Fourth Column Research Articles

Introduction to the Column: Reflective Practice

Welcome to the fourth reflective practice column. In this issue, we develop on the themes dealt with in the previous issues, in particular teacher reflection, mentoring and a personal narrative approach to exploring language advisor identity and practice. Over five papers, we see teachers and advisors reflecting on practice to develop their practice and, perhaps most importantly, sharing this reflection with others.

Consequences of μ−τ reflection symmetry for 3+1 neutrino mixing

We investigate the consequences of $\mu-\tau$ reflection symmetry in presence of a light sterile neutrino for the $3+1$ neutrino mixing scheme. We discuss the implications of total $\mu-\tau$ reflection symmetry as well partial $\mu-\tau$ reflection symmetry. For the total $\mu-\tau$ reflection symmetry we find values of $\theta_{23}$ and $\delta$ remains confined near $\pi/4$ and $\pm \pi/2$ respectively. The current allowed region for $\theta_{23}$ and $\delta$ in case of inverted hierarchy lies outside the area preferred by the total $\mu-\tau$ reflection symmetry. However, interesting predictions on the neutrino mixing angles and Dirac CP violating phases are obtained considering partial $\mu-\tau$ reflection symmetry. We obtain predictive correlations between the neutrino mixing angle $\theta_{23}$ and Dirac CP phase $\delta$ and study the testability of these correlations at the future long baseline experiment DUNE. We find that while the imposition of $\mu-\tau$ reflection symmetry in the first column admit both normal and inverted neutrino mass hierarchy, demanding $\mu-\tau$ reflection symmetry for the second column excludes the inverted hierarchy. Interestingly, the sterile mixing angle $\theta_{34}$ gets tightly constrained considering the $\mu-\tau$ reflection symmetry in the fourth column. We also study consequences of $\mu-\tau$ reflection symmetry for the Majorana phases and neutrinoless double beta decay.

Drug-Drug Interactions (DDIs) in Psychiatric Practice, Part 5: Major Types of Pharmacodynamic DDIs Based on Mechanism of Action (With Updated Neuroscience-based Nomenclature).

This column is the fifth in a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. In the preceding column, a classificatory system based on mechanism of action was presented and a table was provided outlining the primary, known mechanism(s) of action of all commonly used psychiatric medications. This column presents a parallel table summarizing major types of pharmacodynamic DDIs based on mechanism of action. Clinicians can use these 2 tables to predict pharmacodynamically mediated DDIs. As discussed in the third column in this series, a classification scheme for drugs based on what enzymes, if any, are responsible for their biotransformation as a necessary step in their eventual elimination and whether a drug is an inhibitor or inducer of those enzymes can be used to predict pharmacokinetic DDIs mediated by cytochrome P450 enzymes, just as the mechanism-based classification system presented in this and the fourth column in this series can be used to predict pharmacodynamic-based DDIs. The ultimate intent of this series is to present a simple way of conceptualizing neuropsychiatric medications in terms of their pharmacodynamics and pharmacokinetics to allow prescribers to take these facts into consideration when they need to use >1 drug in combination to optimally treat a patient.

Thermal analysis of a cryogenic distillation column for hydrogen isotopes separation

Cryogenic distillation (CD) of hydrogen in combination with Liquid Phase Catalytic Exchange (LPCE) or Combined Electrolytic Catalytic Exchange (CECE) process is used for tritium removal/recovery from tritiated water from fission rectors like CANDU and is the proposed technology for ITER/DEMO. Tritiated water is being obtained after long time operation of CANDU reactors, or in case of ITER mainly by the Detritiation System.The cryogenic system of the Experimental Pilot plant for tritium and deuterium separation from ICSI Rm. Valcea consists of four distillation columns and significant effort is required in various batch mode operations for achieving high tritium concentration.Some problems have been experienced with the fourth column of the cascade regarding the heat transient transfer during start-up. This paper intent is to present a CAE/FEA (Computer Aided Engineering/Finite Element Analysis) thermal simulation of the column during the transitory thermal regime in order to investigate the temperature distribution along the column and its connections to other equipment. The simulation is done on the as-built design of the column and takes in consideration the actual configuration. This work provides an important platform to understand the thermal phenomena during cool down of a cryogenic distillation column besides finding the failures in thermal insulation or design flaws. The results of the simulation can be used as lessons-learned for future design work of cryogenic systems like Tritium Removal Facility from Cernavoda Nuclear Power Plant or ITER/DEMO Isotope Separation System.

