Right Unilateral Ultrabrief Pulse ECT in Geriatric Depression: Phase 1 of the PRIDE Study.

PubMed

Kellner, Charles H; Husain, Mustafa M; Knapp, Rebecca G; McCall, W Vaughn; Petrides, Georgios; Rudorfer, Matthew V; Young, Robert C; Sampson, Shirlene; McClintock, Shawn M; Mueller, Martina; Prudic, Joan; Greenberg, Robert M; Weiner, Richard D; Bailine, Samuel H; Rosenquist, Peter B; Raza, Ahmad; Kaliora, Styliani; Latoussakis, Vassilios; Tobias, Kristen G; Briggs, Mimi C; Liebman, Lauren S; Geduldig, Emma T; Teklehaimanot, Abeba A; Lisanby, Sarah H

2016-11-01

The Prolonging Remission in Depressed Elderly (PRIDE) study evaluated the efficacy of right unilateral ultrabrief pulse electroconvulsive therapy (ECT) combined with venlafaxine for the treatment of geriatric depression. PRIDE was a two-phase multisite study. Phase 1 was an acute course of right unilateral ultrabrief pulse ECT, combined with open-label venlafaxine at seven academic medical centers. In phase 2 (reported separately), patients who had remitted were randomly assigned to receive pharmacotherapy (venlafaxine plus lithium) or pharmacotherapy plus continuation ECT. In phase 1, depressed patients received high-dose ECT (at six times the seizure threshold) three times per week. Venlafaxine was started during the first week of treatment and continued throughout the study. The primary outcome measure was remission, assessed with the 24-item Hamilton Depression Rating Scale (HAM-D), which was administered three times per week. Secondary outcome measures were post-ECT reorientation and safety. Paired t tests were used to estimate and evaluate the significance of change from baseline in HAM-D scores. Of 240 patients who entered phase 1 of the study, 172 completed it. Overall, 61.7% (148/240) of all patients met remission criteria, 10.0% (24/240) did not remit, and 28.3% (68/240) dropped out; 70% (169/240) met response criteria. Among those who remitted, the mean decrease in HAM-D score was 24.7 points (95% CI=23.4, 25.9), with a mean final score of 6.2 (SD=2.5) and an average change from baseline of 79%. The mean number of ECT treatments to remission was 7.3 (SD=3.1). Right unilateral ultrabrief pulse ECT, combined with venlafaxine, is a rapidly acting and highly effective treatment option for depressed geriatric patients, with excellent safety and tolerability. These data add to the evidence base supporting the efficacy of ECT to treat severe depression in elderly patients.

Effective treatment of cutaneous and subcutaneous malignant tumours by electrochemotherapy.

PubMed Central

Mir, L. M.; Glass, L. F.; Sersa, G.; Teissié, J.; Domenge, C.; Miklavcic, D.; Jaroszeski, M. J.; Orlowski, S.; Reintgen, D. S.; Rudolf, Z.; Belehradek, M.; Gilbert, R.; Rols, M. P.; Belehradek, J.; Bachaud, J. M.; DeConti, R.; Stabuc, B.; Cemazar, M.; Coninx, P.; Heller, R.

1998-01-01

Electrochemotherapy (ECT) enhances the effectiveness of chemotherapeutic agents by administering the drug in combination with short intense electric pulses. ECT is effective because electric pulses permeabilize tumour cell membranes and allow non-permeant drugs, such as bleomycin, to enter the cells. The aim of this study was to demonstrate the anti-tumour effectiveness of ECT with bleomycin on cutaneous and subcutaneous tumours. This article summarizes results obtained in independent clinical trials performed by five cancer centres. A total of 291 cutaneous or subcutaneous tumours of basal cell carcinoma (32), malignant melanoma (142), adenocarcinoma (30) and head and neck squamous cell carcinoma (87) were treated in 50 patients. Short and intense electric pulses were applied to tumours percutaneously after intravenous or intratumour administration of bleomycin. The tumours were measured and the response to the treatment evaluated 30 days after the treatment. Objective responses were obtained in 233 (85.3%) of the 273 evaluable tumours that were treated with ECT. Clinical complete responses were achieved in 154 (56.4%) tumours, and partial responses were observed in 79 (28.9%) tumours. The application of electric pulses to the patients was safe and well tolerated. An instantaneous contraction of the underlying muscles was noticed. Minimal adverse side-effects were observed. ECT was shown to be an effective local treatment. ECT was effective regardless of the histological type of the tumour. Therefore, ECT offers an approach to the treatment of cutaneous and subcutaneous tumours in patients with minimal adverse side-effects and with a high response rate. PMID:9649155

Efficacy and cognitive side effects after brief pulse and ultrabrief pulse right unilateral electroconvulsive therapy for major depression: a randomized, double-blind, controlled study.

PubMed

Spaans, Harm-Pieter; Verwijk, Esmée; Comijs, Hannie C; Kok, Rob M; Sienaert, Pascal; Bouckaert, Filip; Fannes, Katrien; Vandepoel, Koen; Scherder, Erik J A; Stek, Max L; Kho, King H

2013-11-01

To compare the efficacy and cognitive side effects of high-dose unilateral brief pulse electroconvulsive therapy (ECT) with those of high-dose unilateral ultrabrief pulse ECT in the treatment of major depression. From April 2007 until March 2011, we conducted a prospective, double-blind, randomized multicenter trial in 3 tertiary psychiatric hospitals. All patients with a depressive disorder according to DSM-IV criteria were eligible. Depression severity was assessed with the Montgomery-Asberg Depression Rating Scale; primary efficacy outcomes were response, defined as a score decrease ≥ 60% from baseline, and remission, defined as a score < 10 at 2 consecutive weekly assessments. Total scores on the Autobiographical Memory Interview and Amsterdam Media Questionnaire were the primary outcome measures for retrograde amnesia. Other cognitive domains included category fluency (semantic memory) and letter fluency (lexical memory). Patients received twice-weekly unilateral brief pulse (1.0 millisecond) or ultrabrief pulse (0.3-0.4 millisecond) ECT 8 times seizure threshold until remission, for a maximum of 6 weeks. Of the 116 patients, 75% (n = 87) completed the study. Among completers, 68.4% (26/58) of those in the brief pulse group achieved remission versus 49.0% (24/49) of those in the ultrabrief pulse group (P = .019), and the brief pulse group needed fewer treatment sessions to achieve remission: mean (SD) of 7.1 (2.6) versus 9.2 (2.3) sessions (P = .008). No significant group differences were found in the evaluation of the cognitive assessments. The efficacy and speed of remission seen with high-dose brief pulse right unilateral ECT twice weekly were superior to those seen with high-dose ultrabrief pulse right unilateral ECT, with equal cognitive side effects as defined by retrograde amnesia, semantic memory, and lexical memory. Netherlands National Trial Register number: NTR1304. © Copyright 2013 Physicians Postgraduate Press, Inc.

The Clinical and Service Outcomes of Unilateral and Bilateral ECT Electrode Placements in Australian Aged Psychiatry Services.

PubMed

D'Cunha, Craig; Plakiotis, Christos; Macfarlane, Stephen; Moss, Francine; Reddy, Murali; Singh, Dhiren; Tofler, David; White, Erica; O'Connor, Daniel W

2016-03-01

The aim of the study was to determine whether depressed aged inpatients treated with brief pulse unilateral electroconvulsive therapy (ECT) differed from those treated with bilateral (bitemporal or bifrontal) ECT with respect to numbers of treatments, length of hospital admission, changes in scores on depression and cognitive scales, and serious adverse effects. An audit of routinely collected data regarding 221 acute ECT courses in 7 public aged psychiatry services in Victoria, Australia. Patients given unilateral, bifrontal, and bitemporal treatments were similar with respect to personal, clinical, and treatment characteristics. Most treatments were administered in line with local clinical guidelines and were rated as effective. Psychiatrists preferred unilateral ECT in the first instance with stimulus dosing based on patients' seizure thresholds. Approximately a quarter of unilateral courses were switched later to bitemporal placement, most probably because of insufficient progress. Bilateral treatments were associated with a larger number of treatments, less improvement in scores on mood and cognitive scales, and more refusals to continue treatment than unilateral-only ECT. Brief pulse unilateral ECT proved more effective than bitemporal and bifrontal ECT for most aged patients, especially when coupled with stimulus dosing based on seizure threshold.

Unilateral ultra-brief pulse electroconvulsive therapy for depression in Parkinson's disease.

PubMed

Williams, N R; Bentzley, B S; Sahlem, G L; Pannu, J; Korte, J E; Revuelta, G; Short, E B; George, M S

2017-04-01

Electroconvulsive therapy (ECT) has demonstrated efficacy in treating core symptoms of Parkinson's disease (PD); however, widespread use of ECT in PD has been limited due to concern over cognitive burden. We investigated the use of a newer ECT technology known to have fewer cognitive side effects (right unilateral [RUL] ultra-brief pulse [UBP]) for the treatment of medically refractory psychiatric dysfunction in PD. This open-label pilot study included 6 patients who were assessed in the motoric, cognitive, and neuropsychiatric domains prior to and after RUL UBP ECT. Primary endpoints were changes in total score on the HAM-D-17 and GDS-30 rating scales. Patients were found to improve in motoric and psychiatric domains following RUL UBP ECT without cognitive side effects, both immediately following ECT and at 1-month follow-up. This study demonstrates that RUL UBP ECT is safe, feasible, and potentially efficacious in treating multiple domains of PD, including motor and mood, without clear cognitive side effects. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of electrical stimulus composition on cardiac electrophysiology in a rodent model of electroconvulsive therapy.

PubMed

Singh, Nagendra Madan; Sathyaprabha, T N; Thirthalli, Jagadisha; Andrade, Chittaranjan

2018-01-01

No electroconvulsive therapy (ECT) study on humans or in animal models has so far examined whether differently composed electrical stimuli exert different cardiac electrophysiological effects at constant electrical dose. The subject is important because cardiac electrophysiological changes may provide indirect information about ECT seizure quality as modulated by stimulus composition. Adult female Wistar rats ( n = 20/group) received fixed, moderately suprathreshold (18 mC) electrical stimuli. This stimulus in each of eight groups was formed by varying pulse amplitude, pulse width, pulse frequency, and stimulus duration. The electrocardiogram was recorded, and time and frequency domain variables were examined in 30 s epochs in preictal (30 s before electroconvulsive shock [ECS]), early postictal (starting 15 s after stimulation), and late postictal (5 h after ECS) periods. Alpha for statistical significance was set at P < 0.01 to adjust for multiple hypothesis testing. Cardiac electrophysiological indices in the eight groups did not differ significantly at baseline. At both early and late postictal time points, almost no analysis yielded statistically significant differences between groups for four time domain variables, including heart rate and standard deviation of R-R intervals, and for six frequency domain variables, including low-frequency power, high-frequency power, and total power. Cardiac electrophysiological measures may not be helpful to identify differences in seizure quality that are driven by differences in the composition of electrical stimuli at constant, moderately suprathreshold electrical dose. The generalization of this conclusion to threshold electrical doses and to human contexts requires a study.

Early effects of modern electroconvulsive therapy on subjective memory in patients with mania or depression

PubMed Central

Bag, Sevda; Canbek, Ozge; Atagun, Ilhan Murat; Kutlar, Tarik Mehmet

2016-01-01

Context: Although electroconvulsive therapy (ECT) is considered a very effective tool for the treatment of psychiatric diseases, memory disturbances are among the most important adverse effects. Aims: This study aimed to assess prospectively early subjective memory complaints in depressive and manic patients due to bilateral, brief-pulse ECT, at different stages of the treatment, compare the associations between psychiatric diagnosis, sociodemographic characteristics, and ECT characteristics. Settings and Design: This prospective study was done with patients undergoing ECT between November 2008 and April 2009 at a tertiary care psychiatry hospital of 2000 beds. Materials and Methods: A total of 140 patients, scheduled for ECT with a diagnosis of bipolar disorder (depressive or manic episode) or unipolar depression according to Diagnostic and Statistical Manual of Mental Disorders IV diagnostic criteria, were included in the study and invited to complete the Squire Subjective Memory Questionnaire (SSMQ) before ECT, after the first and third sessions and end of ECT treatment. Statistical Analysis: Mean values were compared with the Kruskal–Wallis test and comparison of the longitudinal data was performed with a nonparametric longitudinal data analysis method, F1_LD_F1 design. Results: SSMQ scores of the patients before ECT were zero. SSMQ scores showed a decrease after the first and third ECT sessions and before discharge, showing a memory disturbance after ECT and were significantly less severe in patients with mania in comparison to those with depression. Conclusions: These findings suggest an increasing degree of subjective memory complaints with bilateral brief-pulse ECT parallel to the increasing number of ECT sessions. PMID:27385854

Safety and efficacy of caffeine-augmented ECT in elderly depressives: a retrospective study.

PubMed

Kelsey, M C; Grossberg, G T

1995-07-01

Prior studies have shown that in younger depressives undergoing ECT whose seizure durations declined despite maximum settings on three different ECT devices, pretreatment with caffeine lengthened seizures and resulted in clinical improvement. Caffeine (half life, 140-270 minutes) was well tolerated even in patients with pre-existing cardiovascular disease. The purpose of this retrospective study was to determine the safety and efficacy of caffeine augmented ECT in elderly depressed patients. The charts of 14 elderly depressives (average age 75.6, range 59-83; 2 males, 12 females) who received caffeine-augmented ECT were reviewed. Patients pre- and post-ECT medications, blood pressure, pulse, and seizure times (cuff and EEG) for each ECT performed were noted. The following conclusions were drawn from our study: (1) Caffeine definitely increases the seizure length and was useful in our setting when the energy settings could not be increased anymore. (2) Caffeine augmentation inconsistently causes an increase in pulse rate, on average, in the elderly. (3) Caffeine inconsistently produces an increase in mean arterial pressure. (4) Caffeine did not consistently produce an increase in the maximum rate-pressure product. We conclude from this study that caffeine-augmented ECT is safe and effective in increasing seizure duration in the elderly. However, more research needs to be done to determine optimal dosing and tolerability.

A Systematic Review and Meta-Analysis of Brief Versus Ultrabrief Right Unilateral Electroconvulsive Therapy for Depression.

PubMed

Tor, Phern-Chern; Bautovich, Alison; Wang, Min-Jung; Martin, Donel; Harvey, Samuel B; Loo, Colleen

2015-09-01

Electroconvulsive therapy (ECT) is an effective depression treatment, but it has potential cognitive side effects. Ultrabrief pulse (UBP) right unilateral (RUL) ECT is an increasingly used treatment option that can potentially combine efficacy with lesser cognitive side effects. However, current trials are underpowered or have conflicting results. A systematic review and meta-analysis was conducted to evaluate the relative efficacy and cognitive effects of brief pulse (BP) and UBP RUL ECT. MEDLINE, EMBASE, PsycINFO, CENTRAL, DARE, and the International Clinical Trials Registry Platform were searched with the search terms ECT, electroconvulsive therapy, electroconvulsive shock, electroconvulsive shock therapy, electrical stimulation, electroconvulsive combined with brief, ultra*, pulse, and trial in English, all fields including title, abstract, subject heading, and full text up to June 20, 2013, for studies comparing BP and UBP RUL ECT in depressed patients that reported formalized mood ratings for depression. Six studies met the inclusion criteria, comprising a total of 689 patients. Efficacy, cognitive, response, and remission outcomes were extracted from each publication or obtained directly from authors. BP RUL ECT was significantly more efficacious in treating depression than UBP RUL ECT (standardized mean difference = 0.25; 95% CI, 0.08–0.41; P = .004) but showed significantly more cognitive side effects in all cognitive domains examined (global cognition, anterograde learning and recall, retrograde memory) (P < .01). The mean number of treatment sessions given was 8.7 for BP ECT and 9.6 for UBP ECT (P < .001). UBP had a lower remission rate (OR = 0.71; 95% CI, 0.51–0.99; P = .045), with a number needed to treat of 12.1. BP compared with UBP RUL ECT was slightly more efficacious in treating depression and required fewer treatment sessions, but led to greater cognitive side effects. The decision of whether to use BP or UBP RUL ECT should be made on an individual patient basis and should be based on a careful weighing of the relative priorities of efficacy versus minimization of cognitive impairment.

Effects of electrical stimulus composition on cardiac electrophysiology in a rodent model of electroconvulsive therapy

PubMed Central

Singh, Nagendra Madan; Sathyaprabha, T. N.; Thirthalli, Jagadisha; Andrade, Chittaranjan

2018-01-01

Background: No electroconvulsive therapy (ECT) study on humans or in animal models has so far examined whether differently composed electrical stimuli exert different cardiac electrophysiological effects at constant electrical dose. The subject is important because cardiac electrophysiological changes may provide indirect information about ECT seizure quality as modulated by stimulus composition. Materials and Methods: Adult female Wistar rats (n = 20/group) received fixed, moderately suprathreshold (18 mC) electrical stimuli. This stimulus in each of eight groups was formed by varying pulse amplitude, pulse width, pulse frequency, and stimulus duration. The electrocardiogram was recorded, and time and frequency domain variables were examined in 30 s epochs in preictal (30 s before electroconvulsive shock [ECS]), early postictal (starting 15 s after stimulation), and late postictal (5 h after ECS) periods. Alpha for statistical significance was set at P < 0.01 to adjust for multiple hypothesis testing. Results: Cardiac electrophysiological indices in the eight groups did not differ significantly at baseline. At both early and late postictal time points, almost no analysis yielded statistically significant differences between groups for four time domain variables, including heart rate and standard deviation of R-R intervals, and for six frequency domain variables, including low-frequency power, high-frequency power, and total power. Conclusions: Cardiac electrophysiological measures may not be helpful to identify differences in seizure quality that are driven by differences in the composition of electrical stimuli at constant, moderately suprathreshold electrical dose. The generalization of this conclusion to threshold electrical doses and to human contexts requires a study. PMID:29736058

A comparison of RUL ultrabrief pulse (0.3 ms) ECT and standard RUL ECT.

PubMed

Loo, Colleen K; Sainsbury, Kirby; Sheehan, Patrick; Lyndon, Bill

2008-11-01

An important goal in electroconvulsive therapy (ECT) research is to minimize associated cognitive side-effects while maintaining its high efficacy. This study explored the use of a novel approach, right unilateral (RUL) ECT with an ultrabrief pulsewidth (0.3 ms) (RUL-UB), in comparison with standard RUL ECT. Seventy-four depressed in-patients received RUL-UB ECT at six times seizure threshold, and 22 patients received standard RUL ECT (1.0 ms pulsewidth) at five times seizure threshold. Formal, prospective evaluations of mood and cognitive functioning over the treatment course were done by a rater blinded to treatment condition. Efficacy was maintained using the ultrabrief pulsewidth, with equivalent numbers of responders and remitters to the standard RUL ECT group, although the speed of response was slower. Cognitive outcomes were superior in the RUL-UB ECT group, particularly in the retention of verbal and visual information, as well as in retrograde autobiographical memory.

Randomized comparison of ultra-brief bifrontal and unilateral electroconvulsive therapy for major depression: cognitive side-effects.

PubMed

Sienaert, P; Vansteelandt, K; Demyttenaere, K; Peuskens, J

2010-04-01

The cognitive side-effects of bifrontal (BF) and right unilateral (UL) ultra-brief pulse (0.3 ms) electroconvulsive therapy (ECT) were compared, in the treatment of patients with a depressive episode. Neuropsychological functioning in patients with a medication refractory depressive episode, that were treated with a course of BF ultra-brief ECT at 1.5 times seizure threshold (ST) or UL ultra-brief ECT at 6 times ST, by random assignment, was assessed before treatment, and 1 and 6 weeks after the treatment course, by a blinded rater. Of the 64 patients that were included, 32 (50%) received BF ECT, and 32 (50%) received UL ECT, by random assignment. Neuropsychological testing 1 and 6 weeks after treatment was performed by 30 (93.75%) and 19 (59.37%) patients, respectively, in the BF-group and 29 (90.62%) and 20 (62.50%), respectively, in the UL-group. There was no deterioration in any of the neuropsychological measures. Patients rated their memory as clearly improved after treatment. There were no significant differences between the patients given BF ECT and those given UL ECT. Ultrabrief pulse ECT, used either in combination with a UL electrode position and a stimulus of 6 times ST, or a BF electrode position with a stimulus of 1.5 times ST, are effective antidepressant techniques, that do not have a deleterious effect on cognitive function. Copyright 2009 Elsevier B.V. All rights reserved.

Cognitive-behavioral therapy as continuation treatment to sustain response after electroconvulsive therapy in depression: a randomized controlled trial.

PubMed

Brakemeier, Eva-Lotta; Merkl, Angela; Wilbertz, Gregor; Quante, Arnim; Regen, Francesca; Bührsch, Nicole; van Hall, Franziska; Kischkel, Eva; Danker-Hopfe, Heidi; Anghelescu, Ion; Heuser, Isabella; Kathmann, Norbert; Bajbouj, Malek

2014-08-01

Although electroconvulsive therapy (ECT) is the most effective acute antidepressant intervention, sustained response rates are low. It has never been systematically assessed whether psychotherapy, continuation ECT, or antidepressant medication is the most efficacious intervention to maintain initial treatment response. In a prospective, randomized clinical trial, 90 inpatients with major depressive disorder (MDD) were treated with right unilateral ultra-brief acute ECT. Electroconvulsive therapy responders received 6 months guideline-based antidepressant medication (MED) and were randomly assigned to add-on therapy with cognitive-behavioral group therapy (CBT-arm), add-on therapy with ultra-brief pulse continuation electroconvulsive therapy (ECT-arm), or no add-on therapy (MED-arm). After the 6 months of continuation treatment, patients were followed-up for another 6 months. The primary outcome parameter was the proportion of patients who remained well after 12 months. Of 90 MDD patients starting the acute phase, 70% responded and 47% remitted to acute ECT. After 6 months of continuation treatment, significant differences were observed in the three treatment arms with sustained response rates of 77% in the CBT-arm, 40% in the ECT-arm, and 44% in the MED-arm. After 12 months, these differences remained stable with sustained response rates of 65% in the CBT-arm, 28% in the ECT-arm, and 33% in the MED-arm. These results suggest that ultra-brief pulse ECT as a continuation treatment correlates with low sustained response rates. However, the main finding implicates cognitive-behavioral group therapy in combination with antidepressants might be an effective continuation treatment to sustain response after successful ECT in MDD patients. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Chronic catatonic schizophrenia treated successfully with right unilateral ultrabrief pulse electroconvulsive therapy: case report.

PubMed

Cupina, Denise; Patil, Sachin; Loo, Colleen

2013-06-01

Catatonia is a syndrome with prominent motor and behavioral symptoms commonly seen in acutely ill psychiatric patients. Catatonic symptoms have been considered as positive predictors of response to electroconvulsive therapy (ECT); however, few studies so far have addressed the role of ECT treatment technique in schizophrenia. We present the case of a 41-year-old woman with chronic catatonic schizophrenia who was treated successfully with a course of ultrabrief right unilateral ECT.

Electroconvulsive therapy (ECT) in a six-year-old girl suffering from major depressive disorder with catatonic features.

PubMed

Esmaili, Taghi; Malek, Ayyoub

2007-02-01

ECT is generally both effective and safe in the treatment of adolescents, but treatment using ECT in children of pre-pubertal age has been less reported and is a controversial treatment. This article reports a 6-year-old girl who has been diagnosed as having major depressive disorder with catatonic features and 50% loss of weight due to food refusal. The seven-session ECT treatment with bilateral and brief pulse stimulation was successfully done. Propofol 1% was used for anesthesia. After the third session, the patient's clinical improvement began by eating. As the ECT sessions went on the signs of depression and catatonic features completely resolved. There were no noticeable clinical side effects. ECT should be considered in severe cases of child psychiatric disorders where it is life threatening, as an effective and safe method.

The Anaesthetic-ECT Time Interval in Electroconvulsive Therapy Practice--Is It Time to Time?

PubMed

Gálvez, Verònica; Hadzi-Pavlovic, Dusan; Wark, Harry; Harper, Simon; Leyden, John; Loo, Colleen K

2016-01-01

Because most common intravenous anaesthetics used in ECT have anticonvulsant properties, their plasma-brain concentration at the time of seizure induction might affect seizure expression. The quality of ECT seizure expression has been repeatedly associated with efficacy outcomes. The time interval between the anaesthetic bolus injection and the ECT stimulus (anaesthetic-ECT time interval) will determine the anaesthetic plasma-brain concentration when the ECT stimulus is administered. The aim of this study was to examine the effect of the anaesthetic-ECT time interval on ECT seizure quality and duration. The anaesthetic-ECT time interval was recorded in 771 ECT sessions (84 patients). Right unilateral brief pulse ECT was applied. Anaesthesia given was propofol (1-2 mg/kg) and succinylcholine (0.5-1.0 mg/kg). Seizure quality indices (slow wave onset, amplitude, regularity, stereotypy and post-ictal suppression) and duration were rated through a structured rating scale by a single blinded trained rater. Linear Mixed Effects Models analysed the effect of the anaesthetic-ECT time interval on seizure quality indices, controlling for propofol dose (mg), ECT charge (mC), ECT session number, days between ECT, age (years), initial seizure threshold (mC) and concurrent medication. Longer anaesthetic-ECT time intervals lead to significantly higher quality seizures (p < 0.001 for amplitude, regularity, stereotypy and post-ictal suppression). These results suggest that the anaesthetic-ECT time interval is an important factor to consider in ECT practice. This time interval should be extended to as long as practically possible to facilitate the production of better quality seizures. Close collaboration between the anaesthetist and the psychiatrist is essential. Copyright © 2015 Elsevier Inc. All rights reserved.

Bitemporal Versus High-Dose Unilateral Twice-Weekly Electroconvulsive Therapy for Depression (EFFECT-Dep): A Pragmatic, Randomized, Non-Inferiority Trial.

PubMed

Semkovska, Maria; Landau, Sabine; Dunne, Ross; Kolshus, Erik; Kavanagh, Adam; Jelovac, Ana; Noone, Martha; Carton, Mary; Lambe, Sinead; McHugh, Caroline; McLoughlin, Declan M

2016-04-01

ECT is the most effective treatment for severe depression. Previous efficacy studies, using thrice-weekly brief-pulse ECT, reported that high-dose (6× seizure threshold) right unilateral ECT is similar to bitemporal ECT but may have fewer cognitive side effects. The authors aimed to assess the effectiveness and cognitive side effects of twice-weekly moderate-dose (1.5× seizure threshold) bitemporal ECT with high-dose unilateral ECT in real-world practice. This was a pragmatic, patient- and rater-blinded, noninferiority trial of patients with major depression (N=138; 63% female; age=56.7 years [SD=14.8]) in a national ECT service with a 6-month follow-up. Participants were independently randomly assigned to bitemporal or high-dose unilateral ECT. The primary outcome was change in the 24-item Hamilton Depression Rating Scale (HAM-D) score after the ECT course; the prespecified noninferiority margin was 4.0 points. Secondary outcomes included response and remission rates, relapse status after 6 months, and cognition. Of the eligible patients, 69 were assigned to bitemporal ECT and 69 to unilateral ECT. High-dose unilateral ECT was noninferior to bitemporal ECT regarding the 24-item HAM-D scores after the ECT course (mean difference=1.08 points in favor of unilateral ECT [95% CI=-1.67 to 3.84]). There were no significant differences for response and remission or 6-month relapse status. Recovery of orientation was quicker following unilateral ECT (median=19.1 minutes versus 26.4 minutes). Bitemporal ECT was associated with a lower percent recall of autobiographical information (odds ratio=0.66) that persisted for 6 months. Twice-weekly high-dose unilateral ECT is not inferior to bitemporal ECT for depression and may be preferable because of its better cognitive side-effect profile.

Neuroversion: using electroconvulsive therapy as a bridge to deep brain stimulation implantation.

PubMed

Williams, Nolan R; Sahlem, Greg; Pannu, Jaspreet; Takacs, Istvan; Short, Baron; Revuelta, Gonzalo; George, Mark S

2017-02-01

Parkinson's disease (PD) is a movement disorder with significant neuropsychiatric comorbidities. Electroconvulsive therapy (ECT) is effective in treating these neuropsychiatric symptoms; however, clinicians are reluctant to use ECT in patients with deep brain stimulation (DBS) implantations for fear of damaging the device, as well as potential cognitive side effects. Right unilateral ultra-brief pulse (RUL UBP) ECT has a more favorable cognitive side-effect profile yet has never been reported in PD patients with DBS implants. We present a case series of three patients with a history of PD that all presented with psychiatric decompensation immediately prior to planned DBS surgery. All three patients had DBS electrode(s) in place at the time and an acute course of ECT was utilized in a novel method to "bridge" these individuals to neurosurgery. The patients all experienced symptom resolution (psychosis and/or depression and/or anxiety) without apparent cognitive side effects. This case series not only illustrates that right unilateral ultra-brief pulse can be utilized in patients with DBS electrodes but also illustrates that this intervention can be utilized as a neuromodulatory "bridge", where nonoperative surgical candidates with unstable psychiatric symptoms can be converted to operative candidates in a manner similar to electrical cardioversion.

Contemporary use and practice of electroconvulsive therapy worldwide

PubMed Central

Leiknes, Kari Ann; Jarosh-von Schweder, Lindy; Høie, Bjørg

2012-01-01

To explore contemporary (from 1990) utilization and practice of electroconvulsive therapy (ECT) worldwide. Systematic search (limited to studies published 1990 and after) was undertaken in the databases Medline, Embase, PsycINFO, SveMed, and EBSCO/Cinahl. Primary data-based studies/surveys with reported ECT utilization and practice in psychiatric institutions internationally, nationally, and regionally; city were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria, and extracted ECT utilization and practice data from those retrieved in full text. Seventy studies were included, seven from Australia and New Zealand, three Africa, 12 North and Latin America, 33 Europe, and 15 Asia. Worldwide ECT differences and trends were evident, average number ECTs administered per patient were eight; unmodified (without anesthesia) was used in Asia (over 90%), Africa, Latin America, Russia, Turkey, Spain. Worldwide preferred electrode placement was bilateral, except unilateral at some places (Europe and Australia/New Zealand). Although mainstream was brief-pulse wave, sine-wave devices were still used. Majority ECT treated were older women with depression in Western countries, versus younger men with schizophrenia in Asian countries. ECT under involuntary conditions (admissions), use of ambulatory-ECT, acute first line of treatment, as well as administered by other professions (geriatricians, nurses) were noted by some sites. General trends were only some institutions within the same country providing ECT, training inadequate, and guidelines not followed. Mandatory reporting and overall country ECT register data were sparse. Many patients are still treated with unmodified ECT today. Large global variation in ECT utilization, administration, and practice advocates a need for worldwide sharing of knowledge about ECT, reflection, and learning from each other's experiences. PMID:22741102

Bitemporal v. high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Kolshus, E; Jelovac, A; McLoughlin, D M

2017-02-01

Brief-pulse electroconvulsive therapy (ECT) is the most acutely effective treatment for severe depression though concerns persist about cognitive side-effects. While bitemporal electrode placement is the most commonly used form worldwide, right unilateral ECT causes less cognitive side-effects though historically it has been deemed less effective. Several randomized trials have now compared high-dose (>5× seizure threshold) unilateral ECT with moderate-dose (1.0-2.5× seizure threshold) bitemporal ECT to investigate if it is as effective as bitemporal ECT but still has less cognitive side-effects. We aimed to systematically review these trials and meta-analyse clinical and cognitive outcomes where appropriate. We searched PubMed, PsycINFO, Web of Science, Cochrane Library and EMBASE for randomized trials comparing these forms of ECT using the terms 'electroconvulsive' OR 'electroshock' AND 'trial'. Seven trials (n = 792) met inclusion criteria. Bitemporal ECT did not differ from high-dose unilateral ECT on depression rating change scores [Hedges's g = -0.03, 95% confidence interval (CI) -0.17 to 0.11], remission (RR 1.06, 95% CI 0.93-1.20), or relapse at 12 months (RR 1.42, 95% CI 0.90-2.23). There was an advantage for unilateral ECT on reorientation time after individual ECT sessions (mean difference in minutes = -8.28, 95% CI -12.86 to -3.70) and retrograde autobiographical memory (Hedges's g = -0.46, 95% CI -0.87 to -0.04) after completing an ECT course. There were no differences for general cognition, category fluency and delayed visual and verbal memory. High-dose unilateral ECT does not differ from moderate-dose bitemporal ECT in antidepressant efficacy but has some cognitive advantages.

Feasibility of employing model-based optimization of pulse amplitude and electrode distance for effective tumor electropermeabilization.

PubMed

Sel, Davorka; Lebar, Alenka Macek; Miklavcic, Damijan

2007-05-01

In electrochemotherapy (ECT) electropermeabilization, parameters (pulse amplitude, electrode setup) need to be customized in order to expose the whole tumor to electric field intensities above permeabilizing threshold to achieve effective ECT. In this paper, we present a model-based optimization approach toward determination of optimal electropermeabilization parameters for effective ECT. The optimization is carried out by minimizing the difference between the permeabilization threshold and electric field intensities computed by finite element model in selected points of tumor. We examined the feasibility of model-based optimization of electropermeabilization parameters on a model geometry generated from computer tomography images, representing brain tissue with tumor. Continuous parameter subject to optimization was pulse amplitude. The distance between electrode pairs was optimized as a discrete parameter. Optimization also considered the pulse generator constraints on voltage and current. During optimization the two constraints were reached preventing the exposure of the entire volume of the tumor to electric field intensities above permeabilizing threshold. However, despite the fact that with the particular needle array holder and pulse generator the entire volume of the tumor was not permeabilized, the maximal extent of permeabilization for the particular case (electrodes, tissue) was determined with the proposed approach. Model-based optimization approach could also be used for electro-gene transfer, where electric field intensities should be distributed between permeabilizing threshold and irreversible threshold-the latter causing tissue necrosis. This can be obtained by adding constraints on maximum electric field intensity in optimization procedure.

Electroconvulsive therapy for medication-refractory depression in a patient with ruptured intracranial dermoid cyst, meningioma, and neurofibromatosis.

PubMed

Thukral-Mahajan, Priyanka; Shah, Nilesh; Kalra, Gurvinder; Andrade, Chittaranjan

2017-01-01

Electroconvulsive therapy (ECT) is considered relatively contraindicated in patients with intracranial space-occupying lesions. A 53-year-old male presented with a 5-year history of medication-refractory major depressive disorder. Brain imaging findings suggested the presence of a ruptured dermoid cyst in the transverse sinus and a calcified meningioma in the temporal lobe sulcal space. There was no evidence of mass effect. Neurofibromatosis was the only other clinical condition present. The patient had no clinical neurological deficits. Since the depression was severe and he was suicidal, ECT was advised. There was a substantial improvement after four bilateral and then eight right unilateral brief-pulse ECTs administered on alternate days, thrice weekly. There were no complications associated with ECT. The treatment gains were maintained with maintenance antidepressant medication at a 1-year follow-up. This is probably the first reported case of the use of ECT in a medication-refractory, severely depressed patient with a ruptured intracranial dermoid cyst and with a calcifying meningioma. The results testify to the safety of ECT even in high-risk patients.

Adaptive sparse grid approach for the efficient simulation of pulsed eddy current testing inspections

NASA Astrophysics Data System (ADS)

Miorelli, Roberto; Reboud, Christophe

2018-04-01

Pulsed Eddy Current Testing (PECT) is a popular NonDestructive Testing (NDT) technique for some applications like corrosion monitoring in the oil and gas industry, or rivet inspection in the aeronautic area. Its particularity is to use a transient excitation, which allows to retrieve more information from the piece than conventional harmonic ECT, in a simpler and cheaper way than multi-frequency ECT setups. Efficient modeling tools prove, as usual, very useful to optimize experimental sensors and devices or evaluate their performance, for instance. This paper proposes an efficient simulation of PECT signals based on standard time harmonic solvers and use of an Adaptive Sparse Grid (ASG) algorithm. An adaptive sampling of the ECT signal spectrum is performed with this algorithm, then the complete spectrum is interpolated from this sparse representation and PECT signals are finally synthesized by means of inverse Fourier transform. Simulation results corresponding to existing industrial configurations are presented and the performance of the strategy is discussed by comparison to reference results.

A Novel Strategy for Continuation ECT in Geriatric Depression: Phase 2 of the PRIDE Study.

