Cariprazine — an Alternative Treatment for Clozapine-resistant Schizophrenia?

Adam Montgomery(Adam Montgomery ),Marianna Rogowska(Marianna Rogowska ),Luiz Dratcu(Luiz Dratcu ) 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.1

Treatment-resistant schizophrenia (TRS) poses a significant therapeutic challenge in psychiatric practice. Clozapine is recognized as a treatment of choice in TRS but is not always effective in alleviating patients’ symptoms. Additionally, clozapine therapy is associated with multiple side effects and monitoring requirements that often limit its use and negatively affect patients’ compliance with the treatment. Although clozapine augmentation options are available, there is currently no alternative monotherapy proven to be effective in TRS. We present a case of a young man with TRS who failed to respond to appropriate trials of risperidone, aripiprazole and also clozapine, and who experienced impairing adverse effects of clozapine that made further clozapine treatment not only futile but also detrimental to his health. He was successfully treated with cariprazine monotherapy, which culminated in the remission of his both positive and negative symptoms of psychosis as well as in the marked improvement in social functioning. Cariprazine, a newer atypical antipsychotic endowed with a D3-preferring mode of action, may offer a better tolerated and more acceptable treatment option for patients with difficult-to-treat psychotic symptoms.

Patterns of failure for hypopharynx cancer patients treated with limited high-dose radiotherapy treatment volumes

Adam Burr(Adam Burr ),Paul Harari(Paul Harari ),Aaron Wieland(Aaron Wieland ),Randall Kimple(Randall Kimple ),Gregory Hartig(Gregory Hartig ),Matthew Witek(Matthew Witek ) 대한방사선종양학회 2022 Radiation Oncology Journal Vol.40 No.4

Purpose: Optimal radiotherapy treatment volumes for patients with locally advanced hypopharynx squamous cell carcinoma should ensure maximal tumor coverage with minimal inclusion of normal surrounding structures. Here we evaluated the effectiveness of a direct 3-mm high-dose gross tumor volume to planning target volume expansion on clinical outcomes for hypopharynx cancers. Materials and Methods: We performed a retrospective analysis of patients with hypopharynx carcinoma treated between 2004 and 2018 with primary radiotherapy using a direct high-dose gross tumor volume to planning target volume expansion and with or without concurrent systemic therapy. Diagnostic imaging of recurrences was co-registered with the planning CT. Spatial and volumetric analyses of contoured recurrences were compared with planned isodose lines. Failures were initially defined as in field, marginal, elective nodal, and out of field. Each failure was further classified as central high-dose, peripheral high-dose, central intermediate/low-dose, peripheral intermediate/low-dose, and extraneous. Clinical outcomes were analyzed by Kaplan-Meier estimation. Results: Thirty-six patients were identified. At a median follow-up at 52.4 months, estimated 5-year overall survival was 59.3% (95% confidence interval [CI], 36.3%–74.1%), 5-year local and nodal control was 71.7% (95% CI, 47.1%–86.3%) and 69.9% (95% CI, 57.0%–82.6%), respectively. The most common failure was in the high-dose primary target volume. The gastrostomy tube retention rate at 1 year among patients without recurrence was 13.0% (95% CI, 3.2%–29.7%). Conclusion: Minimal high-dose target volume expansions for hypopharynx cancers were associated with favorable locoregional control. This approach may enable therapy intensification to improve clinical outcomes.

NiCu@C Bifunctional Electrocatalysts for HER and OER in Alkaline Electrolyte

Adam Szaniel,Ngoc-Anh Nguyen,Oleksii Omelianovych,Enkhjin Chuluunbat,Liudmila L. Larina,Ho-Suk Choi 한국신재생에너지학회 2022 AFORE Vol.2022 No.9

What’s on tablet PC: an introduction to FOAM at home

Adam J. Singer,Eric J Morley,Haney Mallemat 대한응급의학회 2016 Clinical and Experimental Emergency Medicine Vol.3 No.3

