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

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

Compressive Object Tracking using Entangled Photons

We present a compressive sensing protocol that tracks a moving object by removing static components from a scene. The implementation is carried out on a ghost imaging scheme to minimize both the number of photons and the number of measurements required to form a quantum image of the tracked object. This procedure tracks an object at low light levels with fewer than 3% of the measurements required for a raster scan, permitting us to more effectively use the information content in each photon.Comment: 10 pages, 4 figure

An Experimental Approach to a Rapid Propulsion and Aeronautics Concepts Testbed

Modern aircraft design tools have limitations for predicting complex propulsion-airframe interactions. The demand for new tools and methods addressing these limitations is high based on the many recent Distributed Electric Propulsion (DEP) Vertical Take-Off and Landing (VTOL) concepts being developed for Urban Air Mobility (UAM) markets. We propose that low cost electronics and additive manufacturing can support the conceptual design of advanced autonomy-enabled concepts, by facilitating rapid prototyping for experimentally driven design cycles. This approach has the potential to reduce complex aircraft concept development costs, minimize unique risks associated with the conceptual design, and shorten development schedule by enabling the determination of many "unknown unknowns" earlier in the design process and providing verification of the results from aircraft design tools. A modular testbed was designed and built to evaluate this rapid design-build-test approach and to support aeronautics and autonomy research targeting UAM applications utilizing a complex, transitioning-VTOL aircraft configuration. The testbed is a modular wind tunnel and flight model. The testbed airframe is approximately 80% printed, with labor required for assembly. This paper describes the design process, fabrication process, ground testing, and initial wind tunnel structural and thermal loading of a proof-of-concept aircraft, the Langley Aerodrome 8 (LA-8)

Climate-smart solutions for Mali: Findings from implementing the Climate-Smart Agriculture Prioritization Framework

This info note summarizes findings of a pilot project aiming to develop a participatory framework to prioritize CSA practices and interventions to guide CSA investments in Mali. It was undertaken by researchers from the Malian Association of Awareness to Sustainable Development (AMEDD) and the International Center Tropical Agriculture (CIAT) as part of the CGIAR Research Program on Climate Change, Agriculture, and Food Security (CCAFS). Implementation was led by the Agency of Environment and Sustainable Development (AEDD) on behalf of the National Science-Policy dialogue platforms on Climate Change, Agriculture and Food Security (CCASA). Supported by the West Africa Regional Program, this research is part of a multi-region Prioritization project funded by CCAFS Flagship 1 on Climate-Smart Agricultural Practices

Compte-rendu synthétique de l’atelier «Priorisation d’investissement en Agriculture Intelligente face au Climat au Mali»

Le Programme de recherche du CGIAR sur le Changement Climatique, l’Agriculture et la Sécurité Alimentaire (CCAFS) a pour but principal de surmonter les menaces imposées par le changement climatique afin d’atteindre la sécurité alimentaire, d’améliorer les moyens de subsistances des agriculteurs et la gestion des ressources naturelles. Le programme régional Afrique de l’Ouest vise à identifier les partenariats, les opportunités et les obstacles à l'action, les mesures et les moyens de communication nécessaires pour maintenir et disséminer largement les cas de réussite, identifier les lacunes de connaissances et de capacités, et les réponses politiques possibles pour soutenir l'adaptation et l'atténuation au changement climatique. En effet, dans un pays comme le Mali, caractérisé par l’irrégularité de la pluviométrie et des années sèches récurrentes de plus en plus fréquentes affectant la productivité agricole, la prise en compte du changement climatique dans les politiques et stratégies de développement, en vue d’améliorer durablement les systèmes de production agricole s’impose. C’est partant de ces constats que l’Agriculture Intelligente face au Climat (Climate-Smart Agriculture) se présente comme une réponse innovante pour la réalisation des objectifs nationaux en matière de sécurité alimentaire et de développement durable. Ce concept prend en compte l’intégration des pratiques et technologies agricoles pour à la fois améliorer la production, augmenter la résilience et réduire les émissions de gaz à effet de serre quand cela est possible. L’un des premiers défis est donc l’identification et la promotion de ces pratiques, technologies et politiques durables et intelligentes face au climat, et pour cela il faut disposer d’outils de priorisation et d’analyse permettant d’estimer le cout/bénéfices du point de vue social, économique et environnemental

The Freshman, vol. 4, no. 8 [issue misnumbered]

The Freshman was a weekly, student newsletter issued on Mondays throughout the academic year. The newsletter included calendar notices, coverage of campus social events, lectures, and athletic teams. The intent of the publication was to create unity, a sense of community, and class spirit among first year students. The Class of 1937 run of The Freshman featured original cover art by sketch artist Jack Frost (John Edward Frost, 1915-1997), who was born in Eastport, Maine. He attended the University of Maine for only a single academic year before moving to Massachusetts to work for the Boston Herald. Frost later became a columnist and illustrator for the Boston Post

It's Harder to Splash on Soft Solids

Droplets splash when they impact dry, flat substrates above a critical velocity that depends on parameters such as droplet size, viscosity and air pressure. By imaging ethanol drops impacting silicone gels of different stiffnesses we show that substrate stiffness also affects the splashing threshold. Splashing is reduced or even eliminated: droplets on the softest substrates need over 70\% more kinetic energy to splash than they do on rigid substrates. We show that this is due to energy losses caused by deformations of soft substrates during the first few microseconds of impact. We find that solids with Young's moduli $\lesssim 100$kPa reduce splashing, in agreement with simple scaling arguments. Thus materials like soft gels and elastomers can be used as simple coatings for effective splash prevention. Soft substrates also serve as a useful system for testing splash-formation theories and sheet-ejection mechanisms, as they allow the characteristics of ejection sheets to be controlled independently of the bulk impact dynamics of droplets.Comment: 5 pages, 4 figure