456 research outputs found

    A neural network based technique for short-term forecasting of anomalous load periods

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    The paper illustrates a part of the research activity conducted by authors in the field of electric Short Term Load Forecasting (STLF) based on Artificial Neural Network (ANN) architectures. Previous experiences with basic ANN architectures have shown that, even though these architectures provide results comparable with those obtained by human operators for most normal days, they evidence some accuracy deficiencies when applied to ''anomalous'' load conditions occurring during holidays and long weekends. For these periods a specific procedure based upon a combined (unsupervised/supervised) approach has been proposed. The unsupervised stage provides a preventive classification of the historical load data by means of a Kohonen's Self Organizing Map (SOM) The supervised stage, performing the proper forecasting activity, is obtained by using a multi-layer perceptron with a backpropagation learning algorithm similar to the ones above mentioned. The unconventional use of information deriving from the classification stage permits the proposed procedure to obtain a relevant enhancement of the forecast accuracy for anomalous load situations

    The FDA “black box” warning on antidepressant suicide risk in young adults: More harm than benefits?

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    The decision made in the year 2004 by the U.S. Food and Drug Administration (FDA) to require a boxed warning on antidepressants regarding the risk of suicidality in young adults still represents a matter of controversy. The FDA warning was grounded on industry-sponsored trials carried one decade ago or earlier. However, within the past decade, an increasing number of reports have questioned the actual validity of the FDA warning, especially considering a decline in the prescription of the antidepressant drugs associated with an increase in the rate of suicidal events among people with severe depression. The present report provides an overview of the FDA black box warning, also documenting two Major Depressive Disorder patients whose refusal to undergo a pharmacological antidepressant treatment possibly led to an increased risk for suicidal behaviors. The concerns raised by the FDA black box warning need to be considered in real-world clinical practice, stating the associated clinical and public health implications

    Different fracture risk profile in patients treated with anti-osteoporotic drugs in real-life

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    In this retrospective study, we intended to investigate the baseline fracture risk profile in patients who started treatment with different anti-osteoporotic medications. We analyzed retrospectively the fracture risk calculated with DeFRA, a validated FRAX derived tool, in women who started an anti-osteoporotic treatment from 2010 to 2017. We analyzed baseline data of 12,024 post-menopausal women aged over 50 years. Teriparatide initiators had a baseline 10-year risk of major osteoporotic fracture of 82.1% with a Standard Deviation (SD) of 66.5%. Denosumab initiators and zoledronic acid initiators had a greater 10-year baseline risk of fracture (54.3%, SD 46.5% and 47.0%, SD 42.0 respectively) than patients initiated on alendronate (24.9%, SD 34.6%) and patients initiated on risedronate (23.9%, SD 24.1%). Using DeFRA, a FRAXℱ derived tool, we showed significantly different fracture risk profiles in women who were started on various therapeutic agents for the treatment of osteoporosis in routine clinical practice

    Association between exposure to fine particulate matter and osteoporosis: a population-based cohort study

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    Long-term environmental air pollution exposure was associated with osteoporosis' risk in a cohort of women at high risk of fracture. Cortical sites seemed to be more susceptible to the exposure's effect

    Lurasidone in the Treatment of Bipolar Depression: Systematic Review of Systematic Reviews

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    Introduction. A burgeoning number of systematic reviews considering lurasidone in the treatment of bipolar depression have occurred since its Food and Drug Administration extended approval in 2013. While a paucity of available quantitative evidence still precludes preliminary meta-analysis on the matter, the present quality assessment of systematic review of systematic reviews, nonetheless, aims at highlighting current essential information on the topic. Methods. Both published and unpublished systematic reviews about lurasidone mono- or adjunctive therapy in the treatment of bipolar depression were searched by two independent authors inquiring PubMed/Cochrane/Embase/Scopus from inception until October 2016. Results. Twelve included systematic reviews were of moderate-to-high quality and consistent in covering the handful of RCTs available to date, suggesting the promising efficacy, safety, and tolerability profile of lurasidone. Concordance on the drug profile seems to be corroborated by a steadily increasing number of convergent qualitative reports on the matter. Limitations. Publication, sponsorship, language, citation, and measurement biases. Conclusions. Despite being preliminary in nature, this overview stipulates the effectiveness of lurasidone in the acute treatment of Type I bipolar depression overall. As outlined by most of the reviewed evidence, recommendations for future research should include further controlled trials of extended duration

    Celecoxib Adjunctive Treatment to Antipsychotics in Schizophrenia: A Review of Randomized Clinical Add-On Trials

