The total burden of migraine includes not only the episodes with headache pain but extends throughout the interictal periods. Interictal symptoms and associated psychological responses may profoundly impact well-being and drive treatment-seeking behavior. A cross-sectional online survey was conducted with participants aged ≥ 18 years, 250 with episodic migraine (EM) and 250 with chronic migraine (CM), having ≥ 4 monthly migraine headache days. All were naïve to galcanezumab or began ≤ 6 months before survey completion. The study evaluated factors associated with the Migraine Interictal Burden Scale (MIBS-4), including social determinants of health and well-being. Multiple linear regression, logistic regression, and random forests (RF) were used to explore predictors of MIBS-4. The majority of participants (90

An efficient three-phase resonant DC link inverter is put forward to optimise the efficiency. The assisted circuit is added on the DC link. When the main switches need to be operated, the assisted circuit has been in resonance state in advance. The voltage across DC link changes to zero, so that the main switches can act in the mode of zero-voltage soft-switching. Besides, the auxiliary switch can also act in the mode of soft-switching. Through control of the interval time of the action of the auxiliary switches, the zero-state duration of the DC link voltage can be adjusted, so that various flexible pulse width modulation strategies can be applied in the inverter. The workflow of the assisted circuit and the implementation conditions of soft-switching are illustrated at length. The experimental results indicate the main switches and the auxiliary switches can act in the mode of soft-switching. The efficiency at 4.5 kW is equal to 98.5%, which is superior to that of other similar inverters. Hence, the topology can provide reference for the design of efficient inverters.

Three ionic liquids, including 1-ethyl-3-methylimidazolium acetate ([EMIM][Ac]), 1-butyl -3-methylimidazolium acetate ([BMIM][Ac]) and 1-hexyl -3-methylimidazolium acetate ([HMIM][Ac]), were selected as entrainers to separate the azeotropic system of acetonitrile + isopropanol. Isobaric vapor liquid equilibrium data of the acetonitrile + isopropanol + ILs ternary systems were determined at 101.3 kPa. The separation performance of the three ionic liquids were analyzed and compared. The nonrandom two-liquid (NRTL) model was used to correlate the experimental data. The addition of [EMIM][Ac] and [BMIM][Ac] could increase the relative volatility of acetonitrile to isopropanol at acetonitrile-rich region, whereas [HMIM][Ac] produced an salting-out effect on acetonitrile at fullconcentration region and the effect was more obvious with the increase of its content. All three ILs could break the azeotropic point as their content reach a certain value. The NRTL model was proved to be applicable to the acetonitrile and isopropanol systems containing the three ILs. The separation performance of the three ionic liquids is [HMIM][Ac]>[BMIM][Ac]>[EMIM][Ac]. (C) 2020 Elsevier B.V. All rights reserved.

Purpose/Background RE-KINECT (NCT03062033) was designed to assess the presence and impact of possible tardive dyskinesia (TD) in antipsychotic-treated outpatients. Methods/Procedures The study included adults with 3 or more months of lifetime antipsychotic exposure and 1 or more psychiatric disorder. Based on clinician observation and assessment, patients were assigned to cohort 1 (without involuntary movements or with non-TD involuntary movements) or cohort 2 (with involuntary movements confirmed by clinician as possible TD). Baseline assessments included the following: patient characteristics; location/severity of involuntary movements; and impact of possible TD on health-related quality of life, including the EuroQoL 5-Dimensions 5-Level questionnaire. Findings/Results Of 739 eligible patients, 204 (27.6%) had clinician-confirmed possible TD (cohort 2). Compared with cohort 1, patients in cohort 2 were significantly older (P < 0.0001), more likely to have schizophrenia or schizoaffective disorder (P < 0.0001) and longer lifetime exposure to antipsychotics (P < 0.0001), and less likely to be working or studying, based on clinician perception (P = 0.0010). Clinician- and patient-rated severity of possible TD movements was significantly correlated in each of 4 body regions (head/face, neck/trunk, upper extremities, lower extremities), for maximum severity in any region, and for total number of affected regions (P < 0.001 for all correlations). For the patient-rated EuroQoL 5-Dimensions 5-Level, the health state visual analog scale score was significantly lower (worse) in cohort 2 versus cohort 1 (66.8 vs 69.7; P = 0.0002), as was the utility index score (0.71 vs 0.76; P < 0.0175). Implications/Conclusions Results from this real-world population indicate that TD occurs frequently and can significantly reduce quality of life in patients with a psychiatric disorder.

