Bistable polarization switching in mutually coupled vertical-cavity surface-emitting lasers

3 pages.-- OCIS codes: 250.5270, 260.5430.-- Final full-text version of the paper available at: http://dx.doi.org/10.1364/OL.31.000996.We theoretically investigate the polarization-resolved dynamics of two vertical-cavity surface-emitting semiconductor lasers that are mutually coupled through coherent optical injection. We find a sequence of bistable polarization switchings that can be induced by either changing the coupling strength or the optical propagation phase. The successive polarization switchings are correlated to the creation of new compound-cavity modes when these parameters are continuously varied.The authors acknowledge financial support from MEC (Spain) and Feder, project FIS2004-00953. JM is supported by the CSIC (Spain) through the program I3P-PC2003. MS acknowledges support from UIB (Spain)

Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial.

BACKGROUND: Dissociative seizures are paroxysmal events resembling epilepsy or syncope with characteristic features that allow them to be distinguished from other medical conditions. We aimed to compare the effectiveness of cognitive behavioural therapy (CBT) plus standardised medical care with standardised medical care alone for the reduction of dissociative seizure frequency. METHODS: In this pragmatic, parallel-arm, multicentre randomised controlled trial, we initially recruited participants at 27 neurology or epilepsy services in England, Scotland, and Wales. Adults (≥18 years) who had dissociative seizures in the previous 8 weeks and no epileptic seizures in the previous 12 months were subsequently randomly assigned (1:1) from 17 liaison or neuropsychiatry services following psychiatric assessment, to receive standardised medical care or CBT plus standardised medical care, using a web-based system. Randomisation was stratified by neuropsychiatry or liaison psychiatry recruitment site. The trial manager, chief investigator, all treating clinicians, and patients were aware of treatment allocation, but outcome data collectors and trial statisticians were unaware of treatment allocation. Patients were followed up 6 months and 12 months after randomisation. The primary outcome was monthly dissociative seizure frequency (ie, frequency in the previous 4 weeks) assessed at 12 months. Secondary outcomes assessed at 12 months were: seizure severity (intensity) and bothersomeness; longest period of seizure freedom in the previous 6 months; complete seizure freedom in the previous 3 months; a greater than 50% reduction in seizure frequency relative to baseline; changes in dissociative seizures (rated by others); health-related quality of life; psychosocial functioning; psychiatric symptoms, psychological distress, and somatic symptom burden; and clinical impression of improvement and satisfaction. p values and statistical significance for outcomes were reported without correction for multiple comparisons as per our protocol. Primary and secondary outcomes were assessed in the intention-to-treat population with multiple imputation for missing observations. This trial is registered with the International Standard Randomised Controlled Trial registry, ISRCTN05681227, and ClinicalTrials.gov, NCT02325544. FINDINGS: Between Jan 16, 2015, and May 31, 2017, we randomly assigned 368 patients to receive CBT plus standardised medical care (n=186) or standardised medical care alone (n=182); of whom 313 had primary outcome data at 12 months (156 [84%] of 186 patients in the CBT plus standardised medical care group and 157 [86%] of 182 patients in the standardised medical care group). At 12 months, no significant difference in monthly dissociative seizure frequency was identified between the groups (median 4 seizures [IQR 0-20] in the CBT plus standardised medical care group vs 7 seizures [1-35] in the standardised medical care group; estimated incidence rate ratio [IRR] 0·78 [95% CI 0·56-1·09]; p=0·144). Dissociative seizures were rated as less bothersome in the CBT plus standardised medical care group than the standardised medical care group (estimated mean difference -0·53 [95% CI -0·97 to -0·08]; p=0·020). The CBT plus standardised medical care group had a longer period of dissociative seizure freedom in the previous 6 months (estimated IRR 1·64 [95% CI 1·22 to 2·20]; p=0·001), reported better health-related quality of life on the EuroQoL-5 Dimensions-5 Level Health Today visual analogue scale (estimated mean difference 6·16 [95% CI 1·48 to 10·84]; p=0·010), less impairment in psychosocial functioning on the Work and Social Adjustment Scale (estimated mean difference -4·12 [95% CI -6·35 to -1·89]; p<0·001), less overall psychological distress than the standardised medical care group on the Clinical Outcomes in Routine Evaluation-10 scale (estimated mean difference -1·65 [95% CI -2·96 to -0·35]; p=0·013), and fewer somatic symptoms on the modified Patient Health Questionnaire-15 scale (estimated mean difference -1·67 [95% CI -2·90 to -0·44]; p=0·008). Clinical improvement at 12 months was greater in the CBT plus standardised medical care group than the standardised medical care alone group as reported by patients (estimated mean difference 0·66 [95% CI 0·26 to 1·04]; p=0·001) and by clinicians (estimated mean difference 0·47 [95% CI 0·21 to 0·73]; p<0·001), and the CBT plus standardised medical care group had greater satisfaction with treatment than did the standardised medical care group (estimated mean difference 0·90 [95% CI 0·48 to 1·31]; p<0·001). No significant differences in patient-reported seizure severity (estimated mean difference -0·11 [95% CI -0·50 to 0·29]; p=0·593) or seizure freedom in the last 3 months of the study (estimated odds ratio [OR] 1·77 [95% CI 0·93 to 3·37]; p=0·083) were identified between the groups. Furthermore, no significant differences were identified in the proportion of patients who had a more than 50% reduction in dissociative seizure frequency compared with baseline (OR 1·27 [95% CI 0·80 to 2·02]; p=0·313). Additionally, the 12-item Short Form survey-version 2 scores (estimated mean difference for the Physical Component Summary score 1·78 [95% CI -0·37 to 3·92]; p=0·105; estimated mean difference for the Mental Component Summary score 2·22 [95% CI -0·30 to 4·75]; p=0·084), the Generalised Anxiety Disorder-7 scale score (estimated mean difference -1·09 [95% CI -2·27 to 0·09]; p=0·069), and the Patient Health Questionnaire-9 scale depression score (estimated mean difference -1·10 [95% CI -2·41 to 0·21]; p=0·099) did not differ significantly between groups. Changes in dissociative seizures (rated by others) could not be assessed due to insufficient data. During the 12-month period, the number of adverse events was similar between the groups: 57 (31%) of 186 participants in the CBT plus standardised medical care group reported 97 adverse events and 53 (29%) of 182 participants in the standardised medical care group reported 79 adverse events. INTERPRETATION: CBT plus standardised medical care had no statistically significant advantage compared with standardised medical care alone for the reduction of monthly seizures. However, improvements were observed in a number of clinically relevant secondary outcomes following CBT plus standardised medical care when compared with standardised medical care alone. Thus, adults with dissociative seizures might benefit from the addition of dissociative seizure-specific CBT to specialist care from neurologists and psychiatrists. Future work is needed to identify patients who would benefit most from a dissociative seizure-specific CBT approach. FUNDING: National Institute for Health Research, Health Technology Assessment programme