PubMed

Kellner, Charles H; Husain, Mustafa M; Knapp, Rebecca G; McCall, W Vaughn; Petrides, Georgios; Rudorfer, Matthew V; Young, Robert C; Sampson, Shirlene; McClintock, Shawn M; Mueller, Martina; Prudic, Joan; Greenberg, Robert M; Weiner, Richard D; Bailine, Samuel H; Rosenquist, Peter B; Raza, Ahmad; Kaliora, Styliani; Latoussakis, Vassilios; Tobias, Kristen G; Briggs, Mimi C; Liebman, Lauren S; Geduldig, Emma T; Teklehaimanot, Abeba A; Dooley, Mary; Lisanby, Sarah H

2016-11-01

The randomized phase (phase 2) of the Prolonging Remission in Depressed Elderly (PRIDE) study evaluated the efficacy and tolerability of continuation ECT plus medication compared with medication alone in depressed geriatric patients after a successful course of ECT (phase 1). PRIDE was a two-phase multisite study. Phase 1 was an acute course of right unilateral ultrabrief pulse ECT, augmented with venlafaxine. Phase 2 compared two randomized treatment arms: a medication only arm (venlafaxine plus lithium, over 24 weeks) and an ECT plus medication arm (four continuation ECT treatments over 1 month, plus additional ECT as needed, using the Symptom-Titrated, Algorithm-Based Longitudinal ECT [STABLE] algorithm, while continuing venlafaxine plus lithium). The intent-to-treat sample comprised 120 remitters from phase 1. The primary efficacy outcome measure was score on the 24-item Hamilton Depression Rating Scale (HAM-D), and the secondary efficacy outcome was score on the Clinical Global Impressions severity scale (CGI-S). Tolerability as measured by neurocognitive performance (reported elsewhere) was assessed using an extensive test battery; global cognitive functioning as assessed by the Mini-Mental State Examination (MMSE) is reported here. Longitudinal mixed-effects repeated-measures modeling was used to compare ECT plus medication and medication alone for efficacy and global cognitive function outcomes. At 24 weeks, the ECT plus medication group had statistically significantly lower HAM-D scores than the medication only group. The difference in adjusted mean HAM-D scores at study end was 4.2 (95% CI=1.6, 6.9). Significantly more patients in the ECT plus medication group were rated "not ill at all" on the CGI-S compared with the medication only group. There was no statistically significant difference between groups in MMSE score. Additional ECT after remission (here operationalized as four continuation ECT treatments followed by further ECT only as needed) was beneficial in sustaining mood improvement for most patients.

Final Report. Grant DOE DE-FG02-04ER54768

DOE Office of Scientific and Technical Information (OSTI.GOV)

Betti, Riccardo

The magnetized spherical implosion campaign funded by this grant is summarized in this progress report. The main goal of this grant was to improve the seed eld generator MIFEDS (Magneto- Inertial Fusion Energy Delivery System) on the OMEGA laser to enable experiments at high elds (> 8 T) and to carry out magnetized spherical implosion experiments to study the e ect of magnetic elds on the fusion yield. New experiments were carried out in the last budget period to study the e ect of higher elds and shaped laser pulses. These new experiments improved the magnetized implosion database and allowedmore » us to improve the con dence of our conclusions with respect to the e ect of magnetic elds on implosion performance. The main conclusion is that adding magnetic eld leads to a 30% higher neutron yield, but using seed magnetic eld higher than 8 T does not further increase the neutron yield. A further conclusion is that the yield enhancement due to the magnetic eld is approximately independent of the laser pulse shape.« less

Effect of age and anticonvulsants on seizure threshold during bilateral electroconvulsive therapy with brief-pulse stimulus: A chart-based analysis

PubMed Central

Nitturkar, Abhishek R.; Sinha, Preeti; Bagewadi, Virupakshappa I.; Thirthalli, Jagadisha

2016-01-01

Background: Efficacy and adverse effects of electroconvulsive therapy (ECT) depend on the extent to which the electrical stimulus exceeds patients' seizure thresholds (STs). Titration method of estimating ST is recommended. Age and co-prescribed anticonvulsants (ACs) are known to affect ST. Literature on ST in bilateral ECT (BLECT) is sparse. Objective: To explore the clinical and demographic determinants of ST in a clinically representative sample of patients prescribed with BLECT. Materials and Methods: ECT records of 640 patients who received BLECT in 2011 in an academic psychiatric setting were studied. Demographic, clinical, pharmacological, and ECT details were analyzed. As per the standard practice, during the 1st ECT session, ST was determined by titration method, starting with 30 milli-Coulombs (mC) and increasing by 30 mC and thence in steps of 60 mC. Increase in ST over up to 6th session of ECT was noted. Receiver operating characteristic curve was used to find age cut-off with high specificity for ST ≥120 mC. The associations of ST and increase in ST with the age cut-off and other clinical factors were assessed using Chi-square test and logistic regression analysis. Results: The mean age was 30.98 years (+11.23 years) and mean ST at 1st ECT session was 130.36 mC (+51.96 mC). There was significantly high positive correlation (r = 0.37, P < 0.001) between age and ST. Cut-off age of 45 years had high specificity: Only 4.6% of those older than 45 years had ST <120 mC. Higher proportion of patients on AC had ST ≥120 mC. These associations were seen even after controlling for potential confounds of each other using logistic regression analysis. The results were similar for increase in ST over the course of ECT. Sex, diagnosis, use of antipsychotics, antidepressants, lithium, and benzodiazepines (BZPs) had no effect on ST or its increase. Conclusions: For BLECT using brief-pulse stimulus, ST depends on age and use of AC. For patients above the age of 45 years, ST estimation may be started at 120 mC with least risk of using unduly higher stimulus. Other medications including BZPs have little influence on ST. PMID:27385853

Effect of age and anticonvulsants on seizure threshold during bilateral electroconvulsive therapy with brief-pulse stimulus: A chart-based analysis.

PubMed

Nitturkar, Abhishek R; Sinha, Preeti; Bagewadi, Virupakshappa I; Thirthalli, Jagadisha

2016-01-01

Efficacy and adverse effects of electroconvulsive therapy (ECT) depend on the extent to which the electrical stimulus exceeds patients' seizure thresholds (STs). Titration method of estimating ST is recommended. Age and co-prescribed anticonvulsants (ACs) are known to affect ST. Literature on ST in bilateral ECT (BLECT) is sparse. To explore the clinical and demographic determinants of ST in a clinically representative sample of patients prescribed with BLECT. ECT records of 640 patients who received BLECT in 2011 in an academic psychiatric setting were studied. Demographic, clinical, pharmacological, and ECT details were analyzed. As per the standard practice, during the 1(st) ECT session, ST was determined by titration method, starting with 30 milli-Coulombs (mC) and increasing by 30 mC and thence in steps of 60 mC. Increase in ST over up to 6(th) session of ECT was noted. Receiver operating characteristic curve was used to find age cut-off with high specificity for ST ≥120 mC. The associations of ST and increase in ST with the age cut-off and other clinical factors were assessed using Chi-square test and logistic regression analysis. The mean age was 30.98 years (+11.23 years) and mean ST at 1(st) ECT session was 130.36 mC (+51.96 mC). There was significantly high positive correlation (r = 0.37, P < 0.001) between age and ST. Cut-off age of 45 years had high specificity: Only 4.6% of those older than 45 years had ST <120 mC. Higher proportion of patients on AC had ST ≥120 mC. These associations were seen even after controlling for potential confounds of each other using logistic regression analysis. The results were similar for increase in ST over the course of ECT. Sex, diagnosis, use of antipsychotics, antidepressants, lithium, and benzodiazepines (BZPs) had no effect on ST or its increase. For BLECT using brief-pulse stimulus, ST depends on age and use of AC. For patients above the age of 45 years, ST estimation may be started at 120 mC with least risk of using unduly higher stimulus. Other medications including BZPs have little influence on ST.

Vascular risk factors in older patients with depression: outcome of electroconvulsive therapy versus medication.

PubMed

Spaans, Harm-Pieter; Kok, Rob M; Bouckaert, Filip; Van Den Berg, Julia F; Tunney, Orlaith C; Sienaert, Pascal; Verwijk, Esmée; Kho, King H; Stek, Max L

2018-02-01

Research suggests that in depression, vascular burden predicts a lower efficacy for medication (MED) and a more favourable outcome for electroconvulsive therapy (ECT). Therefore, we investigated the influence of the following vascular risk factors (VRF): hypercholesterolemia, hypertension, smoking, diabetes mellitus, cardiovascular disease, and cerebral vascular accident/transient ischemic attack, on remission from major depression after ECT versus MED. The study sample consisted of 81 inpatients with a DSM-IV unipolar major depression diagnosis (mean age 72.2 years, SD = 7.6, mean Montgomery-Åsberg Depression Rating Scale score 32.9, SD = 6.2) participating in a randomized controlled trial comparing nortriptyline versus venlafaxine and 43 inpatients (mean age 73.7 years, SD = 7.5, mean Montgomery-Åsberg Depression Rating Scale score 30.6, SD = 7.1) from an randomized controlled trial comparing brief pulse versus ultrabrief pulse ECT. The presence of VRF was established from the medical records. The remission rate of patients with VRF was compared with those of patients without VRF. The remission rate was 58% (19/33) in the ECT group with ≥1 VRF and 32% (23/73) in the MED group with ≥1 VRF (χ 2  = 6.456, p = 0.011). Comparing patients with no VRF versus ≥1 VRF, the remission rate decreased from 80 to 58% (χ 2  = 1.652, p = 0.276) in ECT patients and from 38 to 32% (χ 2  = 0.119, p = 0.707) in MED patients. Applying different cut-offs for the number of VRFs yielded the same trends. Logistic regression revealed no interaction between VRF and treatment condition. The superior efficacy of ECT over pharmacotherapy in major depression in older age was independent of the presence of VRF. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Near-infrared spectroscopy of the human brain during electroconvulsive therapy

NASA Astrophysics Data System (ADS)

Fantini, Sergio; Fabbri, Francesco; Nadgir, Shalini; Henry, Michael E.; Renshaw, Perry F.; Franceschini, Maria-Angela

2003-07-01

We report non-invasive, bilateral measurements of cerebral oxygenation performed with near-infrared spectroscopy (NIRS) on ten patients undergoing right unilateral electro-convulsive therapy (ECT). Right unilateral ECT consists of delivering an electrical current through the right brain hemisphere to induce a seizure, which is associated with significant changes in systemic and regional physiological parameters. In this work, we have examined the regional cerebral oxygenation (StO2) measured with NIRS on the right and left sides of the frontal brain region, and the systemic arterial oxygenation (SaO2) measured with pulse oximetry. On the ten patients examined, we have found that the decrease in the cerebral oxygenation on the side ipsilateral to the ECT electrical discharge (ΔStO2(ipsi)) is consistently stronger than the decrease on the contralateral side (ΔStO2(contra)). The average and standard deviation for the ipsilateral and contralateral oxygenation changes across the ten patients are ΔStO2(ipsi) = -22 +/- 10% and ΔStO2(contra) = -6 +/- 10%, respectively. By contrast, we observed two distinct behaviors in the arterial saturation; in five patients, SaO2 did not significantly change during the ECT procedure, and in three patients, SaO2 decreased by -16+/- 6%, an intermediate value with respect to the changes observed in StO2(ipsi) and StO2(contra) (we do not have the SaO2 recording in the remaining two patients for technical reasons). These results indicate that NIRS monitoring of the cerebral oxygenation during ECT has the potential of being a valuable addition to the standard monitoring of arterial saturation with pulse oximetry.

Effects of stimulus intensity on the efficacy and safety of twice-weekly, bilateral electroconvulsive therapy (ECT) combined with antipsychotics in acute mania: a randomised controlled trial.

PubMed

Mohan, Titus S P; Tharyan, Prathap; Alexander, Jacob; Raveendran, Nirmal S

2009-03-01

To examine differences in speed of improvement and remission in people with mania undergoing bilateral, brief-pulse, twice-weekly electroconvulsive therapy (ECT) at stimulus intensities administered just above and 2.5 times their individually titrated seizure threshold. Consecutive, eligible subjects with mania, prescribed ECT, were randomised to receive treatments at stimulus doses either just above or 2.5 times their individually titrated seizure thresholds. Main outcomes were the speed of improvement and remission as measured by the Young Mania Rating Scale (YMRS) and the Clinical Global Impressions-Improvement scale (CGI-I) and cognitive side effects assessed by the Mini-Mental State Exam, the Wechsler Memory Scale, and a scale for autobiographical memory. A total of 24/26 subjects (92.3%) given threshold ECT and 22/24 subjects (91.7%) given suprathreshold ECT were significantly improved [CGI = 2; odds ratio (OR) = 1.1, 95% confidence interval (CI): 0.1-8.4; p = 1.0] at the end of ECT. A total of 88% of the sample had remitted [YMRS < 10; threshold 23/26 (88.5%) versus suprathreshold 21/24 (87.5%)], with no significant differences between interventions (OR = 1.1, 95% CI: 0.2- 6.0; p = 1.0). The interventions did not differ significantly in the time or number of ECT treatments required for improvement or remission. Both interventions were equally safe. Bilateral, twice-weekly ECT delivered at stimulus intensities just above individually titrated seizure threshold was as effective and safe as ECT administered at stimulus intensities 2.5 times seizure threshold in rapidly resolving the symptoms of acute mania.

Seizure threshold increases can be predicted by EEG quality in right unilateral ultrabrief ECT.

PubMed

Gálvez, Verònica; Hadzi-Pavlovic, Dusan; Waite, Susan; Loo, Colleen K

2017-12-01

Increases in seizure threshold (ST) over a course of brief pulse ECT can be predicted by decreases in EEG quality, informing ECT dose adjustment to maintain adequate supra-threshold dosing. ST increases also occur over a course of right unilateral ultrabrief (RUL UB) ECT, but no data exist on the relationship between ST increases and EEG indices. This study (n = 35) investigated if increases in ST over RUL UB ECT treatments could be predicted by a decline in seizure quality. ST titration was performed at ECT session one and seven, with treatment dosing maintained stable (at 6-8 times ST) in intervening sessions. Seizure quality indices (slow-wave onset, mid-ictal amplitude, regularity, stereotypy, and post-ictal suppression) were manually rated at the first supra-threshold treatment, and last supra-threshold treatment before re-titration, using a structured rating scale, by a single trained rater blinded to the ECT session being rated. Twenty-one subjects (60%) had a ST increase. The association between ST changes and EEG quality indices was analysed by logistic regression, yielding a significant model (p < 0.001). Initial ST (p < 0.05) and percentage change in mid-ictal amplitude (p < 0.05) were significant predictors of change in ST. Percentage change in post-ictal suppression reached trend level significance (p = 0.065). Increases in ST over a RUL UB ECT course may be predicted by decreases in seizure quality, specifically decline in mid-ictal amplitude and potentially in post-ictal suppression. Such EEG indices may be able to inform when dose adjustments are necessary to maintain adequate supra-threshold dosing in RUL UB ECT.

Global synchronization of parallel processors using clock pulse width modulation

DOEpatents

Chen, Dong; Ellavsky, Matthew R.; Franke, Ross L.; Gara, Alan; Gooding, Thomas M.; Haring, Rudolf A.; Jeanson, Mark J.; Kopcsay, Gerard V.; Liebsch, Thomas A.; Littrell, Daniel; Ohmacht, Martin; Reed, Don D.; Schenck, Brandon E.; Swetz, Richard A.

2013-04-02

A circuit generates a global clock signal with a pulse width modification to synchronize processors in a parallel computing system. The circuit may include a hardware module and a clock splitter. The hardware module may generate a clock signal and performs a pulse width modification on the clock signal. The pulse width modification changes a pulse width within a clock period in the clock signal. The clock splitter may distribute the pulse width modified clock signal to a plurality of processors in the parallel computing system.

Antidepressant Effects of Electroconvulsive Therapy Correlate With Subgenual Anterior Cingulate Activity and Connectivity in Depression

PubMed Central

Liu, Yi; Du, Lian; Li, Yongmei; Liu, Haixia; Zhao, Wenjing; Liu, Dan; Zeng, Jinkun; Li, Xingbao; Fu, Yixiao; Qiu, Haitang; Li, Xirong; Qiu, Tian; Hu, Hua; Meng, Huaqing; Luo, Qinghua

2015-01-01

Abstract The mechanisms underlying the effects of electroconvulsive therapy (ECT) in major depressive disorder (MDD) are not fully understood. Resting-state functional magnetic resonance imaging (rs-fMRI) is a new tool to study the effects of brain stimulation interventions, particularly ECT. The authors aim to investigate the mechanisms of ECT in MDD by rs-fMRI. They used rs-fMRI to measure functional changes in the brain of first-episode, treatment-naive MDD patients (n = 23) immediately before and then following 8 ECT sessions (brief-pulse square-wave apparatus, bitemporal). They also computed voxel-wise amplitude of low-frequency fluctuation (ALFF) as a measure of regional brain activity and selected the left subgenual anterior cingulate cortex (sgACC) to evaluate functional connectivity between the sgACC and other brain regions. Increased regional brain activity measured by ALFF mainly in the left sgACC following ECT. Functional connectivity of the left sgACC increased in the ipsilateral parahippocampal gyrus, pregenual ACC, contralateral middle temporal pole, and orbitofrontal cortex. Importantly, reduction in depressive symptoms were negatively correlated with increased ALFF in the left sgACC and left hippocampus, and with distant functional connectivity between the left sgACC and contralateral middle temporal pole. That is, across subjects, as depression improved, regional brain activity in sgACC and its functional connectivity increased in the brain. Eight ECT sessions in MDD patients modulated activity in the sgACC and its networks. The antidepressant effects of ECT were negatively correlated with sgACC brain activity and connectivity. These findings suggest that sgACC-associated prefrontal-limbic structures are associated with the therapeutic effects of ECT in MDD. PMID:26559309

Decreased Cognitive Functioning After Electroconvulsive Therapy Is Related to Increased Hippocampal Volume: Exploring the Role of Brain Plasticity.

PubMed

van Oostrom, Iris; van Eijndhoven, Philip; Butterbrod, Elke; van Beek, Maria H; Janzing, Joost; Donders, Rogier; Schene, Aart; Tendolkar, Indira

2018-06-01

Electroconvulsive therapy (ECT) is still the most effective treatment of severe and therapy-refractory major depressive disorder. Cognitive side effects are the major disadvantage of ECT. Cognitive deficits are generally temporary in nature and may be mediated by the hippocampus. Recent studies have shown a temporary increase in hippocampal volume and a temporary decrease in cognitive functioning post-ECT compared with pre-ECT. This study investigates whether these volumetric changes are related to changes in cognitive functioning after ECT. Nineteen medication-free patients with treatment-resistant major depressive disorder underwent a whole-brain magnetic resonance imaging scan and a neuropsychological examination (including the Rey auditory verbal learning task, Wechsler Memory Scale Visual Reproduction, fluency, Trail Making Task) within 1 week before and within 1 week after the course of ECT. Electroconvulsive therapy was administered twice a week bitemporally with a brief pulse. A matched healthy control group (n = 18) received the same neuropsychological examination and at a similar interval to that of the patients. Hippocampal volumes increased significantly from pretreatment to posttreatment in patients. Mean performance on cognitive tasks declined, or remained stable, whereas performance in controls generally improved because of retesting effects. The increase in hippocampal volume was related to changes in cognitive performance, indicating that this increase co-occurred with a decrease in cognitive functioning. Our findings tentatively suggest that the temporal increase in hippocampal volume after treatment, which may result from neurotrophic processes and is thought to be crucial for the antidepressive effect, is also related to the temporary cognitive side effects of ECT.

Basal cell carcinoma: 10-year experience with electrochemotherapy.

PubMed

Campana, Luca G; Marconato, Roberto; Valpione, Sara; Galuppo, Sara; Alaibac, Mauro; Rossi, Carlo R; Mocellin, Simone

2017-05-31

Electrochemotherapy (ECT), by combining manageable cytotoxic agents with short electric pulses, represents an effective palliative skin-directed therapy. The accumulated evidence indicates that ECT stands out as a safe and well-tolerated alternative treatment for patients with multiple or large basal cell carcinoma (BCC), who are not suitable for conventional treatments. However, long-term data and shared indications are lacking. In this observational study, we retrospectively analyzed 84 prospectively collected patients with multiple, recurrent or locally advanced BCC who were not candidate for standard therapies and received bleomycin-based ECT according to the European Standard Operative Procedures of ECT, from 2006 to 2016. Disease extent was local, locally advanced and metastatic in 40 (48%), 41 (49%) and 3 (3%), respectively. Forty-four (52%) individuals had multiple BCCs. Grade 3 skin toxicity after ECT was observed in 6% of cases. Clearance rate was 50% (95% CI 39-61%). Primary presentation (p = 0.004), tumor size <3 cm (p < 0.001), well-defined borders (p = 0.021), absence of tumor ulceration (p = 0.001), non-aggressive BCC histology (p = 0.046) and age ≤69 years were associated with higher complete response rate. In patients with local BCC, the clearance rate was 72.5 and 85% after one or two ECT cycles, respectively. In the laBCC group, 32 patients (78%) achieved an objective response. Five-year recurrence rate for local and laBCC was 20 and 38%, respectively (p ≤ 0.001). One or two ECT cycles with bleomycin may be a valuable palliative treatment in well-selected patients with multiple BCCs and favorable tumor features. Validation of predictive factors will be imperative to match patients with optimal ECT treatment modalities. Management of laBCC with ECT warrants further investigation. Trial registration ISRCTN14633165 Registered 24 March 2017 (retrospectively registered).

Pulse Width Affects Scalp Sensation of Transcranial Magnetic Stimulation.

PubMed

Peterchev, Angel V; Luber, Bruce; Westin, Gregory G; Lisanby, Sarah H

Scalp sensation and pain comprise the most common side effect of transcranial magnetic stimulation (TMS), which can reduce tolerability and complicate experimental blinding. We explored whether changing the width of single TMS pulses affects the quality and tolerability of the resultant somatic sensation. Using a controllable pulse parameter TMS device with a figure-8 coil, single monophasic magnetic pulses inducing electric field with initial phase width of 30, 60, and 120 µs were delivered in 23 healthy volunteers. Resting motor threshold of the right first dorsal interosseus was determined for each pulse width, as reported previously. Subsequently, pulses were delivered over the left dorsolateral prefrontal cortex at each of the three pulse widths at two amplitudes (100% and 120% of the pulse-width-specific motor threshold), with 20 repetitions per condition delivered in random order. After each pulse, subjects rated 0-to-10 visual analog scales for Discomfort, Sharpness, and Strength of the sensation. Briefer TMS pulses with amplitude normalized to the motor threshold were perceived as slightly more uncomfortable than longer pulses (with an average 0.89 point increase on the Discomfort scale for pulse width of 30 µs compared to 120 µs). The sensation of the briefer pulses was felt to be substantially sharper (2.95 points increase for 30 µs compared to 120 µs pulse width), but not stronger than longer pulses. As expected, higher amplitude pulses increased the perceived discomfort and strength, and, to a lesser degree the perceived sharpness. Our findings contradict a previously published hypothesis that briefer TMS pulses are more tolerable. We discovered that the opposite is true, which merits further study as a means of enhancing tolerability in the context of repetitive TMS. Copyright © 2016 Elsevier Inc. All rights reserved.

Pulse width affects scalp sensation of transcranial magnetic stimulation

PubMed Central

Peterchev, Angel V.; Luber, Bruce; Westin, Gregory G.; Lisanby, Sarah H.

2016-01-01

Background Scalp sensation and pain comprise the most common side effect of transcranial magnetic stimulation (TMS), which can reduce tolerability and complicate experimental blinding. Objective We explored whether changing the width of single TMS pulses affects the quality and tolerability of the resultant somatic sensation. Methods Using a controllable pulse parameter TMS device with a figure-8 coil, single monophasic magnetic pulses inducing electric field with initial phase width of 30, 60, and 120 µs were delivered in 23 healthy volunteers. Resting motor threshold of the right first dorsal interosseus was determined for each pulse width, as reported previously. Subsequently, pulses were delivered over the left dorsolateral prefrontal cortex at each of the three pulse widths at two amplitudes (100% and 120% of the pulse-width-specific motor threshold), with 20 repetitions per condition delivered in random order. After each pulse, subjects rated 0-to-10 visual analog scales for Discomfort, Sharpness, and Strength of the sensation. Results Briefer TMS pulses with amplitude normalized to the motor threshold were perceived as slightly more uncomfortable than longer pulses (with an average 0.89 points increase on the Discomfort scale for pulse width of 30 µs compared to 120 µs). The sensation of the briefer pulses was felt to be substantially sharper (2.95 point increase for 30 µs compared to 120 µs pulse width), but not stronger than longer pulses. As expected, higher amplitude pulses increased the perceived discomfort and strength, and, to a lesser degree the perceived sharpness. Conclusions Our findings contradict a previously published hypothesis that briefer TMS pulses are more tolerable. We discovered that the opposite is true, which merits further study as a means of enhancing tolerability in the context of repetitive TMS. PMID:28029593

Feasibility, safety, and preliminary efficacy of Low Amplitude Seizure Therapy (LAP-ST): A proof of concept clinical trial in man.

PubMed

Youssef, Nagy A; Sidhom, Emad

2017-11-01

Current pulse amplitude used in clinical ECT may be higher than needed. Reducing pulse amplitude may improve focality of the electric field and thus cognitive adverse effects. Here we examine the feasibility, safety, and whether Low Pulse Amplitude Seizure Therapy (LAP-ST, 0.5-0.6A) minimizes cognitive adverse effects while retaining efficacy. Patients with treatment-resistant primary mood (depressive episodes) or psychotic disorders who were clinically indicated to undergo ECT were offered to be enrolled in an open-label study. The study consisted of a full acute course of LAP-ST under standard anesthesia and muscle relaxation. The primary outcome was feasibility of seizure induction. Clinical outcome measures were: time to reorientation (TRO), Mini Mental State Examination, Montgomery Aberg Depression Scale, and Brief Psychiatric Rating Scale, and Clinical Global Impression Scale. Twenty-two patients consented for enrollment in the study. LAP-ST was feasible, and all patients had seizures in the first session. Participants had a quick orientation with median TRO of 4.5min. Treatment was efficacious for both depressive and psychotic symptoms. Relatively small sample size, non-blinded, and no randomization was performed in this initial proof of concept study. This first human preliminary data of a full course of focal LAP-ST demonstrates that seizure induction is feasible. These results, although preliminary, suggest that the LAP-ST compared to the standard ECT techniques may result in less cognitive side effects, but comparable efficacy. Larger studies are needed to replicate these findings. Copyright © 2017 Elsevier B.V. All rights reserved.

On an image reconstruction method for ECT

NASA Astrophysics Data System (ADS)

Sasamoto, Akira; Suzuki, Takayuki; Nishimura, Yoshihiro

2007-04-01

An image by Eddy Current Testing(ECT) is a blurred image to original flaw shape. In order to reconstruct fine flaw image, a new image reconstruction method has been proposed. This method is based on an assumption that a very simple relationship between measured data and source were described by a convolution of response function and flaw shape. This assumption leads to a simple inverse analysis method with deconvolution.In this method, Point Spread Function (PSF) and Line Spread Function(LSF) play a key role in deconvolution processing. This study proposes a simple data processing to determine PSF and LSF from ECT data of machined hole and line flaw. In order to verify its validity, ECT data for SUS316 plate(200x200x10mm) with artificial machined hole and notch flaw had been acquired by differential coil type sensors(produced by ZETEC Inc). Those data were analyzed by the proposed method. The proposed method restored sharp discrete multiple hole image from interfered data by multiple holes. Also the estimated width of line flaw has been much improved compared with original experimental data. Although proposed inverse analysis strategy is simple and easy to implement, its validity to holes and line flaw have been shown by many results that much finer image than original image have been reconstructed.

S -ketamine compared to etomidate during electroconvulsive therapy in major depression.

PubMed

Zavorotnyy, Maxim; Kluge, Ina; Ahrens, Kathrin; Wohltmann, Thomas; Köhnlein, Benjamin; Dietsche, Patricia; Dannlowski, Udo; Kircher, Tilo; Konrad, Carsten

2017-12-01

Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0.96 (0.26) mg/kg. Right unilateral brief pulse ECTs were performed. The number of ECTs was individually adjusted to clinical needs, mean (SD) = 13.0 (4.3). Seizure characteristics, adverse events, and the clinical global impression (CGI) scores were compared between the both groups during ECT series. In the S-ketamine group, a lower initial seizure threshold (p = 0.014), stimulation charge (p < 0.001), higher postictal suppression (p < 0.001), EEG ictal amplitude (p = 0.04), EEG coherence (p < 0.001) and maximum heart rate (p = 0.015) were measured. Etomidate was associated with more frequent abortive seizures (p = 0.02) and restimulations (p = 0.01). The CGI scores, the number of sessions within an ECT series, and the incidence of adverse events did not differ between groups. Due to its lower initial seizure threshold, S-ketamine might hold a potential to become a clinically favorable anesthetic agent during ECT. However, the current findings should be interpreted with caution, and further prospective randomized clinical trials are required. Also, specific adverse effects profile of S-ketamine, especially with regard to the cardiovascular risk, needs to be taken into account.

Ultrasound guided electrochemotherapy for the treatment of a clear cell thymoma in a cat

PubMed Central

Spugnini, Enrico Pierluigi; Menicagli, Francesco; Pettorali, Michela; Baldi, Alfonso

2017-01-01

A twelve-year-old male castrated domestic shorthair cat was presented for rapidly progressing respiratory distress. The cat was depressed, tachypneic and moderately responsive. Ultrasonography showed a mediastinal mass associated with a significant pleural effusion that needed tapping every five to seven days. Ultrasound guided biopsy yielded a diagnosis of clear cell thymoma upon histopathology. After complete staging procedures, the owner elected to treat the cat with electrochemotherapy (ECT) using systemic bleomycin. Two sessions of ultrasound guided ECT were performed at two week intervals with trains of biphasic electric pulses applied using needle electrodes until complete coverage of the area was achieved. The treatment was well tolerated and resulted in partial remission (PR). Additional sessions were performed on a monthly basis. The cat is still in PR after fourteen months. ECT resulted in improved local control and should be considered among the available adjuvant treatments in pets carrying visceral tumors. PMID:28331834

Case Report: Successful Use of the Combination of Electroconvulsive Therapy and Clozapine in Treating Treatment-Resistant Schizophrenia and Catatonia in an Adult with Intellectual Disability.

PubMed

Desarkar, Pushpal; Blumberger, Daniel; Daskalakis, Zafiris Jeff

2018-04-25

There is paucity of empirical data regarding the use of either clozapine or electroconvulsive therapy (ECT) in the acute phase and maintenance treatment of schizophrenia in adults with intellectual disability. Herein we report the successful acute and long-term remission of psychotic symptoms and catatonia with the combination of clozapine and ECT in a 26-year-old female with moderate ID and treatment-resistant schizophrenia. To our knowledge, this is the first case example of the successful use of the combination of bilateral, standard-pulse ECT and clozapine in both acute and long-term treatment of treatment-resistant schizophrenia and catatonia in an adult with ID. Our report adds further support to the emerging evidence regarding the efficacy and safety of this combination in treatment-resistant schizophrenia.

Novel Instruments for the Implementation of Electrochemotherapy Protocols: From Bench Side to Veterinary Clinic.

PubMed

Spugnini, Enrico P; Fais, Stefano; Azzarito, Tommaso; Baldi, Alfonso

2017-03-01

Electrochemotherapy (ECT) is a medical strategy that allows an increased efficacy of chemotherapy agents after the application of permeabilizing electric pulses having appropriate characteristics (form, voltage, frequency). In the past 10 years, the clinical efficacy of this therapeutic approach in several spontaneous models of tumors in animals has been shown. Moreover, some of the molecular and cellular mechanisms responsible for this phenomenon have been elucidated. Our group has been deeply involved in the development of new ECT protocols for companion animals, implementing the use of the technique as first line treatment, and evaluating different chemotherapy agents in laboratory animals as well as pets. This article summarizes the most important advances in veterinary ECT, including the development of novel equipment, therapeutic protocols, and their translation to humans. J. Cell. Physiol. 232: 490-495, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Voyager Uranus encounter 0.2lbf T/VA short pulse test report

NASA Technical Reports Server (NTRS)

1986-01-01

The attitude control thrusters on the Voyager spacecraft were tested for operation at electrical pulse widths of less than the current 10-millisecond minimum to reduce impulse bit and, therefore, reduce image smear of pictures taken during the Uranus encounter. Thrusters with the identical configuration of the units on the spacecraft were fired in an altitude chamber to characterize impulse bit and impulse bit variations as a function of electrical pulse widths and to determine if the short pulses decreased thruster life. Pulse widths of 4.0 milliseconds provide approximately 45 percent of the impulse provided by a 10-ms pulse, and thruster-to-thruster and pulse-to-pulse variation is approximately plus or minus 10 percent. Pulse widths shorter than 4 ms showed wide variation, and no pulse was obtained at 3 ms. Three thrusters were each subjected to 75,000 short pulses of 4 ms or less without performance degradation. A fourth thruster exhibited partial flow blockage after 13,000 short pulses, but this was attributed to prevous test history and not short pulse exposure. The Voyager attitude control thrusters should be considered flight qualified for short pulse operation at pulse widths of 4.0 ms or more.

Ultra-narrow pulse generator with precision-adjustable pulse width

NASA Astrophysics Data System (ADS)

Fu, Zaiming; Liu, Hanglin

2018-05-01

In this paper, a novel ultra-narrow pulse generation approach is proposed. It is based on the decomposition and synthesis of pulse edges. Through controlling their relative delay, an ultra-narrow pulse could be generated. By employing field programmable gate array digital synthesis technology, the implemented pulse generator is with programmable ability. The amplitude of pulse signals is controlled by the radio frequency amplifiers and bias tees, and high precision can be achieved. More importantly, the proposed approach can break through the limitation of device's propagation delay and optimize the resolution and the accuracy of the pulse width significantly. The implemented pulse generator has two channels, whose minimum pulse width, frequency range, and amplitude range are 100 ps, 15 MHz-1.5 GHz, and 0.1 Vpp-1.8 Vpp, respectively. Both resolution of pulse width and channel delay are 1 ps, and amplitude resolution is 10 mVpp.

Control of laser pulse waveform in longitudinally excited CO2 laser by adjustment of excitation circuit

NASA Astrophysics Data System (ADS)

Uno, Kazuyuki; Jitsuno, Takahisa

2018-05-01

In a longitudinally excited CO2 laser that had a 45 cm-long discharge tube with a 1:1:2 mixture of CO2/N2/He gas at a pressure of 3.0 kPa, we realized the generation of a short laser pulse with a spike pulse width of about 200 ns and a pulse tail length of several tens of microseconds, control of the energy ratio of the spike pulse part to the pulse tail part in the short laser pulse, the generation of a long laser pulse with a pulse width of several tens of microseconds, and control of the pulse width in the long laser pulse, by using four types of excitation circuits in which the capacitance was adjusted. In the short laser pulse, the energy ratio was in the range 1:14-1:112. In the long laser pulse, the pulse width was in the range 25.7-82.7 μs.

Surface ablation of aluminum and silicon by ultrashort laser pulses of variable width

NASA Astrophysics Data System (ADS)

Zayarny, D. A.; Ionin, A. A.; Kudryashov, S. I.; Makarov, S. V.; Kuchmizhak, A. A.; Vitrik, O. B.; Kulchin, Yu. N.

2016-06-01

Single-shot thresholds of surface ablation of aluminum and silicon via spallative ablation by infrared (IR) and visible ultrashort laser pulses of variable width τlas (0.2-12 ps) have been measured by optical microscopy. For increasing laser pulse width τlas < 3 ps, a drastic (threefold) drop of the ablation threshold of aluminum has been observed for visible pulses compared to an almost negligible threshold variation for IR pulses. In contrast, the ablation threshold in silicon increases threefold with increasing τlas for IR pulses, while the corresponding thresholds for visible pulses remained almost constant. In aluminum, such a width-dependent decrease in ablation thresholds has been related to strongly diminished temperature gradients for pulse widths exceeding the characteristic electron-phonon thermalization time. In silicon, the observed increase in ablation thresholds has been ascribed to two-photon IR excitation, while in the visible range linear absorption of the material results in almost constant thresholds.

A phantom for quantitation of partial volume effects in ECT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mullani, N.A.

1989-02-01

A special phantom has been designed, built and tested to measure the quantitative recovery of ECT data from the heart as a function of the size of the object and the angulation of a 1 cm thick simulated myocardium inclined with respect to the image plane. The phantom consists of five objects of 0.5, 1.0, 1.5. 2.0, and 3.0 cm width and six 1 cm thick strips inclined at 0, 30, 45, 60, 90, and -90 degrees with respect to the axial direction. Recovery coefficients for different object sizes and simulated 1 cm thick myocardium inclined at different angles canmore » be obtained from a single scan. Adequacy of axial sampling can be observed visually by creating the long axis view of the phantom.« less

TEMPORAL EVOLUTION OF THE VELA PULSAR’S PULSE PROFILE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palfreyman, J. L.; Dickey, J. M.; Ellingsen, S. P.

