Diode-pumped Nd: BaY 2 F 8 picosecond laser mode-locked with carbon nanotube saturable absorbers

Picosecond pulse generation near 1-m wavelength has been achieved with a Nd: BaY 2 F 8 (Nd:BaYF) laser mode-locked using a single-walled carbon nanotube saturable absorber (SWCNT-SA). The laser was operated at its main 1049-nm transition, generating 8.5-ps pulses with Ϸ70-mW output power for Ϸ570-mW absorbed pump power. This is the first demonstration of cw mode-locking in the picosecond regime with Nd-doped crystals and SWCNT-SAs. The requirements on the SWCNT-SA for successful mode-locking in relatively narrowband neodymium lasers are reviewed and their implications are discussed

Combinations of QT-prolonging drugs: towards disentangling pharmacokinetic and pharmaco-dynamic effects in their potentially additive nature.

Background: Whether arrhythmia risks will increase if drugs with electrocardiographic (ECG) QT-prolonging properties are combined is generally supposed but not well studied. Based on available evidence, the Arizona Center for Education and Research on Therapeutics (AZCERT) classification defines the risk of QT prolongation for exposure to single drugs. We aimed to investigate how combining AZCERT drug categories impacts QT duration and how relative drug exposure affects the extent of pharmacodynamic drug–drug interactions. Methods: In a cohort of 2558 psychiatric inpatients and outpatients, we modeled whether AZCERT class and number of coprescribed QT-prolonging drugs correlates with observed rate-corrected QT duration (QTc) while also considering age, sex, inpatient status, and other QTc-prolonging risk factors. We concurrently considered administered drug doses and pharmacokinetic interactions modulating drug clearance to calculate individual weights of relative exposure with AZCERT drugs. Because QTc duration is concentration-dependent, we estimated individual drug exposure with these drugs and included this information as weights in weighted regression analyses. Results: Drugs attributing a ‘known’ risk for clinical consequences were associated with the largest QTc prolongations. However, the presence of at least two versus one QTc-prolonging drug yielded nonsignificant prolongations [exposure-weighted parameter estimates with 95% confidence intervals for ‘known’ risk drugs + 0.93 ms (–8.88;10.75)]. Estimates for the ‘conditional’ risk class increased upon refinement with relative drug exposure and coadministration of a ‘known’ risk drug as a further risk factor. Conclusions: These observations indicate that indiscriminate combinations of QTc-prolonging drugs do not necessarily result in additive QTc prolongation and suggest that QT prolongation caused by drug combinations strongly depends on the nature of the combination partners and individual drug exposure. Concurrently, it stresses the value of the AZCERT classification also for the risk prediction of combination therapies with QT-prolonging drugs

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

Characterization of tunable low power Yb-doped fiber CW oscillators

A continuous-wave fiber laser characterization based on a Findlay–Clay analysis is proposed. With this procedure, commonly used for solid-state lasers, information about saturation power and reabsorption loss is obtained. The knowledge of these parameters is commonly sufficient for a number of fiber oscillator design issues, but it also allows estimating values for fabrication dependent parameters, such as absorption and emission cross-sections, doping concentrations and dopant effective diffusion areas. As an application example, a single-mode low-power oscillator employing standard and well-known fiber components has been studied, providing values in good agreement with previously reported spectroscopical measurements

Ripensare la pratica psichiatrica: riflessioni sul ruolo della psichiatria nella società moderna

In this paper we will describe cultural, social and scientific changes occurred in psychiatry in the last years, identifying the new target for mental health professionals. Groups of young psychiatrists from the Italian Psychiatric Association, the European Psychiatric Association and the World Psychiatric Association have established an international network that launched a debate on the future role of psychiatry. In a rapidly changing world, there is the need to: 1) adapt training in psychiatry to the modern world; 2) identify the new target of mental health professionals; 3) enhance the image of psychiatry in the society; 4) overcome stigma towards people with mental disorders. In recent years, socio-cultural and scientific changes have had a significant impact on the psychiatrists' clinical practice. Mental health professionals should deal with these changes appropriately in order to overcome the current "crisis" of psychiatry, which should be considered as a developmental phase rather than a conceptual one. From time to time psychiatry is criticized both from inside and outside the profession. The current crisis was unavoidable due to the recent socio-cultural changes, but it should be considered an opportunity to adapt the profession to modern times

Ripensare la pratica psichiatrica: riflessioni sul ruolo della psichiatria nella società moderna = Shall psychiatry change its target? Reflections on the evolving role of psychiatry

Scopo del lavoro è quello di descrivere i cambiamenti culturali, sociali e scientifici della psichiatria, proponendo un nuovo ruolo per gli operatori della salute mentale. I gruppi dei giovani psichiatri della Società Italiana di Psichiatria, della European Psychiatric Association e della World Psychiatric Association hanno costituito un network internazionale che ha avviato un dibattito sul ruolo futuro della psichiatria. In seguito ai recenti progressi scientifici, culturali e sociali si avverte la necessità di: 1) adeguare la formazione in psichiatria agli standard moderni; 2) identificare il nuovo target per gli operatori della salute mentale; 3) promuovere l’immagine della psichiatria nella società moderna; 4) sviluppare strategie efficaci per combattere lo stigma verso le persone con disturbi mentali. I cambiamenti socio-culturali e scientifici degli ultimi decenni hanno avuto un impatto significativo sulla pratica clinica, ponendo numerose sfide per gli psichiatri moderni. Le generazioni future di psichiatri dovranno affrontare queste sfide in modo costruttivo, considerando la fase attuale come un momento di crescita e di adattamento. Riteniamo che la psichiatria, contrariamente a quanto recentemente riportato, non sia affatto in crisi. Questo momento di transizione deve essere considerato un momento di crescita dell’intera disciplina per poter restare al passo con i tempi.In this paper we will describe cultural, social and scientific changes occurred in psychiatry in the last years, identifying the new target for mental health professionals. Groups of young psychiatrists from the Italian Psychiatric Association, the European Psychiatric Association and the World Psychiatric Association have established an international network that launched a debate on the future role of psychiatry. In a rapidly changing world, there is the need to: 1) adapt training in psychiatry to the modern world; 2) identify the new target of mental health professionals; 3) enhance the image of psychiatry in the society; 4) overcome stigma towards people with mental disorders. In recent years, socio-cultural and scientific changes have had a significant impact on the psychiatrists' clinical practice. Mental health professionals should deal with these changes appropriately in order to overcome the current "crisis" of psychiatry, which should be considered as a developmental phase rather than a conceptual one. From time to time psychiatry is criticized both from inside and outside the profession. The current crisis was unavoidable due to the recent socio-cultural changes, but it should be considered an opportunity to adapt the profession to modern times