Characteristics of 698 patients with dissociative seizures: A UK multicenter study

Objective We aimed to characterize the demographics of adults with dissociative (nonepileptic) seizures, placing emphasis on distribution of age at onset, male:female ratio, levels of deprivation, and dissociative seizure semiology. Methods We collected demographic and clinical data from 698 adults with dissociative seizures recruited to the screening phase of the CODES (Cognitive Behavioural Therapy vs Standardised Medical Care for Adults With Dissociative Non‐Epileptic Seizures) trial from 27 neurology/specialist epilepsy clinics in the UK. We described the cohort in terms of age, age at onset of dissociative seizures, duration of seizure disorder, level of socioeconomic deprivation, and other social and clinical demographic characteristics and their associations. Results In what is, to date, the largest study of adults with dissociative seizures, the overall modal age at dissociative seizure onset was 19 years; median age at onset was 28 years. Although 74% of the sample was female, importantly the male:female ratio varied with age at onset, with 77% of female but only 59% of male participants developing dissociative seizures by the age of 40 years. The frequency of self‐reported previous epilepsy was 27%; nearly half of these epilepsy diagnoses were retrospectively considered erroneous by clinicians. Patients with predominantly hyperkinetic dissociative seizures had a shorter disorder duration prior to diagnosis in this study than patients with hypokinetic seizures (P < .001); dissociative seizure type was not associated with gender. Predominantly hyperkinetic seizures were most commonly seen in patients with symptom onset in their late teens. Thirty percent of the sample reported taking antiepileptic drugs; this was more common in men. More than 50% of the sample lived in areas characterized by the highest levels of deprivation, and more than two‐thirds were unemployed. Significance Females with dissociative seizures were more common at all ages, whereas the proportion of males increased with age at onset. This disorder was associated with socioeconomic deprivation. Those with hypokinetic dissociative seizures may be at risk for delayed diagnosis and treatment

