1,265 research outputs found
Is bitemporal ECT more effective than bifrontal ECT in reducingthe symptoms of depression in adults?
OBJECTIVE: The objective of this selective EBM review is to determine whether or not bitemporal ECT is more effective than bifrontal ECT in the treatment of adults with major depressive disorder. STUDY DESIGN: Review of three published randomized controlled trials, all English language. All RCTs were published after 1999 and studied patients older than 17 years old. DATA SOURCES: Three randomized control trials were found using PubMED, OVID, and Medline. Articles were selected based on relevance and that the outcomes of the studies mattered to patients. OUTCOME(S) MEASURED: Hamilton Rating Scale for Depression- 24 item completed by practitioner. RESULTS: The results of the Kellner6 study was that bitemporal ECT placement had an average change in HRSD-24 score of 22.4 points, from 33.7 to 11.3 (P\u3c0.0001), and a remission rate of 64% (95% CI 53-75%). Bitemporal ECT was 3% more effective than bifrontal ECT for treating depression. 6 The Bailine2 study concluded that bitemporal ECT placement had an average change in HRSD-24 score of 22.7 points, from 27.7 to 5.0 and a remission rate of 95.8%. Bifrontal ECT was 4.2% more effective than bitemporal ECT for treating depression. 2 The Ranjkesh8 study reported that bitemporal ECT placement had an average change in HRSD-24 score of 24.3 points, from 32.1 to 7.8, and a remission rate of 100%. There was no difference in effectiveness when comparing bitemporal ECT to bifrontal ECT.8 CONCLUSIONS: The results of the three randomized controlled trials found that bitemporal ECT and bifrontal ECT are effective in the treatment of adults with major depressive disorder. The analysis of the three randomized controlled trials is inconclusive to whether bitemporal is more effective than bifrontal ECT in treating adults with major depressive disorder
The effect of multitalker background noise on speech intelligibility in Parkinson\u27s disease and controls
This study investigated the effect of multi-talker background noise on speech intelligibility in participants with hypophonia due to Parkinson’s disease (PD). Ten individuals with PD and 10 geriatric controls were tested on four speech intelligibility tasks at the single word, sentence, and conversation level in various conditions of background noise. Listeners assessed speech intelligibility using word identification or orthographic transcription procedures. Results revealed non-significant differences between groups when intelligibility was assessed in no background noise. PD speech intelligibility decreased significantly relative to controls in the presence of background noise. A phonetic error analysis revealed a distinct error profile for PD speech in background noise. The four most frequent phonetic errors were glottal-null, consonant-null in final position, stop place of articulation, and initial position cluster-singleton. The results demonstrate that individuals with PD have significant and distinctive deficits in speech intelligibility and phonetic errors in the presence of background noise
A Competitive Education: How Charter Schools Include and Exclude
A Competitive Education examines how the charter school movement is one of both inclusion and exclusion, while also serving as a study in rhetorical theory. Written as a senior thesis in the discipline of Writing and Rhetoric, this paper includes an introduction and reflection analyzing the text of the document from a rhetorical perspective. The article, written in a journalistic style, is presented in two ways: first, as one long article, and then as two shorter articles. The content of the articles looks at the history, politics, and real world effects of the charter school movement in California and across the United States
Listening to galaxies tuning at z ~ 2.5 - 3.0: The first strikes of the Hubble fork
We investigate the morphological properties of 494 galaxies selected from the
GMASS survey at z>1, primarily in their optical rest frame, using HST images,
from the CANDELS survey. We propose that the Hubble sequence of galaxy
morphologies takes shape at redshift 2.5<z<3. The fractions of both ellipticals
and disks decrease with increasing lookback time at z>1, such that at redshifts
z=2.5-2.7 and above, the Hubble types cannot be identified, and most galaxies
are classified as irregular. The quantitative morphological analysis shows
that, at 1<z<3, morphological parameters are not as effective in distinguishing
the different morphological Hubble types as they are at low redshift. No
significant morphological k-correction was found to be required for the Hubble
type classification, with some exceptions. In general, different morphological
types occupy the two peaks of the rest-frame (U-B) colour bimodality of
galaxies: most irregulars occupy the blue peak, while ellipticals are mainly
found in the red peak, though with some level of contamination. Disks are more
evenly distributed than either irregulars and ellipticals. We find that the
position of a galaxy in a UVJ diagram is related to its morphological type: the
"quiescent" region of the plot is mainly occupied by ellipticals and, to a
lesser extent, by disks. We find that only ~33% of all morphological
ellipticals in our sample are red and passively evolving galaxies. Blue
galaxies morphologically classified as ellipticals show a remarkable structural
similarity to red ones. Almost all irregulars have a star-forming galaxy
spectrum. In addition, the majority of disks show some sign of star-formation
activity in their spectra, though in some cases their red continuum is
indicative of old stellar populations. Finally, an elliptical morphology may be
associated with either passively evolving or strongly star-forming galaxies.Comment: 27 pages, 16 figures, 5 tables. "Morphological atlas" in the
appendix. Revised version accepted for publication in A&
CO excitation in the Seyfert galaxy NGC7130
We present a coherent multi-band modelling of the CO Spectral Energy
Distribution of the local Seyfert Galaxy NGC7130 to assess the impact of the