The mechanisms of emission and changes in rotation frequency (“glitching”) of the Vela pulsar (J0835−4510) are not well understood. Further insight into these mechanisms can be achieved by long-term studies of integrated pulse width, timing residuals, and bright-pulse rates. We have undertaken an intensive observing campaign of Vela and collected over 6000 hr of single-pulse data. The data shows that the pulse width changes with time, including marked jumps in width after micro-glitches (frequency changes). The abundance of bright pulses also changes after some micro-glitches, but not all. The secular changes in pulse width have three possible cyclic periods thatmore » match with X-ray periodicities of a helical jet that are interpreted as free precession.« less

Broadband tunable integrated CMOS pulser with 80-ps minimum pulse width for gain-switched semiconductor lasers.

PubMed

Chen, Shaoqiang; Diao, Shengxi; Li, Pengtao; Nakamura, Takahiro; Yoshita, Masahiro; Weng, Guoen; Hu, Xiaobo; Shi, Yanling; Liu, Yiqing; Akiyama, Hidefumi

2017-07-31

High power pulsed lasers with tunable pulse widths are highly favored in many applications. When combined with power amplification, gain-switched semiconductor lasers driven by broadband tunable electric pulsers can meet such requirements. For this reason, we designed and produced a low-cost integrated CMOS pulse generator with a minimum pulse width of 80 ps and a wide tuning range of up to 270 ns using a 40-nm microelectronic process technique. We used this pulser to drive a 1.3-µm semiconductor laser diode directly, and thereafter investigated the gain-switching properties of the laser system. The optical pulses consist of a spike followed by a steady state region. Tuning the width of the electrical pulse down to approximately 1.5 ns produces optical pulses consisting only of the spike, which has a minimum pulse-width of 100 ps. Moreover, the duration of the steady state can be tuned continuously by tuning the electrical pulse width, with a peak power of approximately 5 mW. The output voltage of the electric pulser has a tuning range of 0.8-1.5 V that can be used to directly drive semiconductor laser diodes with wavelengths in the near-infrared spectrum, which are suitable for power amplification with rare-earth doped fiber amplifiers.

Well-behaved dynamics in a dissipative nonideal periodically kicked rotator.

PubMed

Chacón, R; Martínez García-Hoz, A

2003-12-01

Well-behaved dynamical properties are found in a dissipative kicked rotator subjected to a periodic string of asymmetric pulses of finite amplitude and width. The stability boundaries of the equilibrium are determined to arbitrary approximation for trigonometric pulses by means of circular harmonic balance, and to first approximation for general elliptic pulses by means of an elliptic harmonic balance method. The bifurcation behavior at the stability boundaries is determined numerically. We show how the extension of the instability region of the equilibrium in pulse parameter space reaches a maximum as the pulse width is varied. We also characterize the dependence of the mean duration of the transients to the equilibrium on the pulse width. The evolution of the basins of attraction of chaotic attractors when solely the pulse width is varied is characterized numerically. Finally, we show that the order-chaos route when solely the width of the pulses is altered appears to be especially rich, including different types of crises. The mechanism underlying these reshaping-induced crises is discussed with the aid of a two-dimensional map.

Capacitor charging FET switcher with controller to adjust pulse width

DOEpatents

Mihalka, Alex M.

1986-01-01

A switching power supply includes an FET full bridge, a controller to drive the FETs, a programmable controller to dynamically control final output current by adjusting pulse width, and a variety of protective systems, including an overcurrent latch for current control. Power MOSFETS are switched at a variable frequency from 20-50 kHz to charge a capacitor load from 0 to 6 kV. A ferrite transformer steps up the DC input. The transformer primary is a full bridge configuration with the FET switches and the secondary is fed into a high voltage full wave rectifier whose output is connected directly to the energy storage capacitor. The peak current is held constant by varying the pulse width using predetermined timing resistors and counting pulses. The pulse width is increased as the capacitor charges to maintain peak current. A digital ripple counter counts pulses, and after the desired number is reached, an up-counter is clocked. The up-counter output is decoded to choose among different resistors used to discharge a timing capacitor, thereby determining the pulse width. A current latch shuts down the supply on overcurrent due to either excessive pulse width causing transformer saturation or a major bridge fault, i.e., FET or transformer failure, or failure of the drive circuitry.

Losses analysis of soft magnetic ring core under sinusoidal pulse width modulation (SPWM) and space vector pulse width modulation (SVPWM) excitations

NASA Astrophysics Data System (ADS)

Gao, Hezhe; Li, Yongjian; Wang, Shanming; Zhu, Jianguo; Yang, Qingxin; Zhang, Changgeng; Li, Jingsong

2018-05-01

Practical core losses in electrical machines differ significantly from those experimental results using the standardized measurement method, i.e. Epstein Frame method. In order to obtain a better approximation of the losses in an electrical machine, a simulation method considering sinusoidal pulse width modulation (SPWM) and space vector pulse width modulation (SVPWM) waveforms is proposed. The influence of the pulse width modulation (PWM) parameters on the harmonic components in SPWM and SVPWM is discussed by fast Fourier transform (FFT). Three-level SPWM and SVPWM are analyzed and compared both by simulation and experiment. The core losses of several ring samples magnetized by SPWM, SVPWM and sinusoidal alternating current (AC) are obtained. In addition, the temperature rise of the samples under SPWM, sinusoidal excitation are analyzed and compared.

LINEAR COUNT-RATE METER

DOEpatents

Henry, J.J.

1961-09-01

A linear count-rate meter is designed to provide a highly linear output while receiving counting rates from one cycle per second to 100,000 cycles per second. Input pulses enter a linear discriminator and then are fed to a trigger circuit which produces positive pulses of uniform width and amplitude. The trigger circuit is connected to a one-shot multivibrator. The multivibrator output pulses have a selected width. Feedback means are provided for preventing transistor saturation in the multivibrator which improves the rise and decay times of the output pulses. The multivibrator is connected to a diode-switched, constant current metering circuit. A selected constant current is switched to an averaging circuit for each pulse received, and for a time determined by the received pulse width. The average output meter current is proportional to the product of the counting rate, the constant current, and the multivibrator output pulse width.

Width-tunable pulse laser via optical injection induced gain modulation of semiconductor optical amplifiers

NASA Astrophysics Data System (ADS)

Pan, Honggang; Zhang, Ailing; Tong, Zhengrong; Zhang, Yue; Song, Hongyun; Yao, Yuan

2018-03-01

A width-tunable pulse laser via an optical injection induced gain modulation of a semiconductor optical amplifier (SOA) is demonstrated. When the pump current of the SOA is 330 mA or 400 mA and a continuous wave is injected into the laser cavity with different powers, bright or dark pulses with different pulse widths and frequency repetition rates are obtained. The bright and dark pulses are formed by the effect of gain dispersion and cross-gain modulation of the SOA.

High resolution, high rate X-ray spectrometer

DOEpatents

Goulding, Frederick S.; Landis, Donald A.

1987-01-01

A pulse processing system (10) for use in an X-ray spectrometer in which a ain channel pulse shaper (12) and a fast channel pulse shaper (13) each produce a substantially symmetrical triangular pulse (f, p) for each event detected by the spectrometer, with the pulse width of the pulses being substantially independent of the magnitude of the detected event and with the pulse width of the fast pulses (p) being substantially shorter than the pulse width of the main channel pulses (f). A pile-up rejector circuit (19) allows output pulses to be generated, with amplitudes linearly related to the magnitude of the detected events, whenever the peak of a main channel pulse (f) is not affected by a preceding or succeeding main channel pulse, while inhibiting output pulses wherein peak magnitudes of main channel pulses are affected by adjacent pulses. The substantially symmetrical triangular main channel pulses (f) are generated by the weighted addition (27-31) of successive RC integrations (24, 25, 26) of an RC differentiated step wave (23). The substantially symmetrical triangular fast channel pulses (p) are generated by the RC integration ( 43) of a bipolar pulse (o) in which the amplitude of the second half is 1/e that of the first half, with the RC time constant of integration being equal to one-half the width of the bipolar pulse.

Performance of large aperture tapered fiber phase conjugate mirror with high pulse energy and 1-kHz repetition rate.

PubMed

Zhao, Zhigang; Dong, Yantao; Pan, Sunqiang; Liu, Chong; Chen, Jun; Tong, Lixin; Gao, Qingsong; Tang, Chun

2012-01-16

A large aperture fused silica tapered fiber phase conjugate mirror is presented with a maximum 70% stimulated Brillouin scattering (SBS) reflectivity, which is obtained with 1 kHz repetition rate, 15 ns pulse width and 38 mJ input pulse energy. To the best of our knowledge, this is the highest SBS reflectivity ever reported by using optical fiber as a phase conjugate mirror for such high pulse repetition rate (1 kHz) and several tens of millijoule (mJ) input pulse energy. The influences of fiber end surface quality and pump pulse widths on SBS reflectivity are investigated experimentally. The results show that finer fiber end surface quality and longer input pulse widths are preferred for obtaining higher SBS reflectivity with higher input pulse energy. Double passing amplification experiments are also performed. 52 mJ pulse energy is achieved at 1 kHz repetition rate, with a reflected SBS pulse width of 1.5 ns and a M(2) factor of 2.3. The corresponding peak power reaches 34.6 MW. Obvious beam quality improvement is observed.

Revisiting NMR composite pulses for broadband 2H excitation

PubMed Central

Shen, Ming; Roopchand, Rabia; Mananga, Eugene S.; Amoureux, Jean-Paul; Chen, Qun; Boutis, Gregory S.; Hu, Bingwen

2014-01-01

Quadrupolar echo NMR spectroscopy of static solids often requires RF excitation that covers spectral widths exceeding 100 kHz, which is difficult to obtain due to instrumental limitations. In this work we revisit four well-known composite pulses (COM-I, II, III and IV) for broadband excitation in deuterium quadrupolar echo spectroscopy. These composite pulses are combined with several phase cycling schemes that were previously shown to decrease finite pulse width distortions in deuterium solid-echo experiments performed with two single pulses. The simulations and experiments show that COM-II and IV composite pulses combined with an 8-step phase cycling aid in achieving broadband excitation with limited pulse width distortions. PMID:25583576

SYSTEM FOR AND METHOD OF DETERMINING RANGE

DOEpatents

Horrell, M.W.; Sanders, E.R.

1963-11-01

A system and method for indicating a predetermined altitude of an object or aircraft is described. The device utilizes a pulse transmit-receive system wherein pulses of predetermined width are transmitted towards the ground and the reflected pulses received gating only pulses having a predetermined width. (AEC)

Experimental study of atmospheric-pressure micro-plasmas for the ambient sampling of conductive materials

NASA Astrophysics Data System (ADS)

Duan, Zhengchao; He, Feng; Si, Xinlu; Bradley, James W.; Ouyang, Jiting

2018-02-01

Conductive solid material sampling by micro-plasma under ambient atmosphere was studied experimentally. A high-voltage pulse generator was utilized to drive discharge between a tungsten needle and metal samples. The effects of pulse width on discharge, micro-plasma and sampling were investigated. The electrical results show that two discharge current pulses can be formed in one voltage pulse. The duration of the first current pulse is of the order of 100 ns. The duration of the second current pulse depends on the width of the voltage pulse. The electrical results also show that arc micro-plasma was generated during both current pulses. The results of the emission spectra of different sampled materials indicate that the relative emission intensity of elemental metal ions will increase with pulse width. The excitation temperature and electron density of the arc micro-plasmas increase with the voltage pulse width, which contributes to the increase of relative emission intensity of metal ions. The optical images and energy dispersive spectroscopy results of the sampling spots on metal surfaces indicate that discharge with a short voltage pulse can generate a small sputtering crater.

Hybrid Pulsed Nd:YAG Laser

NASA Astrophysics Data System (ADS)

Miller, Sawyer; Trujillo, Skyler; Fort Lewis College Laser Group Team

This work concerns the novel design of an inexpensive pulsed Nd:YAG laser, consisting of a hybrid Kerr Mode Lock (KLM) and Q-switch pulse. The two pulse generation systems work independently, non simultaneously of each other, thus generating the ability for the user to easily switch between ultra-short pulse widths or large energy density pulses. Traditionally, SF57 glass has been used as the Kerr medium. In this work, novel Kerr mode-locking mediums are being investigated including: tellurite compound glass (TeO2), carbon disulfide (CS2), and chalcogenide glass. These materials have a nonlinear index of refraction orders of magnitude,(n2), larger than SF57 glass. The Q-switched pulse will utilize a Pockels cell. As the two pulse generation systems cannot be operated simultaneously, the Pockels cell and Kerr medium are attached to kinematic mounts, allowing for quick interchange between systems. Pulse widths and repetition rates will vary between the two systems. A goal of 100 picosecond pulse widths are desired for the mode-locked system. A goal of 10 nanosecond pulse widths are desired for the Q-switch system, with a desired repetition rate of 50 Hz. As designed, the laser will be useful in imaging applications.

Performance benefits from pulsed laser heating in heat assisted magnetic recording

NASA Astrophysics Data System (ADS)

Xu, B. X.; Cen, Z. H.; Goh, J. H.; Li, J. M.; Toh, Y. T.; Zhang, J.; Ye, K. D.; Quan, C. G.

2014-05-01

Smaller cross track thermal spot size and larger down track thermal gradient are desired for increasing the density of heat assisted magnetic recording. Both parameters are affected significantly by the thermal energy accumulation and diffusion in the recording media. Pulsed laser heating is one of the ways to reduce the thermal diffusion. In this paper, we describe the benefits from the pulsed laser heating such as the dependences of the cross track thermal width, down track thermal gradient, the required laser pulse/average powers, and the transducer temperature rise on the laser pulse width at different media thermal properties. The results indicate that as the pulse width decreases, the thermal width decreases, the thermal gradient increases, the required pulse power increases and the average power decreases. For shorter pulse heating, the effects of the medium thermal properties on the thermal performances become weaker. This can greatly relax the required thermal properties of the media. The results also show that the pulsed laser heating can effectively reduce the transducer temperature rise and allow the transducer to reach its "dynamically" stable temperature more quickly.

Sub-nanosecond ranging possibilities of optical radar at various signal levels and transmitted pulse widths

NASA Technical Reports Server (NTRS)

Poultney, S. K.

1971-01-01

The behavior of the photomultiplier is considered, as well as the method of derivation of the photomultiplier output pulse and its relation to the reflected light pulse width and amplitude, and the calibration of range precision and accuracy. Pulsed laser radars with light pulse widths of 30, 3, and 0.1 nanosec a considered, with the 0.1 nanosec system capable of highest precision in several modes of operation, including a high repetition rate, single photoelectron reception mode. An alternate calibration scheme using a fast, triggerable light pulser is described in detail.

Dynamics of short-pulse generation via spectral filtering from intensely excited gain-switched 1.55-μm distributed-feedback laser diodes.

PubMed

Chen, Shaoqiang; Yoshita, Masahiro; Sato, Aya; Ito, Takashi; Akiyama, Hidefumi; Yokoyama, Hiroyuki

2013-05-06

Picosecond-pulse-generation dynamics and pulse-width limiting factors via spectral filtering from intensely pulse-excited gain-switched 1.55-μm distributed-feedback laser diodes were studied. The spectral and temporal characteristics of the spectrally filtered pulses indicated that the short-wavelength component stems from the initial part of the gain-switched main pulse and has a nearly linear down-chirp of 5.2 ps/nm, whereas long-wavelength components include chirped pulse-lasing components and steady-state-lasing components. Rate-equation calculations with a model of linear change in refractive index with carrier density explained the major features of the experimental results. The analysis of the expected pulse widths with optimum spectral widths was also consistent with the experimental data.

Emission Characteristics of Laser-Induced Plasma Using Collinear Long and Short Dual-Pulse Laser-Induced Breakdown Spectroscopy (LIBS).

PubMed

Wang, Zhenzhen; Deguchi, Yoshihiro; Liu, Renwei; Ikutomo, Akihiro; Zhang, Zhenzhen; Chong, Daotong; Yan, Junjie; Liu, Jiping; Shiou, Fang-Jung

2017-09-01

Collinear long and short dual-pulse laser-induced breakdown spectroscopy (DP-LIBS) was employed to clarify the emission characteristics from laser-induced plasma. The plasma was sustained and became stable by the long pulse-width laser with the pulse width of 60 μs under free running (FR) conditions as an external energy source. Comparing the measurement results of stainless steel in air using single-pulse LIBS (SP-LIBS) and DP-LIBS, the emission intensity was markedly enhanced using DP-LIBS. The temperature of plasma induced by DP-LIBS was maintained at a higher temperature under different gate delay time and short pulse-width laser power conditions compared with those measured using short SP-LIBS. Moreover, the variation rates of plasma temperatures measured using DP-LIBS were also lower. The superior detection ability was verified by the measurement of aluminum sample in water. The spectra were clearly detected using DP-LIBS, whereas it cannot be identified using SP-LIBS of short and long pulse widths. The effects of gate delay time and short pulse-width laser power were also discussed. These results demonstrate the feasibility and enhanced detection ability of the proposed collinear long and short DP-LIBS method.

Receiver design, performance analysis, and evaluation for space-borne laser altimeters and space-to-space laser ranging systems

NASA Technical Reports Server (NTRS)

Davidson, Frederic M.; Sun, Xiaoli; Field, Christopher T.

1995-01-01

Laser altimeters measure the time of flight of the laser pulses to determine the range of the target. The simplest altimeter receiver consists of a photodetector followed by a leading edge detector. A time interval unit (TIU) measures the time from the transmitted laser pulse to the leading edge of the received pulse as it crosses a preset threshold. However, the ranging error of this simple detection scheme depends on the received, pulse amplitude, pulse shape, and the threshold. In practice, the pulse shape and the amplitude are determined by the target target characteristics which has to be assumed unknown prior to the measurement. The ranging error can be improved if one also measures the pulse width and use the average of the leading and trailing edges (half pulse width) as the pulse arrival time. The ranging error becomes independent of the received pulse amplitude and the pulse width as long as the pulse shape is symmetric. The pulse width also gives the slope of the target. The ultimate detection scheme is to digitize the received waveform and calculate the centroid as the pulse arrival time. The centroid detection always gives unbiased measurement even for asymmetric pulses. In this report, we analyze the laser altimeter ranging errors for these three detection schemes using the Mars Orbital Laser Altimeter (MOLA) as an example.

Precise delay measurement through combinatorial logic

NASA Technical Reports Server (NTRS)

Burke, Gary R. (Inventor); Chen, Yuan (Inventor); Sheldon, Douglas J. (Inventor)

2010-01-01

A high resolution circuit and method for facilitating precise measurement of on-chip delays for FPGAs for reliability studies. The circuit embeds a pulse generator on an FPGA chip having one or more groups of LUTS (the "LUT delay chain"), also on-chip. The circuit also embeds a pulse width measurement circuit on-chip, and measures the duration of the generated pulse through the delay chain. The pulse width of the output pulse represents the delay through the delay chain without any I/O delay. The pulse width measurement circuit uses an additional asynchronous clock autonomous from the main clock and the FPGA propagation delay can be displayed on a hex display continuously for testing purposes.

Planning of electroporation-based treatments using Web-based treatment-planning software.

PubMed

Pavliha, Denis; Kos, Bor; Marčan, Marija; Zupanič, Anže; Serša, Gregor; Miklavčič, Damijan

2013-11-01

Electroporation-based treatment combining high-voltage electric pulses and poorly permanent cytotoxic drugs, i.e., electrochemotherapy (ECT), is currently used for treating superficial tumor nodules by following standard operating procedures. Besides ECT, another electroporation-based treatment, nonthermal irreversible electroporation (N-TIRE), is also efficient at ablating deep-seated tumors. To perform ECT or N-TIRE of deep-seated tumors, following standard operating procedures is not sufficient and patient-specific treatment planning is required for successful treatment. Treatment planning is required because of the use of individual long-needle electrodes and the diverse shape, size and location of deep-seated tumors. Many institutions that already perform ECT of superficial metastases could benefit from treatment-planning software that would enable the preparation of patient-specific treatment plans. To this end, we have developed a Web-based treatment-planning software for planning electroporation-based treatments that does not require prior engineering knowledge from the user (e.g., the clinician). The software includes algorithms for automatic tissue segmentation and, after segmentation, generation of a 3D model of the tissue. The procedure allows the user to define how the electrodes will be inserted. Finally, electric field distribution is computed, the position of electrodes and the voltage to be applied are optimized using the 3D model and a downloadable treatment plan is made available to the user.

Role of defects in laser-induced modifications of silica coatings and fused silica using picosecond pulses at 1053 nm: II Scaling laws and the density of precursors

DOE PAGES

Laurence, T. A.; Negres, R. A.; Ly, S.; ...

2017-06-22

Here, we investigate the role of defects in laser-induced damage of fused silica and of silica coatings produced by e-beam and PIAD processes which are used in damage resistant, multi-layer dielectric, reflective optics. We perform experiments using 1053 nm, 1–60 ps laser pulses with varying beam size, number of shots, and pulse widths in order to understand the characteristics of defects leading to laser-induced damage. This pulse width range spans a transition in mechanisms from intrinsic material ablation for short pulses to defect-dominated damage for longer pulses. We show that for pulse widths as short as 10 ps, laser-induced damagemore » properties of fused silica and silica films are dominated by isolated absorbers. The density of these precursors and their fluence dependence of damage initiation suggest a single photon process for initial energy absorption in these precursors. Higher density precursors that initiate close to the ablation threshold at shorter pulse widths are also observed in fused silica, whose fluence and pulse width scaling suggest a multiphoton initiation process. We also show that these initiated damage sites grow with subsequent laser pulses. We show that scaling laws obtained in more conventional ways depend on the beam size and on the definition of damage for ps pulses. For this reason, coupling scaling laws with the density of precursors are critical to understanding the damage limitations of optics in the ps regime.« less

Role of defects in laser-induced modifications of silica coatings and fused silica using picosecond pulses at 1053 nm: II Scaling laws and the density of precursors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laurence, T. A.; Negres, R. A.; Ly, S.

Here, we investigate the role of defects in laser-induced damage of fused silica and of silica coatings produced by e-beam and PIAD processes which are used in damage resistant, multi-layer dielectric, reflective optics. We perform experiments using 1053 nm, 1–60 ps laser pulses with varying beam size, number of shots, and pulse widths in order to understand the characteristics of defects leading to laser-induced damage. This pulse width range spans a transition in mechanisms from intrinsic material ablation for short pulses to defect-dominated damage for longer pulses. We show that for pulse widths as short as 10 ps, laser-induced damagemore » properties of fused silica and silica films are dominated by isolated absorbers. The density of these precursors and their fluence dependence of damage initiation suggest a single photon process for initial energy absorption in these precursors. Higher density precursors that initiate close to the ablation threshold at shorter pulse widths are also observed in fused silica, whose fluence and pulse width scaling suggest a multiphoton initiation process. We also show that these initiated damage sites grow with subsequent laser pulses. We show that scaling laws obtained in more conventional ways depend on the beam size and on the definition of damage for ps pulses. For this reason, coupling scaling laws with the density of precursors are critical to understanding the damage limitations of optics in the ps regime.« less

[Loudness optimized registration of compound action potential in cochlear implant recipients].

PubMed

Berger, Klaus; Hocke, Thomas; Hessel, Horst

2017-11-01

Background Postoperative measurements of compound action potentials are not always possible due to the insufficient acceptance of the CI-recipients. This study investigated the impact of different parameters on the acceptance of the measurements. Methods Compound action potentials of 16 CI recipients were measured with different pulse-widths. Recipients performed a loudness rating at the potential thresholds with the different sequences. Results Compound action potentials obtained with higher pulse-widths were rated softer than those obtained with smaller pulse-widths. Conclusions Compound action potentials measured with higher pulse-widths generate a gap between loudest acceptable presentation level and potential threshold. This gap contributes to a higher acceptance of postoperative measurements. Georg Thieme Verlag KG Stuttgart · New York.

Optimal time-domain technique for pulse width modulation in power electronics

NASA Astrophysics Data System (ADS)

Mayergoyz, I.; Tyagi, S.

2018-05-01

Optimal time-domain technique for pulse width modulation is presented. It is based on exact and explicit analytical solutions for inverter circuits, obtained for any sequence of input voltage rectangular pulses. Two optimal criteria are discussed and illustrated by numerical examples.

Pulse width and height modulation for multi-level resistance in bi-layer TaOx based RRAM

NASA Astrophysics Data System (ADS)

Alamgir, Zahiruddin; Beckmann, Karsten; Holt, Joshua; Cady, Nathaniel C.

2017-08-01

Mutli-level switching in resistive memory devices enables a wide range of computational paradigms, including neuromorphic and cognitive computing. To this end, we have developed a bi-layer tantalum oxide based resistive random access memory device using Hf as the oxygen exchange layer. Multiple, discrete resistance levels were achieved by modulating the RESET pulse width and height, ranging from 2 kΩ to several MΩ. For a fixed pulse height, OFF state resistance was found to increase gradually with the increase in the pulse width, whereas for a fixed pulse width, the increase in the pulse height resulted in drastic changes in resistance. Resistive switching in these devices transitioned from Schottky emission in the OFF state to tunneling based conduction in the ON state, based on I-V curve fitting and temperature dependent current measurements. These devices also demonstrated endurance of more than 108 cycles with a satisfactory Roff/Ron ratio and retention greater than 104 s.

Wedge-shaped slice-selective adiabatic inversion pulse for controlling temporal width of bolus in pulsed arterial spin labeling

PubMed Central

Guo, Jia; Buxton, Richard B.; Wong, Eric C.

2015-01-01

Purpose In pulsed arterial spin labeling (PASL) methods, arterial blood is labeled via inverting a slab with uniform thickness, resulting in different temporal widths of boluses in vessels with different flow velocities. This limits the temporal resolution and signal-to-noise ratio (SNR) efficiency gains in PASL-based methods intended for high temporal resolution and SNR efficiency, such as Turbo-ASL and Turbo-QUASAR. Theory and Methods A novel wedge-shaped (WS) adiabatic inversion pulse is developed by adding in-plane gradient pulses to a slice-selective (SS) adiabatic inversion pulse to linearly modulate the inversion thicknesses at different locations while maintaining the adiabatic properties of the original pulse. A hyperbolic secant (HS) based WS inversion pulse was implemented. Its performance was tested in simulations, phantom and human experiments, and compared to an SS HS inversion pulse. Results Compared to the SS inversion pulse, the WS inversion pulse is capable of inducing different inversion thicknesses at different locations. It can be adjusted to generate a uniform temporal width of boluses in arteries at locations with different flow velocities. Conclusion The WS inversion pulse can be used to control the temporal widths of labeled boluses in PASL experiments. This should benefit PASL experiments by maximizing labeling duty cycle, and improving temporal resolution and SNR efficiency. PMID:26451521

Assessing a novel immuno-oncology-based combination therapy: Ipilimumab plus electrochemotherapy

PubMed Central

Mozzillo, Nicola; Simeone, Ester; Benedetto, Lucia; Curvietto, Marcello; Giannarelli, Diana; Gentilcore, Giusy; Camerlingo, Rosa; Capone, Mariaelena; Madonna, Gabriele; Festino, Lucia; Caracò, Corrado; Di Monta, Gianluca; Marone, Ugo; Di Marzo, Massimiliano; Grimaldi, Antonio M; Mori, Stefano; Ciliberto, Gennaro; Ascierto, Paolo A

2015-01-01

Melanoma is responsible for most skin cancer-related deaths and is one of the most common cancers diagnosed in young adults. In melanoma, tumors can become established by activation of the negative regulator of cytotoxic T lymphocytes (CTLs), CTL antigen-4 (CTLA-4). Ipilimumab blocks the interaction of CTLA-4 with CD80/CD86 and augments T-cell activation and proliferation. In electrochemotherapy (ECT), local application of short high-voltage pulses renders cell membranes transiently permeable to chemotherapeutic drugs. The combination of ipilimumab and ECT may be beneficial for the treatment of metastatic melanoma; however, no prospective data are available to date. Here, we report the retrospective analysis of patients treated with ipilimumab in an expanded access program (EAP) who also received ECT. Fifteen patients with previously treated metastatic melanoma who received ipilimumab 3 mg/kg every three weeks for four cycles and underwent ECT for local disease control and/or palliation of cutaneous lesions with bleomycin 15 mg/m2 after the first ipilimumab infusion were included in the analysis. Over the study period, a local objective response was observed in 67% of patients (27% complete response [CR] and 40% partial response [PR]). According to immune-related response criteria, a systemic response was observed in nine patients (five PR and four stable disease [SD]), resulting in a disease control rate of 60%. Evaluation of circulating T-regulatory (T-reg) cells demonstrated significant differences between responders and non-responders. Overall, treatment was well-tolerated and without notable toxicity. In conclusion, the combination of ipilimumab and ECT appears to be beneficial to patients with advanced melanoma, warranting further investigation in prospective trials. PMID:26155423

Assessing a novel immuno-oncology-based combination therapy: Ipilimumab plus electrochemotherapy.

PubMed

Mozzillo, Nicola; Simeone, Ester; Benedetto, Lucia; Curvietto, Marcello; Giannarelli, Diana; Gentilcore, Giusy; Camerlingo, Rosa; Capone, Mariaelena; Madonna, Gabriele; Festino, Lucia; Caracò, Corrado; Di Monta, Gianluca; Marone, Ugo; Di Marzo, Massimiliano; Grimaldi, Antonio M; Mori, Stefano; Ciliberto, Gennaro; Ascierto, Paolo A

2015-06-01

Melanoma is responsible for most skin cancer-related deaths and is one of the most common cancers diagnosed in young adults. In melanoma, tumors can become established by activation of the negative regulator of cytotoxic T lymphocytes (CTLs), CTL antigen-4 (CTLA-4). Ipilimumab blocks the interaction of CTLA-4 with CD80/CD86 and augments T-cell activation and proliferation. In electrochemotherapy (ECT), local application of short high-voltage pulses renders cell membranes transiently permeable to chemotherapeutic drugs. The combination of ipilimumab and ECT may be beneficial for the treatment of metastatic melanoma; however, no prospective data are available to date. Here, we report the retrospective analysis of patients treated with ipilimumab in an expanded access program (EAP) who also received ECT. Fifteen patients with previously treated metastatic melanoma who received ipilimumab 3 mg/kg every three weeks for four cycles and underwent ECT for local disease control and/or palliation of cutaneous lesions with bleomycin 15 mg/m 2 after the first ipilimumab infusion were included in the analysis. Over the study period, a local objective response was observed in 67% of patients (27% complete response [CR] and 40% partial response [PR]). According to immune-related response criteria, a systemic response was observed in nine patients (five PR and four stable disease [SD]), resulting in a disease control rate of 60%. Evaluation of circulating T-regulatory (T-reg) cells demonstrated significant differences between responders and non-responders. Overall, treatment was well-tolerated and without notable toxicity. In conclusion, the combination of ipilimumab and ECT appears to be beneficial to patients with advanced melanoma, warranting further investigation in prospective trials.

EVOLUTION OF FAST MAGNETOACOUSTIC PULSES IN RANDOMLY STRUCTURED CORONAL PLASMAS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yuan, D.; Li, B.; Pascoe, D. J.

2015-02-01

We investigate the evolution of fast magnetoacoustic pulses in randomly structured plasmas, in the context of large-scale propagating waves in the solar atmosphere. We perform one-dimensional numerical simulations of fast wave pulses propagating perpendicular to a constant magnetic field in a low-β plasma with a random density profile across the field. Both linear and nonlinear regimes are considered. We study how the evolution of the pulse amplitude and width depends on their initial values and the parameters of the random structuring. Acting as a dispersive medium, a randomly structured plasma causes amplitude attenuation and width broadening of the fast wavemore » pulses. After the passage of the main pulse, secondary propagating and standing fast waves appear. Width evolution of both linear and nonlinear pulses can be well approximated by linear functions; however, narrow pulses may have zero or negative broadening. This arises because narrow pulses are prone to splitting, while broad pulses usually deviate less from their initial Gaussian shape and form ripple structures on top of the main pulse. Linear pulses decay at an almost constant rate, while nonlinear pulses decay exponentially. A pulse interacts most efficiently with a random medium with a correlation length of about half of the initial pulse width. This detailed model of fast wave pulses propagating in highly structured media substantiates the interpretation of EIT waves as fast magnetoacoustic waves. Evolution of a fast pulse provides us with a novel method to diagnose the sub-resolution filamentation of the solar atmosphere.« less

Multiple current peaks in room-temperature atmospheric pressure homogenous dielectric barrier discharge plasma excited by high-voltage tunable nanosecond pulse in air

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, De-Zheng; Wang, Wen-Chun; Zhang, Shuai

2013-05-13

Room temperature homogenous dielectric barrier discharge plasma with high instantaneous energy efficiency is acquired by using nanosecond pulse voltage with 20-200 ns tunable pulse width. Increasing the voltage pulse width can lead to the generation of regular and stable multiple current peaks in each discharge sequence. When the voltage pulse width is 200 ns, more than 5 organized current peaks can be observed under 26 kV peak voltage. Investigation also shows that the organized multiple current peaks only appear in homogenous discharge mode. When the discharge is filament mode, organized multiple current peaks are replaced by chaotic filament current peaks.

Design of a variable width pulse generator feasible for manual or automatic control

NASA Astrophysics Data System (ADS)

Vegas, I.; Antoranz, P.; Miranda, J. M.; Franco, F. J.

2017-01-01

A variable width pulse generator featuring more than 4-V peak amplitude and less than 10-ns FWHM is described. In this design the width of the pulses is controlled by means of the control signal slope. Thus, a variable transition time control circuit (TTCC) is also developed, based on the charge and discharge of a capacitor by means of two tunable current sources. Additionally, it is possible to activate/deactivate the pulses when required, therefore allowing the creation of any desired pulse pattern. Furthermore, the implementation presented here can be electronically controlled. In conclusion, due to its versatility, compactness and low cost it can be used in a wide variety of applications.

Reactive nanolaminate pulsed-laser ignition mechanism: Modeling and experimental evidence of diffusion limited reactions

DOE PAGES

Yarrington, C. D.; Abere, M. J.; Adams, D. P.; ...

2017-04-03

We irradiated Al/Pt nanolaminates with a bilayer thickness (tb, width of an Al/Pt pair-layer) of 164 nm with single laser pulses with durations of 10 ms and 0.5 ms at 189 W/cm 2 and 1189 W/cm 2, respectively. The time to ignition was measured for each pulse, and shorter ignition times were observed for the higher power/shorter pulse width. While the shorter pulse shows uniform brightness, videographic images of the irradiated area shortly after ignition show a non-uniform radial brightness for the longer pulse. A diffusion-limited single step reaction mechanism was implemented in a finite element package to model themore » progress from reactants to products at both pulse widths. Finally, the model captures well both the observed ignition delay and qualitative observations regarding the non-uniform radial temperature.« less

Ignition Characteristics of Single-Walled Carbon Nanotubes (SWCNTs) Utilizing a Camera Flash for Distributed Ignition of Liquid Sprays (Preprint)

DTIC Science & Technology

2008-10-01

acoustic phenomenon. Our results indicate that the shorter pulse width (with lower energy/pulse) required ~30-35 mJ/pulse to initiate ignition of... acoustic behavior and some other novel phenomena associated with radiation absorption by SWCNTs. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17...pressure level (SPL) from the photo acoustic phenomenon. Our results indicate that the shorter pulse width (with lower energy/pulse) required ~30-35

Tissue effects of Ho:YAG laser with varying fluences and pulse widths

NASA Astrophysics Data System (ADS)

Vari, Sandor G.; van der Veen, Maurits J.; Pergadia, Vani R.; Shi, Wei-Qiang; Duffy, J. T.; Weiss, Andrew B.; Fishbein, Michael C.; Grundfest, Warren S.

1994-02-01

We investigated the effect of varying fluence and pulse width on the ablation rate and consequent thermal damage of the Ho:YAG (2.130 micrometers ) laser. The rate of ablation on fresh bovine knee joint tissues, fibrous cartilage, hyaline cartilage, and bone in saline was determined after varying the fluence (160 - 640 J/cm2) and pulse width (150, 250, 450 microsecond(s) ec, FWHM) at a repetition rate of 2 Hz. A 400/440 micrometers fiber was used. The ablation rate increased linearly with the fluence. In fibrocartilage, different pulse durations generated significant changes in the ablation rates, but showed minor effects on hyaline cartilage and bone. The heat of ablation for all three tissue types decreased after lengthening the pulse.

Waveform synthesizer

DOEpatents

Franks, L.A.; Nelson, M.A.

1979-12-07

The invention is a method by which an optical pulse of an arbitrary but defined shape may be transformed into a virtual multitude of optical or electrical output pulse shapes. Since the method is not limited to any particular input pulse shape, the output pulse shapes that can be generated thereby are virtually unlimited. Moreover, output pulse widths as narrow as about 0.1 nsec can be readily obtained since optical pulses of less than a few picoseconds are available for use as driving pulses. The range of output pulse widths obtainable is very large, the limiting factors being the driving source energy and the particular shape of the desired output pulse.

