Department of Fundamental and Applied Sciences for Engineering, Sapienza Università di Roma via A. Scarpa 16, 00161 Roma Italy
Many technologies we use are inspired by nature. This happens in different domains, ranging from mechanics to optics to computer sciences. Nature has incredible potentialities that man still does not know or that he striving to learn through experience. These potentialities concern the ability to solve complex problems through approaches of various types of distributed intelligence. In fact, there are forms of intelligence in nature that differ from that of man, but are nevertheless exceedingly efficient. Man has often used as a model those forms of distributed intelligence that allow colonies of animals to develop places of housing or collective behaviors of extreme complexity. Recently, M. Alonzo et alii (Sci.Rep. 8, 5716 (2018)) published a hardware implementation to solve complex routing problems in modern information networks by exploiting the immense possibilities offered by light. This article presents an addressable photonic circuit based on the decision-making processes of ant colonies looking for food. When ants search for food, they modify their surroundings by leaving traces of pheromone, which may be reinforced and function as a type of path marker for when food has been found. This process is based on stigmergy, or the modification of the environment to implement distributed decision-making processes. The photonic hardware implementation that this work proposes is a photonic X-junction that simulates this stigmergic procedure. The experimental implementation is based on the use of non-linear substrates, i.e. materials that can be modified by light, simulating the modification induced by the ants on the surrounding environment when they leave the pheromone traces. Here, two laser beams generate two crossing channels in which the index of refraction is increased with respect to the whole substrate. These channels act as integrated waveguides (almost self-written optical fibers) within which optical information can be propagated (as happens for the ants that follow traces of pheromone already “written”). The proposed device is a X-junction with two crossing waveguides, whose refractive index contrast is defined by the intensities of the writing light beams. The higher the writing intensity, the greater the induced index variation, as if it were an increasingly intense pheromone trace. The information will follow the most contrasted harm of the junction, which is driven and eventually switched by the writing light intensity. Any optical information that will be sent to the device will follow the most intense trace, i.e. the most contrasted waveguide. The paper demonstrates a device that can be wholly operated using the light and that can be the basis of complex hardware configurations that might reproduce the stigmergic distributed intelligence. This is a highly significant innovation in the field of electronic and photonic technologies, within which artificial cognition and decision processes are implemented into a hardware circuit and not in a software code.DOI: 10.29245/2578-2959/2018/5.1156 View / Download Pdf View Full Text
M. Fernández Rodríguez1,2*, M. Menéndez Granda3, Villaverde González4
1Mental Health Center I “La Magdalena” University Hospital San Agustín de Avilés. Health Area III, Asturias, Spain
2Gender Identity Treatment Unit of Principality of Asturias (UTIGPA), Spain
3Master of General Health Psychology, University of Oviedo, Asturias, Spain
4Intern Resident Psychologist, University Hospital San Agustín Avilés. Health Area III Asturias, Spain
The aim of this article is to highlight the historical path of transsexualism diagnosis since its inclusion to its elimination from the catalogue of mental disorders. We analyse the terminological changes that may account for this phenomenon in order to depathologise and just as the controversies raised by its location in the new Manual of International Statistical Classification of Diseases and Related Health Problems ICD-11.
ICD-11 drives out the term "Transsexualism" and replaces it with the term "Gender Incongruence" (GI). This new terminology will no longer be part of the chapter on mental disorders (Chapter 6) but a new chapter (Chapter 17) entitled "Conditions relating to sexual health" is created. These changes of ICD-11 represent a breakthrough and a great sense of freedom for trans people, since WHO has included the different variants of gender in normality by not being considered a mental disorder.