In silico, in vitro: antioxidant and antihepatotoxic activity of gnetol from Gnetum ula Brongn.

Introduction: Gnetum ula is a notable medicinal plant used to cure various ailments. The stem part of the plant is used traditionally to treat jaundice and other disorders. The present work is to investigate the in vitro hepatoprotective and antioxidant activity of ethanol extract of stem of G. ula (GUE) and its isolated compound gnetol. Methods: Column chromatography was carried out for GUE and various column fractions were obtained. DPPH and reducing power assays were performed for GUE and column fractions. The potent fraction was characterized, interpreted and tested for in vitro hepatoprotective activity on the BRL3A cell line. In silico docking studies of gnetol compound on the protein TGF-β (transforming growth factor – β) and Peroxisome proliferator-activated receptor α (PPARα) was carried out. Results: DPPH scavenging and reducing power assay showed that the fourth column fraction has antioxidant potential than other fractions. The fourth column fraction was characterized to obtain gnetol compound. BRL3A cell line was used for the toxicity study of GUE and gnetol. Both, the extract and the isolated compound were found to be nontoxic with CTC50 value more than 1000 µg/mL. At the concentration of 200 µg/mL, GUE and gnetol offered cell protection of 50.2% and 54.3%, however, silymarin showed 77.15% protection at 200 µg/mL concentration against CCl4 treated BRL3A cell line. The docking results of the ligand molecule TGF-β showed that gnetol has the binding affinity of -7.0 and standard silymarin being -6.8. TGF-β showed good hydrophobic interactions and formed two hydrogen bonds with the amino acids. For PPARα protein, gnetol showed the binding affinity of -8.4 and silymarin with -6.5. Hydrogen bonding and good hydrophobic interactions against the amino acid molecules in relation to the PPARα protein are shown. Conclusion: Gnetum ula stem extract and its isolated compound are safe and offered significant hepatoprotection against CCl4 induced toxicity. Isolated compound gnetol exhibited a potent antioxidant activity offering protection to liver damage. However, in vivo studies need to be carried out to validate the traditional use of G. ula .

Corrigendum.

CorrigendumCORRIGENDUMPublished Online:25 Jul 2018https://doi.org/10.1152/japplphysiol.zdg-2718.corrOriginal articleMoreSectionsPDF (48 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Sagayama H, Yamada Y, Racine NM, Shriver TC, Schoeller DA and DLW Study Group. Dilution space ratio of 2H and 18O of doubly labeled water method in humans. J Appl Physiol 120: 1349–1354, 2016. First published March 17, 2016; doi:10.1152/japplphysiol.01037.2015. The dose for 2H2O had an erroneous description and “between 0.10 and 0.16 g/kg estimated TBW” is correct. Additionally, the column heading of Table 1 has been switched from “BMI, kg/m2” to “Body fat, %”. The fourth column is “Body fat, %”, and the fifth column is “BMI, kg/m2”.This article has no references to display. Download PDF Previous Back to Top FiguresReferencesRelatedInformation Related ArticlesDilution space ratio of 2H and 18O of doubly labeled water method in humans 01 Jun 2016Journal of Applied Physiology More from this issue > Volume 125Issue 1July 2018Pages 242-242 Copyright & PermissionsCopyright © 2018 the American Physiological Societyhttps://doi.org/10.1152/japplphysiol.zdg-2718.corrPubMed30444678History Published online 25 July 2018 Published in print 1 July 2018 Metrics