Intraoperative versus postoperative electrochemotherapy in high grade soft tissue sarcomas: a preliminary study in a spontaneous feline model.

PubMed

Spugnini, Enrico P; Baldi, Alfonso; Vincenzi, Bruno; Bongiorni, Franco; Bellelli, Corrado; Citro, Gennaro; Porrello, Alessandro

2007-02-01

Feline soft tissue sarcomas are spontaneous, rapidly growing, and aggressive neoplasms that mimic their human counterpart. The purpose of this study was to evaluate the feasibility and efficacy of electrochemotherapy (ECT) in an adjuvant fashion for the treatment of feline sarcomas, and the possibility of repeated treatments in the case of recurrence. Cats with fibrosarcoma (FSA) were assigned to receive surgery or surgery plus ECT. Feline patients recruited in the ECT study were enrolled in a microscopic arm (39 patients) or a macroscopic arm (19 patients) on the basis of their tumor status (absence or presence of gross disease). Patients received local injection of bleomycin followed by bursts of eight biphasic pulses at a voltage of 1,300 V/cm for postoperative and of 800 V/cm for intraoperative treatments. The median time to recurrence was 4 months for cats treated with surgery alone, 19 months for the postoperative cohort, and 12 months for the intraoperative group. Moreover, ten patients with recurring neoplasms were retreated and experienced responses lasting 6 to 28+ months. Side effects were minimal. Of interest, the metastatic rate (1.7%) in our patients was negligible: only one cat had distant spread. The results suggest that ECT is a well tolerated and potentially useful addition to surgery in controlling high-grade sarcomas. On the basis of these results, additional evaluations are warranted in pets and in humans.

Broadband supercontinuum generation with femtosecond pulse width in erbium-doped fiber laser (EDFL)

NASA Astrophysics Data System (ADS)

Rifin, S. N. M.; Zulkifli, M. Z.; Hassan, S. N. M.; Munajat, Y.; Ahmad, H.

2016-11-01

We demonstrate two flat plateaus and the low-noise spectrum of supercontinuum generation (SCG) in a highly nonlinear fiber (HNLF), injected by an amplified picosecond pulse seed of a carbon nanotube-based passively mode locked erbium-doped fiber laser. A broad spectrum of width approximately 1090 nm spanning the range 1130-2220 nm is obtained and the pulse width is compressed to the shorter duration of 70 fs. Variations of the injected peak power up to 33.78 kW into the HNLF are compared and the broad spectrum SCG profiles slightly expand for each of the injected peak powers. This straightforward configuration of SCG offers low output power and ultra-narrow femtosecond pulse width. The results facilitate the development of all fiber time-domain spectroscopy systems based on the photoconductive antenna technique.

State dependent model predictive control for orbital rendezvous using pulse-width pulse-frequency modulated thrusters

NASA Astrophysics Data System (ADS)

Li, Peng; Zhu, Zheng H.; Meguid, S. A.

2016-07-01

This paper studies the pulse-width pulse-frequency modulation based trajectory planning for orbital rendezvous and proximity maneuvering near a non-cooperative spacecraft in an elliptical orbit. The problem is formulated by converting the continuous control input, output from the state dependent model predictive control, into a sequence of pulses of constant magnitude by controlling firing frequency and duration of constant-magnitude thrusters. The state dependent model predictive control is derived by minimizing the control error of states and control roughness of control input for a safe, smooth and fuel efficient approaching trajectory. The resulting nonlinear programming problem is converted into a series of quadratic programming problem and solved by numerical iteration using the receding horizon strategy. The numerical results show that the proposed state dependent model predictive control with the pulse-width pulse-frequency modulation is able to effectively generate optimized trajectories using equivalent control pulses for the proximity maneuvering with less energy consumption.

Propagation and spatiotemporal coupling characteristics of ultra-short Gaussian vortex pulse

NASA Astrophysics Data System (ADS)

Nie, Jianye; Liu, Guodong; Zhang, Rongzhu

2018-05-01

Based on Collins diffraction integral formula, the propagation equation of ultra-short Gaussian vortex pulse beam has been derived. Using the equation, the intensity distribution variations of vortex pulse in the propagation process are calculated. Specially, the spatiotemporal coupling characteristics of ultra-short vortex beams are discussed in detail. The results show that some key parameters, such as transverse distance, transmission distance, pulse width and topological charge number will influence the spatiotemporal coupling characteristics significantly. With the increasing of transverse distance, the waveforms of the pulses distort obviously. And when transmission distance is far than 50 mm, the distribution curve of transverse intensity gradually changes into a Gaussian type. In addition, initial pulse width will affect the distribution of light field, however, when initial pulse width is larger than 3 fs, the spatiotemporal coupling effect will be insignificant. Topological charge number does not affect the time delay characteristics, since with the increasing of topological charge number, the waveform of the pulse distorts gradually but the time delay does not occur.

Pulsed helium ionization detection system

DOEpatents

Ramsey, R.S.; Todd, R.A.

1985-04-09

A helium ionization detection system is provided which produces stable operation of a conventional helium ionization detector while providing improved sensitivity and linearity. Stability is improved by applying pulsed dc supply voltage across the ionization detector, thereby modifying the sampling of the detectors output current. A unique pulse generator is used to supply pulsed dc to the detector which has variable width and interval adjust features that allows up to 500 V to be applied in pulse widths ranging from about 150 nsec to about dc conditions.

Pulsed helium ionization detection system

DOEpatents

Ramsey, Roswitha S.; Todd, Richard A.

1987-01-01

A helium ionization detection system is provided which produces stable operation of a conventional helium ionization detector while providing improved sensitivity and linearity. Stability is improved by applying pulsed dc supply voltage across the ionization detector, thereby modifying the sampling of the detectors output current. A unique pulse generator is used to supply pulsed dc to the detector which has variable width and interval adjust features that allows up to 500 V to be applied in pulse widths ranging from about 150 nsec to about dc conditions.

Effect of Pulse Width on Oxygen-fed Ozonizer

NASA Astrophysics Data System (ADS)

Okada, Sho; Wang, Douyan; Namihira, Takao; Katsuki, Sunao; Akiyama, Hidenori

Though general ozonizers based on silent discharge (barrier discharge) have been used to supply ozone at many industrial situations, there is still some problem, such as improvements of ozone yield. In this work, ozone was generated by pulsed discharge in order to improve the characteristics of ozone generation. It is known that a pulse width gives strong effect to the improvement of energy efficiency in exhaust gas processing. In this paper, the effect of pulse duration on ozone generation by pulsed discharge in oxygen would be reported.

Estimates and Recommendations for Coincidence Geometry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Younes, W.; Ressler, J. J.

2013-05-23

When two truly coincident gamma-rays deposit their energy within the same detector, a composite pulse which is indistinguishable from one due to a single event may be recorded by that detector. This summing e effct is known to become more important as the distance from source to detector is decreased [1]. In this short report, we give a rough estimate for the size of this e ect as a function of source-to-detector distance. The formalism used in this report is taken mainly from [2], and similar results can also be found, e.g., in [1, 3, 4]. In general, the sizemore » of the e ect will depend on the exact level scheme of the nucleus studied, but for the sake of extracting numerical values, we will assume a particular level scheme in this report.« less

Inactivation of Viruses by Coherent Excitations with a Low Power Visible Femtosecond Laser

DTIC Science & Technology

2007-06-05

visible femtosecond laser having a wavelength of 425 nm and a pulse width of 100 fs, we show that M13 phages were inactivated when the laser power density...was greater than or equal to 50 MW/cm2. The inactivation of M13 phages was determined by plaque counts and had been found to depend on the pulse width...visible femtosecond laser having a wavelength of 425 nm and a pulse width of 100 fs, we show that M13 phages were inactivated when the laser power

The effect of laser pulse tailored welding of Inconel 718

NASA Technical Reports Server (NTRS)

Mccay, T. Dwayne; Mccay, Mary Helen; Sharp, C. Michael; Womack, Michael G.

1990-01-01

Pulse tailored laser welding has been applied to wrought, wrought grain grown, and cast Inconel 718 using a CO2 laser. Prior to welding, the material was characterized metallographically and the solid state transformation regions were identified using Differential Scanning Calorimetry and high temperature x-ray diffraction. Bead on plate welds (restrained and unrestrained) were then produced using a matrix of pulse duty cycles and pulsed average power. Subsequent characterization included heat affected zone width, penetration and underbead width, the presence of cracks, microfissures and porosity, fusion zone curvature, and precipitation and liquated region width. Pedigree welding on three selected processing conditions was shown by microstructural and dye penetrant analysis to produce no microfissures, a result which strongly indicates the viability of pulse tailored welding for microfissure free IN 718.

1645-nm single-frequency, injection-seeded Q-switched Er:YAG master oscillator and power amplifier

NASA Astrophysics Data System (ADS)

Wang, Shuo; Gao, Chunqing; Shi, Yang; Song, Rui; Na, Quanxin; Gao, Mingwei; Wang, Qing

2018-02-01

A 1645-nm injection-seeded Q-switched Er:YAG master oscillator and power amplifier system is reported. The master oscillator generates single-frequency pulse energy of 11.10 mJ with a pulse width of 188.8 ns at 200 Hz. An Er:YAG monolithic nonplanar ring oscillator is employed as a seed laser. The output pulse from the master oscillator is amplified to 14.33-mJ pulse energy through an Er:YAG amplifier, with a pulse width of 183.3 ns. The M2-factors behind the amplifier are 1.14 and 1.23 in x- and y-directions, respectively. The full width at half maximum of the fast Fourier transformation spectrum of the heterodyne beating signal is 2.84 MHz.

Theoretical analysis of low-power fast optogenetic control of firing of Chronos-expressing neurons.

PubMed

Saran, Sant; Gupta, Neha; Roy, Sukhdev

2018-04-01

A detailed theoretical analysis of low-power, fast optogenetic control of firing of Chronos-expressing neurons has been presented. A three-state model for the Chronos photocycle has been formulated and incorporated in a fast-spiking interneuron circuit model. The effect of excitation wavelength, pulse irradiance, pulse width, and pulse frequency has been studied in detail and compared with ChR2. Theoretical simulations are in excellent agreement with recently reported experimental results and bring out additional interesting features. At very low irradiances ([Formula: see text]), the plateau current in Chronos exhibits a maximum. At [Formula: see text], the plateau current is 2 orders of magnitude smaller and saturates at longer pulse widths ([Formula: see text]) compared to ChR2 ([Formula: see text]). [Formula: see text] in Chronos saturates at much shorter pulse widths (1775 pA at 1.5 ms and [Formula: see text]) than in ChR2. Spiking fidelity is also higher at lower irradiances and longer pulse widths compared to ChR2. Chronos exhibits an average maximal driven rate of over [Formula: see text] in response to [Formula: see text] stimuli, each of 1-ms pulse-width, in the intensity range 0 to [Formula: see text]. The analysis is important to not only understand the photodynamics of Chronos and Chronos-expressing neurons but also to design opsins with optimized properties and perform precision experiments with required spatiotemporal resolution.

A compact high current pulsed electron gun with subnanosecond electron pulse widths

NASA Technical Reports Server (NTRS)

Khakoo, M. A.; Srivastava, S. K.

1984-01-01

A magnetically-collimated, double-pulsed electron gun capable of generating electron pulses with a peak instantaneous current of approximately 70 microamps and a temporal width of 0.35 ns (FWHM) has been developed. Calibration is accomplished by measuring the lifetime of the well known 2(1P)-to-1(1S) transition in helium (58.4nm) at a near-threshold electron-impact energy by use of the delayed-coincidence technique.

Effects of varying duty cycle and pulse width on high-intensity focused ultrasound (HIFU)-induced transcranial thrombolysis.

PubMed

Hölscher, Thilo; Raman, Rema; Fisher, David J; Ahadi, Golnaz; Zadicario, Eyal; Voie, Arne

2013-01-01

The goal was to test the effects of various combinations of pulse widths (PW) and duty cycles (DC) on high-intensity focused ultrasound (HIFU)-induced sonothrombolysis efficacy using an in vitro flow model. An ExAblate™ 4000 HIFU headsystem (InSightec, Inc., Israel) was used. Artificial blood clots were placed into test tubes inside a human calvarium and exposed to pulsatile flow. Four different duty cycles were tested against four different pulse widths. For all study groups, an increase in thrombolysis efficacy could be seen in association with increasing DC and/or PW (p < 0.0001). Using transcranial HIFU, significant thrombolysis can be achieved within seconds and without the use of lytic drugs in vitro. Longer duty cycles in combination with longer pulse widths seem to have the highest potential to optimize clot lysis efficacy.

Effects of varying duty cycle and pulse width on high-intensity focused ultrasound (HIFU)-induced transcranial thrombolysis

PubMed Central

2013-01-01

The goal was to test the effects of various combinations of pulse widths (PW) and duty cycles (DC) on high-intensity focused ultrasound (HIFU)-induced sonothrombolysis efficacy using an in vitro flow model. An ExAblate™ 4000 HIFU headsystem (InSightec, Inc., Israel) was used. Artificial blood clots were placed into test tubes inside a human calvarium and exposed to pulsatile flow. Four different duty cycles were tested against four different pulse widths. For all study groups, an increase in thrombolysis efficacy could be seen in association with increasing DC and/or PW (p < 0.0001). Using transcranial HIFU, significant thrombolysis can be achieved within seconds and without the use of lytic drugs in vitro. Longer duty cycles in combination with longer pulse widths seem to have the highest potential to optimize clot lysis efficacy. PMID:25512862

Design and performance of a pulse transformer based on Fe-based nanocrystalline core.

PubMed

Yi, Liu; Xibo, Feng; Lin, Fuchang

2011-08-01

A dry-type pulse transformer based on Fe-based nanocrystalline core with a load of 0.88 nF, output voltage of more than 65 kV, and winding ratio of 46 is designed and constructed. The dynamic characteristics of Fe-based nanocrystalline core under the impulse with the pulse width of several microseconds were studied. The pulse width and incremental flux density have an important effect on the pulse permeability, so the pulse permeability is measured under a certain pulse width and incremental flux density. The minimal volume of the toroidal pulse transformer core is determined by the coupling coefficient, the capacitors of the resonant charging circuit, incremental flux density, and pulse permeability. The factors of the charging time, ratio, and energy transmission efficiency in the resonant charging circuit based on magnetic core-type pulse transformer are analyzed. Experimental results of the pulse transformer are in good agreement with the theoretical calculation. When the primary capacitor is 3.17 μF and charge voltage is 1.8 kV, a voltage across the secondary capacitor of 0.88 nF with peak value of 68.5 kV, rise time (10%-90%) of 1.80 μs is obtained.

Probe-pulse optimization for nonresonant suppression in hybrid fs/ps coherent anti-Stokes Raman scattering at high temperature.

PubMed

Miller, Joseph D; Slipchenko, Mikhail N; Meyer, Terrence R

2011-07-04

Hybrid femtosecond/picosecond coherent anti-Stokes Raman scattering (fs/ps CARS) offers accurate thermometry at kHz rates for combustion diagnostics. In high-temperature flames, selection of probe-pulse characteristics is key to simultaneously optimizing signal-to-nonresonant-background ratio, signal strength, and spectral resolution. We demonstrate a simple method for enhancing signal-to-nonresonant-background ratio by using a narrowband Lorentzian filter to generate a time-asymmetric probe pulse with full-width-half-maximum (FWHM) pulse width of only 240 fs. This allows detection within just 310 fs after the Raman excitation for eliminating nonresonant background while retaining 45% of the resonant signal at 2000 K. The narrow linewidth is comparable to that of a time-symmetric sinc2 probe pulse with a pulse width of ~2.4 ps generated with a conventional 4-f pulse shaper. This allows nonresonant-background-free, frequency-domain vibrational spectroscopy at high temperature, as verified using comparisons to a time-dependent theoretical fs/ps CARS model.

flexTMS--a novel repetitive transcranial magnetic stimulation device with freely programmable stimulus currents.

PubMed

Gattinger, Norbert; Moessnang, Georg; Gleich, Bernhard

2012-07-01

Transcranial magnetic stimulation (TMS) is able to noninvasively excite neuronal populations due to brief magnetic field pulses. The efficiency and the characteristics of stimulation pulse shapes influence the physiological effect of TMS. However, commercial devices allow only a minimum of control of different pulse shapes. Basically, just sinusoidal and monophasic pulse shapes with fixed pulse widths are available. Only few research groups work on TMS devices with controllable pulse parameters such as pulse shape or pulse width. We describe a novel TMS device with a full-bridge circuit topology incorporating four insulated-gate bipolar transistor (IGBT) modules and one energy storage capacitor to generate arbitrary waveforms. This flexible TMS (flexTMS ) device can generate magnetic pulses which can be adjusted with respect to pulse width, polarity, and intensity. Furthermore, the equipment allows us to set paired pulses with a variable interstimulus interval (ISI) from 0 to 20 ms with a step size of 10  μs. All user-defined pulses can be applied continually with repetition rates up to 30 pulses per second (pps) or, respectively, up to 100 pps in theta burst mode. Offering this variety of flexibility, flexTMS will allow the enhancement of existing TMS paradigms and novel research applications.

Pulse-Width-Modulating Driver for Brushless dc Motor

NASA Technical Reports Server (NTRS)

Salomon, Phil M.

1991-01-01

High-current pulse-width-modulating driver for brushless dc motor features optical coupling of timing signals from low-current control circuitry to high-current motor-driving circuitry. Provides high electrical isolation of motor-power supply, helping to prevent fast, high-current motor-driving pulses from being coupled through power supplies into control circuitry, where they interfere with low-current control signals.

Steering population transfer of the Na2 molecule by an ultrashort pulse train

NASA Astrophysics Data System (ADS)

Niu, Dong-Hua; Wang, Shuo; Zhan, Wei-Shen; Tao, Hong-Cai; Wang, Si-Qi

2018-05-01

We theoretically investigate the complete population transfer among quantum states of the Na2 molecule using ultrashort pulse trains using the time-dependent wave packet method. The population accumulation of the target state can be steered by controlling the laser parameters, such as the variable pulse pairs, the different pulse widths, the time delays and the repetition period between two contiguous pulses; in particular, the pulse pairs and the pulse widths have a great effect on the population transfer. The calculations show that the ultrashort pulse train is a feasible solution, which can steer the population transfer from the initial state to the target state efficiently with lower peak intensities.

Device for detecting imminent failure of high-dielectric stress capacitors. [Patent application

DOEpatents

McDuff, G.G.

1980-11-05

A device is described for detecting imminent failure of a high-dielectric stress capacitor utilizing circuitry for detecting pulse width variations and pulse magnitude variations. Inexpensive microprocessor circuitry is utilized to make numerical calculations of digital data supplied by detection circuitry for comparison of pulse width data and magnitude data to determine if preselected ranges have been exceeded, thereby indicating imminent failure of a capacitor. Detection circuitry may be incorporated in transmission lines, pulse power circuitry, including laser pulse circuitry or any circuitry where capacitors or capacitor banks are utilized.

Device for detecting imminent failure of high-dielectric stress capacitors

DOEpatents

McDuff, George G.

1982-01-01

A device for detecting imminent failure of a high-dielectric stress capacitor utilizing circuitry for detecting pulse width variations and pulse magnitude variations. Inexpensive microprocessor circuitry is utilized to make numerical calculations of digital data supplied by detection circuitry for comparison of pulse width data and magnitude data to determine if preselected ranges have been exceeded, thereby indicating imminent failure of a capacitor. Detection circuitry may be incorporated in transmission lines, pulse power circuitry, including laser pulse circuitry or any circuitry where capacitors or capactior banks are utilized.

Note: A rectangular pulse generator for 50 kV voltage, 0.8 ns rise time, and 10 ns pulse width based on polymer-film switch.

PubMed

Wu, Hanyu; Zhang, Xinjun; Sun, Tieping; Zeng, Zhengzhong; Cong, Peitian; Zhang, Shaoguo

2015-10-01

In this article, we describe a rectangular pulse generator, consisting of a polymer-film switch, a tri-plate transmission line, and parallel post-shaped ceramic resistor load, for 50-kV voltage, 0.8-ns rise time, and 10-ns width. The switch and resistors are arranged in atmospheric air and the transmission line can work in atmospheric air or in transformer oil to change the pulse width from 6.7 ns to 10 ns. The fast switching and low-inductance characteristics of the polymer-film switch ensure the fast rising wavefront of <1 ns. This generator can be applied in the calibration of nanosecond voltage dividers and used for electromagnetic pulse tests as a fast-rising current injection source.

Cumulative detection probabilities and range accuracy of a pulsed Geiger-mode avalanche photodiode laser ranging system

NASA Astrophysics Data System (ADS)

Luo, Hanjun; Ouyang, Zhengbiao; Liu, Qiang; Chen, Zhiliang; Lu, Hualan

2017-10-01

Cumulative pulses detection with appropriate cumulative pulses number and threshold has the ability to improve the detection performance of the pulsed laser ranging system with GM-APD. In this paper, based on Poisson statistics and multi-pulses cumulative process, the cumulative detection probabilities and their influence factors are investigated. With the normalized probability distribution of each time bin, the theoretical model of the range accuracy and precision is established, and the factors limiting the range accuracy and precision are discussed. The results show that the cumulative pulses detection can produce higher target detection probability and lower false alarm probability. However, for a heavy noise level and extremely weak echo intensity, the false alarm suppression performance of the cumulative pulses detection deteriorates quickly. The range accuracy and precision is another important parameter evaluating the detection performance, the echo intensity and pulse width are main influence factors on the range accuracy and precision, and higher range accuracy and precision is acquired with stronger echo intensity and narrower echo pulse width, for 5-ns echo pulse width, when the echo intensity is larger than 10, the range accuracy and precision lower than 7.5 cm can be achieved.

Power supply circuit for an ion engine sequentially operated power inverters

NASA Technical Reports Server (NTRS)

Cardwell, Jr., Gilbert I. (Inventor)

2000-01-01

A power supply circuit for an ion engine suitable for a spacecraft has a voltage bus having input line and a return line. The power supply circuit includes a pulse width modulation circuit. A plurality of bridge inverter circuits is coupled to the bus and the pulse width modulation circuit. The pulse width modulation circuit generates operating signals having a variable duty cycle. Each bridge inverter has a primary winding and a secondary winding. Each secondary winding is coupled to a rectifier bridge. Each secondary winding is coupled in series with another of the plurality of rectifier bridges.

Effects of 532 nm pulsed-KTP laser parameters on vessel ablation in the avian chorioallantoic membrane: implications for vocal fold mucosa.

PubMed

Broadhurst, Matthew S; Akst, Lee M; Burns, James A; Kobler, James B; Heaton, James T; Anderson, R Rox; Zeitels, Steven M

2007-02-01

Selective vascular ablation (photoangiolysis) using pulsed lasers that target hemoglobin is an effective treatment strategy for many vocal fold lesions. However, vessel rupture with extravasation of blood reduces selectivity for vessels, which is frequently observed with the 0.45-ms, 585-nm pulsed dye laser. Previous studies have shown that vessel rupture is the result of vaporization of blood, an event that varies with laser pulse width and pulse fluence (energy per unit area). Clinical observations using a 532-nm wavelength pulsed potassium-titanyl-phosphate (KTP) laser revealed less laser-induced hemorrhage than the pulsed dye laser. This study investigated settings for the pulsed KTP laser to achieve selective vessel destruction without rupture using the avian chorioallantoic membrane under conditions similar to flexible laryngoscopic delivery of the laser in clinical practice. The chick chorioallantoic membrane offers convenient access to many small blood vessels similar in size to those targeted in human vocal fold. Using a 532-nm pulsed KTP laser, pulse width, pulse energy, and working distance from the optical delivery fiber were varied to assess influence on the ability to achieve vessel coagulation without vessel wall rupture. Third-order vessels (n = 135) were irradiated: Energy (471-550 mJ), pulse width (10, 15, 30 ms), and fiber-to-tissue distance (1 mm, 3 mm) were varied systematically. Selective vessel destruction without vessel wall rupture was more often achieved by increasing pulse width, increasing the fiber-to-tissue distance, and decreasing energy. Vessel destruction without rupture was consistently achieved using 15- or 30-ms pulses with a fiber-to-tissue distance of 3 mm (pulse fluence of 13-16 J/cm). This study substantiates our clinical observation that a 532-nm pulsed KTP laser was effective for ablating microcirculation while minimizing vessel wall rupture and hemorrhage.

Single-shot temporal characterization of kilojoule-level, picosecond pulses on OMEGA EP

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waxer, Leon; Dorrer, Christophe; Kalb, Adam

To achieve a variety of experimental conditions, the OMEGA EP laser provides kilojoule-level pulses over a pulse-width range of 0.6 to 100 ps. Precise knowledge of the pulse width is important for laser system safety and the interpretation of experimental results. This paper describes the development and implementation of a single-shot, ultrashort-pulse measurement diagnostic, which provides an accurate characterization of the output pulse shape. We also present a brief overview of the measurement algorithm; discuss design considerations necessary for implementation in a complex, user-facility environment; and review the results of the diagnostic commissioning shots, which demonstrated excellent agreement with predictions.

Single-shot temporal characterization of kilojoule-level, picosecond pulses on OMEGA EP

DOE PAGES

Waxer, Leon; Dorrer, Christophe; Kalb, Adam; ...

2018-02-19

To achieve a variety of experimental conditions, the OMEGA EP laser provides kilojoule-level pulses over a pulse-width range of 0.6 to 100 ps. Precise knowledge of the pulse width is important for laser system safety and the interpretation of experimental results. This paper describes the development and implementation of a single-shot, ultrashort-pulse measurement diagnostic, which provides an accurate characterization of the output pulse shape. We also present a brief overview of the measurement algorithm; discuss design considerations necessary for implementation in a complex, user-facility environment; and review the results of the diagnostic commissioning shots, which demonstrated excellent agreement with predictions.

Purification of Nanoscale Electron-Beam-Induced Platinum Deposits via a Pulsed Laser-Induced Oxidation Reaction

DOE PAGES

Stanford, Michael G.; Lewis, Brett B.; Noh, Joo Hyon; ...

2014-11-05

Platinum–carbon deposits made via electron-beam-induced deposition were purified in this study via a pulsed laser-induced oxidation reaction and erosion of the amorphous carbon to form pure platinum. Purification proceeds from the top down and is likely catalytically facilitated via the evolving platinum layer. Thermal simulations suggest a temperature threshold of ~485 K, and the purification rate is a function of the PtC 5 thickness (80–360 nm) and laser pulse width (1–100 μs) in the ranges studied. The thickness dependence is attributed to the ~235 nm penetration depth of the PtC 5 composite at the laser wavelength, and the pulse-width dependencemore » is attributed to the increased temperatures achieved at longer pulse widths. Finally, remarkably fast purification is realized at cumulative laser exposure times of less than 1 s.« less

Purification of Nanoscale Electron-Beam-Induced Platinum Deposits via a Pulsed Laser-Induced Oxidation Reaction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stanford, Michael G.; Lewis, Brett B.; Noh, Joo Hyon

Platinum–carbon deposits made via electron-beam-induced deposition were purified in this study via a pulsed laser-induced oxidation reaction and erosion of the amorphous carbon to form pure platinum. Purification proceeds from the top down and is likely catalytically facilitated via the evolving platinum layer. Thermal simulations suggest a temperature threshold of ~485 K, and the purification rate is a function of the PtC 5 thickness (80–360 nm) and laser pulse width (1–100 μs) in the ranges studied. The thickness dependence is attributed to the ~235 nm penetration depth of the PtC 5 composite at the laser wavelength, and the pulse-width dependencemore » is attributed to the increased temperatures achieved at longer pulse widths. Finally, remarkably fast purification is realized at cumulative laser exposure times of less than 1 s.« less

Effect of pulse width on near-infrared supercontinuum generation in nonlinear fiber amplifier

NASA Astrophysics Data System (ADS)

Song, Rui; Lei, Cheng-Min; Chen, Sheng-Ping; Wang, Ze-Feng; Hou, Jing

2015-08-01

The effect of pulse width on near-infrared supercontinuum generation in nonlinear fiber amplifier is investigated theoretically and experimentally. The complex Ginzburg-Landau equation and adaptive split-step Fourier method are used to simulate the propagation of pulses with different pulse widths in the fiber amplifier, and the results show that a longer pulse is more profitable in near-infrared supercontinuum generation if the central wavelength of the input laser lies in the normal dispersion region of the gain fiber. A four-stage master oscillator power amplifier configuration is adopted and the output spectra under picosecond and nanosecond input pulses are compared with each other. The experimental results are in good accordance with the simulations which can provide some guidance for further optimization of the system. Project supported by the National Natural Science Foundation of China (Grant Nos. 11404404 and 11274385) and the Outstanding Youth Fund Project of Hunan Province and the Fund of Innovation of National University of Defense Technology, China (Grant No. B120701).

Total Ionizing Dose Test Report for the UC1823A Pulse Width Modulator

NASA Technical Reports Server (NTRS)

Chen, Dakai; Forney, James

2017-01-01

The purpose of this study is to examine the total ionizing dose susceptibility for the UC1823A pulse width modulator manufactured by Texas Instruments, Inc. The part is suspected to be vulnerable to enhanced low dose rate sensitivity (ELDRS).

Resolving the shape of a sonoluminescence pulse in sulfuric acid by the use of streak camera.

PubMed

Huang, Wei; Chen, Weizhong; Cui, Weicheng

2009-06-01

A streak camera is used to measure the shape of sonoluminescence pulses from a cavitation bubble levitated stably in a sulfuric acid solution. The shape and response to an acoustic pressure field of the sonoluminescence pulse in 85% by weight sulfuric acid are qualitatively similar to those in water. However, the pulse width in sulfuric acid is wider than that in water by over one order of magnitude. The width of the sonoluminescence pulse is strongly dependent on the concentration of the sulfuric acid solution, while the skewed distribution of the shape remains unchanged.

A compact plasma pre-ionized TEA-CO2 laser pulse clipper for material processing

NASA Astrophysics Data System (ADS)

Gasmi, Taieb

2017-08-01

An extra-laser cavity CO2-TEA laser pulse clipper using gas breakdown techniques for high spatial resolution material processing and shallow material engraving and drilling processes is presented. Complete extinction of the nitrogen tail, that extends the pulse width, is obtained at pressures from 375 up to 1500 torr for nitrogen and argon gases. Excellent energy stability and pulse repeatability were further enhanced using high voltage assisted preionized plasma gas technique. Experimental data illustrates the direct correlation between laser pulse width and depth of engraving in aluminum and alumina materials.

Plasma induced degradation of Indigo Carmine by bipolar pulsed dielectric barrier discharge(DBD) in the water-air mixture.

PubMed

Zhang, Ruo-Bing; Wu, Yan; Li, Guo-Feng; Wang, Ning-Hui; Li, Jie

2004-01-01

Degradation of the Indigo Carmine (IC) by the bipolar pulsed DBD in water-air mixture was studied. Effects of various parameters such as gas flow rate, solution conductivity, pulse repetitive rate and ect., on color removal efficiency of dying wastewater were investigated. Concentrations of gas phase o3 and aqueous phase H2O2 under various conditions were measured. Experimental results showed that air bubbling facilitates the breakdown of water and promotes generation of chemically active species. Color removal efficiency of IC solution can be greatly improved by the air aeration under various solution conductivities. Decolorization efficiency increases with the increase of the gas flow rate, and decreases with the increase of the initial solution conductivity. A higher pulse repetitive rate and a larger pulse capacitor C(p) are favorable for the decolorization process. Ozone and hydrogen peroxide formed decreases with the increase of initial solution conductivity. In addition, preliminary analysis of the decolorization mechanisms is given.

National Dam Safety Program. Alder Pond Dam (Inventory Number N.Y. 1489), Black River Basin, Oneida County, New York. Phase I Inspection Report,

DTIC Science & Technology

1981-06-17

CAMAL )57 7) Maximum K~nown Flood 8) At Time of Inspection______ 93-15-4( 9/8C) AL R Po4 PAPA CREST: (CLAT IE) ELEVATION: .7 Type: -AQI H 5 a Width...T - L jR iT BLACK RNE. CAmAL --- Io 1500 A .T- PRO F ILE. T-OP EABA"MEIPT (CANAL) --ECT -14 A-A to/8O 100 I-.U 2O 11 0. 7 22I- co I.)-- LII___ ___ __1

TU-FG-BRB-08: Challenges, Limitations and Future Outlook Towards Clinical Translation of Proton Acoustic Range Verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yousefi, S; Ahmad, M; Xiang, L

Purpose: To report our investigations of proton acoustic imaging, including computer simulations and preliminary experimental studies at clinical facilities. The ultimate achievable accuracy, sensitivity and clinical translation challenges are discussed. Methods: The acoustic pulse due to pressure rise was estimated using finite element model. Since the ionoacoustic pulse is highly dependent on the proton pulse width and energy, multiple pulse widths were studied. Based on the received signal spectrum at piezoelectric ultrasound transducer with consideration of random thermal noise, maximum spatial resolution of the proton-acoustic imaging modality was calculated. The simulation studies defined the design specifications of the system tomore » detect proton acoustic signal from Hitachi and Mevion clinical machines. A 500 KHz hydrophone with 100 dB amplification was set up in a water tank placed in front of the proton nozzle A 40 MHz data acquisition was synchronized by a trigger signal provided by the machine. Results: Given 30–800 mGy dose per pulse at the Bragg peak, the minimum number of protons detectable by the proton acoustic technique was on the order of 10×10^6 per pulse. The broader pulse widths produce signal with lower acoustic frequencies, with 10 µs pulses producing signals with frequency less than 100 kHz. As the proton beam pulse width increases, a higher dose rate is required to measure the acoustic signal. Conclusion: We have established the minimal detection limit for protonacoustic range validation for a variety of pulse parameters. Our study indicated practical proton-acoustic range verification can be feasible with a pulse shorter than 10 µs, 5×10^6 protons/pulse, 50 nA beam current and a highly sensitive ultrasonic transducer. The translational challenges into current clinical machines include proper magnetic shielding of the measurement equipment, providing a clean trigger signal from the proton machine, providing a shorter proton beam pulse and higher dose per pulse.« less

Method for detecting and distinguishing between specific types of environmental radiation using a high pressure ionization chamber with pulse-mode readout

DOE Office of Scientific and Technical Information (OSTI.GOV)

Degtiarenko, Pavel V.

An environmental radiation detector for detecting and distinguishing between all types of environmental radiation, including photons, charged particles, and neutrons. A large volume high pressure ionization chamber (HPIC) includes BF.sub.3 gas at a specific concentration to render the radiation detector sensitive to the reactions of neutron capture in Boron-10 isotope. A pulse-mode readout is connected to the ionization chamber capable of measuring both the height and the width of the pulse. The heavy charged products of the neutron capture reaction deposit significant characteristic energy of the reaction in the immediate vicinity of the reaction in the gas, producing a signalmore » with a pulse height proportional to the reaction energy, and a narrow pulse width corresponding to the essentially pointlike energy deposition in the gas. Readout of the pulse height and the pulse width parameters of the signals enables distinguishing between the different types of environmental radiation, such as gamma (x-rays), cosmic muons, and neutrons.« less

Imaging Surfaces and Nanostructures

DTIC Science & Technology

2011-02-28

Principles and Perspectives," Phys. Chern. Chern. Phys. 10, 2879 (2008). 8) A. Gahlmann, S. T. Park, and A. H. Zewail , " Ultrashort Electron Pulses ...1~ copy with high spatiotemporal reso- 104 lutions. The time resolution becomes limited only by the laser pulse width and energy width of the...definition, transformations in which atoms move at speeds of the order of I krnls is in the femtosecond domain, and although laser light pulses can

Effects of finite pulse width on two-dimensional Fourier transform electron spin resonance.

PubMed

Liang, Zhichun; Crepeau, Richard H; Freed, Jack H

2005-12-01

Two-dimensional (2D) Fourier transform ESR techniques, such as 2D-ELDOR, have considerably improved the resolution of ESR in studies of molecular dynamics in complex fluids such as liquid crystals and membrane vesicles and in spin labeled polymers and peptides. A well-developed theory based on the stochastic Liouville equation (SLE) has been successfully employed to analyze these experiments. However, one fundamental assumption has been utilized to simplify the complex analysis, viz. the pulses have been treated as ideal non-selective ones, which therefore provide uniform irradiation of the whole spectrum. In actual experiments, the pulses are of finite width causing deviations from the theoretical predictions, a problem that is exacerbated by experiments performed at higher frequencies. In the present paper we provide a method to deal with the full SLE including the explicit role of the molecular dynamics, the spin Hamiltonian and the radiation field during the pulse. The computations are rendered more manageable by utilizing the Trotter formula, which is adapted to handle this SLE in what we call a "Split Super-Operator" method. Examples are given for different motional regimes, which show how 2D-ELDOR spectra are affected by the finite pulse widths. The theory shows good agreement with 2D-ELDOR experiments performed as a function of pulse width.