The aim of this paper is to highlight the historical development of the diagnosis of transsexualism from its inclusion to the elimination of the chapter of mental disorders. Terminological changes that can best reflect this phenomenon to depathologize and the controversies raised by its location in the new manual of ICD-11 are analyzed.DOI: 10.29245/2578-2959/2018/5.1157 View / Download Pdf View Full Text
Apostolos P. Georgopoulos1,2,3,4,5*, Lisa M. James1,2,3,4, Peka Christova1,2,3, Brian E. Engdahl1,2,3,6
1 Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
2 Department of Neuroscience, University of Minnesota Medical School, Minneapolis, Minnesota, USA
3 Center for Cognitive Sciences, University of Minnesota, Minneapolis, Minnesota, USA
4 Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
5 Department of Neurology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
6 Department of Psychology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
Posttraumatic stress disorder (PTSD) is a debilitating disorder that can develop following exposure to a traumatic event. Although the cause of PTSD is known, the brain mechanisms of its development remain unknown, especially why it arises in some people but not in others. Most of the research on PTSD has dealt with psychological and brain mechanisms underlying its symptomatology, including intrusive memories, fear and avoidance (see ref.1 for a broad coverage of PTSD research)1. Here we focus, instead, on the origin of PTSD, namely on the neural mechanisms underlying its development. Specifically, we propose a two-hit model for PTSD development, with the following components. (a) The 1st hit is a neuroimmune challenge, as a preexisting condition, and the 2nd hit is intense glutamatergic neurotransmission, induced by the traumatic event; (b) the key molecule that mediates the effects of these two hits is intercellular adhesion molecule 5 (ICAM-5) which was found to be differentially expressed in PTSD2. ICAM-5 is activated by neuroimmune challenge3,4 and glutamatergic neurotransmission5,6, it further enhances glutamatergic transmission6, and exerts a potent effect on synapse formation and neural plasticity, in addition to immunoregulatory functions3,4,7; and (c) with respect to the neural network(s) involved, the brain areas most involved are medial temporal cortical areas, and interconnected cortical and subcortical areas8-10. We hypothesize that the net result of intense glutamatergic transmission in those areas induced by a traumatic event in the presence of ongoing neuroimmune challenge leads to increased levels of ICAM-5 which further enhances glutamatergic transmission and thus leads to a state of a neural network with highly correlated neural interactions, as has been observed in functional neuroimaging studies8-10. We assume that such a “locked-in” network underlies the intrusive re-experiencing in PTSD and maintains associated symptomatology, such as fear and avoidance.DOI: 10.29245/2578-2959/2018/5.1165 View / Download Pdf View Full Text
DOI: 10.29245/2578-2959/2018/5.1166 View / Download Pdf View Full Text
Rebecca Grzadzinski1,2*, Catherine Lord3
1University of North Carolina at Chapel Hill (UNC), Chapel Hill, NC, USA
2Carolina Institute for Developmental Disabilities, Carrboro, NC, USA
3University of California at Los Angeles (UCLA), Los Angeles, CA, USA
DOI: 10.29245/2578-2959/2018/5.1169 View / Download Pdf View Full Text
E. Ahnemark1*, M. Di Schiena2, A.-C. Fredman2,8, E. Medin3,4, J. K. Söderling5, Y. Ginsberg6,7
1Shire, Vasagatan 7, SE-111 20 Stockholm, Sweden
2Prima Child and Adult Psychiatry AB, Stockholm, Sweden
3PAREXEL International, Stockholm, Sweden
4Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
5Bell Analytics, Stockholm, Sweden
6Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
7Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Stockholm, Sweden
8Psychiatry Centre, Stockholm County Council, Södertälje, Sweden
Priyanka Patil, Thomas L. Schwartz*
Dept of Psychiatry, SUNY Upstate Medical University, Syracuse, New York
Background: The standard of care for schizophrenia treatment is the class of medications called the second generation antipsychotics (SGA). However, response rates of schizophrenia to SGA are far from ideal, and approximately one third of patients are likely to need high dosing, polypharmacy or switching of antipsychotics. To do this safely, clinicians’ knowledge of SGA pharmacodynamics, pharmacokinetics, therapeutic drug monitoring (TDM) levels, as well as, dose equivalency is imperative.
• To review standard dosing, pharmacokinetic, and pharmacodynamic properties of the SGA.
• To further review the use of high, or “super-dosing”, of SGA.
• To investigate the clinical importance of monitoring drug levels for SGA.
• To describe possible SGA dose equivalency.
Materials and Methods: A Medline, PubMed (including observational studies, randomized controlled trials, meta-analyses, and systematic reviews) and textbook review was conducted without any date or language restriction. Each SGA (risperidone, paliperidone, lurasidone, ziprasidone, iloperidone, olanzapine, quetiapine, asenapine, aripiprazole, brexpiprazole and cariprazine) was searched and cross referenced with higher dosing, TDM, pharmacodynamics and pharmacokinetics. All possible studies were included. This paper focused on schizophrenia and use of SGA by oral route. Clozapine was excluded. Although it is an SGA, its properties and efficacy are different enough from other SGA and were felt beyond the scope of this current paper.
Discussion: A discussion of the concepts of pharmacokinetic failure, pharmacodynamic failure, Therapeutic Drug Monitoring, SGA dosing equivalencies and super dosing of SGA monotherapies is presented. SGA have pharmacodynamic and pharmacokinetic profiles which are distinctive and lead to unique side-effect profiles, drug-drug interactions, and clinical effects. For example, a SGA such as olanzapine, quetiapine and ziprasidone have evidence that high dosing is of value. Also, TDM drug monitoring is more clinically relevant in certain SGA like olanzapine, quetiapine, and risperidone. These differences are critically delineated.
Summary: This review article allows for a formal, evidence-based discussion regarding several advanced psychopharmacologic concepts which should allow the individual prescriber to elevate their prescribing practices.DOI: 10.29245/2578-2959/2018/5.1138 View / Download Pdf View Full Text