The Threat to “Our Democracy” and the Neoliberal Crisis of Legitimacy

Adam Kotsko 연세대학교 신과대학(연합신학대학원) 2021 신학논단 Vol.106 No.-

최근 미국의 정치 평론가들은 도널드 트럼프가 출범한 정부가 야기한 ‘민주주의’의 위협에 대해 경고하며 이 위협의 직접적인 맥락이 글로벌 금융 위기 이후에 계속 되고 있는 신자유주의 질서의 정당성의 위기라고 주장한다. 하지만 필자는 신자유주의는 단지 경제 정책과 정치 제도의 문제가 아닌 도덕적 가치들 위에 정당성의 기반을 두는 정치신학적 패러다임을 주장하는 바이다. 신자유주의론은 개인의 자유를 최고의 가치로 여기며, 이는 시장 경쟁에서만 완전히 실현될 수 있다고 주장한다. 이 신념에 따라 신자유주의는 계속해서 시장 경쟁의 모델에 따라 사회를 재편하려고 시도한다. 그러나 이런 신자유주의가 정의하는 인간의 자유는 매우 협소한 시각에서 바라본 자유에 불과하며, 사회적 실패의 책임을 묻기에 충분한 매개가 될지는 모르나 현 시대의 위기 상황을 바꾸기에는 충분하지 않다. 신자유주의와 민주주의의 관계는 항상 모호하다. 자유 선택에 기반을 둔 이데올로기는 투표 결과를 완전히 무시할 수는 없지만 신자유주의만을 택하는 것은 자유를 거부하는 것을 의미할 수 있기 때문이다. 따라서 레이건 치하에서 신자유주의가 처음 도입된 후 미국의 선거 제도는 한정된 권한과 분열된 정부를 낳았고, 더 적극적으로 반민주적인 결과를 낳았다. 신자유주의를 정당화하는 전략의 근본적 당위성은 글로벌 금융 위기로 인해 산산조각이 나고 말았다. 이러한 종말론적인 도전에 직면하여 시스템은 위기의 원인에 대해 점점 더 엄격하고 편집증적인 이야기를 만들어냈다. 결론적으로 필자는 트럼프의 기행이 대중을 설득시킬 정당성과 실질적 대안을 잃어버린 채 권력에서 쇠퇴하는 신자유주의 질서의 자연스러운 산물이라고 주장하는 바이다. In recent years, US political commentators have warned of increasingly dire threats to “our democracy” stemming from Donald Trump and his Republican colleagues. What is missing is any attention to the more immediate context of Trump’s rise and his anti-democratic machinations: the ongoing legitimation crisis of the neoliberal order in the wake of the Global Financial Crisis. As I argue in Neoliberalism’s Demons, neoliberalism is not just a matter of economic policies and political institutions—it is a political theological paradigm that grounds its legitimacy on moral values that are enshrined as its “ultimate concern.” Chief among these values is individual free choice, which can only be fully actualized in market competition. Hence neoliberalism seeks to remake as much of society as possible on the model of market competition. Yet neoliberalism’s very narrow vision of human freedom is a trap, giving us just enough agency to take the blame for social failures but not enough to change our circumstances. Neoliberalism’s relationship with democracy has always been ambiguous. On the one hand, an ideology founded on free choice cannot totally ignore the ballot box. On the other hand, choosing anything but neoliberalism means rejecting freedom. Hence, after the initial installation of neoliberalism under Reagan, the American electoral system has produced narrow mandates and divided government—and, increasingly, actively anti-democratic results. The basic plausibility of the neoliberal strategy of legitimation was shattered by the Global Financial Crisis. Faced with such an apocalyptic challenge, the system did not change course but doubled down, spinning increasingly punitive and paranoid narratives about the causes of the crisis. Far from an aberration, Trump is a natural outgrowth of a declining neoliberal order that no longer commands popular legitimacy but clings to power by excluding and scapegoating real alternatives.

