay is, to contribute to a theory of philosophical practice. To do this, the author develops a criticism of reductionist practices in philosophy. The theoretical point of departure is an abridged survey of the two paradigmatic changes in European philosophy in the 20th century, i.e., Husserl’s phenomenology, and Wittgenstein’s language game analysis. The line of thinking is illustrated by a case story of the author. Part I discusses the phenomenological and linguistic turns in European philosophy. Part II describes and discusses a case story. Part III criticizes two forms of reductionism in philosophical practice, namely psychological and conceptual reductionism. Part IV gives an initial impetus to a theory of philosophical practice beyond any reductionism. In the present essay, the author is dealing with Western philosophy only, as the origins of post-Modern philosophical practice are rooted in Western philosophy. Lately, Eastern philosophy has been an inspiration for philosophical practice as well.
Mechanical properties of whey protein/Na alginate gel microparticles
Leon, A.M.,Medina, W.T.,Park, D.J.,Aguilera, J.M. Applied Science Publishers 2016 Journal of food engineering Vol.188 No.-
<P>A proportion of the fast-growing elderly population needs special foods which are soft to chew and easily swallowed. Gel microparticles, GMP, (e.g., less than 100 mu m in size) are an alternative as texture modifiers in liquid and pureed foods, and may be used as carriers of needed flavors and nutrients. GMP (sizes < 40 mu m) were fabricated from whey protein isolate (WPI)/sodium alginate (NaAlg) mixtures by size reduction of bulk gels made by the cold-gelation method. A cell test based on back extrusion was designed to evaluate the mechanical properties of a GMP paste and image analysis techniques implemented to resolve the size of GMP. A good correlation (R-2 = 0.89) was obtained between the stress (at 60% strain) of bulk gels and that of GMP. Compression stress at 30% strain depended on the concentrations of WPI and NaAlg and a maximum was observed at intermediate values. Through Principal Component Analysis gels with low and high sodium alginate contents were clearly explaining 93% of the variability. The ample range of mechanical properties of GMP suggest that they may be used to design or modify the texture of soft foods. (C) 2016 Elsevier Ltd. All rights reserved.</P>
Leon de Haas 강원대학교 인문과학연구소 2018 Journal of Humanities Therapy Vol.9 No.1
Lydia Amir calls on philosophers to take responsibility in society by offering rational alternatives to irrational New Age cosmology in spiritual matters and to amateurish psychological answers in moral issues. She offers a skeptical worldview, in which humor plays the key role. This essay discusses her worldview critically. Her view of epistemology is limited, like her view of skepticism. In both cases, the Socratic practice of skeptical investigation of truth claims in dialogical encounters is ignored. Her project is seen as one of the contemporary attempts to restore philosopher’s lost key role in society.