A comparison of placebo response with major depressive disorder in patients recruited through newspaper advertising versus consultation referrals

Recent evidence indicates few differences between patients recruited through advertising and by consultation referral, and there is some suggestion that those recruited through advertising are more representative of the target community population. However little has been reported on differences in placebo response and compliance in these two patient groups. We conducted a retrospective chart review of 49 patients with major depressive disorder (MDD), recruited through advertising or consultation, randomized to placebo in five clinical trials. Variables included demographics, clinical history, efficacy, compliance, and completion data. Homogeneity was demonstrated for most variables. Differences in placebo groups included significantly lower Hamilton Rating Scale for Depression (HAM-D) scores for the advertisement group throughout the trials. Advertisement patients were also more likely to be early placebo responders and in remission at Days 14 and 28. No differences were found in completion rates or reasons for early termination. Compliance was excellent for both groups. Early placebo response of the advertisement group reinforces the need for trials of at least 8 weeks. In addition, consultation patients may have a more severe illness and be treatment resistant, suggesting they are less generalizable to community practice populations.     

2 cm long monolithic multisection laser for active modelocking at 2.2 GHz

A 2 cm long three-contact multisection laser has been fabricated for modelocking at very low repetition rates. Active modelocking yields 8.0-12.3 ps pulses at 2.2, 4.3 and 6.5 GHz corresponding to the fundamental, first, and second harmonics of the cavity resonance frequency. This device demonstrates the feasibility of fabricating monolithic pulse sources operating at rates as low as the OC-48 Sonet transmission rate (2.488 Gbit/s).<>     

Professional integrity in clinical research

In response to public concern over abuses in human medical experimentation, the dominant approach to the ethics of clinical research during the past 30 years has been regulation, particularly via institutional review board review and approval of scientific protocols and written consent forms. However, the effectiveness of regulatory mechanisms in ensuring the ethical conduct of clinical research is limited. Little attention has been devoted to the nature and role of professional integrity of physician investigators, a conscientious framework for guiding investigators in the socially important but morally complex activity of clinical research. Professional integrity is vital in forging an ethically sound relationship between investigators and patient volunteers, a relationship that differs in important ways from the patient-physician relationship in standard clinical practice. We examine critically 2 models of the moral identity of physician investigators, the investigator as clinician and the investigator as scientist; in neither of these 2 models can the physician investigator eliminate completely the moral conflicts posed by clinical research. The professional integrity of physician investigators depends on a coherent moral identity that is proper to the enterprise of clinical research. The roles of clinician and scientist must be integrated to manage conscientiously the ethical complexity, ambiguity, and tensions between the potentially competing loyalties of science and care of volunteer patients.     

A formant bandwidth estimation procedure for vowel synthesis [43.72.Ja]

The specification of vowel formant bandwidths for speech synthesis has been inconsistent in the past, perhaps due to the difficulty of measuring formant bandwidths in natural speech and the possible perceptual insignificance of formant bandwidths on the intelligibility of synthetic speech. Here, regression equations are presented for the estimation of formant bandwidths based on measurements from natural speech which is based only on formant center frequency and independent of other formant values. Current usage, as well as comparison with another well-known estimation algorithm suggests that the new procedure should be quite acceptable for some types of speech synthesis.     

Renewable energy in competitive electricity markets

A restructured electricity system may undervalue renewable energy. We remain wary of unregulated markets, but urge the renewable energy community to begin considering how they could adapt to increasing customer choice.     

Temperature and modulation characteristics of resonant-cavitylight-emitting diodes

Resonant-cavity light-emitting diodes (RCLED) are novel, high-efficiency light-emitting diodes which employ optical microcavities. These diodes have higher intensities and higher spectral purity as compared to conventional LEDs. Analytical formulas are derived for the enhancement of the spontaneous emission along the optical axis of the cavity. The design rules for high-efficiency operation of RCLEDs are established. The temperature dependence of the emission intensity is analyzed in the range 20-80° and it is described by an exponential dependence with a characteristic temperature of 112 K. The modulation characteristics of RCLEDs exhibit 3 dB frequencies of 580 MHz. Eye diagrams at transmission rates of 622 Mb/s are wide open indicating the suitability of RCLEDs for high-speed data transmission     

Polarisation insensitive semiconductor optical amplifier withintegrated electroabsorption modulators

The authors demonstrate a 1.55 μm wavelength multiquantum well semiconductor optical amplifier, integrated with bulk layer electroabsorption modulators and passive waveguide beam expanders at the input and output ports. The device has a fibre to fibre gain of 9 dB, an extinction ratio of 15 dB per modulator, a spectral range >35 nm, and polarisation sensitivity <1 dB     

A 16-Kbit Θ-search associative memory

The design of a high-capacity Θ-search associative memory (Θ∈{<,>,⩽,⩾,=≠}) is presented. PSPICE simulation and layouts show that the proposed Θ-search associative memory chip consisting of 256 words, each 64-b long, can fit on a 13.5-mm×9.5-mm chip. It can perform maskable Θ-search operations over its contents in 110 ns     

Adaptive detection of DS/CDMA signals in fading channels

This paper examines the behavior of the minimum mean-squared error (MMSE) receiver in frequency-nonselective-fading channels. It is noted that the MMSE receiver will often lose phase lock on the desired signal when the desired signal dips into a deep fade. A modification to the MMSE receiver is presented which is demonstrated to function quite nicely in flat-fading channels. Analytical results for the modified MMSE receiver are presented and found to agree very well with simulation results. These analytical results are then compared to the theoretical performance of the conventional (i.e., correlator) receiver in terms of both bit-error rate (BER) and capacity. As expected, the modified MMSE receiver was found to offer a substantial improvement in both BER and capacity. Finally, a simple empirically derived formula is given which will give a good approximation to the BER of the modified MMSE receiver in a Rayleigh-fading environment. This formula can also be used to determine the number of users a given system can support. It is noted that as E_b/N₀ grows, it is quite feasible to approach 100% channel utilization with the MMSE receiver, whereas a conventional receiver is typically limited to a utilization of 10%-20%     

Psychopharmacotherapy for addictive and comorbid disorders: current studies

Proper diagnosis of comorbid disorders is crucial in treatment planning for the dually diagnosed. Since psychoactive substance use can obfuscate the diagnosis, special care must be taken to exclude organically based syndromes. Adequate periods of abstinence should first be achieved and subsequently the patient re-examined for residual symptoms compatible with a nonaddictive, nonsubstance-induced psychiatric disorder. The integration of concurrent treatment of both the mental and the addictive disorders appears to be the best approach for treatment of comorbid psychiatric and addictive disorders. An abstinence-based model that typically utilizes a 12-step group therapy is often employed for the addictive illnesses. Other forms of psychosocial therapies such as case managers are being used as well. Presently, physicians' prescribing practices for comorbid addicted patients are based on traditional approaches to use of medications in psychiatric patients, and their attitudes towards addictive disorders may play a significant role in determining the overall success of treatment.