Experimental investigation of the effect of compound protrusion-pin array on heat transfer in an internal rotating cooling channel

An experimental investigation was conducted to study the effect of protrusions and their combination with pins on heat transfer enhancement in a rotating internal passage with an orientation angle of 90° for Reynolds numbers (Re) of 10,000 and 20,000. The trailing surface showed the highest Nusselt number (Nu). The highest and lowest local Nusselt number was at the front and back of the protrusion respectively. A short disturbed wake region was observed behind the protrusion as a result of complex three dimensional flow. Addition of pins in the configuration resulted in an increase of the average Nusselt number, specifically a 35%, 50% and 142% for trailing, static and leading surfaces respectively, compared to protrusions only case for Re of 10,000. On removal of the third column of protrusions, average Nusselt number showed a decrease of 8.25%, 3.1% and 2.3% for trailing, static and leading cases respectively, compared to the protrusion-pin case for Re of 10,000. It also caused elongation of the stagnation and wake flow fields around the fourth column comprising of pins. Pressure drop results indicated that the protrusion only case was the lowest compared to protrusion-pin.

Effect of Water Table Depth on Nutrient Concentrations Below the Water Table in a Spodosol

Water table depth manipulations as implemented in sugarcane fields of Southwestern Florida, USA, were hypothesized to influence the nutrient concentrations below the water table. Concentrations of phosphorus (P), potassium (K), nitrogen (N), and bromide (Br−) were monitored above and below the water table using a column leaching experiment. Three columns were packed with Immokalee soil (A, E, and Bh horizons) classified as a spodosol and fertilizers (NPK) were applied on the soil surface as solids using rates of 11 kg P ha−1, 166 kg K ha−1, and 200 kg N ha−1. A fourth column where fertilizer mixture and bromide were not added acted as a blank. Potassium was also applied as KBr with bromide used as tracer for water movement. Water table was maintained at 30 cm for 6 weeks and lowered to 50 cm deep for another 6 weeks. Samplers were placed in A, E, and Bh horizons and outlets were placed at 30 and 50 cm deep to obtain solutions for monitoring nutrients and tracer. Solution samplers placed in E and Bh horizons were located below the water table. Slightly elevated P, N, and K concentrations in E horizon for a 50-cm water table depth treatment were observed. For both water table treatments, minimal loss of applied N, P, and K below the water table was observed. The results of the study have shown that movement of nutrients below the water table is slow, and depends on the type of nutrients applied and the water table depth.

Correction to: Assessing the role of futures position substitutability in a monthly model of factor demand for softwood lumber

In the original article’s Table 2, the test result of the fourth null hypothesis (in the table’s fourth column) should read “Fail to reject the null that $${r} \le 3$$ ”. While the original article’s Table 2 data (trace values) and text analysis of Table 2’s data are correct and consistent, and demonstrate how the trace values provide evidence that is insufficient to reject the fourth hypothesis test that $${r} \le 3$$ , the table’s “test result” section in the fourth column for the fourth hypothesis test incorrectly stated “Reject the null that $${r} \le 3$$ ”.