Abstract Purpose/Background RE-KINECT (NCT03062033) was designed to assess the presence and impact of possible tardive dyskinesia (TD) in antipsychotic-treated outpatients. Methods/Procedures The study included adults with 3 or more months of lifetime antipsychotic exposure and 1 or more psychiatric disorder. Based on clinician observation and assessment, patients were assigned to cohort 1 (without involuntary movements or with non-TD involuntary movements) or cohort 2 (with involuntary movements confirmed by clinician as possible TD). Baseline assessments included the following: patient characteristics; location/severity of involuntary movements; and impact of possible TD on health-related quality of life, including the EuroQoL 5-Dimensions 5-Level questionnaire. Findings/Results Of 739 eligible patients, 204 (27.6%) had clinician-confirmed possible TD (cohort 2). Compared with cohort 1, patients in cohort 2 were significantly older (P < 0.0001), more likely to have schizophrenia or schizoaffective disorder (P < 0.0001) and longer lifetime exposure to antipsychotics (P < 0.0001), and less likely to be working or studying, based on clinician perception (P = 0.0010). Clinician- and patient-rated severity of possible TD movements was significantly correlated in each of 4 body regions (head/face, neck/trunk, upper extremities, lower extremities), for maximum severity in any region, and for total number of affected regions (P < 0.001 for all correlations). For the patient-rated EuroQoL 5-Dimensions 5-Level, the health state visual analog scale score was significantly lower (worse) in cohort 2 versus cohort 1 (66.8 vs 69.7; P = 0.0002), as was the utility index score (0.71 vs 0.76; P < 0.0175). Implications/Conclusions Results from this real-world population indicate that TD occurs frequently and can significantly reduce quality of life in patients with a psychiatric disorder.

Vapor-liquid equilibrium (VLE) data for the binary system of ethyl propionate + ethanol and the ternary systems of ethyl propionate + ethanol +1-decyl-3-methylimidazolium acetate ([DMIM][Ac]), ethyl propionate + ethanol +1-octyl-3-methylimidazolium acetate ([OMIM][Ac]) and ethyl propionate + ethanol +1-hexyl-3-methylimidazolium acetate [HMIM][Ac]) were measured at 101.3 kPa. The reliability of the experimental procedure and apparatus was checked by comparing the binary experimental data with the literature data. Herington consistency test was conducted to check the thermodynamic consistency of the experimental data for the ethyl propionate + etanol binary system. The UNIQUAC model. NRTL model and Wilson model were used to correlate the vapor-liquid equilibrium data. The results showed that all three models are applicable to the system, but the calculated results by the NRTL model had the minimum deviation from the experimental data. Van Ness consistency test was carried out to check the reliability of the obtained NRTL parameters for thermodynamic consistency for the ternary systems. The addition of the three ionic liquids (ILs) improved the separation of the ethyl propionate-ethanol azeotropic system. Furthermore, the higher the concentration of the ionic liquid, the better the separation effect. The separation performance of the three ILs is: [DMIMI[Ac] < [OMIM][Ac] < [HMIM][Ac]. (C) 2020 Elsevier B.V. All rights reserved.

An amendment to this paper has been published and can be accessed via the original article.

A novel three-phase resonant dc-link inverter with low energy consumption is presented to achieve efficient operation of the inverter. When the auxiliary resonant circuit is used to make the input voltage across bridge-arms become zero during every switching period, the main switching devices could achieve zero-voltage switching turn-on and zero-current switching turn-off. When the metal oxide semiconductor field effect transistor (MOSFET) or the insulated gate bipolar transistor (IGBT) is used as the main switching device, the lossless switching could be completed, and the capacitive turn-on loss caused by the internal junction capacitance of MOSFET and the turn-off loss caused by the tail current of IGBT are eliminated. The working process of the circuit and the realization condition of the soft-switching are analyzed. The experimental results on the three-phase prototype of 2.5 kW show that the switching devices achieve the soft-switching and the performance of the inverter is improved. Therefore, the novel topology is of great significance for improving the efficiency of the inverter.