Pulse-width-modulated servo valve for autopilot system

NASA Technical Reports Server (NTRS)

Garner, H. D.

1974-01-01

Valve was developed for autopilot wing-lever system and is to be used in light, single-engine aircraft. Valve is controlled by electronic circuit which feeds pulse-width-modulated correction signals to two solenoids. Valve housing is cast from plastic, making it very economical to fabricate.

Auditory-nerve single-neuron thresholds to electrical stimulation from scala tympani electrodes.

PubMed

Parkins, C W; Colombo, J

1987-12-31

Single auditory-nerve neuron thresholds were studied in sensory-deafened squirrel monkeys to determine the effects of electrical stimulus shape and frequency on single-neuron thresholds. Frequency was separated into its components, pulse width and pulse rate, which were analyzed separately. Square and sinusoidal pulse shapes were compared. There were no or questionably significant threshold differences in charge per phase between sinusoidal and square pulses of the same pulse width. There was a small (less than 0.5 dB) but significant threshold advantage for 200 microseconds/phase pulses delivered at low pulse rates (156 pps) compared to higher pulse rates (625 pps and 2500 pps). Pulse width was demonstrated to be the prime determinant of single-neuron threshold, resulting in strength-duration curves similar to other mammalian myelinated neurons, but with longer chronaxies. The most efficient electrical stimulus pulse width to use for cochlear implant stimulation was determined to be 100 microseconds/phase. This pulse width delivers the lowest charge/phase at threshold. The single-neuron strength-duration curves were compared to strength-duration curves of a computer model based on the specific anatomy of auditory-nerve neurons. The membrane capacitance and resulting chronaxie of the model can be varied by altering the length of the unmyelinated termination of the neuron, representing the unmyelinated portion of the neuron between the habenula perforata and the hair cell. This unmyelinated segment of the auditory-nerve neuron may be subject to aminoglycoside damage. Simulating a 10 micron unmyelinated termination for this model neuron produces a strength-duration curve that closely fits the single-neuron data obtained from aminoglycoside deafened animals. Both the model and the single-neuron strength-duration curves differ significantly from behavioral threshold data obtained from monkeys and humans with cochlear implants. This discrepancy can best be explained by the involvement of higher level neurologic processes in the behavioral responses. These findings suggest that the basic principles of neural membrane function must be considered in developing or analyzing electrical stimulation strategies for cochlear prostheses if the appropriate stimulation of frequency specific populations of auditory-nerve neurons is the objective.

An experimental and theoretical investigation into the ``worm-hole'' effect

NASA Astrophysics Data System (ADS)

Zhao, Liang; Su, Jiancang; Zhang, Xibo; Pan, Yafeng; Wang, Limin; Fang, Jinpeng; Sun, Xu; Li, Rui; Zeng, Bo; Cheng, Jie

2013-08-01

On a nanosecond time scale, solid insulators abnormally fail in bulk rather than on surface, which is termed as the "worm-hole" effect. By using a generator with adjustable output pulse width and dozens of organic glass (PMMA) and polystyrene (PS) samples, experiments to verify this effect are conducted. The results show that under short pulses of 10 ns, all the samples fail due to bulk breakdown, whereas when the pulse width is tuned to a long pulse of 7 μs, the samples fail as a result of surface flashover. The experimental results are interpreted by analyzing the conditions for the bulk breakdown and the surface flashover. It is found that under short pulses, the flashover threshold would be as high as the bulk breakdown strength (EBD) and the flashover time delay (td) would be longer than the pulse width (τ), both of which make the dielectrics' cumulative breakdown occur easily; whereas under long pulses, that Ef is much lower than EBD and td is smaller than τ is advantageous to the occurrence of the surface flashover. In addition, a general principle on solid insulation design under short pulse condition is proposed based on the experimental results and the theoretical analysis.

Complete chirp analysis of a gain-switched pulse using an interferometric two-photon absorption autocorrelation.

PubMed

Chin, Sang Hoon; Kim, Young Jae; Song, Ho Seong; Kim, Dug Young

2006-10-10

We propose a simple but powerful scheme for the complete analysis of the frequency chirp of a gain-switched optical pulse using a fringe-resolved interferometric two-photon absorption autocorrelator. A frequency chirp imposed on the gain-switched pulse from a laser diode was retrieved from both the intensity autocorrelation trace and the envelope of the second-harmonic interference fringe pattern. To verify the accuracy of the proposed phase retrieval method, we have performed an optical pulse compression experiment by using dispersion-compensating fibers with different lengths. We have obtained close agreement by less than a 1% error between the compressed pulse widths and numerically calculated pulse widths.

Extension of FRI for modeling of electrocardiogram signals.

PubMed

Quick, R Frank; Crochiere, Ronald E; Hong, John H; Hormati, Ali; Baechler, Gilles

2012-01-01

Recent work has developed a modeling method applicable to certain types of signals having a "finite rate of innovation" (FRI). Such signals contain a sparse collection of time- or frequency-limited pulses having a restricted set of allowable pulse shapes. A limitation of past work on FRI is that all of the pulses must have the same shape. Many real signals, including electrocardiograms, consist of pulses with varying widths and asymmetry, and therefore are not well fit by the past FRI methods. We present an extension of FRI allowing pulses having variable pulse width (VPW) and asymmetry. We show example results for electrocardiograms and discuss the possibility of application to signal compression and diagnostics.

Continuation and Maintenance Electroconvulsive Therapy for Mood Disorders: Review of the Literature

PubMed Central

Petrides, Georgios; Tobias, Kristen G.; Kellner, Charles H.; Rudorfer, Matthew V.

2011-01-01

Background Electroconvulsive therapy (ECT) is a highly effective treatment for mood disorders. Continuation ECT (C-ECT) and maintenance ECT (M-ECT) are required for many patients suffering from severe and recurrent forms of mood disorders. This is a review of the literature regarding C- and M-ECT. Methods We conducted a computerized search using the words continuation ECT, maintenance ECT, depression, mania, bipolar disorder and mood disorders. We report on all articles published in the English language from 1998 to 2009. Results We identified 32 reports. There were 24 case reports and retrospective reviews on 284 patients. Two of these reports included comparison groups, and 1 had a prospective follow-up in a subset of subjects. There were 6 prospective naturalistic studies and 2 randomized controlled trials. Conclusions C-ECT and M-ECT are valuable treatment modalities to prevent relapse and recurrence of mood disorders in patients who have responded to an index course of ECT. C-ECT and M-ECT are underused and insufficiently studied despite positive clinical experience of more than 70 years. Studies which are currently under way should allow more definitive recommendations regarding the choice, frequency and duration of C-ECT and M-ECT following acute ECT. PMID:21811083

Evaluation of nonmemory cognitive parameters in psychiatric patients' pre- and post-electroconvulsive therapy: An observational study.

PubMed

Prakash, Jyoti; Srivastava, Kalpana; Manandhar, Pradeep; Saha, Amitabh

2015-01-01

Possibility of cognitive side effects has made electroconvulsive therapy (ECT) questionable. Variable deficits have been debated in memory cognition. Pattern of changes in nonmemory cognition pre- and post-ECT is not clear. Forty patients undergoing ECT were studied on nonmemory cognitive parameters before ECT, after a course of ECT, and after 4 weeks of last. ECT. Nonmemory cognition improved during the course of ECT and over 4 weeks of ECT. ECT does not affect the nonmemory cognition adversely.

Missing pulse detector for a variable frequency source

DOEpatents

Ingram, Charles B.; Lawhorn, John H.

1979-01-01

A missing pulse detector is provided which has the capability of monitoring a varying frequency pulse source to detect the loss of a single pulse or total loss of signal from the source. A frequency-to-current converter is used to program the output pulse width of a variable period retriggerable one-shot to maintain a pulse width slightly longer than one-half the present monitored pulse period. The retriggerable one-shot is triggered at twice the input pulse rate by employing a frequency doubler circuit connected between the one-shot input and the variable frequency source being monitored. The one-shot remains in the triggered or unstable state under normal conditions even though the source period is varying. A loss of an input pulse or single period of a fluctuating signal input will cause the one-shot to revert to its stable state, changing the output signal level to indicate a missing pulse or signal.

Pulsatile Hormonal Signaling to Extracellular Signal-regulated Kinase

PubMed Central

Perrett, Rebecca M.; Voliotis, Margaritis; Armstrong, Stephen P.; Fowkes, Robert C.; Pope, George R.; Tsaneva-Atanasova, Krasimira; McArdle, Craig A.

2014-01-01

Gonadotropin-releasing hormone (GnRH) is secreted in brief pulses that stimulate synthesis and secretion of pituitary gonadotropin hormones and thereby mediate control of reproduction. It acts via G-protein-coupled receptors to stimulate effectors, including ERK. Information could be encoded in GnRH pulse frequency, width, amplitude, or other features of pulse shape, but the relative importance of these features is unknown. Here we examine this using automated fluorescence microscopy and mathematical modeling, focusing on ERK signaling. The simplest scenario is one in which the system is linear, and response dynamics are relatively fast (compared with the signal dynamics). In this case integrated system output (ERK activation or ERK-driven transcription) will be roughly proportional to integrated input, but we find that this is not the case. Notably, we find that relatively slow response kinetics lead to ERK activity beyond the GnRH pulse, and this reduces sensitivity to pulse width. More generally, we show that the slowing of response kinetics through the signaling cascade creates a system that is robust to pulse width. We, therefore, show how various levels of response kinetics synergize to dictate system sensitivity to different features of pulsatile hormone input. We reveal the mathematical and biochemical basis of a dynamic GnRH signaling system that is robust to changes in pulse amplitude and width but is sensitive to changes in receptor occupancy and frequency, precisely the features that are tightly regulated and exploited to exert physiological control in vivo. PMID:24482225

Audit of thrice- versus twice-weekly ECT.

PubMed

Roche, Eric; Lope, Jasmin; Hughes, Helen; McCullagh, Niamh; Larkin, Terence; Feeney, Larkin

2012-09-01

There is a lack of knowledge regarding some basic differences between different electroconvulsive therapy (ECT) treatment schedules. To examine differences, including ECT technical parameters and length of stay, between thrice- and twice-weekly ECT treatment schedules. Prospective audit of the changeover period of administering thrice- to twice-weekly ECT in a Dublin psychiatric hospital. Twice-weekly ECT was associated with significantly lower total electricity dosage administered, a tendency toward shorter overall hospital stay and fewer ECT treatments compared to thrice-weekly ECT. Our results support the current international trend toward giving ECT twice weekly.

A national survey of electroconvulsive therapy use in the Russian Federation.

PubMed

Nelson, Alexander I

2005-09-01

A survey of electroconvulsive therapy (ECT) throughout Russia was undertaken to understand the range of ECT usage and knowledge. A survey form was distributed by mail to 1648 Russian doctors and institutions expected to deal with ECT. A total of 114 replies were received. They indicated that ECT is available to 22.4% of the country's population. In available regions, ECT is given to 1.43% of hospital admissions and 0.54 per 10,000 persons per year. ECT is used in Russian psychiatry, neurology, and addictionology. Outdated ECT instruments are used in more than one third of sites, and EEG and seizure quality are virtually never monitored. Fewer than 20% of ECTs are modified with anesthesia. There is no system or expectation for ECT training or privileging, there is no national organization that aims to advance ECT practice, and ECT research is haphazard. Nevertheless, most respondents are enthusiastic and positive about ECT, and most institutions are eager to adopt modern ECT methods.

A naturalistic study of high-dose unilateral ECT among severely depressed inpatients: how does it work in the clinical practice?

PubMed

Alves, Lucas P C; Freire, Thiago F V; Fleck, Marcelo P A; Rocha, Neusa S

2016-11-11

Naturalistic studies can be useful tools to understand how an intervention works in the real clinical practice. This study aims to investigate the outcomes in a naturalistically treated depressed inpatients cohort, who were referred, or not, to unilateral ECT. Depressed adults according to MINI admitted in a psychiatric unit were divided in unilateral ECT treated and non-ECT treated. Main outcomes were: depression improvement in Hamilton Rating Scale for Depression (HDRS-17) scores; response (HDRS-17 improvement ≥50 %); remission (HDRS-17 score ≤7); length of hospitalization. Forty-three patients were included in unilateral ECT group and 104 in non-ECT group. No differences of psychotic symptoms, melancholic features or past maniac episode were found between groups. Unilateral ECT group had a mean HDRS-17 score higher than non-ECT group at admission (ECT: 25.05 ± 1.03; non-ECT: 21.61 ± 0.69; p = 0.001), but no significant difference was found at discharge (ECT: 7.70 ± 0.81; non-ECT: 7.40 ± 0.51; p = 0.75). Unilateral ECT group had a larger HDRS-17 score reduction during treatment (ECT: 18.24 ± 1.18; non-ECT:14.20 ± 0.76; p = 0.004). There were no significant differences in response and remission rates between groups. Unilateral ECT group had longer mean duration of hospitalization in days (ECT: 35.48 ± 2.48; non-ECT: 24.57 ± 1.50; p < 0.001), but there were no difference in mean time of treatment (ECT group:27.66 ± 1.95; non-ECT: 24.57 ± 1.50; p = 0.25). Unilateral high-dose ECT is still a useful treatment option, in the real world clinical practice, to reduce the intensity of depressive symptoms in highly depressed inpatients.

Continuation of ECT after recovery from transient, ECT-induced, postictal cortical blindness.

PubMed

Sonavane, Sushma; Bambole, Vivek; Bang, Abha; Shah, Nilesh; Andrade, Chittaranjan

2012-03-01

Transient, postictal cortical blindness is a rare adverse effect of electroconvulsive therapy (ECT). There is no information on the safety of continuation of ECT in patients who recover from ECT-induced cortical blindness. An 18-year-old woman with paranoid schizophrenia experienced cortical blindness immediately after her first bifrontotemporal ECT treatment. There was complete, spontaneous recovery of vision after 6 hours. Neurological examination, computed tomography of the brain, and electroencephalographic study revealed no abnormality. A combination of circumstances suggested that continuation of ECT was desirable. After clearances from neurological and ophthalmological teams, she received 6 more ECT treatments, starting 9 days after the first. After resumption of ECT, there was marked improvement in psychopathology across the ECT course. There was no recurrence of visual symptoms. Patients who experience transient, ECT-induced, postictal cortical blindness may not necessarily experience the same adverse effect on rechallenge with ECT.

Enhancement and stabilization of plasma using collinear long-short double-pulse laser-induced breakdown spectroscopy

NASA Astrophysics Data System (ADS)

Cui, Minchao; Deguchi, Yoshihiro; Wang, Zhenzhen; Fujita, Yuki; Liu, Renwei; Shiou, Fang-Jung; Zhao, Shengdun

2018-04-01

A collinear long-short dual-pulse laser-induced breakdown spectroscopy (DP-LIBS) method was employed to enhance and stabilize the laser-induced plasma from steel sample. The long-pulse-width laser beam with the pulse width of 60 μs was generated by a Nd: YAG laser which was operated at FR (free running) mode. The comparative experiments were carried out between single pulse LIBS (SP-LIBS) and long-short DP-LIBS. The recorded results showed that the emission intensities and the temperature of plasma were enhanced by long-short DP-LIBS. The plasma images showed that the plasma was bigger and had a longer lifetime in long-short DP-LIBS situation. Through the calculation of time-resolved plasma temperature and intensity ratio, it can be concluded that the plasma was stabilized by the long-pulse-width laser beam. The long-short DP-LIBS method also generated the stable plasma condition from the samples with different initial temperatures, which overcame the difficulties of LIBS in the online measurement for steel production line.

Noise-like pulse generation in an ytterbium-doped fiber laser using tungsten disulphide

NASA Astrophysics Data System (ADS)

Zhang, Wenping; Song, Yanrong; Guoyu, Heyang; Xu, Runqin; Dong, Zikai; Li, Kexuan; Tian, Jinrong; Gong, Shuang

2017-12-01

We demonstrated the noise-like pulse (NLP) generation in an ytterbium-doped fiber (YDF) laser with tungsten disulphide (WS2). Stable fundamental mode locking and second-order harmonic mode locking were observed. The saturable absorber (SA) was a WS2-polyvinyl alcohol film. The modulation depth of the WS2 film was 2.4%, and the saturable optical intensity was 155 MW cm-2. Based on this SA, the fundamental NLP with a pulse width of 20 ns and repetition rate of 7 MHz were observed. The autocorrelation trace of output pulses had a coherent spike, which came from NLP. The average pulse width of the spike was 550 fs on the top of a broad pedestal. The second-order harmonic NLP had a spectral bandwidth of 1.3 nm and pulse width of 10 ns. With the pump power of 400 mW, the maximum output power was 22.2 mW. To the best of our knowledge, this is the first time a noise-like mode locking in an YDF laser based on WS2-SA in an all normal dispersion regime was obtained.

Effects of single pulse energy on the properties of ceramic coating prepared by micro-arc oxidation on Ti alloy

NASA Astrophysics Data System (ADS)

Wang, Jun-Hua; Wang, Jin; Lu, Yan; Du, Mao-Hua; Han, Fu-Zhu

2015-01-01

The effects of single pulse energy on the properties of ceramic coating fabricated on a Ti-6Al-4V alloy via micro-arc oxidation (MAO) in aqueous solutions containing aluminate, phosphate, and some additives are investigated. The thickness, micro-hardness, surface and cross-sectional morphology, surface roughness, and compositions of the ceramic coating are studied using eddy current thickness meter, micro-hardness tester, JB-4C Precision Surface roughness meter, scanning electron microscopy (SEM) and X-ray diffraction (XRD). Single pulse energy remarkably influences the ceramic coating properties. The accumulative time of impulse width is an important parameter in the scientific and rational measurement of the film forming law of ceramic coating. The ceramic coating thickness approximately linearly increases with the cumulative time of impulse width. Larger impulse width resulted in higher single pulse energy, film forming rates and thicker ceramic coating thickness. The sizes of oxide particles, micro-pores and micro-cracks slightly increase with impulse width and single pulse energy. The main surface conversion products generated during MAO process in aqueous solutions containing aluminate are rutile TiO2, anatase TiO2, and a large amount of Al2TiO5. The effects of single pulse energy on the micro-hardness and phase composition of ceramic coating are not as evident as those of frequency and duty cycle.

Acute electroconvulsive therapy followed by maintenance electroconvulsive therapy decreases hospital re-admission rates of older patients with severe mental illness.

PubMed

Shelef, Assaf; Mazeh, Doron; Berger, Uri; Baruch, Yehuda; Barak, Yoram

2015-06-01

Electroconvulsive therapy (ECT) is a highly effective treatment for patients with severe mental illness (SMI). Maintenance ECT (M-ECT) is required for many elderly patients experiencing severe recurrent forms of mood disorders, whereas M-ECT for schizophrenia patients is a poorly studied treatment. We report on the outcomes in aged patients with SMI: schizophrenia and severe affective disorders treated by M-ECT of varying duration to prevent relapse after a successful course of acute ECT. The study measured the effectiveness of M-ECT in preventing hospital readmissions and reducing admission days. A retrospective chart review of 42 consecutive patients comparing the number and length of psychiatric admissions before and after the start of M-ECT was used. We analyzed diagnoses, previous ECT treatments, number of ECT treatments, and number and length of psychiatric admissions before and after M-ECT. Mean age in our sample was 71.5 (6.9) years. Twenty-two (52%) patients experienced severe affective disorders and 20 (48%) experienced schizophrenia. Patients were administered 92.8 (85.9) M-ECT treatments. Average duration of the M-ECT course was 34 (29.8) months. There were on average 1.88 admissions before M-ECT and only 0.38 admissions in the M-ECT period (P < 0.001). Duration of mean hospitalization stay decreased from 215.9 to 12.4 days during the M-ECT (P < 0.01). Our findings suggest that acute ECT followed by M-ECT is highly effective in selected elderly patients with SMIs.

Anomalous broadening and shift of emission lines in a femtosecond laser plasma filament in air

NASA Astrophysics Data System (ADS)

Ilyin, A. A.; Golik, S. S.; Shmirko, K. A.; Mayor, A. Yu.; Proschenko, D. Yu.

2017-12-01

The temporal evolution of the width and shift of N I 746.8 and O I 777.4 nm lines is investigated in a filament plasma produced by a tightly focused femtosecond laser pulse (0.9 mJ, 48 fs). The nitrogen line shift and width are determined by the joint action of electron impact shift and the far-off resonance AC Stark effect. The intensive (I = 1.2·1010 W/cm2) electric field of ASE (amplified spontaneous emission) and post-pulses result in a possible LS coupling break for the O I 3p 5P level and the generation of Rabi sidebands. The blueshifted main femtosecond pulse and Rabi sideband cause the stimulated emission of the N2 1+ system. The maximal widths of emission lines are approximately 6.7 times larger than the calculated Stark widths.

Multiwavelength self-pulsating fibre laser based on cascaded SPM spectral broadening and filtering

NASA Astrophysics Data System (ADS)

Rochette, Martin; Sun, Kai; Hernández-Cordero, Juan; Chen, Lawrence R.

2008-06-01

We experimentally demonstrate the operation of a laser based on self-phase modulation followed by offset spectral filtering. This laser has three operation modes: a continuous-wave mode, a self-pulsating mode where the laser self ignites and produces pulses, and a pulse-buffering mode where no new pulse is formed from spontaneous emission noise but only pulses already propagating or pulses injected in the laser cavity can be sustained. In the self-pulsating and pulse-buffering modes, the laser is multi-wavelength and continuously tunable over the entire gain band of the amplifiers. The output pulse width is quasi transform-limited with respect to the spectral-width of the filters used in the cavity. Overall, this device provides a simple alternative to pulsed laser source and also represents a promising approach for signal buffering.

Modeling and Numerical Simulation of Microwave Pulse Propagation in Air Breakdown Environment

NASA Technical Reports Server (NTRS)

Kuo, S. P.; Kim, J.

1991-01-01

Numerical simulation is used to investigate the extent of the electron density at a distant altitude location which can be generated by a high-power ground-transmitted microwave pulse. This is done by varying the power, width, shape, and carrier frequency of the pulse. The results show that once the breakdown threshold field is exceeded in the region below the desired altitude location, electron density starts to build up in that region through cascading breakdown. The generated plasma attenuates the pulse energy (tail erosion) and thus deteriorates the energy transmission to the destined altitude. The electron density saturates at a level limited by the pulse width and the tail erosion process. As the pulse continues to travel upward, though the breakdown threshold field of the background air decreases, the pulse energy (width) is reduced more severely by the tail erosion process. Thus, the electron density grows more quickly at the higher altitude, but saturates at a lower level. Consequently, the maximum electron density produced by a single pulse at 50 km altitude, for instance, is limited to a value below 10(exp 6) cm(exp -3). Three different approaches are examined to determine if the ionization at the destined location can be improved: a repetitive pulse approach, a focused pulse approach, and two intersecting beams. Only the intersecting beam approach is found to be practical for generating the desired density level.

Pulse width modulation inverter with battery charger

DOEpatents

Slicker, James M.

1985-01-01

An inverter is connected between a source of DC power and a three-phase AC induction motor, and a microprocessor-based circuit controls the inverter using pulse width modulation techniques. In the disclosed method of pulse width modulation, both edges of each pulse of a carrier pulse train are equally modulated by a time proportional to sin .theta., where .theta. is the angular displacement of the pulse center at the motor stator frequency from a fixed reference point on the carrier waveform. The carrier waveform frequency is a multiple of the motor stator frequency. The modulated pulse train is then applied to each of the motor phase inputs with respective phase shifts of 120.degree. at the stator frequency. Switching control commands for electronic switches in the inverter are stored in a random access memory (RAM) and the locations of the RAM are successively read out in a cyclic manner, each bit of a given RAM location controlling a respective phase input of the motor. The DC power source preferably comprises rechargeable batteries and all but one of the electronic switches in the inverter can be disabled, the remaining electronic switch being part of a "flyback" DC-DC converter circuit for recharging the battery.

Pulse width modulation inverter with battery charger

NASA Technical Reports Server (NTRS)

Slicker, James M. (Inventor)

1985-01-01

An inverter is connected between a source of DC power and a three-phase AC induction motor, and a microprocessor-based circuit controls the inverter using pulse width modulation techniques. In the disclosed method of pulse width modulation, both edges of each pulse of a carrier pulse train are equally modulated by a time proportional to sin .theta., where .theta. is the angular displacement of the pulse center at the motor stator frequency from a fixed reference point on the carrier waveform. The carrier waveform frequency is a multiple of the motor stator frequency. The modulated pulse train is then applied to each of the motor phase inputs with respective phase shifts of 120.degree. at the stator frequency. Switching control commands for electronic switches in the inverter are stored in a random access memory (RAM) and the locations of the RAM are successively read out in a cyclic manner, each bit of a given RAM location controlling a respective phase input of the motor. The DC power source preferably comprises rechargeable batteries and all but one of the electronic switches in the inverter can be disabled, the remaining electronic switch being part of a flyback DC-DC converter circuit for recharging the battery.

Adaptive beam-width control of echolocation sounds by CF-FM bats, Rhinolophus ferrumequinum nippon, during prey-capture flight.

PubMed

Matsuta, Naohiro; Hiryu, Shizuko; Fujioka, Emyo; Yamada, Yasufumi; Riquimaroux, Hiroshi; Watanabe, Yoshiaki

2013-04-01

The echolocation sounds of Japanese CF-FM bats (Rhinolophus ferrumequinum nippon) were measured while the bats pursued a moth (Goniocraspidum pryeri) in a flight chamber. Using a 31-channel microphone array system, we investigated how CF-FM bats adjust pulse direction and beam width according to prey position. During the search and approach phases, the horizontal and vertical beam widths were ±22±5 and ±13±5 deg, respectively. When bats entered the terminal phase approximately 1 m from a moth, distinctive evasive flight by G. pryeri was sometimes observed. Simultaneously, the bats broadened the beam widths of some emissions in both the horizontal (44% of emitted echolocation pulses) and vertical planes (71%). The expanded beam widths were ±36±7 deg (horizontal) and ±30±9 deg (vertical). When moths began evasive flight, the tracking accuracy decreased compared with that during the approach phase. However, in 97% of emissions during the terminal phase, the beam width was wider than the misalignment (the angular difference between the pulse and target directions). These findings indicate that bats actively adjust their beam width to retain the moving target within a spatial echolocation window during the final capture stages.

A simple sub-nanosecond ultraviolet light pulse generator with high repetition rate and peak power.

PubMed

Binh, P H; Trong, V D; Renucci, P; Marie, X

2013-08-01

We present a simple ultraviolet sub-nanosecond pulse generator using commercial ultraviolet light-emitting diodes with peak emission wavelengths of 290 nm, 318 nm, 338 nm, and 405 nm. The generator is based on step recovery diode, short-circuited transmission line, and current-shaping circuit. The narrowest pulses achieved have 630 ps full width at half maximum at repetition rate of 80 MHz. Optical pulse power in the range of several hundreds of microwatts depends on the applied bias voltage. The bias voltage dependences of the output optical pulse width and peak power are analysed and discussed. Compared to commercial UV sub-nanosecond generators, the proposed generator can produce much higher pulse repetition rate and peak power.

The Impact of A "Brief ECT Orientation Module" on The Knowledge and Attitudes of Medical Students Towards ECT in India.

PubMed

Balhara, Yps; Yadav, T; Mathur, S; Kataria, Dk

2012-07-01

Electroconvulsive therapy (ECT) continues to be an intervention that attracts controversy in spite of its proven efficacy. There is limited literature on attitude and knowledge of medical students towards ECT from Asian and African countries. The current study assesses the impact of a "Brief ECT Orientation Module" on the knowledge of and attitudes of Indian medical students towards modified ECT. The study was conducted at a tertiary care multi-specialty hospital associated with a government medical college. The students were administered the study questionnaire on Day 1 of Psychiatry clerkship. Following this, they were administered the Brief ECT Orientation Module. Assessment was made using a questionnaire with items related to knowledge and attitude towards ECT before and after "Brief ECT Orientation Module." Fifty-nine students completed the study. There was a significant improvement in knowledge of medical students on all the three domains of the questionnaire for assessment of knowledge about ECT-related facts. A change in attitudes towards ECT was also observed following Brief ECT Orientation Module, especially among those who witnessed ECT administration. The findings of the current study suggest that the Brief ECT Orientation Module is effective in improving the knowledge and attitude of medical students towards ECT.

A frequency and pulse-width co-modulation strategy for transcutaneous neuromuscular electrical stimulation based on sEMG time-domain features

NASA Astrophysics Data System (ADS)

Zhou, Yu-Xuan; Wang, Hai-Peng; Bao, Xue-Liang; Lü, Xiao-Ying; Wang, Zhi-Gong

2016-02-01

Objective. Surface electromyography (sEMG) is often used as a control signal in neuromuscular electrical stimulation (NMES) systems to enhance the voluntary control and proprioceptive sensory feedback of paralyzed patients. Most sEMG-controlled NMES systems use the envelope of the sEMG signal to modulate the stimulation intensity (current amplitude or pulse width) with a constant frequency. The aims of this study were to develop a strategy that co-modulates frequency and pulse width based on features of the sEMG signal and to investigate the torque-reproduction performance and the level of fatigue resistance achieved with our strategy. Approach. We examined the relationships between wrist torque and two stimulation parameters (frequency and pulse width) and between wrist torque and two sEMG time-domain features (mean absolute value (MAV) and number of slope sign changes (NSS)) in eight healthy volunteers. By using wrist torque as an intermediate variable, customized and generalized transfer functions were constructed to convert the two features of the sEMG signal into the two stimulation parameters, thereby establishing a MAV/NSS dual-coding (MNDC) algorithm. Wrist torque reproduction performance was assessed by comparing the torque generated by the algorithms with that originally recorded during voluntary contractions. Muscle fatigue was assessed by measuring the decline percentage of the peak torque and by comparing the torque time integral of the response to test stimulation trains before and after fatigue sessions. Main Results. The MNDC approach could produce a wrist torque that closely matched the voluntary wrist torque. In addition, a smaller decay in the wrist torque was observed after the MNDC-coded fatigue stimulation was applied than after stimulation using pulse-width modulation alone. Significance. Compared with pulse-width modulation stimulation strategies that are based on sEMG detection, the MNDC strategy is more effective for both voluntary muscle force reproduction and muscle fatigue reduction.

Effects of pulse width and coding on radar returns from clear air

NASA Technical Reports Server (NTRS)

Cornish, C. R.

1983-01-01

In atmospheric radar studies it is desired to obtain maximum information about the atmosphere and to use efficiently the radar transmitter and processing hardware. Large pulse widths are used to increase the signal to noise ratio since clear air returns are generally weak and maximum height coverage is desired. Yet since good height resolution is equally important, pulse compression techniques such as phase coding are employed to optimize the average power of the transmitter. Considerations in implementing a coding scheme and subsequent effects of an impinging pulse on the atmosphere are investigated.

In Vitro Comparison of Holmium Lasers: Evidence for Shorter Fragmentation Time and Decreased Retropulsion Using a Modern Variable-pulse Laser.

PubMed

Bell, John Roger; Penniston, Kristina L; Nakada, Stephen Y

2017-09-01

To compare the performance of variable- and fixed-pulse lasers on stone phantoms in vitro. Seven-millimeter stone phantoms were made to simulate calcium oxalate monohydrate stones using BegoStone plus. The in vitro setting was created with a clear polyvinyl chloride tube. For each trial, a stone phantom was placed at the open end of the tubing. The Cook Rhapsody H-30 variable-pulse laser was tested on both long- and short-pulse settings and was compared to the Dornier H-20 fixed-pulse laser; 5 trials were conducted for each trial arm. Fragmentation was accomplished with the use of a flexible ureteroscope and a 273-micron holmium laser fiber using settings of 1 J × 12 Hz. The treatment time (in minute) for complete fragmentation was recorded as was the total retropulsion distance (in centimeter) during treatment. Laser fibers were standardized for all repetitions. The treatment time was significantly shorter with the H-30 vs the H-20 laser (14.3 ± 2.5 vs 33.1 ± 8.9 minutes, P = .008). There was no difference between the treatment times using the long vs short pulse widths of the H-30 laser (14.4 ± 3.4 vs 14.3 ± 1.7 minutes, P = .93). Retropulsion differed by laser type and pulse width, H-30 long pulse (15.8 ± 5.7 cm), H-30 short pulse (54.8 ± 7.1 cm), and H-20 (33.2 ± 12.5 cm) (P <.05). The H-30 laser fragmented stone phantoms in half the time of the H-20 laser regardless of the pulse width. Retropulsion effects differed between the lasers, with the H-30 causing the least retropulsion. Longer pulse widths result in less stone retropulsion. Copyright © 2017 Elsevier Inc. All rights reserved.

[Dependence of anti-inflammatory effects of high peak-power pulsed electromagnetic radiation of extremely high frequency on exposure parameters].

PubMed

Gapeev, A B; Mikhaĭlik, E N; Rubanik, A V; Cheremis, N K

2007-01-01

A pronounced anti-inflammatory effect of high peak-power pulsed electromagnetic radiation of extremely high frequency was shown for the first time in a model of zymosan-induced footpad edema in mice. Exposure to radiation of specific parameters (35, 27 GHz, peak power 20 kW, pulse widths 400-600 ns, pulse repetition frequency 5-500 Hz) decreased the exudative edema and local hyperthermia by 20% compared to the control. The kinetics and the magnitude of the anti-inflammatory effect were comparable with those induced by sodium diclofenac at a dose of 3 mg/kg. It was found that the anti-inflammatory effect linearly increased with increasing pulse width at a fixed pulse repetition frequency and had threshold dependence on the average incident power density of the radiation at a fixed pulse width. When animals were whole-body exposed in the far-field zone of radiator, the optimal exposure duration was 20 min. Increasing the average incident power density upon local exposure of the inflamed paw accelerated both the development of the anti-inflammatory effect and the reactivation time. The results obtained will undoubtedly be of great importance in the hygienic standardization of pulsed electromagnetic radiation and in further studies of the mechanisms of its biological action.

Effect of electric barrier on passage and physical condition of juvenile and adult rainbow trout

USGS Publications Warehouse

Layhee, Megan J.; Sepulveda, Adam; Shaw, Amy; Smuckall, Matthew; Kapperman, Kevin; Reyes, Alejandro

2016-01-01

Electric barriers can inhibit passage and injure fish. Few data exist on electric barrier parameters that minimize these impacts and on how body size affects susceptibility, especially to nontarget fish species. The goal of this study was to determine electric barrier voltage and pulse-width settings that inhibit passage of larger bodied rainbow trout Oncorhynchus mykiss (215–410 mm fork length) while allowing passage of smaller bodied juvenile rainbow trout (52–126 mm) in a static laboratory setting. We exposed rainbow trout to 30-Hz pulsed-direct current voltage gradients (0.00–0.45 V cm−1) and pulse widths (0.0–0.7 ms) and recorded their movement, injury incidence, and mortality. No settings tested allowed all juveniles to pass while impeding all adult passage. Juvenile and adult rainbow trout avoided the barrier at higher pulse widths, and fewer rainbow trout passed the barrier at 0.7-ms pulse width compared to 0.1 ms and when the barrier was turned off. We found no effect of voltage gradient on fish passage. No mortality occurred, and we observed external bruising in 5 (7%) juvenile rainbow trout and 15 (21%) adult rainbow trout. This study may aid managers in selecting barrier settings that allow for increased juvenile passage.

PCF based high power narrow line width pulsed fiber laser

NASA Astrophysics Data System (ADS)

Chen, H.; Yan, P.; Xiao, Q.; Wang, Y.; Gong, M.

2012-09-01

Based on semiconductor diode seeded multi-stage cascaded fiber amplifiers, we have obtained 88-W average power of a 1063-nm laser with high repetition rate of up to 1.5 MHz and a constant 2-ns pulse duration. No stimulated Brillouin scattering pulse or optical damage occurred although the maximum pulse peak power has exceeded 112 kW. The output laser exhibits excellent beam quality (M2x = 1.24 and M2y = 1.18), associated with a spectral line width as narrow as 0.065 nm (FWHM). Additionally, we demonstrate high polarization extinction ratio of 18.4 dB and good pulse stabilities superior to 1.6 % (RMS).

Real-time method and apparatus for measuring the temperature of a fluorescing phosphor

DOEpatents

Britton, Jr., Charles L.; Beshears, David L.; Simpson, Marc L.; Cates, Michael R.; Allison, Steve W.

1999-01-01

A method for determining the temperature of a fluorescing phosphor is provided, together with an apparatus for performing the method. The apparatus includes a photodetector for detecting light emitted by a phosphor irradiated with an excitation pulse and for converting the detected light into an electrical signal. The apparatus further includes a differentiator for differentiating the electrical signal and a zero-crossing discrimination circuit that outputs a pulse signal having a pulse width corresponding to the time period between the start of the excitation pulse and the time when the differentiated electrical signal reaches zero. The width of the output pulse signal is proportional to the decay-time constant of the phosphor.