A STUDY ON PRE AND POST PROCESSING OF FINGERPRINT THINNED IMAGE TO REMOVE SPURIOUS MINUTIAE FROM MINUTIAE TABLE

In Fingerprint recognition, after the initial preprocessing, the feature is extracted from the Fingerprint thinned image. Extraction of crucial and beneficial capabilities or features of interest from a fingerprint image is an essential venture during recognition. Feature extraction algorithms pick handiest or only applicable features important for enhancing the performance of matching and recognition rate and outcomes with the feature vector. The feature extraction algorithms or techniques require only relevant features like minutiae details and do not require any background details or domain-specific details. They need to be smooth or easy to compute with a purpose to gain a viable or practicable technique for a huge image series. Minutiae details or fingerprint ridge ending or bifurcation details using skeletonized or thinning approach is a very popular method for feature extraction. The preprocessed thinned image is further post-processed to remove some false minutiae from minutiae table and which is generated through crossing number theory. One more purpose of post-processing is to reduce the number of minutiae points by removing false minutiae structures like spurs, ride breaks, short ridge, holes or islands, bridges, and ladders. In this paper w × w window neighborhood is considered for each minutia in Minutiae Table. Minutiae Table contains Ridge ending or bifurcation code as 1 or 3 with its location details means x and y position in two columns and the sum of these details as its fourth column. These Minutiae tables are used for generating Fingerprint Hash code, which can be used as index-or identity key in order to uniquely identify an individual person or as one factor in Multifactor Authentication Model.

Switchable Enantioselective Three- and Four-Dimensional Dynamic Gas Chromatography–Mass Spectrometry: Example Study of On-Column Molecular Interconversion

A novel hybrid online enantioselective four-dimensional dynamic GC (e4D-DGC) approach to study reversible molecular interconversion through specific isolation of a diastereo and enantiopure oxime, 2-phenylpropanaldehyde oxime, from prior multidimensional separation, is described. It incorporates a pre-enantioseparation step that applies comprehensive two-dimensional GC (GC × GC), prior to multiple microfluidic (Deans) switching for selection of components of a diastereomeric (E,Z) and enantiomeric (R,S) oxime into a third reactor column where isomerization occurs. This is followed by E/Z separation in a fourth analytical column. The enantioselective first dimension (1Denant) yields enantioseparation of E(R), Z(R), E(S), and Z(S) isomers, with a characteristic interconversion zone between the E and Z isomers. However, these are contaminated with underlying stereoisomers. Selected separation regions were then modulated and separated using a second dimension (2D) column via GC × GC, resolving the interfering stereoisomers. Individual pure enantiomers were then selectively heart-cut from within the 2D separation space, cryofocused, then eluted on a 3D reactor column for E ⇌ Z isomerization under controlled oven temperature and flow. Heart-cuts taken over the resulting interconversion distribution were cryotrapped at the inlet of a 4D column, on which achiral separation allows precise quantification of each E and Z isomer of the enantiomer. From peak areas and isomerization time, the forward and backward rate constants (kE→Z and kZ→E) were determined. The described methodology is suited to other configurationally labile molecules (for instance, hydrazones and imines), which exhibit isomerization, and can be used to isolate individual compounds from multicomponent samples, without requiring pure compound synthesis, or complex mathematical models or in-silico simulations.

Do low profile implants provide reliable stability in fixing the sternal fractures as a "fourth vertebral column" in sternovertebral injuries?

Flexion and compression forces to the trunk can cause severe instability of the vertebral column and the anterior chest wall, mostly associated with an unstable fracture of the sternum. In combination, the worst case would be a complete disruption of the trunk. Some authors consider the sternum-rib-complex to be the fourth vertebral column. This study discusses the possibilities to treat instable trunk injuries with sternal fractures concomitant to vertebral spine fractures through anterior sternal plating employing a locked plate osteosynthesis in a low profile design instead of the use of bulky implants. 11 Patients suffering from at least one fracture of a vertebral body in combination with an unstable sternum fracture were stabilized through a locked plate osteosynthesis in low profile design at the sternum between November 2011 and October 2014. The vertebral spine injury was stabilized as well, if necessary. Patients were followed up with a look at the consolidation of the fractures and the question if any failure of the implants occurred. Anterior sternal plating was uneventful in all cases. All Sternal fractures showed sufficient consolidation. No failure of implants has been seen during follow up over two years.. A locked plate osteosynthesis of a sternal fracture in low profile design seem to be an appropriate option for stabilization of the sternum in combined sternovertebral injuries.