AbstractObjectiveTardive dyskinesia (TD) is a hyperkinetic movement disorder associated with antipsychotic treatment. RE KINECT (NCT03062033), a real-world study of outpatients prescribed antipsychotics, was designed to identify the presence of possible TD and characterize the impact of involuntary movements on functioning and quality of life. Data from RE-KINECT were used to compare the impact of possible TD in patients with schizophrenia/schizoaffective disorder [SZD] versus mood/other psychiatric disorders [Mood].MethodsAdults with ≥3months of lifetime exposure to antipsychotics and ≥1 psychiatric disorder were recruited. The presence of possible TD was based on clinicians’ observation of involuntary movements in 4 body regions (head, trunk, upper extremities, and lower extremities). Baseline outcomes included demographics, medication history, location/severity of abnormal movements, impact of abnormal movements on daily activities, the Sheehan Disability Scale (SDS), and the EuroQoL 5-Dimensional questionnaire (EQ-5D-5L).ResultsOf 204 patients with clinician-confirmed possible TD, 111 (54.4%) had a SZD diagnosis and 93 (45.6%) had a mood/other psychiatric diagnosis. Significant differences found between groups (Mood vs SZD) included: mean age (56.9 vs 52.7 years; P=0.0263); male sex (33.3% vs 62.2%; P<0.0001); African-American race (7.5% vs 26.1%; P=0.0005); mean lifetime exposure to antipsychotics (9.5 vs 19.5 years; P<0.0001); and percentage of patients currently taking ≥2 psychiatric medications (93.5% vs 79.3%; P=0.0093). Based on clinician observation, there were no significant differences between diagnosis groups in the number of body regions impacted by abnormal movements, maximum severity score across all 4 regions, or patient awareness of possible TD. Over 30% of patients in both groups reported that involuntary movements had “some” or “a lot” of impact on their ability to continue usual activities, be productive, and socialize. No significant differences between the diagnosis groups (Mood vs SZD) were found for mean SDS total score (12.8 vs 10.8), SDS domain scores (work/school [4.1 vs 4.2], social life [4.3 vs 3.7], family life [4.1 vs 3.5]), EQ-5D-5L utility score (0.68 vs 0.74), or EQ-5D-5L health state VAS (64.8 vs 68.5).ConclusionsIn this cohort of outpatients with possible TD, those with Mood disorders were more likely to be older, female, and white than patients with SZD. The ability to function and quality of life were equally impaired in both groups. Further studies on the impact of TD are needed.Funding Acknowledgements: Neurocrine Biosciences, Inc.

Introduction Older age is a risk factor for developing tardive dyskinesia (TD), a persistent movement disorder associated with prolonged exposure to antipsychotics. In older patients, TD symptoms may appear after shorter antipsychotic treatment. RE-KINECT (NCT03062033), a real-world study of outpatients prescribed antipsychotics, was designed to identify the presence of drug-induced involuntary movements consistent with TD (i.e., "possible TD") and to characterize the impact of these movements on health-related quality of life. Baseline data from RE-KINECT were analyzed to explore the patient experience of possible TD and how it affects functioning in older adults (≥55 years). Methods Adults with ≥3 months of lifetime exposure to antipsychotics and ≥1 psychiatric disorder were recruited. The presence of possible TD was based on clinicians' observation and assessment of involuntary movements in 4 body regions (head/face, trunk/neck, upper extremities, and lower extremities). Patients were categorized into Cohort 1 (without visible movements or possible TD) or Cohort 2 (with visible movements and confirmed by clinician as consistent with possible TD). Baseline outcomes for all patients included demographics, clinical history, patient-reported health status (score range, 0 ["no health problems"] to 10 ["health as bad as you can imagine"]), and the patient-reported EuroQoL 5-Dimensional 5-Level questionnaire (EQ-5D-5L; domain score range, 1 [no problems or symptoms] to 5 [extreme problems or symptoms]). Clinicians also assessed the location and severity (ratings, "none", "some", or "a lot") of abnormal movements in Cohort 2 patients. Exploratory statistical testing was conducted between older adults (≥55 years) in Cohorts 1 and 2. Results Of the 738 patients enrolled in the study, the results of those ≥55 years (N=300, 41%) are presented here. Within this subgroup, 114 (38%) had clinician-confirmed possible TD (Cohort 2) and 186 (62%) had no visible movements or had movements that were inconsistent with TD (Cohort 1). In Cohort 2 patients, the highest frequencies of severe abnormal movements (severity rating: "a lot") were observed in the head/face (25%) and upper extremities (14%). Cohort 2 patients were less likely to be married, more likely to live in care homes, and were more likely to have longer lifetime exposure to antipsychotics than Cohort 1 patients (Table). More patients in Cohort 2 had schizophrenia or schizoaffective disorder, while those in Cohort 1 were more likely to have a mood disorder. Patients in Cohort 2 also had slightly higher mean EQ-5D-5L scores at baseline in four EQ-5D-5L domains, suggesting a somewhat greater impact on health-related quality of life, particularly in the domain of self-care. Conclusions Results from this real-world sample of older psychiatric outpatients suggest that the greater risk and severity of TD in this population may be associated with more limited support systems and reduced quality of life, which are separate from the effects of age itself. This research was funded by This research was fully funded by Neurocrine Biosciences, Inc.