Admission rates for emergency department patients with venous thromboembolism and estimation of the proportion of low risk pulmonary embolism patients: a US perspective

Adam J. Singer,Henry C. Thode,W. Frank Peacock IV 대한응급의학회 2016 Clinical and Experimental Emergency Medicine Vol.3 No.3

Objective Introduction of target specific anticoagulants and recent guidelines encourage outpatient management of low risk patients with venous thromboembolism. We describe hospital admission rates over time for patients presenting to US emergency departments (EDs) with deep vein thrombosis (DVT) and pulmonary embolism (PE) and estimate the proportion of low-risk PE patients who could potentially be managed as outpatients. Methods We performed a structured analysis of the National Hospital Ambulatory Medical Care Survey (a nationally representative weighted sampling of US ED visits) database for the years 2006–2010 including all adult patients with a primary diagnosis of DVT or PE. Simplified pulmonary embolus scoring index (sPESI) scores were determined in patients with PE to identify low risk patients. Results There were an estimated 652,000 and 394,000 ED visits for DVT and PE over the 5-year period (0.17%). Mean (SE) age was 59 (1.3), 50% were female, and 40% were > 65 years. Admission rates for DVT and PE were 52% and 90% respectively with no significant changes over time. In patients with DVT, predictors for admission were age (odds ratio, 1.03 per year of age [95% confidence interval, 1.01 to 1.05]) and race (odds ratio, 4.1 [95% confidence interval, 0.9 to 19.8] for Hispanics and 2.9 [1.2 to 7.4] for Blacks). Of all ED patients with PE, 51% were low risk based on sPESI scores. Conclusion Admission rates for DVT and PE have remained high and unchanged, especially with PE, minorities, and in older patients. Based on sPESI scores, up to half of PE patients might be eligible for early discharge or outpatient therapy.

Dissecting the Attitudes of Political Science Students Towards Democracy and the 2004 Elections in Indonesia

Adam Tyson,Paul Tyson 서울대학교행정대학원 2007 Asian Journal of Political Science Vol.15 No.3

Students’ attitudes towards Indonesia’s transition from an authoritarian era todemocracy varied from strong support for the democratic transition to nostalgia forthe authoritarian era’s strong leadership and economic prosperity. A sample of 317students from three Indonesian universities was asked to rate the importance of political,economic, legal and social democratic principles. In addition to concerns aboutcorruption, economic decline and security, students differed significantly centring onthe importance of legitimate elections, representation, tolerance, accountability, humanrights and gender equality. The majority of students were pessimistic about the elections;paradoxically some students optimistic about the general elections rated democraticprinciples the least important. After discussing the implications, political attitudes aboutdemocracy and elections were related to cognitive consistency and dissonance theory.

Hepatoprotective effects of Nigella sativa seed extract against acetaminophen-induced oxidative stress

Adam, G.O.,Rahman, Md.M.,Lee, S.J.,Kim, G.B.,Kang, H.S.,Kim, J.S.,Kim, S.J. Elsevier 2016 Asian Pacific journal of tropical medicine Vol.9 No.3

<P>Objective: To investigate the protective effects of Nigella saliva seed extract (NSSE) against acetaminophen (APAP)-induced hepatotoxicity in TIB-73 cells and rats. Methods: Toxicity in TIB-73 cells was induced with 10 mu mol/L APAP and the protective effects of NSSE were evaluated at 25. 50. 75, 100 mu g/mL. For in vivo examination, a total of 30 rats were equally divided into five experimental groups; normal control (vehicle), APAP (800 mg/kg body weight single IP injection) as a hepatotoxic control, and three APAP and NS pretreated (2 weeks) groups (APAP+NSSE 100 me; APAP+NSSE 300 mg and APAP+NSSE 900 mg/kg). Results: TIB-73 cell viability was drastically decreased by (49.0 +/- 11.9)% after the 10 union. APAP treatment, which also increased reactive oxygen species production. Co-treatment with NSSE at 25. 50, 75, and 100 mu g/mL significantly improved cell viability and suppressed reactive oxygen species generation. In vivo, the APAP induced alterations in blood lactate levels, pH, anionic gap. and ion levels (HCO3-, Mg2+ and K+), which tended to normalize with the NSSE pretreatment. The NSSE also significantly decreased elevated serum levels of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and alkaline phosphatase induced by APAP, which correlated with decreased levels of hepatic lipid peroxidation (malondialdehyde), increased superoxide dismutase levels, and reduced glutathione concentrations. Improved hepatic histology was also found in the treatment groups other than APAP group. Conclusions: The in vitro and in vivo findings of this study demonstrated that the NSSE has protective effects against APAP-induced hepatotoxicity and metabolic disturbances by improving antioxidant activities and suppressing both lipid peroxidation and ROS generation.</P>

