46 research outputs found

    Changes in Body Weight and Psychotropic Drugs: A Systematic Synthesis of the Literature

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    <div><h3>Introduction</h3><p>Psychotropic medication use is associated with weight gain. While there are studies and reviews comparing weight gain for psychotropics within some classes, clinicians frequently use drugs from different classes to treat psychiatric disorders.</p> <h3>Objective</h3><p>To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence-based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics.</p> <h3>Methodology and Results</h3><p>We developed a novel hierarchical search strategy that made use of systematic reviews that were already available. When such evidence was not available we went on to evaluate randomly controlled trials, followed by cohort and other clinical trials, narrative reviews, and, where necessary, clinical opinion and anecdotal evidence. The data from the publication with the highest level of evidence based on our hierarchical classification was presented. Recommendations from an expert panel supplemented the evidence used to rank these drugs within their respective classes. Approximately 9500 articles were identified in our literature search of which 666 citations were retrieved. We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts. There were few discrepancies between published evidence and the expert panel in ranking these drugs.</p> <h3>Conclusion</h3><p>Potential for weight gain is an important consideration in choice of any psychotropic. This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices.</p> </div

    Effect of fine to coarse aggregate ratio on the rheology and fracture energy of steel fibre reinforced self-compacting concretes

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    In this study, the influence of aggregate grading and steel fibre properties on the flow properties and fracture energy of steel fibre reinforced self-compacting concrete (SFRSCC) has been investigated. Two types of hooked-end steel fibres at three different dosages (20,40 and 60 kg/m(3)) were incorporated into self-compacting mixtures having similar paste contents but different fine to coarse aggregate (FA/CA) ratios (0.94, 1.72 and 2.50 by weight). Besides the flowability and passing ability of fresh concrete, the mechanical properties of hardened concrete including the fracture energy have also been investigated. The relations between flexural parameters and fibre orientation were established by image analysis technique. Test results showed that hooked-end steel fibre inclusion into the plain self-compacting concrete negatively affects the flowability and passing ability of the mixture. Increasing FA/CA ratio enhances these rheological parameters and provides better fibre orientation. On the other hand, increasing FA/CA ratio decreases the fracture energy of plain SCC mixtures and the fibre incorporated series which were less affected from fibre inclusion follow the same trend with the plain SCC. The proper FA/CA ratio for the best rheological and mechanical performance depends on the fibre content, aspect ratio and their influence on the flowability of the mixture. In order to obtain better fibre orientation and hence higher fracture energy, relatively higher FA/CA ratios should be used when the fibre content and aspect ratio are relatively high
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