Sternal metastasis - the forgotten column and its effect on thoracic spine stability.

Sternal metastases are not studied extensively in the literature. There is a paucity of information on their role in metastatic disease. The concept of the fourth column was described by Berg in 1993, and has been proven in case report, clinically and biomechanical studies. The role of the sternum as a support to the thoracic spine is well documented in the trauma patients, but not much is known about its role in cancer patients. This review examines what is known on the role of the fourth column. Following this we have identified two likely scenarios that sternal metastases may impact management: (1) sternal pathological fracture increases the mobility of the semi-rigid thorax with the loss of the biomechanical support of the sternum-rib-thoracic spine complex; and (2) a sternal metastasis increases the risk of fracture, and while being medical treated the thoracic spine should be monitored for acute kyphosis and neurological injury secondarily to the insufficiency of the fourth column.

Correction to: 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America.

In the article by Yancy et al, “2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America,” which published online May 20, 2016, and appeared in the September 27, 2016, issue of the journal ( Circulation. 2016;134:e282–e293. DOI: 10.1161/CIR.0000000000000435), several corrections were needed. 1. On page e282, …

Erratum for Mokhtari et al., Characterization of Samples Identified as Hepatitis C Virus Genotype 1 without Subtype by Abbott RealTime HCV Genotype II Assay Using the New Abbott HCV Genotype Plus RUO Test.

Volume 54, no. 2, p. [296–299][1], 2016. Page 297, Table 2: For the heading of the third column, “gt 1b” should read “gt 1a,” and for the heading of the fourth column, “gt 1a” should read “gt 1b.” [1]: /lookup/doi/10.1128/JCM.02264-15

Correction to: Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.

HomeCirculationVol. 134, No. 8Correction to: Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association Free AccessCorrectionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessCorrectionPDF/EPUBCorrection to: Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association Originally published23 Aug 2016https://doi.org/10.1161/CIR.0000000000000427Circulation. 2016;134:e113This article corrects the followingInfective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of ComplicationsIn the article by Baddour et al, “Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association,” which published ahead of print on September 15, 2015, and appeared in the October 13, 2015, issue of the journal (Circulation. 2015;132:1435–1486. DOI: 10.1161/CIR.0000000000000296), several corrections were needed.On pages 1446–1463, the levels of headings have been updated.On page 1447, in the bottom of the left column, the third recommendation read, “Vancomycin alone may be a reasonable alternative in patients who are intolerant of β-lactam therapy (Class IIb; Level of Evidence C).” The strength of the recommendation has been updated to read, “(Class IIa; Level of Evidence C).”On page 1448, in Table 8, the third row, fourth column, the Level of Evidence has been updated from “B” to “C.”On page 1457, in the right column, the second heading, “Double–β-Lactam Regimens,” has been updated to “Double–β-Lactam Regimens for E faecalis IE.”On page 1462, in Table 16, the following changes have been made:First row, third column (“Duration, wk”), the entry read, “4.” It has been updated to read, “4, NVE; 6, PVE.”Second line of the table legend, a definition has been added: “NVE, native valve infective endocarditis.”On page 1464, in the left column, fourth paragraph, second sentence, reference 217 has been updated to reference 230.On page 1469, the following changes have been made:Left column, first paragraph, second sentence, reference 12 has been updated to reference 17.Left column, first paragraph under the heading “Anticoagulation,” third sentence, reference 287 has been updated to reference 286.Left column, last paragraph, second sentence, reference 288 has been updated to reference 287, and reference 289 has been updated to reference 288.Right column, first paragraph, last sentence, reference 290 has been updated to reference 289.Right column, second paragraph, first sentence, reference 291 has been updated to reference 290.These corrections have been made to the current online version of the article, which is available at http://circ.ahajournals.org/content/132/15/1435.full.FootnotesCirculation is available at http://circ.ahajournals.org. Previous Back to top Next FiguresReferencesRelatedDetailsCited By (2020) Arthritis as a manifestation of infective endocarditis, The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", 10.26565/2313-6693-2020-39-13:39, . Halford B, Piazza M, Berka H and Taylor C (2019) Blocking a rash diagnosis: a rare case of infective endocarditis, BMJ Case Reports, 10.1136/bcr-2018-226213, 12:3, (e226213), Online publication date: 1-Mar-2019. Popov D (2018) Daptomycin in the treatment of infective endocarditis, Clinical Microbiology and Antimicrobial Chemotherapy, 10.36488/cmac.2018.1.35-40, 20:1, (35-40), . Gallagher R, Wilson M, Hite P and Jackson B (2020) A Case Report of Acute Heart Failure Due to Infective Aortic Endocarditis Diagnosed by Point-of-care Ultrasound, Clinical Practice and Cases in Emergency Medicine, 10.5811/cpcem.2020.3.45002, 4:2, (193-196) Ajaka L, Heil E and Schmalzle S (2020) Dalbavancin in the Treatment of Bacteremia and Endocarditis in People with Barriers to Standard Care, Antibiotics, 10.3390/antibiotics9100700, 9:10, (700) Related articlesInfective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of ComplicationsLarry M. Baddour, et al. Circulation. 2015;132:1435-1486 August 23, 2016Vol 134, Issue 8 Advertisement Article InformationMetrics © 2016 American Heart Association, Inc.https://doi.org/10.1161/CIR.0000000000000427PMID: 27550972 Originally publishedAugust 23, 2016 PDF download Advertisement