AGN activity on the molecular gas. We take advantage of all the available data
from X-ray to the sub-mm, including ALMA data. The high-resolution (~0.2") ALMA
CO(6-5) data constrain the spatial extension of the CO emission down to ~70 pc
scale. From the analysis of the archival CHANDRA and NuSTAR data, we infer the
presence of a buried, Compton-thick AGN of moderate luminosity, L_2-10keV ~
1.6x10^{43} ergs-1. We explore photodissociation and X-ray-dominated regions
(PDRs and XDRs) models to reproduce the CO emission. We find that PDRs can
reproduce the CO lines up to J~6, however, the higher rotational ladder
requires the presence of a separate source of excitation. We consider X-ray
heating by the AGN as a source of excitation, and find that it can reproduce
the observed CO Spectral Energy Distribution. By adopting a composite PDR+XDR
model, we derive molecular cloud properties. Our study clearly indicates the
capabilities offered by current-generation of instruments to shed light on the
properties of nearby galaxies adopting state-of-the art physical modelling.Comment: 5 pages, 3 figures, accepted for publication in MNRAS Letter
Unveiling the inner morphology and gas kinematics of NGC 5135 with ALMA
The local Seyfert 2 galaxy NGC5135, thanks to its almost face-on appearance,
a bulge overdensity of stars, the presence of a large-scale bar, an AGN and a
Supernova Remnant, is an excellent target to investigate the dynamics of
inflows, outflows, star formation and AGN feedback. Here we present a
reconstruction of the gas morphology and kinematics in the inner regions of
this galaxy, based on the analysis of Atacama Large Millimeter Array (ALMA)
archival data. To our purpose, we combine the available 100 pc resolution
ALMA 1.3 and 0.45 mm observations of dust continuum emission, the spectroscopic
maps of two transitions of the CO molecule (tracer of molecular mass in star
forming and nuclear regions), and of the CS molecule (tracer of the dense star
forming regions) with the outcome of the SED decomposition. By applying the
BAROLO software (3D-Based Analysis of Rotating Object via Line
Observations), we have been able to fit the galaxy rotation curves
reconstructing a 3D tilted-ring model of the disk. Most of the observed
emitting features are described by our kinematic model. We also attempt an
interpretation for the emission in few regions that the axisymmetric model
fails to reproduce. The most relevant of these is a region at the northern edge
of the inner bar, where multiple velocity components overlap, as a possible
consequence of the expansion of a super-bubble.Comment: 15 pages, 13 figures, resubmitted to MNRAS after moderate revision
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Shedding light on walking in the dark: the effects of reduced lighting on the gait of older adults with a higher-level gait disorder and controls
OBJECTIVE: To study the effects of reduced lighting on the gait of older adults with a high level gait disorder (HLGD) and to compare their response to that of healthy elderly controls. METHODS: 22 patients with a HLGD and 20 age-matched healthy controls were studied under usual lighting conditions (1000 lumens) and in near darkness (5 lumens). Gait speed and gait dynamics were measured under both conditions. Cognitive function, co-morbidities, depressive symptoms, and vision were also evaluated. RESULTS: Under usual lighting conditions, patients walked more slowly, with reduced swing times, and increased stride-to-stride variability, compared to controls. When walking under near darkness conditions, both groups slowed their gait. All other measures of gait were not affected by lighting in the controls. In contrast, patients further reduced their swing times and increased their stride-to-stride variability, both stride time variability and swing time variability. The unique response of the patients was not explained by vision, mental status, co-morbidities, or the values of walking under usual lighting conditions. CONCLUSION: Walking with reduced lighting does not affect the gait of healthy elderly subjects, except for a reduction in speed. On the other hand, the gait of older adults with a HLGD becomes more variable and unsteady when they walk in near darkness, despite adapting a slow and cautious gait. Further work is needed to identify the causes of the maladaptive response among patients with a HLGD and the potential connection between this behavior and the increased fall risk observed in these patients
AGN feedback at z~2 and the mutual evolution of active and inactive galaxies
The relationships between galaxies of intermediate stellar mass and moderate
luminosity active galactic nuclei (AGNs) at 1<z<3 are investigated with the
Galaxy Mass Assembly ultra-deep Spectroscopic Survey (GMASS) sample
complemented with public data in the GOODS-South field. Using X-ray data,
hidden AGNs are identified in unsuspected star-forming galaxies with no
apparent signs of non-stellar activity. In the color-mass plane, two parallel
trends emerge during the ~2 Gyr between the average redshifts z~2.2 and z~1.3:
while the red sequence becomes significantly more populated by ellipticals, the
majority of AGNs with L(2-10 keV)>10^42.3 erg s^-1 disappear from the blue
cloud/green valley where they were hosted predominantly by star-forming systems
with disk and irregular morphologies. These results are even clearer when the
rest-frame colors are corrected for dust reddening. At z~2.2, the ultraviolet
spectra of active galaxies (including two Type 1 AGNs) show possible gas
outflows with velocities up to about -500 km s^-1 that are not observed neither
in inactive systems at the same redshift, nor at lower redshifts. Such outflows
indicate the presence of gas that can move faster than the escape velocities of
active galaxies. These results suggest that feedback from moderately luminous
AGNs (logL_X~2 by contributing to
outflows capable of ejecting part of the interstellar medium and leading to a
rapid decrease in the star formation in host galaxies with stellar masses
10<logM<11 M_Sun.Comment: Astrophysical Journal Letters, in press (6 pages, 4 figures
CO excitation in the Seyfert galaxy NGC 34: stars, shock or AGN driven?
