Treatment algorithm use to optimize management of symptomatic patients with a history of mania

BACKGROUND: While monotherapy has significant limitations in bipolar disorder, few published data addressing alternatives exist. Treatment algorithms have been proposed, but none have undergone empirical evaluation. This study provides a systematic prospective, open evaluation of the effectiveness and tolerability of a treatment algorithm for patients with histories of mania. METHOD: Twenty-eight symptomatic outpatients from a public mental health facility who were diagnosed as having either bipolar I or schizoaffective illness, bipolar type, entered the study. Minimum blood levels of lithium and divalproex sodium were defined. Medications were pushed to predetermined levels (as tolerated) before proceeding to the next algorithm step. Clinical symptoms were assessed monthly using the Brief Psychiatric Rating Scale (BPRS, 27 item) and Clinical Global Impressions scale. RESULTS: Pretreatment and posttreatment clinical symptoms were compared. Over 50% of patients attained 30% improvement from baseline BPRS after 4 months. Thirty-six percent of patients (N = 10) became mood stable, 46% (N = 13) remained mood unstable, and 18% (N = 5) dropped out before completing the algorithm. Although patients who finished the algorithm were taking more medication, either dosage and/or drugs, somatic complaints did not increase. CONCLUSION: The potential benefit of a defined treatment algorithm was demonstrated for these complex and persistently ill patients. Despite long treatment histories, patients improved with more frequent visits and addition of medication(s). A randomized controlled trial comparing a similar treatment algorithm with treatment-as-usual is warranted.     

Preparation and characterization of lanthanum silicon nitride

Lanthanum silicon nitride (LaSi₃N₅) powder has been prepared under the relatively mild conditions of 1400 ° C and 1 atm nitrogen. Chemical, X-ray diffraction, solid state nuclear magnetic resonance spectra and morphological information on this powder is presented. The X-ray diffraction data and previously published information have been used to develop a more complete specification of the unit cell dimensions.²⁹Si magic-angle spinning nuclear magnetic resonance spectra of LaSi₃N₅ show two chemical shifts at –64.5 and –56.5 p.p.m. These shifts reflect two electronically different types of silicon which have been attributed to the effects of quadrupolar¹³⁹La nuclei and their spatial arrangements around silicon atoms.     

Rheological studies on a slurry biofuel to aid in evaluating its suitability as a fuel

Biomass is an often abundant, renewable, low ash and low sulfur fuel. Due to these properties, biofuels are promising alternatives for traditional petroleum-based fuel applications; however, traditional biofuels for internal combustion engines are not cost competitive with gasoline, diesel or fuel oils. One method to reduce the cost of biofuels is to use slurry fuels which have a potential lower cost than liquid biofuels due to high conversion efficiencies. Slurry biofuels, such as a mixture of corn and water, could provide a biofuel alternative for diesel engines, pressurized gasifiers and heating oil applications such as burners or gas turbines. Use of these biomass slurries poses important questions about their stability and suitability for practical applications in internal combustion engines and combustors.This work reports rheology data for stable corn-starch water slurries (CSWS) which used a polyacrylic acid thickener to eliminate settling of the slurry and to provide desirable shear-thinning behavior for most of the compositions evaluated. The effect of shear rate on the viscosity of the CSWS was studied using a BOHLIN-controlled stress (CS) rheometer. The well-known Ostwald—de Waele power law and Sisko models for viscosity fit the data. The effect of corn starch content, thickener content and temperature on the viscosity of CSWS was also studied. The favorable shear thinning properties were observed for starch contents up to 45% starch and should aid pumping, injection and spraying. The lower heating values of the slurries, however, are undesirably low.     