Determining Whether a Definitive Causal Relationship Exists Between Aripiprazole and Tardive Dyskinesia and/or Dystonia in Patients With Major Depressive Disorder, Part 4: Case Report Data.

This series of columns has 3 main goals: (1) to explain class warnings as used by the United States Food and Drug Administration, (2) to increase awareness of movement disorders that may occur in patients treated with antipsychotic medications, and (3) to understand why clinicians should refrain from immediately assuming a diagnosis of tardive dyskinesia/dystonia (TD) in patients who develop abnormal movements during treatment with antipsychotics. The first column in the series presented a patient who developed abnormal movements while being treated with aripiprazole as an augmentation strategy for major depressive disorder and reviewed data concerning the historical background, incidence, prevalence, and risk factors for tardive and spontaneous dyskinesias, the clinical presentations of which closely resemble each other. The second column in the series reviewed the unique mechanism of action of aripiprazole and reviewed preclinical studies and an early-phase human translational study that suggest a low, if not absent, risk of TD with aripiprazole. The third column in this series reviewed the registration trial data for aripiprazole across all of its indications and found a raw incidence of TD ranging from 0.004 (4 out of 987) in long-term studies of the drug as an augmentation strategy for major depressive disorder to 0.0016 (19 out of 11,897) based on all short-term (ie, weeks to <6 mo) and long-term (6 mo to 1 y) studies combined. This fourth column in the series reviews the "real-world" data on aripiprazole and assesses whether these data also support the conclusion that aripiprazole has a low to absent risk of causing TD. The "real-world" data consist of case reports from the medical literature and the United States Food and Drug Administration Adverse Event Reporting System (FAERS). We found 37 cases in the medical literature reporting what was termed TD in association with aripiprazole treatment as well as 27 case reports suggesting improvement in preexisting TD with aripiprazole treatment. On the basis of the case reports from the medical literature, the potential or raw incidence of TD during "real-world" treatment with aripiprazole was 0.0000062 (37 out of the 6 million individuals who had been treated with aripiprazole in the United States as of 2013 according to a report from Otsuka). A query of the FAERS yielded 312 cases of TD in which aripiprazole was the primary suspect. On the basis of the FAERS data and again assuming 6 million individuals exposed to aripiprazole, this yields a raw incidence of 0.000052 (312 out of 6 million) for TD in patients treated with aripiprazole. However, these estimates have limitations because they are based on anecdotal reports and pharmacovigilance data and, thus, the events themselves were not confirmed or verified in a systematic way. Further, the figure of 6 million people exposed to aripiprazole was based on data reported to the authors by the drug's manufacturer and only applies to exposure in the United States. The final column in this 5-part series will discuss the types of prohibitively expensive and logistically difficult studies that would be needed to determine whether a definitive causal relationship between aripiprazole and TD exists.

