Neurophysiology

Contains a report on a research project.National Institutes of Health (Grant NB-01865-05 and Grant MH-04737-03)Bell Telephone Laboratories, IncorporatedNational Science Foundation (Grant G-16526)National Aeronautics and Space Administration (Grant NsG-496)United States Air Force, Aeronautical Systems Division (Contract AF33(616)-7783)Teagle Foundation, IncorporatedNational Science Foundation (Grant G-16526

Critical appraisal and update on the clinical utility of agomelatine, a melatonergic agonist, for the treatment of major depressive disease in adults

This article describes the pharmacology of the novel atypical antidepressant drug agomelatine, critically reviews and evaluates its clinical use for the treatment of major depression, and suggests areas for further research. Agomelatine is a synthetic analog of the hormone melatonin. It stimulates the activity of melatonin MT1 and MT2 receptors and inhibits the activity of serotonin 5HT-2C receptor subtypes. Three acute trials demonstrated clinically modest, but statistically significant benefits over placebo. Three acute trials did not find agomelatine more effective than placebo. A meta-analysis of these six trials demonstrated a small, statistically significant, marginally clinically relevant difference between agomelatine and placebo. The only placebo-controlled study in elderly patients did not demonstrate a significant benefit for agomelatine. It was more effective than placebo in only one of two relapse prevention studies. Agomelatine was generally well tolerated compared to placebo. Its side-effect profile is different than and compares favorably to other antidepressant drugs. The overall tolerability of agomelatine in head-to-head comparisons was not substantially better than active drug comparators. Agomelatine is contraindicated in patients with impaired liver function and in patients taking drugs that potently inhibit CYP-1A2 metabolic enzymes. Because elevated liver enzymes are common, and there is a rare risk of more serious liver reactions, routine laboratory monitoring of liver function is recommended periodically throughout treatment. Agomelatine does not have clinically significant advantages compared to other antidepressant drugs, and it has certain limitations and disadvantages. Because of its unique pharmacology and relatively benign tolerability profile, however, it may be a useful alternative for patients who do not respond to or cannot tolerate other antidepressant drugs

Neurophysiology

Contains reports on two research projects.Bell Telephone Laboratories Incorporate

Treating Dual Diagnosis Patients: Challenges and Opportunities

The use and abuse of drugs and alcohol have recently gained greater attention both from the public and the medical profession. Despite increasing cognizance of its unfortunate consequences, substance use has become a more pervasive element of contemporary society. As substance abuse has come to affect more segments of the population, it is not surprising that this problem also has affected the mentally ill. Awareness of the mentally ill substance abuser has grown, although this population has not been well studied or well served by the mental health system. These dually diagnosed patients often are depicted as the square pegs of psychiatry, not quite fitting into the round hole of mental health treatment. The reason for this is clear. Because of the current structure of the mental health service delivery system, psychiatric and substance abuse services are provided almost exclusively by independent systems (1,2). As a result, those patients who are perhaps most in need of treatment are most likely to fall through the cracks of the system. Providing services for this group of patients represents a clinical and administrative challenge, which has not been adequately addressed by the psychiatric profession. In this paper, I suggest that psychiatrists can accept greater responsibility for working with the dually diagnosed, and that this responsibility could begin with the psychiatrist-in-training. Although the problem may be difficult to overcome, psychiatry is in a unique position to accept this responsibility, effect changes in the system, and have a positive impact on the lives of patients with dual diagnoses

Demonstrating Continuous Variable EPR Steering in spite of Finite Experimental Capabilities using Fano Steering Bounds

We show how one can demonstrate continuous-variable Einstein-Podolsky-Rosen (EPR) steering without needing to characterize entire measurement probability distributions. To do this, we develop a modified Fano inequality useful for discrete measurements of continuous variables, and use it to bound the conditional uncertainties in continuous-variable entropic EPR-steering inequalities. With these bounds, we show how one can hedge against experimental limitations including a finite detector size, dead space between pixels, and any such factors that impose an incomplete sampling of the true measurement probability distribution. Furthermore, we use experimental data from the position and momentum statistics of entangled photon pairs in parametric downconversion to show that this method is sufficiently sensitive for practical use.Comment: 7 pages, 2 figure

Neurophysiology

Contains reports on one research project.Bell Telephone Laboratories (Grant

Compressively characterizing high-dimensional entangled states with complementary, random filtering

The resources needed to conventionally characterize a quantum system are overwhelmingly large for high- dimensional systems. This obstacle may be overcome by abandoning traditional cornerstones of quantum measurement, such as general quantum states, strong projective measurement, and assumption-free characterization. Following this reasoning, we demonstrate an efficient technique for characterizing high-dimensional, spatial entanglement with one set of measurements. We recover sharp distributions with local, random filtering of the same ensemble in momentum followed by position---something the uncertainty principle forbids for projective measurements. Exploiting the expectation that entangled signals are highly correlated, we use fewer than 5,000 measurements to characterize a 65, 536-dimensional state. Finally, we use entropic inequalities to witness entanglement without a density matrix. Our method represents the sea change unfolding in quantum measurement where methods influenced by the information theory and signal-processing communities replace unscalable, brute-force techniques---a progression previously followed by classical sensing.Comment: 13 pages, 7 figure

Neurophysiology

Contains reports on two research projects.National Science Foundation (Grant GP-2495)Bell Telephone Laboratories, Inc.U. S. Air Force Cambridge Research Laboratories under Contract AF19(628)-4147The Teagle Foundation, Inc.National Aeronautics and Space Administration (Grant NsG-496)U. S. Air Force (Aeronautical Systems Division) under Contract AF 33(615)-1747National Institutes of Health (Grant MH-04737-04

Narrative support for young game designers’ writing

Creating narrative-based computer games is a complex and challenging task. Narrative Threads is a suite of software tools designed to aid young people (aged 11-15) in creating their own narrative-based games as a writing development activity. A participatory design process highlighted the areas where additional support was required, and informed the iterative design of Narrative Threads. The tools are implemented as a plugin to a commercial game creation toolset, and constitute character and object design tools, a branching narrative diagramming tool and an augmented story map view. In this paper, we provide an overview of the design of the tools and describe an evaluation carried out with 14 children over a four-day workshop. The study examined tool usage patterns, and compared games created with Narrative Threads to those created using the standard toolset. The results suggest a number of ways in which dynamic external representations of story elements can support writing activities in narrative-based game creation. Young designers using Narrative Threads wrote more character dialogue, made stronger links between the conversations they wrote and wider game events, and designed more complex characters, compared to those using the standard toolset. In addition to showing how Narrative Threads can support young games designers, the results have broader implications for anyone looking to support storytelling and writing through game creation activities and tools