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171.
Therapy of bipolar disorders is a rapidly evolving field. Lithium has efficacy in classic bipolar disorders whereas divalproex sodium and carbamazepine may have broader spectrum efficacy that includes non-classic bipolar disorder. In the last 10 years, a series of anticonvulsants have been approved for marketing in the United States. Gabapentin has indirect g-aminobuytric acid-ergic actions, is generally well tolerated, and appears to have anxiolytic, analgesic, and hypnotic effects. Lamotrigine has antiglutamatergic actions and is generally well tolerated (aside from rash in 1 in 10, and serious rash in 1 in 1,000 patients). Lamotrigine is indicated for maintenance treatment in bipolar disorder. Emerging evidence suggests lamotrigine may have utility in bipolar disorder patients with depression and treatment-refractory rapid cycling, as well as analgesic effects. Topiramate and zonisamide may allow both weight loss, while topiramate may have specific efficacy in bulimia, binge eating disorder, and alcohol dependence. Two small studies found oxcarbazepine had similar efficacy to lithium and haloperidol in acute mania. Phenytoin, an older anticonvulsant, may have adjunctive acute mania efficacy. Levetiracetam, a newer anticonvulsant, may be worth exploring and has minimal drug-drug interactions. None of these newer agents has been shown effective in a large placebo controlled trial for acute mania. Although the clinical profiles of these newer anticonvulsants do not appear to overlap markedly with divalproex and carbamazepine (except perhaps for oxcarbazepine), these novel agents may still offer important new options in relieving a variety of specific target symptoms in patients with bipolar disorder. 相似文献
172.
In modern digital applications, users often interact with virtual representations of themselves or others, called avatars. We examined how these avatars and their perspectives influence stimulus–response compatibility in a Simon task. Participants responded to light/dark blue stimuli with left/right key presses in the presence of a task-irrelevant avatar. Changes in stimulus–response compatibility were used to quantify changes in the mental representation of the task and perspective taking toward this avatar. Experiments 1 and 2 showed that perspective taking for an avatar occurred in orthogonal stimulus–response mappings, causing a compatibility effect from the avatar’s point of view. In the following two experiments we introduced a larger variety of angular disparities between the participant and avatar. In Experiment 3, the Simon effect with lateralized stimulus positions remained largely unaffected by the avatar, pointing toward an absence of perspective taking. In Experiment 4, after avatar hand movements were added in order to strengthen the participants’ sense of agency over the avatar, a spatial compatibility effect from the avatar’s perspective was observed again, and hints of the selective use of perspective taking on a trial-by-trial basis were found. Overall, the results indicate that users can incorporate the perspective of an avatar into their mental representation of a situation, even when this perspective is unnecessary to complete a task, but that certain contextual requirements have to be met. 相似文献
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Zusammenfassung. Das hier vorgestellte Modell lernt graduell, Planungsaufgaben aus der Klasse der Maschinenbelegungsprobleme (job-shop-scheduling problems) zu lösen. Mit Hilfe des Chunking-Mechanismus von Soar wird episodisches Wissen über die Belegungsreihenfolge von Aufträgen auf Maschinen memoriert. Bei der Entwicklung des Modells wurden zahlreiche qualitative (z. B. Transfereffekte) und quantitative Befunde (z. B. Bearbeitungszeiten) aus einer früheren empirischen Untersuchung berücksichtigt. In einer Validierungsstudie wurden dieselben Aufgaben von 14 Probanden und dem Modell bearbeitet. Die Passung von Simulationsdaten und empirischen Ergebnissen fiel insgesamt gut aus. Allerdings löst das Modell die Aufgaben schneller und zeigt auch einen etwas besseren Lernverlauf als die Probanden. Das Modell liefert eine Erklärung für das Rauschen, das typischerweise bei Bearbeitungszeiten zu beobachten ist: es handelt sich um erworbenes Wissen, das mehr oder weniger gut und auch unterschiedlich häufig auf neue Situationen übertragen wird. Der Lernverlauf der Probanden entspricht nur für aggregierte Daten einer Potenzfunktion (power law). Der vorgestellte Mechanismus zeigt, wie ein symbolisches Modell der Informationsverarbeitung graduelle Verhaltensänderungen generiert und wie der offensichtliche Erwerb allgemeiner Prozeduren ohne explizites Lernen von deklarativen Regeln erfolgen kann. Es wird nahegelegt, daß es sich hier um die Modellierung einer Form impliziten Lernens handelt. Summary. The model presented here gradually learns how to perform a job-shop scheduling task. It uses Soar's chunking mechanism to acquire episodic memories about the order to schedule jobs. The model was based on many qualitative (e.g., transfer effects) and quantitative (e.g., solution time) regularities found in previously collected data. The model was tested with new data where scheduling tasks were given to the model and to 14 subjects. The model generally fit these data with the restrictions that the model performs the task (in simulated time) faster than the subjects, and its performance improves somewhat more quickly than the subjects' performance. The model provides an explanation of the noise typically found in problem solving times - it is the result of learning actual pieces of knowledge that transfer more or less to new situations but rarely by an average amount. Only when the data are averaged (i.e., over subjects) does the smooth power law appear. This mechanism demonstrates how symbolic models can exhibit a gradual change in behavior and how the apparent acquisition of general procedures can be performed without resorting to explicit declarative rule generation. We suggest that this may represent a type of implicit learning. 相似文献
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Luc Steels 《Kognitionswissenschaft》1999,8(4):143-150
Linguistics must again concentrate on the evolutionary nature of language, so that language models are more realistic with respect to human natural languages and have a greater explanatory force. Multi-agent systems are proposed as a possible route to develop such evolutionary models and an example is given of a concrete experiment in the origins and evolution of word-meaning based on a multi-agent approach. 相似文献
178.
现行《医疗事故处理办法》颁布实施10 年之久,新形势下需要对其进行修改和完善。“办法”的修改应该体现平等保护医患双方合法权益原则,合理界定医疗事故范围,调整医疗事故鉴定委员会的组成,建立完善的证据管理制度,明确医疗事故损失赔偿的范围和额度。 相似文献
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