Word Salad Challenge

BRANDING OF FOOD BEGAN WITH the names of places or origin of shipping, as in Port or Yorkshire ham. Much later the names of trusted merchants or their family companies appeared on labels and in early advertising. Late in the nineteenth century, some companies began to use imaginary people and animals to advertise, virtual avatars sometimes based on living or cartoon models, while others were entirely invented. Today we take it for granted that food labels and advertising are populated by elves and leprechauns, rabbits and pink panthers, superheroes and puppets. Some characters, like the infamous Frito Bandito, are tightly tethered to a single line of products, while others have a great deal of mobility across entire brands. They are familiar faces in the media brandscape, known to most people in the United States, and they have spread around the globe as food processing has become increasingly globalized. How well do you know these famous marketing professionals? The first part of this quiz asks you to match each food with its imaginary spokes-entity. Some of the products are no longer sold and they may have had more than one fictional spokesperson. Just to make things more challenging, I have added a third column with the names of the companies that now own and control these characters. Finally, the fourth column has imaginary “birthdates,” when the character first began selling food. Extra credit: which of the original characters (the one on which the brandwasbased)wasburiedinPlainsboro,NewJersey,in1941?

Determining Whether a Definitive Causal Relationship Exists Between Aripiprazole and Tardive Dyskinesia and/or Dystonia in Patients With Major Depressive Disorder, Part 2: Preclinical and Early Phase Human Proof of Concept Studies.

This series of columns has 3 main goals: (1) to explain class warnings as used by the United States Food and Drug Administration, (2) to increase awareness of movement disorders that may occur in patients treated with antipsychotic medications, and (3) to understand why clinicians should refrain from immediately assuming a diagnosis of tardive dyskinesia/dystonia (TD) in patients treated with antipsychotics. The first column in this series began with the case of a 76-year-old man with major depressive disorder who developed orofacial dyskinesias while being treated with aripiprazole as an antidepressant augmentation strategy. It was alleged that a higher than intended dose of aripiprazole (ie, 20 mg/d for 2 wk followed by 10 mg/d for 4 wk instead of the intended dose of 2 mg/d) was the cause of the dyskinetic movements in this man, and the authors were asked to review the case and give their opinion. The principal basis for this theory of causation was the class warning about TD in the package insert for aripiprazole. The rationale for concluding aripiprazole caused TD in the 76-year-old man led to this series of columns about aripiprazole, its potential--if any--to cause TD, and the presence of a class warning about TD in its package insert. The central point is to illustrate why class warnings exist and their implications for practice. The first column in this series focused on the historical background, incidence, prevalence, risk factors, and clinical presentations of tardive and spontaneous dyskinesias and concluded with a discussion of diagnostic considerations explaining why clinicians should avoid making a diagnosis of TD until a thorough differential diagnosis has been considered. This second column in the series reviews the pharmacology of aripiprazole and the preclinical and phase I translational human studies that suggest aripiprazole should have a low to nonexistent risk of causing TD compared with other antipsychotics. The third column in the series will review the systematic clinical trial data and "real-world" data on TD and the use of aripiprazole as adjunctive treatment with antidepressants for major depressive disorder to see whether these data support the conclusion of a low to nonexistent relationship between aripiprazole treatment and the development of TD. The fourth and final column in the series will consider the type of study that would need to be performed to avoid a specific class warning, focusing on the TD class warning as an example and discussing why such studies are rarely done.

Correction

Correction