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    Schizophrenia is a severe, chronic and debilitating mental disorder. Past literature has reported various hypotheses about the psychopathology of schizophrenia. Recently, a growing literature has been trying to explain the role of inflammation in the etiopathogenesis of schizophrenia. In the past, numerous immune modulation and anti-inflammatory treatment options have been proposed for schizophrenia, but sometimes the results were inconsistent. Electronic search was carried out in November 2015. PubMed and Scopus databases have been used to find studies to introduce in this review. Only randomized-placebo-controlled add-on trials were taken into account. In this way, six articles were obtained for the discussion. Celecoxib showed beneficial effects mostly in early stages of schizophrenia. In chronic schizophrenia, the data are controversial, possibly in part for methodological reasons

    New Psychoactive Substances and Suicidality: A Systematic Review of the Current Literature

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    Submitted 23 April 2021. Minor revisions requested 31 May 2021. Revisions submitted 3 June 2021. Accepted 3 June 2021. Epub 6 June 2021.Background and Objectives: Over the past twenty years a large number of New Psychoactive Substances (NPS) has entered and modified the recreational drug scene. Their intake has been associated with health-related risks, and especially so for vulnerable populations such as people with severe mental illness, who might be at higher risk of suicidality or self- injurious behaviour. This paper aims at providing an overview of NPS abuse and effects on mental health and suicidality issues, performing a literature review of the current related knowledge, thereby identifying substances that more than others are linked to suicidal behaviours. Materials and Methods: A comprehensive and updated overview of the literature regarding suicidality and NPS categories has been provided. An electronic search was performed, including all papers published up to March 2021, using the following keywords "NPS" OR "new psychoactive substances" OR "novel psychoactive substances" OR "synthetic cannabinoids" OR "phenethylamines" OR "synthetic cathinones" OR “tryptamines” OR “piperazines” OR “new synthetic opioids” OR “designer benzodiazepines”) AND ("suicide" OR "suicidality") NOT review NOT animal on the PubMed, Cochrane Library, and Web of Science online databases. Results: Suicidality and self-injurious behaviour appear to be frequently associated with some NPS such as cathinones, synthetic cannabinoids, and new synthetic opioids. Results are organised according to substances recorded. Conclusion: The growing use of NPS has become a significant clinical issue, posing increasing concern and challenges for clinicians working in both mental health and emergency departments. Thus, considering the associations between NPS and suicidality or self-injurious behaviours, areas where suicide-prevention efforts and strategies might be focused are the early detection, monitoring and restriction of NPS.Peer reviewe

    The role of inhaled loxapine in the treatment of acute agitation in patients with psychiatric disorders: A clinical review

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    Loxapine is a first generation antipsychotic, belonging to the dibenzoxazepine class. Recently, loxapine has been reformulated at a lower dose, producing an inhaled powder that can be directly administered to the lungs to treat the agitation associated with psychiatric disorders, such as schizophrenia and bipolar disorder. Thus, the aim of this narrative and clinical mini-review was to evaluate the efficacy and tolerability of inhaled loxapine in the treatment of acute agitation in patients with psychiatric disorders. The efficacy of inhaled loxapine has been evaluated in one Phase II trial on patients with schizophrenia, and in two Phase III trials in patients with schizophrenia and bipolar disorder. Moreover, there are two published case series on patients with borderline personality disorder and dual diagnosis patients. Inhaled loxapine has proven to be effective and generally well tolerated when administered to agitated patients with schizophrenia and bipolar disorder. Two case series have suggested that inhaled loxapine may also be useful to treat agitation in patients with borderline personality disorder and with dual diagnosis, but further studies are needed to clarify this point. However, the administration of inhaled loxapine requires at least some kind of patient collaboration, and is not recommended in the treatment of severe agitation in totally uncooperative patients. Moreover, the drug-related risk of bronchospasm must always be kept in mind when planning to use inhaled loxapine, leading to a careful patient assessment prior to, and after, administration. Also, the higher costs of inhaled loxapine, when compared to oral and intramuscular medications, should be taken into account when selecting it for the treatment of agitation

    Inflammatory markers and suicidal attempts in depressed patients: A review

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    Major depressive disorder is a chronic and invalidating psychiatric illness and is associated with a greater risk of suicidal behaviors. In recent decades many data have supported a biological link between depressive states and inflammation. Pro-inflammatory cytokines have been found to rise, first of all TNF-α and IL-6. Suicidal behaviors have been consistently associated with increased levels of IL-6 and decreased levels of IL-2. The aim of this review is to investigate the relationship between inflammatory markers in depressed patients with or without suicidal attempts compared to healthy controls
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