Characteristics of 698 patients with dissociative seizures: A UK multicenter study

Objective We aimed to characterize the demographics of adults with dissociative (nonepileptic) seizures, placing emphasis on distribution of age at onset, male:female ratio, levels of deprivation, and dissociative seizure semiology. Methods We collected demographic and clinical data from 698 adults with dissociative seizures recruited to the screening phase of the CODES (Cognitive Behavioural Therapy vs Standardised Medical Care for Adults With Dissociative Non‐Epileptic Seizures) trial from 27 neurology/specialist epilepsy clinics in the UK. We described the cohort in terms of age, age at onset of dissociative seizures, duration of seizure disorder, level of socioeconomic deprivation, and other social and clinical demographic characteristics and their associations. Results In what is, to date, the largest study of adults with dissociative seizures, the overall modal age at dissociative seizure onset was 19 years; median age at onset was 28 years. Although 74% of the sample was female, importantly the male:female ratio varied with age at onset, with 77% of female but only 59% of male participants developing dissociative seizures by the age of 40 years. The frequency of self‐reported previous epilepsy was 27%; nearly half of these epilepsy diagnoses were retrospectively considered erroneous by clinicians. Patients with predominantly hyperkinetic dissociative seizures had a shorter disorder duration prior to diagnosis in this study than patients with hypokinetic seizures (P < .001); dissociative seizure type was not associated with gender. Predominantly hyperkinetic seizures were most commonly seen in patients with symptom onset in their late teens. Thirty percent of the sample reported taking antiepileptic drugs; this was more common in men. More than 50% of the sample lived in areas characterized by the highest levels of deprivation, and more than two‐thirds were unemployed. Significance Females with dissociative seizures were more common at all ages, whereas the proportion of males increased with age at onset. This disorder was associated with socioeconomic deprivation. Those with hypokinetic dissociative seizures may be at risk for delayed diagnosis and treatment