3-D molecular assembly of function in titania-based composite material systems

Various examples of composite titania-based nanostructured materials exhibiting cooperative functionalities between different active components are presented. The fabrication of these integrated composite materials is based on one-pot supramolecular templating techniques combined with acidic sol-gel chemistry. The defined 3-D nanoscale organization and integration of various functional components results in advanced optoelectronic and photonic applications such as visible light sensitization of mesoporous titania photocatalysts with cadmium sulfide nanocrystals acting as sensitizing integral part of the mesopore wall structure, narrow bandwidth emission from rare earth ion activated nanocrystalline mesoporous titania films, and mirrorless lasing in dye-doped hybrid organic/inorganic mesostructured titania waveguides.     

A spline framework for estimating the EEG surface laplacian using the Euclidean metric

This letter develops a framework for EEG analysis and similar applications based on polyharmonic splines. This development overcomes a basic problem with the method of splines in the Euclidean setting: that it does not work on low-degree algebraic surfaces such as spherical and ellipsoidal scalp models. The method's capability is illustrated through simulations on the three-sphere model and using empirical data.     

Emotionally charged earcons reveal affective congruency effects

In the present study, the affective impact of earcons on stimulus classification is investigated. We show, using a picture-categorization task, that the affective connotation of earcons in major and minor mode (representing positive and negative valence, respectively) can be congruent or incongruent with response valence. Twenty participants classified pictures of animals and instruments in 256 trials, using positive and negative Yes or No responses. Together with the pictures, either a chord in major mode or minor mode was played. The affective valence of the chords either did or did not match the valence of responses. Response-time latencies show congruency effects of the matching and non matching sound and response valences, indicating that it is important to carefully investigate human-computer interfaces for potential affective congruency effects, as these can either facilitate or inhibit user performance.     

Qualitative Axioms of Uncertainty as a Foundation for Probability and Decision-Making

Although the concept of uncertainty is as old as Epicurus’s writings, and an excellent quantitative theory, with entropy as the measure of uncertainty having been developed in recent times, there has been little exploration of the qualitative theory. The purpose of the present paper is to give a qualitative axiomatization of uncertainty, in the spirit of the many studies of qualitative comparative probability. The qualitative axioms are fundamentally about the uncertainty of a partition of the probability space of events. Of course, it is common to speak of the uncertainty, or randomness, of a random variable, but only the partition defined by the values of the random variable enter into the definition of uncertainty, not the actual values. It is straightforward to add axioms for decision making following the general line of Savage from the 1950s. Indeed, in the spirit of Epicurus, it is really our intuitive feeling about the uncertainty of the future that motivates much of our thinking about decisions. Here, the distinction between the concepts of probability and uncertainty can be made by citing many familiar examples. Without spelling out the technical details, the axiomatization of qualitative probability with uncertainty as the most important primitive concept, it is possible to raise a different kind of question about bounded rationality. This new question is whether or not one should bound the uncertainty in thinking and investigating any detailed framework of decision making. Discussion of this point is certainly different from the question of bounding rationality by not maximizing expected utility. In practice, we naturally bound uncertainty in our analysis of decision-making problems. As in the case of formulating an alternative for maximizing expected utility, so is the case of rational alternatives to maximizing uncertainty. There are several issues to consider. In the spirit of my other work in qualitative probability, I explore alternatives rather than attempt to give a definitive argument for one single solution.     

Density modeling of polyurethane box foam

A model based on about a dozen fundamental differential equations is used to evaluate and simulate the urethane reactions and physical processes of urethane box foaming. This work focuses on quantitative modeling of foam density for foams using water and physical blowing agents. The final densities of foams range from 30 to 90% of the density as projected with full utilization of the blowing agent. The primary sources of inefficient use of blowing agent are loss of the physical blowing during open‐air mixing and degassing—basically, physical blowing agents with boiling points between 25 and 80°C will evaporate and experience cell rupture in box foams. This loss of blowing agent would not apply to in‐line mixers used for commercial production and should be taken into account with scaling up box or cup foams commercial processes. POLYM. ENG. SCI., 54:1503–1511, 2014. © 2013 Society of Plastics Engineers