Atypical antipsychotic agents; peas in a pod or chalk and cheese?

With escalating health expenditure and a shrinking purse, there is increased focus on the cost efficacy of still patented versus generic medications in general, and for atypical antipsychotics in particular. In a recent BMC Medicine article, Godman and colleagues presented data indicating poor uptake of the off patent atypical antipsychotic risperidone, arguing for authorities to mandate its greater use. This is under the assumption of clinical equivalence of atypical antipsychotics. This commentary argues that there are clinically meaningful differences between atypical antipsychotics and important inter-individual heterogeneity in clinical response and tolerability. Access to a broad range of atypical antipsychotics enables clinicians to tailor care, taking consideration of differential efficacy and adverse effects profile in order to meet the needs of individual patients with improved real world effectiveness of treatment. Restriction of agent choice risks detracting from optimal clinical care, with possible poorer outcomes and greater costs of care. A balance between encouraging use of cheapest in class agent and allowing access to various atypical agents for tailored care is likely to produce optimal health outcomes.Please see related article: http://www.biomedcentral.com/1741-7015/12/98.

Distribution of carbon nanotubes in fresh ordinary Portland cement pastes: understanding from a two-phase perspective

Significant research advances have been made in the field of carbon nanotube (CNT) reinforced ordinary Portland cement (OPC) paste composites in recent years. However, the distribution of CNTs in fresh OPC paste is yet to be fully researched and quantified, thereby creating a technical barrier to CNT utilization in concrete construction. In this study, fresh OPC paste was treated as a two-phase material containing solid particles (cement grains) and liquid solutions (pore solutions). A centrifugation-based technique was proposed to separate these two phases and the presence of CNTs in each phase was quantified. UV-Vis spectrometry showed that the degree of dispersion can achieve above 90 wt% using polycarboxylate superplasticizer. The results suggested an upper limit of 0.26 wt% for CNT addition into water before mixing with OPC, and the dispersion was found to be stable for at least 4 hours. Based on scanning electron imaging, the adsorption phenomenon of CNTs on OPC grains with size less than 4 μm was discovered. Energy-dispersive X-ray spectroscopy indicated these adsorptive particles have lower Ca to Si ratio. It was observed that about 0.5 mg of CNTs per gram of OPC grains was adsorbed in solid OPC grains in typical fresh OPC pastes. On the basis of these results, a conceptual model was proposed for the distribution of CNTs in fresh OPC paste where about 33 wt% of the CNTs stay in pore solution and 65 wt% of CNTs are adsorbed on OPC grains.