Electroconvulsive stimulation (ECS) increases the expression of neuropeptide Y (NPY) in rat brains in a model of neuropathic pain: a quantitative real-time polymerase chain reaction (RT-PCR) study.

PubMed

Okabe, Tadashi; Sato, Chiyo; Matsumoto, Keisuke; Ozawa, Hitoshi; Sakamoto, Atsuhiro

2009-11-01

Electroconvulsive shock therapy (ECT) has been widely used as an effective and established treatment for refractory depression and schizophrenia. Some reports have shown that ECT is also effective for treating refractory neuropathic pain. In a rat model of neuropathic pain produced by chronic constrictive injury (CCI) of the sciatic nerve, thermal hyperalgesia, and mechanical allodynia were observed from day 2 after surgery. An electroconvulsive shock (ECS) was administered to rodents once daily for 6 days on days 7-12 after CCI operation using a pulse generator. Thermal and mechanical stimulation tests were performed to assess pain thresholds. Real-time polymerase chain reaction was used to measure the gene expression levels for 5HT(1A)R, 5HT(2A)R, neuropeptide Y (NPY), and GABAA(alpha1)R in the brain. After ECS, the latency to withdrawal from thermal stimulation was significantly increased; however, pain withdrawal thresholds in response to mechanical stimulation were not significantly changed. Expression ratios of NPY were significantly greater after ECS. Symptoms of neuropathic pain improved and expression of NPY in the brain was increased in CCI model rats after ECS, suggesting that changes in the expression of NPY in the brain may be related to the mechanism of action of ECT in treating neuropathic pain.

The Impact of A “Brief ECT Orientation Module” on The Knowledge and Attitudes of Medical Students Towards ECT in India

PubMed Central

Balhara, YPS; Yadav, T; Mathur, S; Kataria, DK

2012-01-01

Background: Electroconvulsive therapy (ECT) continues to be an intervention that attracts controversy in spite of its proven efficacy. There is limited literature on attitude and knowledge of medical students towards ECT from Asian and African countries. Aim: The current study assesses the impact of a “Brief ECT Orientation Module” on the knowledge of and attitudes of Indian medical students towards modified ECT. Subjects and Methods: The study was conducted at a tertiary care multi-specialty hospital associated with a government medical college. The students were administered the study questionnaire on Day 1 of Psychiatry clerkship. Following this, they were administered the Brief ECT Orientation Module. Assessment was made using a questionnaire with items related to knowledge and attitude towards ECT before and after “Brief ECT Orientation Module.” Results: Fifty-nine students completed the study. There was a significant improvement in knowledge of medical students on all the three domains of the questionnaire for assessment of knowledge about ECT-related facts. A change in attitudes towards ECT was also observed following Brief ECT Orientation Module, especially among those who witnessed ECT administration. Conclusion: The findings of the current study suggest that the Brief ECT Orientation Module is effective in improving the knowledge and attitude of medical students towards ECT. PMID:23440565

Method and apparatus for improved efficiency in a pulse-width-modulated alternating current motor drive

DOEpatents

Konrad, C.E.; Boothe, R.W.

1994-02-15

A scheme for optimizing the efficiency of an AC motor drive operated in a pulse-width-modulated mode provides that the modulation frequency of the power furnished to the motor is a function of commanded motor torque and is higher at lower torque requirements than at higher torque requirements. 6 figures.

Method and apparatus for improved efficiency in a pulse-width-modulated alternating current motor drive

DOEpatents

Konrad, C.E.; Boothe, R.W.

1996-01-23

A scheme for optimizing the efficiency of an AC motor drive operated in a pulse-width-modulated mode provides that the modulation frequency of the power furnished to the motor is a function of commanded motor torque and is higher at lower torque requirements than at higher torque requirements. 6 figs.

Method and apparatus for improved efficiency in a pulse-width-modulated alternating current motor drive

DOEpatents

Konrad, Charles E.; Boothe, Richard W.

1996-01-01

A scheme for optimizing the efficiency of an AC motor drive operated in a pulse-width-modulated mode provides that the modulation frequency of the power furnished to the motor is a function of commanded motor torque and is higher at lower torque requirements than at higher torque requirements.

Method and apparatus for improved efficiency in a pulse-width-modulated alternating current motor drive

DOEpatents

Konrad, Charles E.; Boothe, Richard W.

1994-01-01

A scheme for optimizing the efficiency of an AC motor drive operated in a pulse-width-modulated mode provides that the modulation frequency of the power furnished to the motor is a function of commanded motor torque and is higher at lower torque requirements than at higher torque requirements.

Efficient extreme ultraviolet plasma source generated by a CO2 laser and a liquid xenon microjet target

NASA Astrophysics Data System (ADS)

Ueno, Yoshifumi; Ariga, Tatsuya; Soumagne, George; Higashiguchi, Takeshi; Kubodera, Shoichi; Pogorelsky, Igor; Pavlishin, Igor; Stolyarov, Daniil; Babzien, Marcus; Kusche, Karl; Yakimenko, Vitaly

2007-05-01

We demonstrated efficacy of a CO2-laser-produced xenon plasma in the extreme ultraviolet (EUV) spectral region at 13.5nm at variable laser pulse widths between 200ps and 25ns. The plasma target was a 30μm liquid xenon microjet. To ensure the optimum coupling of CO2 laser energy with the plasma, they applied a prepulse yttrium aluminum garnet laser. The authors measured the conversion efficiency (CE) of the 13.5nm EUV emission for different pulse widths of the CO2 laser. A maximum CE of 0.6% was obtained for a CO2 laser pulse width of 25ns at an intensity of 5×1010W/cm2.

[Microsecond Pulsed Hollow Cathode Lamp as Enhanced Excitation Source of Hydride Generation Atomic Fluorescence Spectrometry].

PubMed

Zhang, Shuo

2015-09-01

The spectral, electrical and atomic fluorescence characteristics of As, Se, Sb and Pb hollow cathode lamps (HCLs) powered by a laboratory-built high current microsecond pulse (HCMP) power supply were studied, and the feasibility of using HCMP-HCLs as the excitation source of hydride generation atomic fluorescence spectrometry (HG-AFS) was evaluated. Under the HCMP power supply mode, the As, Se, Sb, Pb HCLs can maintain stable glow discharge at frequency of 100~1000 Hz, pulse width of 4.0~20 μs and pulse current up to 4.0 A. Relationship between the intensity of characteristic emission lines and HCMP power supply parameters, such as pulse current, power supply voltage, pulse width and frequency, was studied in detail. Compared with the conventional pulsed (CP) HCLs used in commercial AFS instruments, HCMP-HCLs have a narrower pulse width and much stronger pulse current. Under the optimized HCMP power supply parameters, the intensity of atomic emission lines of As, Se, Sb HCLs had sharp enhancement and that indicated their capacity of being a novel HG-AFS excitation source. However, the attenuation of atomic lines and enhancement of ionic lines negated such feasibility of HCMP-Pb HCL. Then the HG-AFS analytical capability of using the HCMP-As/Se/Sb HCLs excitation source was established and results showed that the HCMP-HCL is a promising excitation source for HG-AFS.

The influence of erbium:yttrium-aluminum-garnet laser ablation with variable pulse width on morphology and microleakage of composite restorations.

PubMed

Navarro, Ricardo Scarparo; Gouw-Soares, Sheila; Cassoni, Alessandra; Haypek, Patricia; Zezell, Denise Maria; de Paula Eduardo, Carlos

2010-11-01

The objective of this study was to evaluate the influence of various pulse widths with different energy parameters of erbium:yttrium-aluminum-garnet (Er:YAG) laser (2.94 mum) on the morphology and microleakage of cavities restored with composite resin. Identically sized class V cavities were prepared on the buccal surfaces of 54 bovine teeth by high-speed drill (n = 6, control, group 1) and prepared by Er:YAG laser (Fidelis 320A, Fotona, Slovenia) with irradiation parameters of 350 mJ/ 4 Hz or 400 mJ/2 Hz and pulse width: group 2, very short pulse (VSP); group 3, short pulse (SP); group 4, long pulse (LP); group 5, very long pulse (VLP). All cavities were filled with composite resin (Z-250-3 M), stored at 37 degrees C in distilled water, polished after 24 h, and thermally stressed (700 cycles/5-55 degrees C). The teeth were impermeabilized, immersed in 50% silver nitrate solution for 8 h, sectioned longitudinally, and exposed to Photoflood light for 10 min to reveal the stain. The leakage was evaluated under stereomicroscope by three different examiners, in a double-blind fashion, and scored (0-3). The results were analyzed by Kruskal-Wallis test (P > 0.05) and showed that there was no significant differences between the groups tested. Under scanning electron microscopy (SEM) the morphology of the cavities prepared by laser showed irregular enamel margins and dentin internal walls, and a more conservative pattern than that of conventional cavities. The different power settings and pulse widths of Er:YAG laser in cavity preparation had no influence on microleakage of composite resin restorations.

Simple ps microchip Nd:YVO4 laser with 3.3-ps pulses at 0.2 to 1.4 MHz and single-stage amplification to the microjoule level

NASA Astrophysics Data System (ADS)

Türkyilmaz, Erdal; Lohbreier, Jan; Günther, Christian; Mehner, Eva; Kopf, Daniel; Giessen, Harald; Braun, Bernd

2016-06-01

Commercial picosecond sources have found widespread applications. Typical system parameters are pulse widths below 20 ps, repetition rates between 0.1 and 2 MHz, and microjoule level pulse energies. Most systems are based on short pulse mode-locked oscillators, regenerative amplifiers, and pockel cells as active beam switches. In contrast, we present a completely passive system, consisting of a passively Q-switched microchip laser, a single-stage amplifier, and a pulse compressor. The Q-switched microchip laser has a 50-μm-long Nd:YVO4 gain material optically bonded to a 4.6-mm-thick undoped YVO4 crystal. It delivers pulse widths of 40 ps and repetition rates of 0.2 to 1.4 MHz at a wavelength of 1.064 μm. The pulse energy is a few nanojoule. These 40-ps pulses are spectrally broadened in a standard single-mode fiber and then compressed in a 24-mm-long chirped Bragg grating to as low as 3.3 ps. The repetition rate can be tuned from ˜0.2 to 1.4 MHz by changing the pump power, while the pulse width and the pulse energy from the microchip laser are unchanged. The spectral broadening in the fiber is observed throughout the pulse repetition rate, supporting sub-10-ps pulses. Finally, the pulses are amplified in a single-stage Nd:YVO4 amplifier up to the microjoule level (up to 4 μJ pulse energy). As a result, the system delivers sub-10-ps pulses at a microjoule level with about 1 MHz repetition rate, and thus fulfills the requirements for ps-micromachining. It does not contain any active switching elements and can be integrated in a very compact setup.

Simple ps microchip Nd:YVO4 laser with 3.3 ps pulses at 0.2 - 1.4 MHz and single-stage amplification to the microjoule level

NASA Astrophysics Data System (ADS)

Türkyilmaz, Erdal; Lohbreier, Jan; Günther, Christian; Mehner, Eva; Kopf, Daniel; Giessen, Harald; Braun, Bernd

2016-03-01

Commercial picosecond sources have found widespread applications. Typical system parameters are pulse widths below 20 ps, repetition rates between 0.1 to 2 MHz, and micro Joule level pulse energies. Most systems are based on short pulse modelocked oscillators, regenerative amplifiers, and pockel cells as active beam switches. In contrast we present a completely passive system, consisting of a passively Q-switched microchip laser, a single-stage amplifier, and a pulse compressor. The Q-switched microchip laser has a 50 μm long Nd:YVO4-gain material optically bonded to a 4.6 mm thick undoped YVO4-crystal. It delivers pulse widths of 40 ps and repetition rates of 0.2 - 1.4 MHz at a wavelength of 1.064 μm. The pulse energy is a few nJ. These 40-ps pulses are spectrally broadened in a standard single mode fibre and then compressed in a 24 mm long chirped Bragg grating to as low as 3.3 ps. The repetition rate can be tuned from app. 0.2 to 1.4 MHz by changing the pump power while the pulse width and the pulse energy from the microchip laser are unchanged. The spectral broadening in the fibre is observed throughout the pulse repetition rate, supporting sub-10- ps pulses. Finally, the pulses are amplified in a single-stage Nd:YVO4-amplifier up to the microjoule level (up to 4 μJ pulse energy). As a result the system delivers sub-10-ps pulses at a microjoule level with about 1 MHz repetition rate, and thus fulfills the requirements for ps-micromachining. It does not contain any active switching elements and can be integrated in a very compact setup.

The study of laser pulse width on efficiency of Ho:YAG laser lithotripsy

NASA Astrophysics Data System (ADS)

Zhang, Jian J.; Rutherford, Jonathan; Solomon, Metasebya; Cheng, Brian; Xuan, Jason R.; Gong, Jason; Yu, Honggang; Xia, Michael; Yang, Xirong; Hasenberg, Thomas; Curran, Sean

2017-02-01

When treating ureteral calculi, retropulsion can be reduced by using a longer pulse width without compromising fragmentation efficiency (from the studies by David S. Finley et al. and Hyun Wook Kang et al.). In this study, a lab build Ho:YAG laser was used as the laser pulse source, with pulse energy from 0.2J up to 3.0 J, and electrical pump pulse width from 150 us up to 1000 us. The fiber used in the investigation is a 365 μm core diameter fiber, SureFlexTM, Model S-LLF365. Plaster of Paris calculus phantoms were ablated at different energy levels (0.2, 0.5, 1, 2, 3J) and with different number of pulses (1, 3, 10) using different electrical pump pulse width (333, 667, 1000 μs). The dynamics of the recoil action of a calculus phantom was monitored using a high-speed camera with frame rate up to 1 million frame per second (Photron Fastcam SA5); and the laser-induced craters were evaluated with a 3-D digital microscope (Keyence VHX-900F). A design of experiment software (DesignExpert-10, Minneapolis, MN, USA) is used in this study for the best fit of surface response on volume of dusting and retropulsion amplitude. The numerical formulas for the response surfaces of dusting speed and retropulsion amplitude are generated. More detailed investigation on the optimal conditions for dusting of other kinds of stone samples and the fiber size effect will be conducted as a future study.

Successful use of right unilateral ECT for catatonia: a case series.

PubMed

Cristancho, Pilar; Jewkes, Delaina; Mon, Thetsu; Conway, Charles

2014-03-01

Catatonia is a neuropsychiatric syndrome involving motor signs in association with disorders of mood, behavior, or thought. Bitemporal electrode placement electroconvulsive therapy (ECT) is a proven effective treatment for catatonia, and this mode of ECT delivery is the preferred method of treatment in this condition. Studies in major depressive disorder have demonstrated that suprathreshold, nondominant (right) hemisphere, unilateral electrode placement ECT has fewer adverse effects, especially cognitive adverse effects, than bitemporal ECT. This case series describes the use of right unilateral (RUL) ECT in 5 patients with catatonia. Before ECT, all 5 patients in this series initially failed therapy with benzodiazepines and psychotropic medications. Each catatonic patient received a series of 8 to 12 RUL ECT in an every-other-day series. After ECT, 4 of the 5 patients had a full recovery from catatonia. One patient achieved only partial response to RUL ECT, and no additional benefit was obtained with bitemporal ECT. All patients in this case series tolerated RUL ECT without major adverse effects. This case series illustrates successful use of RUL ECT in patients with catatonia and adds to the early literature demonstrating its effective use in treating this complex condition.

Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on the decline and recovery of muscle force.

PubMed

Bochkezanian, Vanesa; Newton, Robert U; Trajano, Gabriel S; Vieira, Amilton; Pulverenti, Timothy S; Blazevich, Anthony J

2017-05-02

Neuromuscular electrical stimulation (NMES) is commonly used to activate skeletal muscles and reverse muscle atrophy in clinical populations. Clinical recommendations for NMES suggest the use of short pulse widths (100-200 μs) and low-to-moderate pulse frequencies (30-50 Hz). However, this type of NMES causes rapid muscle fatigue due to the (non-physiological) high stimulation intensities and non-orderly recruitment of motor units. The use of both wide pulse widths (1000 μs) and tendon vibration might optimize motor unit activation through spinal reflex pathways and thus delay the onset of muscle fatigue, increasing muscle force and mass. Thus, the objective of this study was to examine the acute effects of patellar tendon vibration superimposed onto wide-pulse width (1000 μs) knee extensor electrical stimulation (NMES, 30 Hz) on peak muscle force, total impulse before "muscle fatigue", and the post-exercise recovery of muscle function. Tendon vibration (Vib), NMES (STIM) or NMES superimposed onto vibration (STIM + Vib) were applied in separate sessions to 16 healthy adults. Total torque-time integral (TTI), maximal voluntary contraction torque (MVIC) and indirect measures of muscle damage were tested before, immediately after, 1 h and 48 h after each stimulus. TTI increased (145.0 ± 127.7%) in STIM only for "positive responders" to the tendon vibration (8/16 subjects), but decreased in "negative responders" (-43.5 ± 25.7%). MVIC (-8.7%) and rectus femoris electromyography (RF EMG) (-16.7%) decreased after STIM (group effect) for at least 1 h, but not after STIM + Vib. No changes were detected in indirect markers of muscle damage in any condition. Tendon vibration superimposed onto wide-pulse width NMES increased TTI only in 8 of 16 subjects, but reduced voluntary force loss (fatigue) ubiquitously. Negative responders to tendon vibration may derive greater benefit from wide-pulse width NMES alone.

Practice of Acute and Maintenance Electroconvulsive Therapy in the Psychiatric Clinic of a University Hospital from Turkey: between 2007 and 2013

PubMed Central

Sengul, Melike Ceyhan Balci; Kenar, Ayse Nur Inci; Hanci, Ezgi; Sendur, İbrahim; Sengul, Cem; Herken, Hasan

2016-01-01

Objective Electroconvulsive therapy (ECT) can be given as the form of acute, continuation or maintenance ECT according to the process of administration. We report our 7 years’ observation with acute and maintenance ECT in a university hospital in Turkey. Methods The medical records of the hospitalized patients treated with acute or maintenance ECT between the years 2007 and 2013 was retrospectively analyzed. The sociodemographic characteristics, diagnosis, data of ECT and the co-administered psychotropic drugs were recorded. The frequency of ECT was calculated by identifying the total number of the hospitalized patients during the study period from the hospital records. Results A total number of 1,432 female and 1,141 male patients hospitalized in a period of 7 years, with a total number of 111 patients treated with ECT. The ratio of ECT was 4%, maintenance/acute ECT 11%. For acute ECT, affective disorders (65.3%) and psychotic disorders (21.6%) were among the leading diagnoses. Maintenance ECT, the diagnosis was; 6 affective disorders, 4 psychotic disorders and 1 obsessive compulsive disorder. There was a significant difference between the patients receiving acute and maintenance ECT in terms of age, duration of illness, and number of previous hospitalizations and ECTs. Conclusion The percentage of patients treated with acute ECT is lower in our institution than that in many other institutions from our country. Acute and maintenance ECT should be considered as an important treatment option particularly for patients with long disease duration, a high number of hospitalizations and a history of benefiting from previous ECTs. PMID:26792041

Experimental demonstration of wavelength conversion between ps-pulses based on cascaded sum- and difference frequency generation (SFG+DFG) in LiNbO3 waveguides

NASA Astrophysics Data System (ADS)

Wang, Jian; Sun, Junqiang; Lou, Chuanhong; Sun, Qizhen

2005-09-01

All-optical wavelength conversion between ps-pulses based on cascaded sum- and difference frequency generation (SFG+DFG) is proposed and experimentally demonstrated in periodically poled LiNbO3 (PPLN) waveguides. The signal pulse with 40-GHz repetition rate and 1.57- ps pulse width is adopted. The converted idler wavelength can be tuned from 1527.4 to 1540.5nm as the signal wavelength is varied from 1561.9 to 1548.4nm. No obvious changes of the pulse shape and width, also no chirp are observed in the converted idler pulse. The results imply that single-to-multiple channel wavelength conversions can be achieved by appropriately tuning the two pump wavelengths.

Experimental demonstration of wavelength conversion between ps-pulses based on cascaded sum- and difference frequency generation (SFG+DFG) in LiNbO3 waveguides.

PubMed

Wang, Jian; Sun, Junqiang; Lou, Chuanhong; Sun, Qizhen

2005-09-19

All-optical wavelength conversion between ps-pulses based on cascaded sum- and difference frequency generation (SFG+DFG) is proposed and experimentally demonstrated in periodically poled LiNbO3 (PPLN) waveguides. The signal pulse with 40-GHz repetition rate and 1.57- ps pulse width is adopted. The converted idler wavelength can be tuned from 1527.4 to 1540.5nm as the signal wavelength is varied from 1561.9 to 1548.4nm. No obvious changes of the pulse shape and width, also no chirp are observed in the converted idler pulse. The results imply that single-to-multiple channel wavelength conversions can be achieved by appropriately tuning the two pump wavelengths.

Cognitive Behavioral Therapy as a Treatment for Electroconvulsive Therapy Phobia: Case Report and Review of Literature.

PubMed

Wo, Nolan King Hop; Guyitt, Brendan; Owen, Richard

2015-12-01

Electroconvulsive therapy (ECT) can raise feelings of fear and anxiety in our patients. No documented cases of phobia regarding ECT or its treatment were found in the literature. We present a patient who developed anxiety regarding ECT that was severe enough to be classified as a phobia. She was successfully treated with cognitive behavioral therapy (CBT) for her phobia and was subsequently able to tolerate ECT. We conducted a literature review of ECT phobia, fear, and anxiety using MEDLINE, PsycINFO, and EMBASE. We outlined how CBT, in our specific case, was helpful in treating extreme and unrealistic fears concerning ECT. We could not find a case of phobia related to ECT in the literature; however, both qualitative and quantitative studies illustrate that ECT causes anxiety and fear. Although cases of ECT phobia are rare, feelings of fear and anxiety surrounding ECT are common. The experience of ECT is individualized for each patient, and CBT can be a successful treatment in those who have anxiety related to ECT.

Electroconvulsive Therapy in the Elderly: New Findings in Geriatric Depression.

PubMed

Geduldig, Emma T; Kellner, Charles H

2016-04-01

This paper reviews recent research on the use of electroconvulsive therapy (ECT) in elderly depressed patients. The PubMed database was searched for literature published within the past 4 years, using the search terms: "electroconvulsive elderly," "electroconvulsive geriatric," "ECT and elderly," and "ECT elderly cognition." The studies in this review indicate excellent efficacy for ECT in geriatric patients. Adverse cognitive effects of ECT in this population are usually transient and not typically severe. In addition, continuation/maintenance ECT (C/M-ECT) may be a favorable strategy for relapse prevention in the elderly after a successful acute course of ECT. ECT is an important treatment option for depressed geriatric patients with severe and/or treatment-resistant illness. New data add to the evidence demonstrating that ECT is a highly effective, safe, and well-tolerated antidepressant treatment option for geriatric patients.

ECT practices in Iraq: a national audit.

PubMed

Alhemiary, Nesif; Ali, Zainab; Abbas, Mohammed J

2015-12-01

Aims and method This national audit examined practice of electroconvulsive therapy (ECT) in Iraq against local standards. Data were collected by a questionnaire sent to heads of departments or medical directors in the 10 Iraqi hospitals which provide ECT and by examining case notes of all patients who had ECT in the first 6 months of 2013. Results Of the 26 psychiatric hospitals in Iraq, 10 provide ECT. There were some resource shortcomings in the ECT clinics (e.g. only 2 had a minimum of 2 rooms and all had no EEG monitoring). During the audit period, 251 patients had ECT. The mean age was 36.2 years and 51.8% were males. Bilateral ECT was used in all cases, general anaesthesia in 77.15%. The main indication for ECT was schizophrenia, followed by severe depression, resistant mania, catatonia and others. Clinical implications More work is needed to ensure all patients receive modified ECT. ECT is still used widely for schizophrenia. This needs further exploration and training.

Twice versus thrice weekly ECT in a clinical population: an evaluation of patient outcomes.

PubMed

Siskind, Dan; Charlson, Fiona; Saraf, Sudeep; Scheurer, Roman; Lie, David Charles

2012-10-30

Increasing demand on electroconvulsive therapy (ECT) services led to a recommendation that low risk patients be considered for twice weekly ECT rather than the usual thrice weekly. We evaluated whether practice changed and compared patient clinical outcomes for twice and thrice weekly ECT. Medical records for all patients receiving ECT in the 2-year study period (1/9/08 to 30/8/10) were reviewed to determine ECT protocol, diagnosis, admission duration and readmission rates. During the study period, 119 patients received 150 treatment courses. Patient outcomes were compared for twice weekly ECT and thrice weekly ECT protocols, as well as for 1 year before and after the recommendation (1/9/09). Twice weekly ECT courses increased (8-20) after the recommendation while thrice weekly ECT courses decreased (64-30). The recommendation had no significant effect on patient outcomes. Comparing twice and thrice weekly ECT, patient clinical outcomes were similar between the two groups, though non-affective twice weekly patients waited longer before starting ECT. In the context of resource constraints, psychiatrists can be influenced to examine and change their ECT prescribing practice. This bodes well for the implementation of evidence-based treatment into mental health services. Secondly, for adults, there appear to be no significant differences in clinical outcomes for twice versus thrice weekly ECT. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Electroconvulsive therapy (ECT) in schizophrenia: a review of recent literature.

PubMed

Sanghani, Sohag N; Petrides, Georgios; Kellner, Charles H

2018-05-01

ECT remains an important, yet underutilized, treatment for schizophrenia. Recent research shows that medication-resistant patients with schizophrenia, including those resistant to clozapine, respond well to ECT augmentation. The purpose of this article is to review recent studies of the use of ECT in the treatment of schizophrenia. We performed an electronic database search for articles on ECT and schizophrenia, published in 2017. The main themes of these articles are: epidemiological data on ECT use from various countries; retrospective studies, prospective studies and meta-analyses focusing on efficacy and cognitive side-effects of ECT in schizophrenia; ECT technical parameters and potential biomarkers. There is growing evidence to support the use of ECT for augmentation of antipsychotic response in the treatment of schizophrenia. Cognitive side-effects are generally mild and transient. In fact, many studies show improvement in cognition, possibly related to the improvement in symptoms. There is wide variation among countries in the use of ECT for the treatment of schizophrenia. There are also variations in the choice of ECT electrode placement, parameters and schedules. These technical differences are likely minor and should not interfere with the treatment being offered to patients. Further, long-term studies are needed to optimize ECT treatment parameters, to examine the effect of maintenance ECT and to investigate neuroimaging/biomarkers to understand the mechanism of action and identify potential response predictors to ECT.

A novel compact low impedance Marx generator with quasi-rectangular pulse output

NASA Astrophysics Data System (ADS)

Liu, Hongwei; Jiang, Ping; Yuan, Jianqiang; Wang, Lingyun; Ma, Xun; Xie, Weiping

2018-04-01

In this paper, a novel low impedance compact Marx generator with near-square pulse output based on the Fourier theory is developed. Compared with the traditional Marx generator, capacitors with different capacity have been used. It can generate a high-voltage quasi-rectangular pulse with a width of 100 ns at low impedance load, and it also has high energy density and power density. The generator consists of 16 modules. Each module comprises an integrative single-ended plastic case capacitor with a nominal value of 54 nF, four ceramic capacitors with a nominal value of 1.5 nF, a gas switch, a charging inductor, a grounding inductor, and insulators which provide mechanical support for all elements. In the module, different discharge periods from different capacitors add to the main circuit to form a quasi-rectangular pulse. The design process of the generator is analyzed, and the test results are provided here. The generator achieved pulse output with a rise time of 32 ns, pulse width of 120 ns, flat-topped width (95%-95%) of 50 ns, voltage of 550 kV, and power of 20 GW.

Method and apparatus for pulse width modulation control of an AC induction motor

DOEpatents

Geppert, Steven; Slicker, James M.

1984-01-01

An inverter is connected between a source of DC power and a three-phase AC induction motor, and a micro-processor-based circuit controls the inverter using pulse width modulation techniques. In the disclosed method of pulse width modulation, both edges of each pulse of a carrier pulse train are equally modulated by a time proportional to sin .THETA., where .THETA. is the angular displacement of the pulse center at the motor stator frequency from a fixed reference point on the carrier waveform. The carrier waveform frequency is a multiple of the motor stator frequency. The modulated pulse train is then applied to each of the motor phase inputs with respective phase shifts of 120.degree. at the stator frequency. Switching control commands of electronic switches in the inverter are stored in a random access memory (RAM) and the locations of the RAM are successively read out in a cyclic manner, each bit of a given RAM location controlling a respective phase input of the motor. The DC power source preferably comprises rechargeable batteries and all but one of the electronic switches in the inverter can be disabled, the remaining electronic switch being part of a "flyback" DC-DC converter circuit for recharging the battery.

Method and apparatus for pulse width modulation control of an AC induction motor

NASA Technical Reports Server (NTRS)

Geppert, Steven (Inventor); Slicker, James M. (Inventor)

1984-01-01

An inverter is connected between a source of DC power and a three-phase AC induction motor, and a micro-processor-based circuit controls the inverter using pulse width modulation techniques. In the disclosed method of pulse width modulation, both edges of each pulse of a carrier pulse train are equally modulated by a time proportional to sin .THETA., where .THETA. is the angular displacement of the pulse center at the motor stator frequency from a fixed reference point on the carrier waveform. The carrier waveform frequency is a multiple of the motor stator frequency. The modulated pulse train is then applied to each of the motor phase inputs with respective phase shifts of 120.degree. at the stator frequency. Switching control commands of electronic switches in the inverter are stored in a random access memory (RAM) and the locations of the RAM are successively read out in a cyclic manner, each bit of a given RAM location controlling a respective phase input of the motor. The DC power source preferably comprises rechargeable batteries and all but one of the electronic switches in the inverter can be disabled, the remaining electronic switch being part of a flyback DC-DC converter circuit for recharging the battery.

Efficacy and cognitive side effects of electroconvulsive therapy (ECT) in depressed elderly inpatients with coexisting mild cognitive impairment or dementia.

PubMed

Hausner, Lucrezia; Damian, Marinella; Sartorius, Alexander; Frölich, Lutz

2011-01-01

To study cognitive performance in depressed geriatric inpatients with or without preexisting cognitive impairment who received a first course of electroconvulsive therapy (ECT). Forty-four elderly inpatients with major depressive disorder (ICD-10 criteria) were included in a prospective consecutive case series of a university hospital. The patients were divided into 3 groups (no cognitive impairment [NCI], mild cognitive impairment [MCI], dementia) and rated for cognitive performance with the MMSE before first ECT, after sixth ECT, and 6 weeks and 6 months after ECT termination. Affective symptoms were rated by 21-item Hamilton Depression Rating Scale (HDRS-21) before and 6 weeks after ECT. Analysis of variance or Kruskal-Wallis tests on ECT-induced MMSE and HDRS-21 score changes were compared to baseline. Binary logistic regression was used for predictor analysis. The study was conducted from April 2004 to April 2008. After initial nonsignificant cognitive deterioration in all 3 groups, the NCI group improved cognitively 6 weeks (P = .018) and 6 months (P = .027) after ECT. The MCI group improved in cognition 6 months (P = .036) after ECT. In the dementia group, mean MMSE scores also improved numerically over the course of ECT without significance. Dementia patients with antidementia treatment improved in cognition to a clinically relevant extent after the sixth ECT. Dementia subjects without antidementia treatment deteriorated. After the sixth ECT, 70.0% of dementia patients (P = .004) presented a cognitive decline, and 68.8% of MCI patients (P < .001) presented a decline 6 weeks after ECT. Six months after ECT, one-third of the dementia patients (P < .036) still had a cognitive decline. Affective symptoms remitted after ECT in all 3 groups (P < .001). Pre-ECT cognitive deficits were the best predictor of MMSE decline (6 weeks after ECT, P = .007; 6 months after ECT, P = .055). ECT is effective and well tolerated in geriatric depressed inpatients regardless of preexisting cognitive impairment. Cognitive deficits were transient. © Copyright 2011 Physicians Postgraduate Press, Inc.

Reliability of High-Power Pulsed IMPATT Diodes.

DTIC Science & Technology

1981-11-01

FOLLOWING 168 HOUR STORAGE AT 3100 C D- 20816 5-14 FIGURE 5.11 READ DOUBLE DRIFT DEVICE FROM WAFER 21693-1 WITH GOLD GERMANIUM SOLDER FOLLOWING...vs. DUTY CYCLE FOR VARIOUS WIDTHS FOR SINGLE DRIFT SCHOTTKY LHL X-BAND GaAs DEVICES D- 20816 6-2 10 _PULSE WIDTH z,- 4 CL 0.11I 0.1 1.0 10 100 DUTY

The Role of Ect2 Nuclear RhoGEF Activity in Ovarian Cancer Cell Transformation

PubMed Central

Huff, Lauren P.; DeCristo, Molly J.; Trembath, Dimitri; Kuan, Pei Fen; Yim, Margaret; Liu, Jinsong; Cook, Danielle R.; Miller, C. Ryan; Der, Channing J.

2013-01-01

Ect2, a Rho guanine nucleotide exchange factor (RhoGEF), is atypical among RhoGEFs in its predominantly nuclear localization in interphase cells. One current model suggests that Ect2 mislocalization drives cellular transformation by promoting aberrant activation of cytoplasmic Rho family GTPase substrates. However, in ovarian cancers, where Ect2 is both amplified and overexpressed at the mRNA level, we observed that the protein is highly expressed and predominantly nuclear and that nuclear but not cytoplasmic Ect2 increases with advanced disease. Knockdown of Ect2 in ovarian cancer cell lines impaired their anchorage-independent growth without affecting their growth on plastic. Restoration of Ect2 expression rescued the anchorage-independent growth defect, but not if either the DH catalytic domain or the nuclear localization sequences of Ect2 were mutated. These results suggested a novel mechanism whereby Ect2 could drive transformation in ovarian cancer cells by acting as a RhoGEF specifically within the nucleus. Interestingly, Ect2 had an intrinsically distinct GTPase specificity profile in the nucleus versus the cytoplasm. Nuclear Ect2 bound preferentially to Rac1, while cytoplasmic Ect2 bound to RhoA but not Rac. Consistent with nuclear activation of endogenous Rac, Ect2 overexpression was sufficient to recruit Rac effectors to the nucleus, a process that required a functional Ect2 catalytic domain. Furthermore, expression of active nuclearly targeted Rac1 rescued the defect in transformed growth caused by Ect2 knockdown. Our work suggests a novel mechanism of Ect2-driven transformation, identifies subcellular localization as a regulator of GEF specificity, and implicates activation of nuclear Rac1 in cellular transformation. PMID:24386507

Study on the amplifier experiment of end-pumped long pulse slab laser

NASA Astrophysics Data System (ADS)

Jin, Quanwei; Chen, Xiaoming; Jiang, JianFeng; Pang, Yu; Tong, Lixin; Li, Mi; Hu, Hao; Lv, Wenqiang; Gao, Qingsong; Tang, Chun

2018-03-01

The amplifier experiment research of end-pumped long pulse slab laser is developed, the results of out-put energy, optical-optical efficiency and pulse waveform are obtained at different experiment conditions, such as peak pumped power, amplifier power and pumped pulse width. The seed laser is CW fundamental transverse-mode operation fiber laser, the laser medium is composited Nd:YAG slab. Under end-pumped and the 2 passes, the laser obtain 7.65J out-put energy and 43.1% optical-optical efficiency with 45kW peak-pumped power and 386μs pump pulse width. The experimental results provide the basic for the optimization design to high frequency, high energy and high beam-quality slab lasers.

Three-Level 48-Pulse STATCOM with Pulse Width Modulation

NASA Astrophysics Data System (ADS)

Singh, Bhim; Srinivas, Kadagala Venkata

2016-03-01

In this paper, a new control strategy of a three-level 48-pulse static synchronous compensator (STATCOM) is proposed with a constant dc link voltage and pulse width modulation at fundamental frequency switching. The proposed STATCOM is realized using eight units of three-level voltage source converters (VSCs) to form a three-level 48-pulse STATCOM. The conduction angle of each three-level VSC is modulated to control the ac converter output voltage, which controls the reactive power of the STATCOM. A fuzzy logic controller is used to control the STATCOM. The dynamic performance of the STATCOM is studied for the control of the reference reactive power, the reference terminal voltage and under the switching of inductive and capacitive loads.

Real-time method and apparatus for measuring the decay-time constant of a fluorescing phosphor

DOEpatents

Britton, Jr., Charles L.; Beshears, David L.; Simpson, Marc L.; Cates, Michael R.; Allison, Steve W.