In patients with schizophrenia, antipsychotic medications, including second-generation antipsychotics, may cause many side-effects (SE) often leading to treatment discontinuation, and possible relapse as a consequence. The impact of treatments on patient-centered outcomes such as health-related quality of life (HRQOL) is less well understood. Even less well understood is the impact of side effects on patient-centered outcomes such as daily functioning and HRQOL. Therefore, the study’s primary goal was to gain a deeper understanding of the impacts of SEs of second generation antipsychotics on patients’ day to day functioning. A cross-sectional, web-based, patient-reported survey was fielded in the United States between July and November 2017. The final survey included patient socio-demographics, a quality of life measure (Quality of Life Enjoyment and Satisfaction Questionnaire Short Form, Q-LES-Q-SF), questions on treatment satisfaction, SEs experienced (Glasgow Antipsychotic Side-Effect Scale, GASS), and questions about the impact of SEs on functioning and emotions. Patients were recruited through patient advocacy and support groups, and medical research panels. Patient inclusion criteria: Self-reported schizophrenia diagnosis; 18 to 65 years old; stable for at least one month at time of screening; prescribed a second-generation antipsychotic medication for 1–12 months; the final sample consisted of those individuals who reported experiencing one or more side-effects based on the GASS. The total sample (n=180) had a mean age of 35 (range 18–61) years old, of which 58.3% were females. Approximately a quarter (27.8%) of the sample had a college degree or higher; 69.4% identified as White, followed by 16.7% Black/ African American, and 6.1% Native Hawaiian/ Pacific Islanders. Most prevalent SEs reported on the GASS were ‘difficulty sleeping’ (81.1%), ‘feeling sleepy during the day’ (77.2%), ‘dry mouth’ (70.6%), and ‘feeling restless (60.6%). The SEs most commonly reported as distressing, for those patients experiencing that SE, were difficulty passing urine (23.3%), and feeling drugged/like a zombie (19.4%). The minimum impact from SEs on daily functioning was 53.2 on a 0–100 Visual Analogue Scale (higher number reflects more negative impact on daily functioning; 0=no impact and 100=very highly impacted). Across the SEs further probed about, the most severe impact was on one’s ‘ability to get or do a job’; specifically, for the SEs ‘shaky hands or arms’ the mean impact was 76.1, followed by 69.8 for restlessness. ‘Problems enjoying sex’ had the greatest effect on one’s ‘intimate relationships’ (mean 74.8), and feeling drugged/like a zombie had the greatest effect on one’s ‘ability to concentrate’ (mean 70.2). The study indicates the importance of incorporating the patient with schizophrenia’s perspective when assessing SE experiences and impact on functioning due to second generation antipsychotic agents. Findings suggest that both activating SEs (restlessness) and sedating SEs (feeling drugged and sleepiness) have pronounced undesirable impact on daily patient functioning.