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 $\sim$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 $^{\rm 3D}$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

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$_{\rm{1-100\,keV}} \simeq 4.0\times10^{42}$ erg s$^{-1}$. ALMA high resolution data ($\theta \simeq 0.2''$) allows us to scan the nuclear region down to a spatial scale of $\approx 100$ 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 ${\rm log}(n/{\rm cm^{-3}})=2.5$ and temperature $T=30$ K, reproduces the low-J CO line luminosities. The XDR is instead characterised by a denser and warmer gas (${\rm log}(n/{\rm cm^{-3}})=4.5$, $T =65$ 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