1999-01-01

A method for determining the decay-time constant of a fluorescing phosphor is provided, together with an apparatus for performing the method. The apparatus includes a photodetector for detecting light emitted by a phosphor irradiated with an excitation pulse and for converting the detected light into an electrical signal. The apparatus further includes a differentiator for differentiating the electrical signal and a zero-crossing discrimination circuit that outputs a pulse signal having a pulse width corresponding to the time period between the start of the excitation pulse and the time when the differentiated electrical signal reaches zero. The width of the output pulse signal is proportional to the decay-time constant of the phosphor.

OH Production Enhancement in Bubbling Pulsed Discharges

NASA Astrophysics Data System (ADS)

Lungu, Cristian P.; Porosnicu, Corneliu; Jepu, Ionut; Chiru, Petrica; Zaroschi, Valentin; Lungu, Ana M.; Saito, Nagahiro; Bratescu, Maria; Takai, Osamu; Velea, Theodor; Predica, Vasile

2010-10-01

The generation of active species, such as H2O2, O*, OH*, HO2*, O3, N2*, etc, produced in aqueous solutions by HV pulsed discharges was studied in order to find the most efficient way in waste water treatment taking into account that these species are almost stronger oxidizers than ozone. Plasma was generated inside gas bubbles formed by the argon, air and oxygen gas flow between the special designed electrodes. The pulse width and pulse frequency influence was studied in order to increase the efficiency of the OH active species formation. The produced active species were investigated by optical emission spectroscopy and correlated with electrical parameters of the discharges (frequency, pulse width, amplitude, and rise and decay time).

A qualitative study of experience of parents of adolescents who received ECT.

PubMed

Grover, Sandeep; Varadharajan, Natarajan; Avasthi, Ajit

2017-12-01

To evaluate the experience of parents of adolescents who received ECT for severe mental illness. Using qualitative methods, 6 parents of 5 adolescents were interviewed by using a self-designed semi-structured interview after the completion of ECT course. The clinicians involved in the ECT procedure, i.e., seeking informed consent and administration of ECT were not aware about the study. All the interviews were recorded and the content was analysed and themes were generated. Parents of all the 5 adolescents expressed that their children were considered for ECT only after the patient had not responded to medication and were unmanageable. Prior to ECT the treating doctors did explain to them about the ECT procedure, they were given information booklet and they were not coerced to consent for ECT. Some of the parents reported that they had dilemma prior to giving consent and were scared prior to the first ECT. However, as the clinical condition of their children improved, they felt that ECT was a good treatment. Majority of the parents felt that ECT was delayed for their children. When asked about restriction in use of ECT in children and adolescents, the parents expressed that it is important for law makers to understand the distress of the parents,when their children are acutely ill. They expressed that decision of administration of ECT must be left to the family and the treating clinicians. Parents of adolescents considered for ECT are generally satisfied with the treatment procedure. Copyright © 2017 Elsevier B.V. All rights reserved.

Using the ultra-long pulse width pulsed dye laser and elliptical spot to treat resistant nasal telangiectasia.

PubMed

Madan, Vishal; Ferguson, Janice

2010-01-01

Thick linear telangiectasia on the ala nasi and nasolabial crease can be resistant to treatment with the potassium-titanyl-phosphate (KTP) laser and the traditional round spot on a pulsed dye laser (PDL). We evaluated the efficacy of a 3 mm x 10 mm elliptical spot using the ultra-long pulse width on a Candela Vbeam(R) PDL for treatment of PDL- and KTP laser-resistant nasal telangiectasia. Nasal telangiectasia resistant to PDL (12 patients) and KTP laser (12 patients) in 18 patients were treated with a 3 mm x 10 mm elliptical spot on the ultra-long pulse pulsed dye laser (ULPDL) utilising long pulse width [595 nm, 40 ms, double pulse, 30:20 dynamic cooling device (DCD)]. Six patients had previously received treatment with both PDL and KTP laser prior to ULPDL (40 treatments, range1-4, mean 2.2). Complete clearance was seen in ten patients, and eight patients displayed more than 80% improvement after ULPDL treatment. Self-limiting purpura occurred with round spot PDL and erythema with KTP laser and ULPDL. Subtle linear furrows along the treatment sites were seen in three patients treated with the KTP laser. ULPDL treatment delivered using a 3 mm x 10 mm elliptical spot was non-purpuric and highly effective in the treatment of nasal telangiectasia resistant to KTP laser and PDL.

Passive, active, and hybrid mode-locking in a self-optimized ultrafast diode laser

NASA Astrophysics Data System (ADS)

Alloush, M. Ali; Pilny, Rouven H.; Brenner, Carsten; Klehr, Andreas; Knigge, Andrea; Tränkle, Günther; Hofmann, Martin R.

2018-02-01

Semiconductor lasers are promising sources for generating ultrashort pulses. They are directly electrically pumped, allow for a compact design, and therefore they are cost-effective alternatives to established solid-state systems. Additionally, their emission wavelength depends on the bandgap which can be tuned by changing the semiconductor materials. Theoretically, the obtained pulse width can be few tens of femtoseconds. However, the generated pulses are typically in the range of several hundred femtoseconds only. Recently, it was shown that by implementing a spatial light modulator (SLM) for phase and amplitude control inside the resonator the optical bandwidth can be optimized. Consequently, by using an external pulse compressor shorter pulses can be obtained. We present a Fourier-Transform-External-Cavity setup which utilizes an ultrafast edge-emitting diode laser. The used InGaAsP diode is 1 mm long and emits at a center wavelength of 850 nm. We investigate the best conditions for passive, active and hybrid mode-locking operation using the method of self-adaptive pulse shaping. For passive mode-locking, the bandwidth is increased from 2.34 nm to 7.2 nm and ultrashort pulses with a pulse width of 216 fs are achieved after external pulse compression. For active and hybrid mode-locking, we also increased the bandwidth. It is increased from 0.26 nm to 5.06 nm for active mode-locking and from 3.21 nm to 8.7 nm for hybrid mode-locking. As the pulse width is strongly correlated with the bandwidth of the laser, we expect further reduction in the pulse duration by increasing the bandwidth.

Coherent THz Repetitive Pulse Generation in a GaSe Crystal by Dual-wavelength Nd:YLF Laser

NASA Astrophysics Data System (ADS)

Bezotosnyi, V. V.; Cheshev, E. A.; Gorbunkov, M. V.; Koromyslov, A. L.; Krokhin, O. N.; Mityagin, Yu. A.; Popov, Yu. M.; Savinov, S. A.; Tunkin, V. G.

We present modification of difference frequency generator of coherent THz radiation in a nonlinear GaSe crystal using dual-wavelength diode-pumped solid-state Nd:YLF laser. Generation at the two wavelengths (1.047 and 1.053 μm) was carried out by equalization of the gains at these wavelengths near the frequency degeneracy of the transverse modes in resonator cavity, Q-switched by acousto-optical modulator. The main parameters of the device were measured: angular synchronism (width 0.6 degrees), polarization ratio (1:100), conversion efficiency (10-7), pulse power (0.8 mW), frequency and width (53,8 сm-1, 0,6 сm-1), pulse width and repetition rate (10 ns,7 kHz). The method is promising for practical purposes.

The use of short and wide x-ray pulses for time-of-flight x-ray Compton Scatter Imaging in cargo security

NASA Astrophysics Data System (ADS)

Calvert, Nick; Betcke, Marta M.; Cresswell, John R.; Deacon, Alick N.; Gleeson, Anthony J.; Judson, Daniel S.; Mason, Peter; McIntosh, Peter A.; Morton, Edward J.; Nolan, Paul J.; Ollier, James; Procter, Mark G.; Speller, Robert D.

2015-05-01

Using a short pulse width x-ray source and measuring the time-of-flight of photons that scatter from an object under inspection allows for the point of interaction to be determined, and a profile of the object to be sampled along the path of the beam. A three dimensional image can be formed by interrogating the entire object. Using high energy x rays enables the inspection of cargo containers with steel walls, in the search for concealed items. A longer pulse width x-ray source can also be used with deconvolution techniques to determine the points of interaction. We present time-of-flight results from both short (picosecond) width and long (hundreds of nanoseconds) width x-ray sources, and show that the position of scatter can be localised with a resolution of 2 ns, equivalent to 30 cm, for a 3 cm thick plastic test object.

All-fiber high-power monolithic femtosecond laser at 1.59 µm with 63-fs pulse width

NASA Astrophysics Data System (ADS)

Hekmat, M. J.; Omoomi, M.; Gholami, A.; Yazdabadi, A. Bagheri; Abdollahi, M.; Hamidnejad, E.; Ebrahimi, A.; Normohamadi, H.

2018-01-01

In this research, by adopting an alternative novel approach to ultra-short giant pulse generation which basically originated from difficulties with traditional employed methods, an optimized Er/Yb co-doped double-clad fiber amplifier is applied to boost output average power of single-mode output pulses to a high level of 2-W at 1.59-µm central wavelength. Output pulses of approximately 63-fs pulse width at 52-MHz repetition rate are obtained in an all-fiber monolithic laser configuration. The idea of employing parabolic pulse amplification for stretching output pulses together with high-power pulse amplification using Er/Yb co-doped active fibers for compressing and boosting output average power plays crucial role in obtaining desired results. The proposed configuration enjoys massive advantages over previously reported literature which make it well-suited for high-power precision applications such as medical surgery. Detailed dynamics of pulse stretching and compressing in active fibers with different GVD parameters are numerically and experimentally investigated.

Generation of switchable domain wall and Cubic-Quintic nonlinear Schrödinger equation dark pulse

NASA Astrophysics Data System (ADS)

Tiu, Z. C.; Suthaskumar, M.; Zarei, A.; Tan, S. J.; Ahmad, H.; Harun, S. W.

2015-10-01

A switchable domain-wall (DW) and Cubic-Quintic nonlinear Schrödinger equation (CQNLSE) dark soliton pulse generation are demonstrated in Erbium-doped fiber laser (EDFL) for the first time. The DW pulse train operates at 1575 nm with a fundamental repetition rate of 1.52 MHz and pulse width of 203 ns as the pump power is increased above the threshold pump power of 80 mW. The highest pulse energy of 2.24 nJ is obtained at the maximum pump power of 140 mW. CQNLSE pulse can also be realized from the same cavity by adjusting the polarization state but at a higher threshold pump power of 104 mW. The repetition rate and pulse width of the CQNLSE dark pulses are obtained at 1.52 MHz and 219 ns, respectively. The highest energy of 0.58 nJ is obtained for the CQNLSE pulse at pump power of 140 mW.

Intense Nanosecond-Pulsed Cavity-Dumped Laser Radiation at 1.04 THz

NASA Astrophysics Data System (ADS)

Wilson, Thomas

2013-03-01

We report first results of intense far-infrared (FIR) nanosecond-pulsed laser radiation at 1.04 THz from a previously described[2] cavity-dumped, optically-pumped molecular gas laser. The gain medium, methyl fluoride, is pumped by the 9R20 line of a TEA CO2 laser[3] with a pulse energy of 200 mJ. The THz laser pulses contain of 30 kW peak power in 5 nanosecond pulse widths at a pulse repetition rate of 10 Hz. The line width, measured by a scanning metal-mesh FIR Fabry-Perot interferometer, is 100 MHz. The novel THz laser is being used in experiments to resonantly excite coherent ns-pulsed 1.04 THz longitudinal acoustic phonons in silicon doping-superlattices. The research is supported by NASA EPSCoR NNX11AM04A and AFOSR FA9550-12-1-0100 awards.

A Novel Transcranial Magnetic Stimulator Inducing Near Rectangular Pulses with Controllable Pulse Width (cTMS)

PubMed Central

Jalinous, Reza; Lisanby, Sarah H.

2013-01-01

A novel transcranial magnetic stimulation (TMS) device with controllable pulse width (PW) and near rectangular pulse shape (cTMS) is described. The cTMS device uses an insulated gate bipolar transistor (IGBT) with appropriate snubbers to switch coil currents up to 7 kA, enabling PW control from 5 μs to over 100 μs. The near-rectangular induced electric field pulses use 22–34% less energy and generate 67–72% less coil heating compared to matched conventional cosine pulses. CTMS is used to stimulate rhesus monkey motor cortex in vivo with PWs of 20 to 100 μs, demonstrating the expected decrease of threshold pulse amplitude with increasing PW. The technological solutions used in the cTMS prototype can expand functionality, and reduce power consumption and coil heating in TMS, enhancing its research and therapeutic applications. PMID:18232369

Battery for ECT Related Cognitive Deficits (B4ECT-ReCoDe): development and validation.

PubMed

Viswanath, Biju; Harihara, Shashidhara N; Nahar, Abhinav; Phutane, Vivek Haridas; Taksal, Aarati; Thirthalli, Jagadisha; Gangadhar, Bangalore N

2013-06-01

The use of electroconvulsive therapy (ECT) in treatment of psychiatric disorders is associated with adverse cognitive effects. There is a need to develop a short assessment tool of cognitive functions during the course of ECT. This study aimed at developing and validating a short, sensitive battery to assess cognitive deficits associated with ECT in India. Battery for ECT Related Cognitive Deficits (B4ECT-ReCoDe), a brief cognitive battery (20-30 min) to assess verbal, visual, working and autobiographic memory, sustained attention, psychomotor speed and subjective memory impairment, was administered to 30 in-patients receiving bilateral ECT, one day after the 1st, 3rd and 6th ECT. Data was analysed using repeated measures analysis of variance and Pearson's correlation. Significant deficits were found in verbal, visual and autobiographic memory, psychomotor speed. Subjective experience of memory loss correlated positively with verbal memory impairment. B4ECT-ReCoDe, a brief, sensitive measure of cognitive impairments associated with ECT can be used in routine clinical practice. Copyright © 2013 Elsevier B.V. All rights reserved.

Amlodipine and the Successful Management of Post-Electroconvulsive Therapy Agitation.

PubMed

Shahriari, Ali; Khooshideh, Maryam; Sheikh, Mahdi

2016-01-01

Electroconvulsive therapy (ECT) is a highly effective nonpharmacologic treatment for the management of depression and some other psychiatric disorders. Post-ECT agitation occurs in up to 12% of ECT treatments and is characterized by motor restlessness, irritability, disorientation, and panic-like behaviors. The severity of post-ECT agitation ranges from mild and self-limited to serious and severe forms requiring prompt medical intervention to protect the patient and the medical staff. In severe agitation medical management may be necessary which consists of using sedative agents, either benzodiazepines or propofol. The side-effects of these sedative agents, especially in the elderly population, necessitate finding ways that could help the prevention of the occurrence of agitation after ECT treatments. We report a 68-year-old female with major depression who was referred for ECT. She experienced severe post-ECT agitation requiring medical intervention after all ECT treatments. Administering of oral amlodipine (5 mg) one hour before ECT treatment successfully prevented the occurrence of post-ECT agitation in this patient. We briefly discuss the possible underlying mechanisms and pathophysiology of amlodipine in the prevention of post-ECT agitation.

Episodic Visual Learning/Memory and Attentional Flexibility in Patients With Major Depressive Disorder After Clinically Effective Electroconvulsive Therapy.

PubMed

Kalogerakou, Stamatina; Oulis, Panagiotis; Anyfandi, Eleni; Konstantakopoulos, George; Papakosta, Vasiliki-Maria; Kontis, Dimitrios; Theochari, Eirini; Angelopoulos, Elias; Zervas, Ioannis M; Mellon, Robert C; Papageorgiou, Charalambos C; Tsaltas, Eleftheria

2015-12-01

This study is a follow-up of a previous one reporting that the neuropsychological profile of pharmacoresistant patients with major depressive disorder referred for electroconvulsive therapy (ECT, ECT group) contrasted with that of their pharmacorespondent counterparts (NECT group). The NECT group exhibited severe visuospatial memory and minor executive deficits; the ECT group presented the reverse pattern. In that same ECT group, the current follow-up study examined the effects of clinically effective ECT on both cognitive domains 2 months later. Fifteen ECT patients were administered Hamilton Depression (HAMD-24), Hamilton Anxiety (HAMA), Mini-Mental State Examination Scales and 5 tests of Cambridge Neuropsychological Test Automated Battery at intake (pre-ECT), end of ECT course (post-ECT), and 2 months thereafter (follow-up). Electroconvulsive therapy was effective in relieving clinical depression. After a post-ECT decline, the patients exhibited significant improvement in both Cambridge Neuropsychological Test Automated Battery, paired associate learning, and Stockings of Cambridge. By contrast, their major pre-ECT deficit in intra/extradimensional set shifting remained virtually unaffected. Our findings suggest that attentional flexibility deficits may constitute a neuropsychological trait-like feature of pharmacoresistant, ECT-referred major depressive disorder patients. However, this deficit does not seem generalized, given patient improvement in episodic visual learning/memory and some indication of improvement in spatial planning after ECT.

Mechanism and influencing factors on critical pulse width of oil-immersed polymer insulators under short pulses

NASA Astrophysics Data System (ADS)

Zhao, Liang; Su, Jian Cang; Li, Rui; Zeng, Bo; Cheng, Jie; Zheng, Lei; Yu, Bin Xiong; Wu, Xiao Long; Zhang, Xi Bo; Pan, Ya Feng

2015-04-01

The critical pulse width (τc) is a pulse width at which the surface flashover threshold (Ef) is equal to the bulk breakdown threshold (EBD) for liquid-polymer composite insulation systems, which is discovered by Zhao et al. [Annual Report Conference on Electrical Insulation and Dielectric Phenomena (IEEE Dielectrics and Electrical Insulation Society, Shenzhen, China, 2013), Vol. 2, pp. 854-857]. In this paper, the mechanism of τc is interpreted in perspective of the threshold and the time delay (td) of surface flashover and bulk breakdown, respectively. It is found that two changes appear as the pulse width decreases which are responsible for the existence of τc: (1) EBD is lower than Ef; (2) td of bulk breakdown is shorter than td of surface flashover. In addition, factors which have influences on τc are investigated, such as the dielectric type, the insulation length, the dielectric thickness, the dielectrics configuration, the pulse number, and the liquid purity. These influences of factors are generalized as three types if τc is expected to increase: (1) factors causing EBD to decrease, such as increasing the pulse number or employing a dielectric of lower EBD; (2) factors causing Ef to increase, such as complicating the insulator's configuration or increasing the liquid purity; (3) factors causing EBD and Ef to increase together, but Ef increases faster than EBD, such as decreasing the dielectric thickness or the insulation length. With the data in references, all the three cases are verified experimentally. In the end, a general method based on τc for solid insulation design is presented and the significance of τc on solid insulation design and on solid demolition are discussed.

Characterization of Pilot Technique

NASA Technical Reports Server (NTRS)

Bachelder, Edward; Aponso, Bimal; Godfroy, Martine

2017-01-01

Skilled pilots often use pulse control when controlling higher order (i.e. acceleration-command) vehicle dynamics. Pulsing does not produce a stick response that resembles what the human Crossover Model predicts. The Crossover Model (CM) assumes the pilot provides compensation necessary (lead or lag) such that the suite of display-human-vehicle approximates an integrator in the region of crossover frequency. However, it is shown that the CM does appear to drive the pilots pulsing behavior in a very predictable manner. Roughly speaking, the pilot generates pulses such that the area under the pulse (pulse amplitude multiplied by pulse width) is approximately equal to area under the hypothetical CM output. This can allow a pilot to employ constant amplitude pulsing so that only the pulse duration (width) is modulated a drastic simplification over the demands of continuous tracking. A pilot pulse model is developed, with which the parameters of the pilots internally-generated CM can be computed in real time for pilot monitoring and display compensation. It is also demonstrated that pursuit tracking may be activated when pulse control is employed.

Pharmacological Strategies in the Prevention of Relapse Following Electroconvulsive Therapy

PubMed Central

Prudic, Joan; Haskett, Roger; McCall, W. Vaughn; Isenberg, Keith; Cooper, Thomas; Rosenquist, Peter B.; Mulsant, Benoit H.; Sackeim, Harold A.

2012-01-01

Objective To determine whether starting antidepressant medication at the start of ECT reduces postECT relapse and to determine whether continuation pharmacotherapy with nortriptyline and lithium (NT-Li) differs in efficacy or side effects from continuation pharmacotherapy with venlafaxine and lithium (VEN-Li). Method During an acute ECT phase, 319 patients were randomized to treatment with moderate dosage bilateral ECT or high dosage right unilateral ECT. They were also randomized to concurrent treatment with placebo, NT, or VEN. Of 181 patients to meet postECT remission criteria, 122 (67.4%) participated in a second continuation pharmacotherapy phase. Patients earlier randomized to NT or VEN continued on the antidepressant, while patients earlier randomized to placebo were now randomized to NT or VEN. Li was added for all patients who were followed until relapse or 6 months. Results Starting an antidepressant medication at the beginning of the ECT course did not impact on the rate or timing of relapse relative to starting pharmacotherapy after ECT completion. The combination of NT-Li did not differ from VEN-Li in any relapse or side effect measure. Older age was strongly associated with lower relapse risk, whereas the type of ECT administered in the acute phase and medication resistance were not predictive. Across sites, 50% of patients relapsed, 33.6% continued in remission 6 months postECT, and 16.4% dropped out. Conclusions Starting an antidepressant medication during ECT does not impact relapse and there are concerns about administering Li during an acute ECT course. Nortriptyline and venlafaxine were equally effective in prolonging remission, although relapse rates following ECT are substantial despite intensive pharmacology. As opposed to the usual abrupt cessation of ECT, the impact of an ECT taper should be evaluated. PMID:23303417

Exploiting solitons in all-optical networks

NASA Astrophysics Data System (ADS)

Atieh, Ahmad K.

Two key components, the pulse generator and optical signal demultiplexer, needed for the implementation of all-optical soliton-based local area and wide area networks are investigated. The technology of generating a bright soliton pulse train from a sinusoidal pulse train produced as the beat signal of two distributed feedback laser diodes passed through a so-called comblike fiber structure is developed. A design methodology for this structure is discussed, and using this approach a soliton pulse source is constructed generating 1553 nm pulses at a repetition rate of 50 GHz, with pulses of full width at half maximum of 2.0 ps. The fiber structure used to generate the bright soliton pulse train employs the lowest average power for the beat signal ever reported in the literature, and the shortest length of fiber. The same structure (with a different design) is also used to produce a 47.6 GHz dark soliton pulse train with a full width at half maximum of 3.8 ps. This is the first reported use of this structure to generate dark solitons. It is shown that the comblike dispersion profile fiber structures may also be exploited for soliton pulse compression producing widths as short as 200 fs. Two approaches to implementation of optical signal demultiplexing are discussed. These are the nonlinear optical loop mirror (NOLM) and the separation of multilevel time division multiplexed signal pulses in the frequency domain by exploiting the relationship between the pulse's energy (i.e. pulse amplitude and width) and the Raman self-frequency shift. A modification of the NOLM scheme is investigated where feedback that adjusts the power of the control signal (by controlling the gain of an erbium-doped fiber amplifier introduced into the control signal input path) is employed to make the structure insensitive to the state of polarization of the signal and control pulses. In order to better understand the physical phenomena exploited in optical fiber soliton transmission and the above schemes, two experiments are conducted to measure the fiber nonlinear ratio (n2/Aeff) and the Raman time constant (TR) in single-mode fibers at 1550 nm. The fiber nonlinear ratio was measured for standard telecommunication fiber, dispersion shifted fiber, and dispersion compensating fiber. A value of 3.0 fs for the Raman time constant was measured and is recommended for soliton pulse propagation modeling in single-mode optical fibers.

Study protocol for the randomised controlled trial: Ketamine augmentation of ECT to improve outcomes in depression (Ketamine-ECT study).

PubMed

Trevithick, Liam; McAllister-Williams, R Hamish; Blamire, Andrew; Branton, Tim; Clark, Ross; Downey, Darragh; Dunn, Graham; Easton, Andrew; Elliott, Rebecca; Ellwell, Clare; Hayden, Katherine; Holland, Fiona; Karim, Salman; Lowe, Jo; Loo, Colleen; Nair, Rajesh; Oakley, Timothy; Prakash, Antony; Sharma, Parveen K; Williams, Stephen R; Anderson, Ian M

2015-10-21

There is a robust empirical evidence base supporting the acute efficacy of electroconvulsive therapy (ECT) for severe and treatment resistant depression. However, a major limitation, probably contributing to its declining use, is that ECT is associated with impairment in cognition, notably in anterograde and retrograde memory and executive function. Preclinical and preliminary human data suggests that ketamine, used either as the sole anaesthetic agent or in addition to other anaesthetics, may reduce or prevent cognitive impairment following ECT. A putative hypothesis is that ketamine, through antagonising glutamate receptors, protects from excess excitatory neurotransmitter stimulation during ECT. The primary aim of the ketamine-ECT study is to investigate whether adjunctive ketamine can attenuate the cognitive impairment caused by ECT. Its secondary aim is to examine if ketamine increases the speed of clinical improvement with ECT. The ketamine ECT study is a multi-site randomised, placebo-controlled, double blind trial. It was originally planned to recruit 160 moderately to severely depressed patients who had been clinically prescribed ECT. This recruitment target was subsequently revised to 100 patients due to recruitment difficulties. Patients will be randomly allocated on a 1:1 basis to receive either adjunctive ketamine or saline in addition to standard anaesthesia for ECT. The primary neuropsychological outcome measure is anterograde verbal memory (Hopkins Verbal Learning Test-Revised delayed recall task) after 4 ECT treatments. Secondary cognitive outcomes include verbal fluency, autobiographical memory, visuospatial memory and digit span. Efficacy is assessed using observer and self-report efficacy measures of depressive symptomatology. The effects of ECT and ketamine on cortical activity during cognitive tasks will be studied in a sub-sample using functional near-infrared spectroscopy (fNIRS). The ketamine-ECT study aims to establish whether or not adjunctive ketamine used together with standard anaesthesia for ECT will significantly reduce the adverse cognitive effects observed after ECT. Potential efficacy benefits of increased speed of symptom improvement and a reduction in the number of ECT treatments required will also be assessed, as will safety and tolerability of adjunctive ketamine. This study will provide important evidence as to whether adjunctive ketamine is routinely indicated for ECT given for depression in routine NHS clinical practice. Current Controlled Trials: ISRCTN14689382 (assigned 30/07/2012); EudraCT Number: 2011-005476-41.

Single event effects in pulse width modulation controllers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Penzin, S.H.; Crain, W.R.; Crawford, K.B.

1996-12-01

SEE testing was performed on pulse width modulation (PWM) controllers which are commonly used in switching mode power supply systems. The devices are designed using both Set-Reset (SR) flip-flops and Toggle (T) flip-flops which are vulnerable to single event upset (SEU) in a radiation environment. Depending on the implementation of the different devices the effect can be significant in spaceflight hardware.

Safety of electroconvulsive therapy in patients with asthma.

PubMed

Mueller, P S; Schak, K M; Barnes, R D; Rasmussen, K G

2006-12-01

Patients with depression and other psychiatric disorders being considered for electroconvulsive therapy (ECT) may also have asthma. Since ECT requires the administration of general anaesthesia, it is assumed that extra care should be taken with asthmatic patients before and during ECT. We sought to investigate the safety of ECT in asthmatic patients. A retrospective review was conducted of the medical records of all of the patients with currently active and managed asthma who underwent ECT for severe depressive syndromes at Mayo Clinic, Rochester, Minnesota, between 1 January 1998, and 30 June 2006. Thirty-four patients with asthma who also underwent ECT were identified. Of these, 27 (79%) were women. The median age was 45 years (range 23-84 years). All 34 patients were using asthma medications daily at the time of ECT. The 34 patients underwent a total of 459 ECT sessions. Four (12%) patients experienced exacerbation of their asthma on a total of five occasions. Each exacerbation was successfully treated with standard asthma medications, and all four patients completed their courses of ECT. ECT in patients with asthma appears to be safe. Although exacerbation of asthma after ECT was rare in our series, a prospective study would be needed to determine the precise risk of pulmonary complications of ECT in asthmatic patients.

Maintenance electroconvulsive therapy (M-ECT) after acute response: examining the evidence for who, what, when, and how?

PubMed

Rabheru, Kiran

2012-03-01

To examine the evidence for maintenance electroconvulsive therapy (M-ECT) to help determine who, when, and how long ECT should be continued. A review of published literature on the use of maintenance ECT (M-ECT) was conducted. It focused primarily on trials published since 1997, meeting the following additional criteria: randomized controlled trial or cohort study with a comparison (matched group or before and after), and at least 10 patients receiving M-/continuation ECT. Where such data are not available, recent case series were reviewed. Relapse rates after discontinuation of ECT are very high. Maintenance ECT is an underused treatment option that can substantially reduce risks of relapse in patients with major depressive disorder and likely in bipolar disorder and schizophrenia as well. Little data are available for the use of M-ECT in neurological disorders, and no cost-effectiveness analyses in the maintenance setting were found. Whereas no clear answers emerge from the literature, there is now a growing body of evidence to suggest that for those who have not responded well to medications but have responded to ECT, M-ECT must be presented as an option to the patient and the family for consideration. Clear consensus guidelines for the use of M-ECT are needed.

Use of electroconvulsive therapy (ECT) in postpartum psychosis--a naturalistic prospective study.

PubMed

Babu, Girish N; Thippeswamy, Harish; Chandra, Prabha S

2013-06-01

Postpartum psychosis (PPP) is a severe psychiatric condition requiring rapid restoration of health in view of significant risks to both mother and the infant. Electroconvulsive therapy (ECT) is often used for treatment of severe PPP. The aims of the study were to describe the indications for ECT among women admitted with PPP to a psychiatric hospital in India. It also aimed at assessing whether women with PPP who received ECT differed in their clinical history, diagnosis, severity of illness, psychopathology, drug dosage, and duration of hospital stay, compared to women who did not receive ECT. Infants of mothers who were breast-feeding their infants while receiving ECT were assessed for adverse effects. This was a naturalistic prospective study of 78 women admitted with PPP, 34 (43.6 %) of whom received ECT. Presence of catatonia, augmentation of medications, and suicidality were common indications for ECT. Catatonic symptoms were significantly higher among women who received ECT. There was no significant difference in duration of hospitalization or severity of psychopathology between women who did and did not receive ECT. Transient side effects to ECT were observed in few women, with no adverse effects noted in infants who were breast-fed. The current study supports the use of ECT as an effective and safe treatment for women with severe PPP.

Predictors of regained occupational functioning after electroconvulsive therapy (ECT) in patients with major depressive disorder--a population based cohort study.

PubMed

Nordenskjöld, Axel; von Knorring, Lars; Brus, Ole; Engström, Ingemar

2013-10-01

The aim of the present study is to investigate the rate of regained occupational functioning among patients treated with electroconvulsive therapy (ECT) for major depression and to define predictors of time to regained occupational functioning. A nested cohort study was performed of patients treated by ECT for unipolar major depressive disorder registered in the Quality register for ECT and in the Swedish Social Insurance Agency registry. Predictive values of single clinical variables and their relative importance were tested with Cox regression analysis. 394 patients were identified. Of those, 266 were on non-permanent sick leave and 128 on disability pension during ECT. Within 1 year post-ECT, 71% of the patients with non-permanent sick leave regained occupational functioning. Factors independently associated with a statistically significant increased time to regained occupational functioning were longer duration of sick leave pre-ECT, milder depression pre-ECT, less complete improvement with ECT, benzodiazepine treatment after ECT and co-morbid substance dependence. A large proportion of the patients do not return to work within several months post-ECT. Paradoxically, patients with more severe depression pre-ECT had a reduced time to regained occupational functioning, indicating a larger effect in this patients group of the treatment. Moreover, the period with sick leave compensation might be reduced if ECT is initiated within the first 3 months of sick leave. Most patients on non-permanent sick leave regain occupational functioning after ECT. However, it usually takes a few months even in symptomatically improved patients.

Electroconvulsive therapy

MedlinePlus

Shock treatment; Shock therapy; ECT; Depression - ECT; Bipolar - ECT ... ECT is a highly effective treatment for depression, most commonly ... who: Are having delusions or other psychotic symptoms with ...

Treatment of Adults With Treatment-Resistant Depression: Electroconvulsive Therapy Plus Antidepressant or Electroconvulsive Therapy Alone? Evidence From an Indirect Comparison Meta-Analysis

PubMed Central

Song, Guo-Min; Tian, Xu; Shuai, Ting; Yi, Li-Juan; Zeng, Zi; Liu, Shuang; Zhou, Jian-Guo; Wang, Yan

2015-01-01

Abstract Electroconvulsive therapy (ECT) and antidepressant are the effective treatment alternatives for patients with treatment-resistant depression (TRD); however, the effects and safety of the ECT plus antidepressant relative to ECT alone remain controversial. We decide to assess the potential of ECT plus antidepressant compared with ECT alone by undertaking an indirect comparison meta-analysis. Databases from PubMed, ISI Web of Science, CENTRAL, Clinicaltrials.gov, EMBASE, CBM (China Biomediccal Literatures Database), and CNKI (China National Knowledge Infrastructure) were searched for relevant studies through November 21, 2014. Literature was screened, data were extracted and methodological quality of the eligible trial was assessed by 2 independent reviewers accordingly. Then, head-to-head and indirect comparison meta-analyses were carried out. A total of 17 studies which including 13 studies regarding ECT plus antidepressant versus antidepressant alone and 4 studies concerning ECT versus antidepressant alone containing a total of 1098 patients were incorporated into this meta-analysis. The head-to-head comparison suggested that response rate can be improved in the ECT plus antidepressant (RR, 1.82; 95% CI, 1.55–2.14) and ECT alone group (RR, 2.24, 95% CI, 1.51–3.33) compared with antidepressant alone, respectively; adverse complications including memory deterioration and somatization were not significantly increased except incidence of memory deterioration in ECT plus antidepressant in the 4th weeks after treatment (RR, 0.09, 95% CI, 0.02–0.49). Indirect comparison meta-analysis showed that no significant differences were detected in response rate and memory deterioration between ECT plus antidepressant and ECT alone. However, ECT plus antidepressant increased the incidence of memory deterioration relative to ECT alone. With present evidence, the regime of ECT plus antidepressant should not be preferentially recommended to treat the patients with TRD relative to ECT alone. PMID:26131818

PAL-XFEL soft X-ray scientific instruments and X-ray optics: First commissioning results

NASA Astrophysics Data System (ADS)

Park, Sang Han; Kim, Minseok; Min, Changi-Ki; Eom, Intae; Nam, Inhyuk; Lee, Heung-Soo; Kang, Heung-Sik; Kim, Hyeong-Do; Jang, Ho Young; Kim, Seonghan; Hwang, Sun-min; Park, Gi-Soo; Park, Jaehun; Koo, Tae-Yeong; Kwon, Soonnam

2018-05-01

We report an overview of soft X-ray scientific instruments and X-ray optics at the free electron laser (FEL) of the Pohang Accelerator Laboratory, with selected first-commissioning results. The FEL exhibited a pulse energy of 200 μJ/pulse, a pulse width of <50 fs full width at half maximum, and an energy bandwidth of 0.44% at a photon energy of 850 eV. Monochromator resolving power of 10 500 was achieved. The estimated total time resolution between optical laser and X-ray pulses was <270 fs. A resonant inelastic X-ray scattering spectrometer was set up; its commissioning results are also reported.

OH Production Enhancement in Bubbling Pulsed Discharges

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lungu, Cristian P.; Porosnicu, Corneliu; Jepu, Ionut

2010-10-13

The generation of active species, such as H{sub 2}O{sub 2}, O{sup *}, OH*, HO{sub 2}*, O{sub 3}, N{sub 2}{sup *}, etc, produced in aqueous solutions by HV pulsed discharges was studied in order to find the most efficient way in waste water treatment taking into account that these species are almost stronger oxidizers than ozone. Plasma was generated inside gas bubbles formed by the argon, air and oxygen gas flow between the special designed electrodes. The pulse width and pulse frequency influence was studied in order to increase the efficiency of the OH active species formation. The produced active speciesmore » were investigated by optical emission spectroscopy and correlated with electrical parameters of the discharges (frequency, pulse width, amplitude, and rise and decay time).« less

Effectiveness of Electroconvulsive Therapy (ECT) in Parkinsonian Symptoms: A Case Series.

PubMed

Grover, Sandeep; Somani, Aditya; Sahni, Neeru; Mehta, Sahil; Choudhary, Swati; Chakravarty, Rahul Kumar; Rabha, Anju Moni

2018-02-01

Depression is a common comorbidity in patients suffering from Parkinson's disease (PD). Available evidence suggests that electroconvulsive therapy (ECT) is an effective treatment for depression and also improves symptoms of PD. However, literature on usefulness of ECT in parkinsonian symptoms is limited. A review of records of all patients receiving ECT from 2010 to April 2017 in the authors' clinic yielded six cases (0.63% of all patients who received ECT at the authors' center over last 7 years) of depression with PD who were treated with ECT. All six patients had improvement in both depression and symptoms of PD following ECT treatment. The improvement achieved with ECT was sustained in four patients. Worsening of PD symptoms 3 to 4 months post-treatment was seen in two patients. ECT appears to be an effective treatment option for management of motoric symptoms in patients with PD, especially those with comorbid psychiatric disorders.