Internationalist Culture in North Korea, 1945-1950

Adam Cathcart,Charles Kraus 한국학중앙연구원 한국학중앙연구원 2008 THE REVIEW OF KOREAN STUDIES Vol.11 No.3

In the period from 1945-1950, North Korean elites were indeed oriented toward the Soviet Union, but they also followed developments in Asia with a sophistication that is too rarely acknowledged in histories. This article uses North Korean foreign affairs publications, political cartoons, and captured government documents from the Korean War to argue that during the “liberation” period prior to June 25, 1950, the North Korean people were attuned to world politics and developments in Northeast Asia in particular. Case studies are made of North Korean perceptions of U.S.-occupied Japan and the Chinese civil war. The paper is intended to clear the way for more objective discussion of the historical stereotype of the DPRK as a state perpetually mired in isolation. In the period from 1945-1950, North Korean elites were indeed oriented toward the Soviet Union, but they also followed developments in Asia with a sophistication that is too rarely acknowledged in histories. This article uses North Korean foreign affairs publications, political cartoons, and captured government documents from the Korean War to argue that during the “liberation” period prior to June 25, 1950, the North Korean people were attuned to world politics and developments in Northeast Asia in particular. Case studies are made of North Korean perceptions of U.S.-occupied Japan and the Chinese civil war. The paper is intended to clear the way for more objective discussion of the historical stereotype of the DPRK as a state perpetually mired in isolation.

Long Vascular Sheaths for Transfemoral Neuroendovascular Procedures in Children

Adam A. Dmytriw,Winston Ha,Suzanne Bickford,Kartik Bhatia,Manohar shroff,Peter Dirks,Prakash Muthusami 대한신경중재치료의학회 2021 Neurointervention Vol.16 No.2

Purpose To evaluate the safety and efficacy of long vascular sheaths for transfemoral neuroendovascular procedures in children. Materials and Methods A retrospective evaluation of transfemoral neuroendovascular procedures in children <18 years, using long sheaths was undertaken analyzing procedure type, fluoroscopic times, technical success, access site and systemic complications. Twenty-seven consecutive procedures were included over a 2-year period. Mean age was 8.4 years (standard deviation [SD] 6.3) (range 17.0 months–16.3 years). Results Patients were 44% female and mean weight was 35.0 kg (SD 22.8) (range 9.8–72.2 kg). A third of the procedures were performed in ≤15 kg children. The most common procedure was for embolization (n=13, 48.1%) and the most common indication was dual microcatheter technique (52%). The most common device used was the 5 Fr Cook Shuttle sheath. Mean fluoroscopy time was 61.9 minutes (SD 43.1). Of these procedures, 93% were technically successful. Femoral vasospasm, when present, was self-limiting. Complications (3/27, 11.1%) included groin hematoma (n=1), neck vessel spasm that resolved with verapamil (n=1), and intracranial thromboembolism (n=1), with no significant difference between the ≤15 kg and >15 kg subcohorts. There were no aorto-femoro-iliac or limb-ischemic complications. Conclusion Long vascular sheaths without short femoral sheaths can be safely used for pediatric neuroendovascular procedures as they effectively increase inner diameter access without increasing the outer sheath diameter. This property increases the range of devices used and intracranial techniques that can be safely performed without arterial compromise, thus increasing the repertoire of the neurointerventionist.