La incidencia de las ONG ́s en la definición de políticas educativas

El presente trabajo surge a partir de una inquietud respecto del nuevo rol adquirido por las Organizaciones No Gubernamentales (ONG´s) en Argentina en las dos últimas décadas, y por su creciente influencia en el diseño e implementación de las políticas públicas, más específicamente, de las políticas educativas.\n El protagonismo alcanzado por estas organizaciones desde el retorno de la democracia en 1983 resulta hoy sorprendente. Las ONG´s lograron establecer una nueva relación con el Estado, los organismos internacionales de financiamiento y el sector empresario, que les permitió posicionarse como nuevas voces “autorizadas” capaces de incorporar nuevos temas a la agenda pública, crear espacios de deliberación sobre los asuntos que ellas consideran de interés común, y generar nuevos valores que guíen los proyectos y políticas. El peso cada vez mayor que fueron adquiriendo en la construcción de las agendas educativas les permitió incluso ser contratadas por los sucesivos gobiernos para llevar a cabo la gestión de ciertos programas.\n En este escenario, los ciudadanos han quedado atrapados en una doble encrucijada: ¿Acaso esta nueva práctica amplía su participación en las políticas públicas o, por el contrario, favorece a un reducido sector de la sociedad? ¿Qué tipo de políticas están proponiendo estas organizaciones? ¿A qué sectores de la sociedad representan? ¿Quiénes financian sus proyectos? ¿Hasta dónde llega su participación en las decisiones que nos involucran a todos? ¿Quién legitima esa incidencia en las políticas públicas? ¿Rinden cuentas a la sociedad acerca de su trabajo y el manejo de sus recursos?\n Partiendo de esta serie de preguntas, el objetivo de la presente investigación será analizar qué tipo de agenda de política educativa construyen las ONG´s con sede en la Ciudad de Buenos Aires que se proponen contribuir a orientar la política pública en esa área, qué temáticas priorizan en relación a la educación actual, desde qué perspectiva plantean los problemas y posibles soluciones y qué propuestas formulan para su mejora.\n Para ello, hemos seleccionado 6 organizaciones que consideramos son aquellas que en los últimos años han adquirido mayor visibilidad en ese campo, a saber: Fundación de Investigaciones Económicas Latinoamericanas (FIEL), Fundación Gobierno y Sociedad, Grupo Sophía, Centro de Implementación de Políticas Públicas Para la Equidad y el Crecimiento (CIPPEC), Asociación Cristiana De Empresas (ACDE) y Fundación SES (Sustentabilidad–Educación–Solidaridad).\n La metodología utilizada para llevar a cabo esta investigación se basó en un análisis discursivo de la información que cada ONG brinda de sí misma a través de su página web, y de las publicaciones y documentos de trabajo que publica en relación a la cuestión educativa.\n Para encarar este trabajo, hemos partido de la hipótesis de que las ONG´s se promueven como organizaciones capaces de ofrecer las mejores soluciones para remediar la crisis educativa actual y para diseñar e implementar las políticas educativas “más efectivas”.\n En las páginas que siguen hemos proyectado el siguiente recorrido: en el primer capítulo, presentaremos un breve marco histórico que de cuenta de las diferentes políticas llevadas a cabo en el campo educativo desde la caída del Estado de Bienestar hasta la actualidad, y tomaremos la Reforma Neoliberal como punto de partida para el análisis. En el segundo capítulo, estudiaremos el surgimiento y la importancia de las ONG´s como nuevos actores en nuestro país, y analizaremos su relación con el Estado, los organismos multilaterales de financiamiento, las empresas y la sociedad civil, y nos detendremos a puntualizar cuáles son las formas en que se produce su incidencia en las políticas públicas. En el tercer capítulo, haremos un análisis discursivo del material publicado por las áreas de educación de cada una de las ONG´s seleccionadas, así como de la información que brindan de sí mismas a través de sus páginas web.Fil: Cikurel, Magalí. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Buenos Aires, Argentin

Threshold electrotonus and ion channel dysfunction in motor neurone disease

SIGLEAvailable from British Library Document Supply Centre- DSC:DXN055745 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

How does investors’ perceived ease of information access affect their investment judgments?

By manipulating the perceived ease of information access through use of a search engine, I provide experimental evidence that investors are more likely to rely on information gist and use shallow processing after using an online search engine to access a firm’s financial information. Results show that investors using a search engine to access a company’s financial information were more likely to invest in a company with a higher likelihood of real earnings management (REM) than a company with the same net income but a lower likelihood of REM. On the other hand, investors who did not use a search engine were more likely to invest in the lower likelihood of REM company. Furthermore, investors who accessed financial information via a search engine judged the financial information more easily available, were more likely to reopen the financial information, and scored lower on the retention test. The study contributes to the accounting literature by showing that technologies that increase perceived ease of information access change how investors process and use financial information.U of I OnlyAuthor requested U of Illinois access only (OA after 2yrs) in Vireo ETD syste

Pilot Study of Intravenous Immunoglobulin in HIV-Associated Myelopathy

There is no effective treatment for HIV-associated myelopathy (HIVM). The introduction of highly active antiretroviral therapy (HAART) has made little difference to its natural history. Spinal cord pathology reveals vacuolization and inflammation. Intravenous immunoglobulin (IVIg) is used successfully in a number of inflammatory conditions associated with HIV. In view of the potential for reversibility of the inflammatory response in HIVM, we treated 17 patients with IVIg twice over a 56-day study period. There was improvement in composite Medical Research Council (MRC) strength scores 28 days following the first infusion (increase in score: 3.94; p = 0.021). The second infusion did not produce further improvement, however there was little reduction from peak strength. These pilot data suggest that further investigation of the use of IVIg in HIVM is warranted