We present a detailed analysis of the X-ray and molecular gas emission in the
nearby galaxy NGC 34, to constrain the properties of molecular gas, and assess
whether, and to what extent, the radiation produced by the accretion onto the
central black hole affects the CO line emission. We analyse the CO Spectral
Line Energy Distribution (SLED) as resulting mainly from Herschel and ALMA
data, along with X-ray data from NuSTAR and XMM-Newton. The X-ray data analysis
suggests the presence of a heavily obscured AGN with an intrinsic luminosity of
L erg s. ALMA high
resolution data () allows us to scan the nuclear region
down to a spatial scale of pc for the CO(6-5) transition. We
model the observed SLED using Photo-Dissociation Region (PDR), X-ray-Dominated
Region (XDR), and shock models, finding that a combination of a PDR and an XDR
provides the best fit to the observations. The PDR component, characterized by
gas density and temperature K,
reproduces the low-J CO line luminosities. The XDR is instead characterised by
a denser and warmer gas (, K), and is
necessary to fit the high-J transitions. The addition of a third component to
account for the presence of shocks has been also tested but does not improve
the fit of the CO SLED. We conclude that the AGN contribution is significant in
heating the molecular gas in NGC 34.Comment: Accepted for publication in MNRAS. 10 pages, 6 figure
Association of immunosuppression and viral load with subcortical brain volume in an international sample of people living with HIV
Importance: Despite more widely accessible combination antiretroviral therapy (cART), HIV-1 infection remains a global public health challenge. Even in treated patients with chronic HIV infection, neurocognitive impairment often persists, affecting quality of life. Identifying the neuroanatomical pathways associated with infection in vivo may delineate the neuropathologic processes underlying these deficits. However, published neuroimaging findings from relatively small, heterogeneous cohorts are inconsistent, limiting the generalizability of the conclusions drawn to date.
Objective: To examine structural brain associations with the most commonly collected clinical assessments of HIV burden (CD4+ T-cell count and viral load), which are generalizable across demographically and clinically diverse HIV-infected individuals worldwide.
Design, Setting, and Participants: This cross-sectional study established the HIV Working Group within the Enhancing Neuro Imaging Genetics Through Meta Analysis (ENIGMA) consortium to pool and harmonize data from existing HIV neuroimaging studies. In total, data from 1295 HIV-positive adults were contributed from 13 studies across Africa, Asia, Australia, Europe, and North America. Regional and whole brain segmentations were extracted from data sets as contributing studies joined the consortium on a rolling basis from November 1, 2014, to December 31, 2019.
Main Outcomes and Measures: Volume estimates for 8 subcortical brain regions were extracted from T1-weighted magnetic resonance images to identify associations with blood plasma markers of current immunosuppression (CD4+ T-cell counts) or detectable plasma viral load (dVL) in HIV-positive participants. Post hoc sensitivity analyses stratified data by cART status.
Results: After quality assurance, data from 1203 HIV-positive individuals (mean [SD] age, 45.7 [11.5] years; 880 [73.2%] male; 897 [74.6%] taking cART) remained. Lower current CD4+ cell counts were associated with smaller hippocampal (mean [SE] β = 16.66 [4.72] mm3 per 100 cells/mm3; P \u3c .001) and thalamic (mean [SE] β = 32.24 [8.96] mm3 per 100 cells/mm3; P \u3c .001) volumes and larger ventricles (mean [SE] β = -391.50 [122.58] mm3 per 100 cells/mm3; P = .001); in participants not taking cART, however, lower current CD4+ cell counts were associated with smaller putamen volumes (mean [SE] β = 57.34 [18.78] mm3 per 100 cells/mm3; P = .003). A dVL was associated with smaller hippocampal volumes (d = -0.17; P = .005); in participants taking cART, dVL was also associated with smaller amygdala volumes (d = -0.23; P = .004).
Conclusions and Relevance: In a large-scale international population of HIV-positive individuals, volumes of structures in the limbic system were consistently associated with current plasma markers. Our findings extend beyond the classically implicated regions of the basal ganglia and may represent a generalizable brain signature of HIV infection in the cART era
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