Effectiveness of Electroconvulsive Therapy (ECT) in Parkinsonian Symptoms

PubMed Central

Somani, Aditya; Sahni, Neeru; Mehta, Sahil; Choudhary, Swati; Chakravarty, Rahul Kumar; Rabha, Anju Moni

2018-01-01

Depression is a common comorbidity in patients suffering from Parkinson’s disease (PD). Available evidence suggests that electroconvulsive therapy (ECT) is an effective treatment for depression and also improves symptoms of PD. However, literature on usefulness of ECT in parkinsonian symptoms is limited. A review of records of all patients receiving ECT from 2010 to April 2017 in the authors’ clinic yielded six cases (0.63% of all patients who received ECT at the authors’ center over last 7 years) of depression with PD who were treated with ECT. All six patients had improvement in both depression and symptoms of PD following ECT treatment. The improvement achieved with ECT was sustained in four patients. Worsening of PD symptoms 3 to 4 months post-treatment was seen in two patients. ECT appears to be an effective treatment option for management of motoric symptoms in patients with PD, especially those with comorbid psychiatric disorders. PMID:29497576

Poor health-related quality of life prior to ECT in depressed patients normalizes with sustained remission after ECT.

PubMed

McCall, W Vaughn; Reboussin, David; Prudic, Joan; Haskett, Roger F; Isenberg, Keith; Olfson, Mark; Rosenquist, Peter B; Sackeim, Harold A

2013-05-01

Health-related quality of life (HRQOL) is diminished in depressed adult outpatients and especially impaired among depressed patients referred for ECT. We compare pretreatment HRQOL in ECT and non-ECT depressed patients from two large samples, and examined whether sustained remission in depressive symptoms after ECT is associated with normalization of HRQOL. HRQOL was measured with the Medical Outcomes Study Short Form 36 (SF36) before ECT and 6 months after ECT in an effectiveness (n=286) and an efficacy (n=243) clinical trial. ECT patients had very low baseline SF36 scores. With one exception, SF36 subscale scores in both trials were significantly lower than those of depressed outpatients. A minority of patients in both trials entered and sustained remission over the 24 week timeframe. Among sustained remitters, average SF36 scores were no different from normative scores of the general adult population, except that in the effectiveness study ECT patients reported less Bodily Pain (p<0.05) and better Mental Health (p<0.05), while in the efficacy study ECT patients reported more difficulty with Role-Emotional (p<0.01). Only a modest number of patients were observed in sustained remission. HRQOL is very poor in patients referred for ECT. Depressed patients who experience sustained remission after ECT, however, can expect improvement in their quality of life that leaves many in a position indistinguishable from the general adult population. Copyright © 2013 Elsevier B.V. All rights reserved.

Electroconvulsive Therapy in Sweden 2013: Data From the National Quality Register for ECT.

PubMed

Nordanskog, Pia; Hultén, Martin; Landén, Mikael; Lundberg, Johan; von Knorring, Lars; Nordenskjöld, Axel

2015-12-01

The use of electroconvulsive therapy (ECT) varies across countries. The aim of this study was to describe and explore the use of ECT in Sweden in 2013. The Swedish mandatory patient register of the National Board of Health and Welfare includes information on diagnoses and treatments, including ECT. All 56 hospitals that provide ECT in Sweden also report to the nonmandatory national quality register for ECT, which contains information on patient and treatment characteristics. In this study, we combined data from both registers. In addition, all hospitals responded to a survey concerning equipment and organization of ECT. We identified 3972 unique patients who received ECT in Sweden in 2013. This translates into 41 ECT-treated individuals per 100,000 inhabitants. Of these patients, 85% opted to participate in the quality register. The median age was 55 years (range, 15-94 years), and 63% were women. The indication was depression in 78% of the treatment series. Of 4 711 hospitalized patients with severe depression, 38% received ECT. The median number of treatments per index series was 7. Unilateral treatment was used in 86% of the series. In Sweden, ECT is used at a relatively high rate as compared with other western countries, and the rate was unchanged from the last survey in 1975. However, there is room for improvement in the specificity of use and availability of ECT for disorders where ECT is considered a first-line treatment.

Poor health-related quality of life prior to ECT in depressed patients normalizes with sustained remission after ECT

PubMed Central

McCall, W. Vaughn; Reboussin, David; Prudic, Joan; Haskett, Roger F.; Isenberg, Keith; Olfson, Mark; Rosenquist, Peter B.; Sackeim, Harold A

2012-01-01

Background Health-related quality of life (HRQOL) is diminished in depressed adult outpatients and especially impaired among depressed patients referred for ECT. We compare pretreatment HRQOL in ECT and non-ECT depressed patients from two large samples, and examined whether sustained remission in depressive symptoms after ECT is associated with normalization of HRQOL. Methods HRQOL was measured with the Medical Outcomes Study Short Form 36 (SF36) before ECT and 6 months after ECT in an effectiveness (n=286) and an efficacy (n=243) clinical trial. Results ECT patients had very low baseline SF36 scores. With one exception, SF36 subscale scores in both trials were significantly lower than those of depressed outpatients. A minority of patients in both trials entered and sustained remission over the 24 week timeframe. Among sustained remitters, average SF36 scores were no different from normative scores of the general adult population, except that in the effectiveness study ECT patients reported less Bodily Pain (p<0.05) and better Mental Health (p<0.05), while in the efficacy study ECT patients reported more difficulty with Role-Emotional. (p<0.01) Limitations Only a modest number of patients were observed in sustained remission. Conclusions HRQOL is very poor in patients referred for ECT. Depressed patients who experience sustained remission after ECT, however, can expect improvement in their quality of life that leaves many in a position indistinguishable from the general adult population. PMID:23158959

Repetitive transcranial magnetic stimulator with controllable pulse parameters

NASA Astrophysics Data System (ADS)

Peterchev, Angel V.; Murphy, David L.; Lisanby, Sarah H.

2011-06-01

The characteristics of transcranial magnetic stimulation (TMS) pulses influence the physiological effect of TMS. However, available TMS devices allow very limited adjustment of the pulse parameters. We describe a novel TMS device that uses a circuit topology incorporating two energy storage capacitors and two insulated-gate bipolar transistor (IGBT) modules to generate near-rectangular electric field pulses with adjustable number, polarity, duration, and amplitude of the pulse phases. This controllable pulse parameter TMS (cTMS) device can induce electric field pulses with phase widths of 10-310 µs and positive/negative phase amplitude ratio of 1-56. Compared to conventional monophasic and biphasic TMS, cTMS reduces energy dissipation up to 82% and 57% and decreases coil heating up to 33% and 41%, respectively. We demonstrate repetitive TMS trains of 3000 pulses at frequencies up to 50 Hz with electric field pulse amplitude and width variability less than the measurement resolution (1.7% and 1%, respectively). Offering flexible pulse parameter adjustment and reduced power consumption and coil heating, cTMS enhances existing TMS paradigms, enables novel research applications and could lead to clinical applications with potentially enhanced potency.

Repetitive transcranial magnetic stimulator with controllable pulse parameters.

PubMed

Peterchev, Angel V; Murphy, David L; Lisanby, Sarah H

2011-06-01

The characteristics of transcranial magnetic stimulation (TMS) pulses influence the physiological effect of TMS. However, available TMS devices allow very limited adjustment of the pulse parameters. We describe a novel TMS device that uses a circuit topology incorporating two energy storage capacitors and two insulated-gate bipolar transistor (IGBT) modules to generate near-rectangular electric field pulses with adjustable number, polarity, duration, and amplitude of the pulse phases. This controllable pulse parameter TMS (cTMS) device can induce electric field pulses with phase widths of 10-310 µs and positive/negative phase amplitude ratio of 1-56. Compared to conventional monophasic and biphasic TMS, cTMS reduces energy dissipation up to 82% and 57% and decreases coil heating up to 33% and 41%, respectively. We demonstrate repetitive TMS trains of 3000 pulses at frequencies up to 50 Hz with electric field pulse amplitude and width variability less than the measurement resolution (1.7% and 1%, respectively). Offering flexible pulse parameter adjustment and reduced power consumption and coil heating, cTMS enhances existing TMS paradigms, enables novel research applications and could lead to clinical applications with potentially enhanced potency.

Design and Analysis of Nano-Pulse Generator for Industrial Wastewater Application

NASA Astrophysics Data System (ADS)

Jang, Sung-Duck; Son, Yoon-Kyoo; Cho, Moo-Hyun; Norov, Enkhbat

2018-05-01

Recently, the application of a pulsed power system is being extended to environmental and industrial fields. The non-dissolution wastewater pollutants from industrial plants can be processed by applying high-voltage pulses with a fast rising time (a few nanoseconds) and short duration (nano to microseconds) in a pulsed corona discharge reactor. The high-voltage nano-pulse generator with a magnetic switch has been developed. It can be used for a spray type water treatment facility. Its corona current in load can be adjusted by pulse width and repetition rate. We investigated the performance of the nano-pulse generator by using the dummy load that is composed of resistor and capacitor equivalent to the actual reactor. In this paper, the results of design, construction and characterization of a high-voltage nano-pulse generator for an industrial wastewater treatment are reported. Consequently, a pulse width of 1.1 μs at the repetition rate of 200 pps, a peak voltage of 41 kV for the nano-pulse generator were achieved across a 640 Ω load. The simulation results on magnetic switch show reasonable agreement with experimental ones.

Knowledge and Attitude of Nursing Students toward Electroconvulsive Therapy

PubMed Central

Sharma, Nitasha; Ghai, Sandhya; Grover, Sandeep

2017-01-01

Background: Electroconvulsive therapy (ECT) is one of the commonly used treatment modalities for patients with severe mental disorders. However, acceptance of ECT by the patient and relatives often depends on how the health-care professionals themselves present the treatment modality to the patients and their relatives. There is a lack of information about the knowledge and attitude toward ECT among health professionals. Aim: This study aimed to evaluate the knowledge about and attitude toward ECT among nursing students. Methodology: Knowledge of and attitudes toward ECT among nursing students were assessed using ECT knowledge and attitude questionnaires. Results: The study included 183 nursing students. Majority (n = 62; 60.8%) of the participants obtained information about ECT from media (movies, television, print media, etc.). None of the students had full knowledge about ECT. Although a significant proportion of students had knowledge about the ECT procedure and consent procedure, majority of them had poor knowledge about the effectiveness, mechanism of action, indications, and side effects of ECT. Negative attitudes were also highly prevalent, with more than two-thirds of the participants having negative attitudes toward ECT on more than half of the attitude items of the scale. Total knowledge score positively correlated with total attitude score, suggesting that higher knowledge was associated with more positive attitude. Conclusions: Although nursing students have knowledge about basic ECT procedure and consent, they lack knowledge about the effectiveness, mechanism of action, indications, and side effects of ECT. Negative attitude toward ECT is also highly prevalent among nursing students. Accordingly, there is a need to improve the knowledge and address the negative attitude of nursing students, which may ultimately lead to better acceptance of the treatment. PMID:28936064

Cognitive training to improve memory in individuals undergoing electroconvulsive therapy: Negative findings.

PubMed

Choi, Jimmy; Wang, Yuanjia; Feng, Tianshu; Prudic, Joan

2017-09-01

Although electroconvulsive therapy (ECT) remains the most effective treatment for severe depression, some patients report persistent memory problems following ECT that impact their quality of life and their willingness to consent to further ECT. While cognitive training has been shown to improve memory performance in various conditions, this approach has never been applied to help patients regain their memory after ECT. In a double-blind study, we tested the efficacy of a new cognitive training program called Memory Training for ECT (Mem-ECT), specifically designed to target anterograde and retrograde memory that can be compromised following ECT. Fifty-nine patients with treatment-resistant depression scheduled to undergo ultra-brief right unilateral ECT were randomly assigned to either: (a) Mem-ECT, (b) active control comprised of nonspecific mental stimulation, or (c) treatment as usual. Participants were evaluated within one week prior to the start of ECT and then again within 2 weeks following the last ECT session. All three groups improved in global function, quality of life, depression, and self-reported memory abilities without significant group differences. While there was a decline in verbal delayed recall and mental status, there was no decline in general retrograde memory or autobiographical memory in any of the groups, with no significant memory or clinical benefit for the Mem-ECT or active control conditions compared to treatment as usual. While we report negative findings, these results continue to promote the much needed discussion on developing effective strategies to minimize the adverse memory side effects of ECT, in hopes it will make ECT a better and more easily tolerated treatment for patients with severe depression who need this therapeutic option. Copyright © 2017 Elsevier Ltd. All rights reserved.

High-sensitivity Cardiac Troponin Elevation after Electroconvulsive Therapy (ECT)

PubMed Central

Duma, Andreas; Pal, Swatilika; Johnston, Joshua; Helwani, Mohammad A.; Bhat, Adithya; Gill, Bali; Rosenkvist, Jessica; Cartmill, Christopher; Brown, Frank; Miller, J. Philip; Scott, Mitchell G; Sanchez-Conde, Francisco; Jarvis, Michael; Farber, Nuri B.; Zorumski, Charles F.; Conway, Charles; Nagele, Peter

2017-01-01

Background While electroconvulsive therapy (ECT) is widely regarded as a life-saving and safe procedure, evidence regarding its effects on myocardial cell injury are sparse. The objective of this investigation was to determine incidence and magnitude of new cardiac troponin elevation after ECT using a novel high-sensitivity cardiac troponin I (hscTnI) assay. Methods This was a prospective cohort study in adult patients undergoing ECT in a single academic center (up to three ECT treatments per patient). The primary outcome was new hscTnI elevation after ECT, defined as an increase of hscTnI >100% after ECT compared to baseline with at least one value above the limit of quantification (10 ng/L). 12-lead ECG and hscTnI values were obtained prior to and 15–30 minutes after ECT; in a subset of patients an additional 2-hour hscTnI value was obtained. Results The final study population was 100 patients and a total of 245 ECT treatment sessions. Eight patients (8/100, 8%) experienced new hscTnI elevation after ECT with a cumulative incidence of 3.7% (9/245 treatments; one patient had two hscTnI elevations), two of whom had a non-ST-elevation myocardial infarction (incidence 2/245, 0.8%). Median hscTnI concentrations did not increase significantly after ECT. Tachycardia and/or elevated systolic blood pressure developed after approximately two thirds of ECT treatments. Conclusions ECT appears safe from a cardiac standpoint in a large majority of patients. A small subset of patients with pre-existing cardiovascular risk factors, however, may develop new cardiac troponin elevation after ECT, the clinical relevance of which is unclear in the absence of signs of myocardial ischemia. PMID:28166110

Knowledge and Attitude of Nursing Students toward Electroconvulsive Therapy.

PubMed

Sharma, Nitasha; Ghai, Sandhya; Grover, Sandeep

2017-08-01

Electroconvulsive therapy (ECT) is one of the commonly used treatment modalities for patients with severe mental disorders. However, acceptance of ECT by the patient and relatives often depends on how the health-care professionals themselves present the treatment modality to the patients and their relatives. There is a lack of information about the knowledge and attitude toward ECT among health professionals. This study aimed to evaluate the knowledge about and attitude toward ECT among nursing students. Knowledge of and attitudes toward ECT among nursing students were assessed using ECT knowledge and attitude questionnaires. The study included 183 nursing students. Majority ( n = 62; 60.8%) of the participants obtained information about ECT from media (movies, television, print media, etc.). None of the students had full knowledge about ECT. Although a significant proportion of students had knowledge about the ECT procedure and consent procedure, majority of them had poor knowledge about the effectiveness, mechanism of action, indications, and side effects of ECT. Negative attitudes were also highly prevalent, with more than two-thirds of the participants having negative attitudes toward ECT on more than half of the attitude items of the scale. Total knowledge score positively correlated with total attitude score, suggesting that higher knowledge was associated with more positive attitude. Although nursing students have knowledge about basic ECT procedure and consent, they lack knowledge about the effectiveness, mechanism of action, indications, and side effects of ECT. Negative attitude toward ECT is also highly prevalent among nursing students. Accordingly, there is a need to improve the knowledge and address the negative attitude of nursing students, which may ultimately lead to better acceptance of the treatment.

Contrasting patterns of deficits in visuospatial memory and executive function in patients with major depression with and without ECT referral.

PubMed

Tsaltas, E; Kalogerakou, S; Papakosta, V-M; Kontis, D; Theochari, E; Koutroumpi, M; Anyfandi, E; Michopoulos, I; Poulopoulou, C; Papadimitriou, G; Oulis, P

2011-05-01

The pretreatment neuropsychological profile of drug-resistant patients with major depressive disorder (MDD) referred for electroconvulsive therapy (ECT) may differ from that of their drug-respondent MDD counterparts. Such differences could help in identifying distinct MDD subtypes, thus offering insights into the neuropathology underlying differential treatment responses. Depressed patients with ECT referral (ECTs), depressed patients with no ECT referral (NECTs) and non-psychiatric Controls (matched groups, n=15) were assessed with memory and executive function tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). ECTs scored significantly lower than NECTs in the Mini-Mental State Examination (MMSE; p=0.01). NECTs performed worse than Controls in the Paired Associates Learning (PAL) task (p<0.03; Control/NECT p<0.01) and the Spatial Recognition Memory (SRM) task (p<0.05; Controls/NECTs p<0.05); ECTs performed between Controls and NECTs, not differing from either. In the Intra/Extradimensional (IED) set-shifting task, ECTs performed worse that Controls and NECTS (IED: p<0.01; Controls/ECTs p<0.01), particularly in the shift phases, which suggests reduced attentional flexibility. In Stockings of Cambridge (SOC), ECTs abandoned the test early more often than Controls and NECTs (H=11, p<0.01) but ECTs who completed SOC performed comparably to the other two groups. A double dissociation emerged from the comparison of cognitive profiles of ECT and NECT patients. ECTs showed executive deficits, particularly in attentional flexibility, but mild deficits in tests of visuospatial memory. NECTs presented the opposite pattern. This suggests predominantly frontostriatal involvement in ECT versus temporal involvement in NECT depressives.

A critical examination of bifrontal electroconvulsive therapy: clinical efficacy, cognitive side effects, and directions for future research.

PubMed

Crowley, Kevin; Pickle, Jody; Dale, Roman; Fattal, Omar

2008-12-01

Bifrontal (BF) electroconvulsive therapy (ECT), although researched less extensively than bitemporal (BT) or right unilateral (RUL) ECT, has been suggested to be comparable to the other 2 electrode placements with respect to clinical efficacy while resulting in less cognitive impairment than BT ECT. Imaging studies have indicated that seizures induced by BF ECT affect the brain differently than BT or RUL ECT, in that BF ECT increases cerebral blood flow in the frontal lobes more intensely than either of the other 2 placements. Therefore, it is possible that the cognitive impairment manifested after a course of BF ECT could also be different than the impairment seen with BT and RUL ECT. Research conducted on cognitive impairment from BF ECT to date has been inadequate due to the use of nonspecific cognitive measures (such as the Mini-Mental Status Examination) or an inordinate focus on memory functioning (which is believed to be mostly subsumed in the temporal lobes). Because BF ECT increases cerebral blood flow in the frontal lobes more intensely than either of the other placements, research must instead focus on investigating the possible effects of BF ECT on executive functioning, which is believed to be subsumed in the frontal lobes. This is especially important because of the established relationship between executive dysfunction and depression and also because of the increasing popularity of BF ECT.

A report on mood and cognitive outcomes with right unilateral ultrabrief pulsewidth (0.3 ms) ECT and retrospective comparison with standard pulsewidth right unilateral ECT.

PubMed

Loo, Colleen; Sheehan, Patrick; Pigot, Melissa; Lyndon, William

2007-11-01

Electroconvulsive therapy (ECT) is a highly effective treatment for depression but its use is limited by the risk of cognitive side effects. This study explored the potential of a novel approach, ultrabrief pulsewidth (0.3 ms) right unilateral (RUL-UB) ECT, to minimise cognitive effects while preserving efficacy. Mood and neuropsychological functioning were objectively rated in 30 patients over a course of RUL-UB ECT at 6 times seizure threshold. Results (mood outcomes, ECT treatment parameters) were compared with a retrospectively assessed group of 30 age and gender matched patients who received RUL ECT (1.0 ms pulsewidth, 3.5 times seizure threshold) at the same hospital. Six treatments of RUL-UB ECT resulted in relatively few cognitive side effects, compared to reports of previous studies. The number of responders did not differ between groups but significantly more treatments were required in the RUL-UB group, suggesting a slower speed of response. Patients were not randomised to the two forms of ECT and data was obtained retrospectively in the RUL ECT comparison group. This study suggests that RUL-UB ECT can be effective in treating depression while incurring lesser cognitive side effects than a commonly used form of RUL ECT, but a greater number of treatments may be required for response.

Pulsed characterization of a UV LED for pulsed power applications on a silicon carbide photoconductive semiconductor switch

NASA Astrophysics Data System (ADS)

Wilson, Nicholas; Mauch, Daniel; Meyers, Vincent; Feathers, Shannon; Dickens, James; Neuber, Andreas

2017-08-01

The electrical and optical characteristics of a high-power UV light emitting diode (LED) (365 nm wavelength) were evaluated under pulsed operating conditions at current amplitudes several orders of magnitude beyond the LED's manufacturer specifications. Geared towards triggering of photoconductive semiconductor switches (PCSSs) for pulsed power applications, measurements were made over varying pulse widths (25 ns-100 μs), current (0 A-250 A), and repetition rates (single shot-5 MHz). The LED forward voltage was observed to increase linearly with increasing current (˜3.5 V-53 V) and decrease with increasing pulse widths. The peak optical power observed was >30 W, and a maximum system efficiency of 23% was achieved. The evaluated LED and auxiliary hardware were successfully used as the optical trigger source for a 4H-SiC PCSS. The lowest measured on-resistance of SiC was approximately 67 kΩ.

Pulsed characterization of a UV LED for pulsed power applications on a silicon carbide photoconductive semiconductor switch.

PubMed

Wilson, Nicholas; Mauch, Daniel; Meyers, Vincent; Feathers, Shannon; Dickens, James; Neuber, Andreas

2017-08-01

The electrical and optical characteristics of a high-power UV light emitting diode (LED) (365 nm wavelength) were evaluated under pulsed operating conditions at current amplitudes several orders of magnitude beyond the LED's manufacturer specifications. Geared towards triggering of photoconductive semiconductor switches (PCSSs) for pulsed power applications, measurements were made over varying pulse widths (25 ns-100 μs), current (0 A-250 A), and repetition rates (single shot-5 MHz). The LED forward voltage was observed to increase linearly with increasing current (∼3.5 V-53 V) and decrease with increasing pulse widths. The peak optical power observed was >30 W, and a maximum system efficiency of 23% was achieved. The evaluated LED and auxiliary hardware were successfully used as the optical trigger source for a 4H-SiC PCSS. The lowest measured on-resistance of SiC was approximately 67 kΩ.

Research on electroconvulsive therapy in India: An overview

PubMed Central

Gangadhar, Bangalore N.; Phutane, Vivek H.; Thirthalli, Jagadisha

2010-01-01

The contribution of researchers from India in the field of electroconvulsive therapy (ECT) has been substantial. Over 250 papers have been published by authors from India in the past five decades on this issue; about half of these have appeared in the Indian Journal of Psychiatry. This article summarizes the papers on ECT research that have appeared in the Journal. A bulk of these articles has focused on establishing the efficacy in different disorders. Considerable numbers of papers describe refinement in the ECT procedure, including anesthetic modification, ECT machine and EEG monitoring. Papers on neurobiology of ECT and long-term follow-up of ECT-treated patients form a minority. Despite the decline in the use of ECT across the globe, papers on ECT have only increased in the recent decades in the Journal. PMID:21836706

Electroconvulsive Therapy Practice in New Zealand.

PubMed

Fisher, Mark Wilkinson; Morrison, John; Jones, Paul Anthony

2017-06-01

The aim of this study was to describe the contemporary practice of electroconvulsive therapy (ECT) in New Zealand. A 53-item questionnaire was sent to all services providing ECT as of December 2015. Electroconvulsive therapy was provided by 16 services covering 15 district health boards funded by the New Zealand government. No private facilities provided ECT. All services providing ECT responded to an online survey questionnaire. Rates of ECT utilization were low relative to similar countries. Survey results indicated ECT was practiced to an overall good standard. Several resource and logistical issues potentially contributing to low ECT utilization were identified. Electroconvulsive therapy in New Zealand is provided using modern equipment and practices. However, overall rates of utilization remain low, perhaps as a result of controversy surrounding ECT and some resourcing issues.

Electroconvulsive therapy - general considerations and experience in Croatia.

PubMed

Mihaljević-Peleš, Alma; Bajs Janović, Maja; Stručić, Ana; Šagud, Marina; Skočić HanŽek, Milena; Živković, Maja; Janović, Špiro

2018-06-01

Despite controversy, ECT has been recognized as significantly effective for the treatment of mental disorders since 1938, when Cerletti and Bini introduced ECT in clinical psychiatric practice for treatment of schizophrenia. In the next period, indication for ECT switched more toward depression and catatonia. ECT was even banned from psychiatric training in 1960's, due to the anti-psychiatric movement, which were fortified by Oscar winning movie "One Flew over the Cuckoo's Nest". Due to its robust effectiveness, ECT revived in the early 1980's and today holds its position in clinical psychiatric practices around the world. Mechanism of ECT on brain and psychopathology is still not fully understood. Main theories have been neurotransmitter, post-receptor, neurophysiological and neuroendocrine theory. Regarding best clinical practices and evidence reported in the literature, ECT today is considered a treatment option for, traditionally, depression, suicidality and catatonia, and also schizophrenia, schizoaffective disorder, bipolar disorder, malignant neuroleptic syndrome, postpartal depression and psychosis, obsessive compulsive disorder, post-traumatic stress disorder, dementia, etc. Recent evidence of ECT efficacy is growing stronger also in the treatment resistant cases, for depression and psychosis. Great advantage of ECT is lack of absolute contraindications. ECT in Croatia was introduced in clinical psychiatric practice in 1960's in four institutions. Mainly due to stigma, but also a tendency for shifting toward hypothesized action mechanism, ECT in Croatia has been re-named to electrostimulative therapy or electroneuromodulatory treatment. In recent decades, the Department of psychiatry in the University Hospital Centre Zagreb (KBC Zagreb), has continuously been practicing ECT. Our department is considered a regional leader, regarding number of patient cases and overall experience in homeland and neighbouring countries. In the 2016, Croatian expert group, selected by the Croatian Psychiatric Association, proposed national guidelines for the ECT. Research in ECT at our department has shown predominance of the treatment for therapy resistance in depression and psychosis. The other research at our department also showed improvement in several cognitive functions of patients after ECT application.

Photonuclear Contributions to SNS Pulse Shapes

DOE Office of Scientific and Technical Information (OSTI.GOV)

McClanahan, Tucker C.; Iverson, Erik B.; Gallmeier, Franz X.

Short-pulsed sources like the Spallation Neutron Source (SNS) and ISIS produce bursts of neutron pulses at rates of 10-60 Hz, with sub-microsecond proton pulses impacting on high-Z target materials. Moderators are grouped around the target to receive the fast neutrons generated from spallation reactions to moderate them effciently to thermal and sub-thermal energies and to feed narrow neutron pulses to neutron scattering instruments. The scattering instruments use the neutrons as a probe for material investigations, and make use of time-of-flight (TOF) methods for resolving the neutron energy. The energy resolution of scattering instruments depends on the narrow time-structure of themore » neutron pulses, while neutrons in the long tail of the emission time distributions can degrade the instrument performance and add undesired background to measurements. The SNS neutronics team is investigating a possible source term impacting the background at short-pulsed spallation sources. The ISIS TS2 project claims to have significantly reduced neutron scattering instrument background levels by the elimination or reduction of iron shielding in the target-moderator-reflector assembly. An alternative hypothesis, also proposed by ISIS, suggests that this apparent reduction arises from moving beamline shielding away from the neutron guide channels, reducing albedo down the beamlines. In both hypotheses, the background neutrons in question are believed to be generated by photonuclear reactions. If the background neutrons are indeed generated via photonuclear channels, then they are generated in a time-dependent fashion, since most of the high-energy photons capable of inducing photonuclear production are gone within a few microseconds following the proton pulse. To evaluate this e ect, we have enabled photonuclear reactions in a series of studies for the SNS first target station (FTS) taking advantage of its Monte Carlo model. Using a mixture of ENDF/B VII.0 and TENDL-2014 photonuclear cross sections available and the CEM03 physics model within MCNPX 2.6.0 in the simulation, we are able to estimate the impact of photoneutron production on both overall neutron production and delayed neutron production. We find that a significant number of photon-induced neutrons are produced a few milliseconds after the proton pulse, following prompt gamma emission through the capture of neutrons in the slowing-down and thermalization processes. We name these "slowing-down delayed neutrons" to distinguish them from either "activation-delayed neutrons" or "beta-delayed neutrons." The beta-delayed and activation-delayed neutrons were not part of this study, and will be addressed elsewhere. While these other delayed neutron channels result in the time-independent (constant) production of fast neutrons outside of the prompt pulse, the slowing-down delayed neutrons also a ect the shape of the pulses. Although numerically insignificant in most cases, we describe a set of scenarios related to T0-chopper operation in which the slowing-down delayed neutrons may be important.« less

ECT2 and RASAL2 mediate mesenchymal-amoeboid transition in human astrocytoma cells.

PubMed

Weeks, Adrienne; Okolowsky, Nadia; Golbourn, Brian; Ivanchuk, Stacey; Smith, Christian; Rutka, James T

2012-08-01

Malignant astrocytomas are highly invasive brain tumors. The Rho family of cytoskeletal GTPases are key regulators of astrocytoma migration and invasion; expression of the guanine nucleotide exchange factor ECT2 is elevated in primary astrocytomas and predicts both survival and malignancy. Mice bearing orthotopically implanted astrocytoma cells with diminished ECT2 levels following ECT2 knockdown exhibit longer survival. Although ECT2 is normally expressed in the nucleus, we show that ECT2 is aberrantly localized to the cytoplasm in both astrocytoma cell lines and primary human astrocytomas, and colocalizes with RAC1 and CDC42 at the leading edge of migrating astrocytoma cells. Inhibition of ECT2 expression by RNA interference resulted in decreased RAC1 and CDC42 activity, but no change in RHO activity, suggesting that ECT2 is capable of activating these pro-migratory Rho family members. ECT2 overexpression in astrocytoma cells resulted in a transition to an amoeboid phenotype that was abolished with the ROCK inhibitor, Y-27632. Cytoplasmic fractionation of astrocytoma cells followed by ECT2 immunoprecipitation and mass spectrometry were used to identify protein-binding partners that modulate the activity of ECT2 toward RAC1 and RHO/ROCK. We identified RASAL2 as an ECT2-interacting protein that regulates RHO activity in astrocytoma cells. RASAL2 knockdown leads to a conversion to an amoeboid phenotype. Our studies reveal that ECT2 has a novel role in mesenchymal-amoeboid transition in human astrocytoma cells. Copyright © 2012 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Electroconvulsive Therapy (ECT) and Race: A Report of ECT Use and Sociodemographic Trends in Texas.

PubMed

Williams, Julie; Chiu, Lawrence; Livingston, Robin

2017-06-01

Minimal research on race and other sociodemographic disparities in patients receiving electroconvulsive therapy (ECT) exists. One previously noted national trend reveals whites receiving ECT disproportionately more than other races. The aim of this study is to determine whether a county ECT program demonstrates similar disparities observed at the state and national levels. This study examined 21 years of ECT data, between 1993 and 2014, provided by the Texas Department of State Health Services, focusing on race, sex, age, and payer source and 2.5 years of the same variables from a Harris County hospital ECT program. In addition, population demographic data for Harris County and the state of Texas during the same period were obtained from the Department of State Health Services Web site. Despite an overall decrease in the population of whites countywide and statewide, whites continue to use more ECT than African Americans, Latinos, and Asians in both Harris County and Texas. However, the rates of ECT use in minorities increased overall. Both countywide and statewide, ECT was used more than twice as often in women than men. Statewide, elderly patients (>65 years old) saw decreases in ECT use, and there was an increase in private third-party payer source. Electroconvulsive therapy remains underused among African Americans, Latinos, and Asians. Hypotheses and areas for future study include cultural beliefs, stigma, patient and provider knowledge of ECT, and access to care. Despite this, the general use of ECT in Texas has increased overall, and minority use is slowly on the rise.

Maintenance ECT as a therapeutic approach to medication-refractory epilepsy in an adult with mental retardation: case report and review of literature.

PubMed

Shah, Nilesh; Pande, Nikhil; Bhat, Tushar; Murke, Mukund; Andrade, Chittaranjan

2012-06-01

Electroconvulsive therapy (ECT) raises the seizure threshold. This physiological change may benefit patients with seizure disorders. Whereas ECT has recently been used to terminate medication-refractory status epilepticus, there is little current literature on its planned administration as a specific maintenance treatment for medication-refractory epilepsy. We used maintenance ECT to treat an 18-year-old man with a long-standing generalized tonic-clonic seizure disorder who had shown poor response to several antiepileptic drugs administered in combination with antiepileptic medication compliance confirmed through drug level monitoring. A total of 52 ECTs were administered across nearly 20 months at a mean frequency of once in nearly 12 days. From the very outset, ECT dramatically decreased the frequency of spontaneous seizures from approximately 6 to 24 per week at baseline to approximately 1 to 2 per week after ECT initiation. The efficacy of maintenance ECT in spontaneous seizure prophylaxis was greater when the ECT treatment interval was narrower. Improvement with ECT was associated with improved behavior and improved psychosocial functioning on clinical report. No cognitive or other adverse effects were reported or clinically ascertained. The ECT charge administered at the last 10 treatment sessions was 1434 millicoulombs. This is probably the highest electrical stimulus dose recorded in literature. Maintenance ECT may reduce the frequency of breakthrough seizures in patients with seizure disorder that is inadequately responsive to antiepileptic medication regimes. Very high ECT seizure thresholds may be observed when many antiepileptic drugs are concurrently administered in high doses.

Maintenance Electroconvulsive Therapy in Severe Bipolar Disorder: A Retrospective Chart Review.

PubMed

Santos Pina, Laura; Bouckaert, Filip; Obbels, Jasmien; Wampers, Martien; Simons, Wim; Wyckaert, Sabien; Sienaert, Pascal

2016-03-01

The aim of this study was to evaluate the effectiveness of continuation and maintenance electroconvulsive therapy (C/M-ECT) in patients with bipolar or schizoaffective disorder. We reviewed the charts of all patients diagnosed with a bipolar or schizoaffective disorder treated with C/M-ECT from August 2009 until December 2013. We gathered demographic data and treatment variables (electrode placement, stimulus dose, and concomitant use of medication; number of C/M-ECT sessions; and number of new ECT courses). Primary outcome measure was the number of hospitalization days during C/M-ECT as compared with an equal period before starting the index course. Twenty women (64.5%) and 11 men (35.5%) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition bipolar disorder (n = 22, 71%) or schizoaffective disorder (n = 9, 29%) received C/M-ECT. The mean (SD) age was 51.23 (14.86; range, 28-74) years. Before the start of the index ECT, patients had a mean of 290 hospitalization days (248.4 days, full hospitalization; 41.6 days, partial hospitalization), whereas during C/M-ECT, they had a mean of 214.7 hospitalization days (85.4 days, full hospitalization; 129.3 days, partial hospitalization). The number of readmissions before ECT was 2.13, whereas during C/M-ECT, it decreased to 1.48. Only the decrease in number of full hospitalization days was significant. Most patients (n = 23, 74.19%) needed an acute course of ECT during M-ECT. Maintenance ECT seems to significantly reduce the number of full hospitalization days in patients with severe bipolar or schizoaffective disorder.

Feasibility of using acoustic method in monitoring the penetration status during the Pulse Mode Laser Welding process

NASA Astrophysics Data System (ADS)

Yusof, M. F. M.; Ishak, M.; Ghazali, M. F.

2017-09-01

In this paper, the feasibility of using acoustic method to monitor the depth of penetration was investigated by determine the characteristic of the acquired sound throughout the pulse mode laser welding process. To achieve the aim, the sound signal was acquired during the pulsed laser welding process on the 2 mm structural carbon steel plate. During the experiment, the laser peak power and pulse width was set to be varied while welding speed was constantly at 2 mm/s. Result from the experiment revealed that the sound pressure level of the acquired sound was linearly related to the pulse energy as well as the depth of penetration for welding process using 2ms pulse width. However, as the pulse width increase, the sound pressure level show insignificant change with respect to the change in the depth of penetration when the pulse energy reaches certain values. The reported result shows that this was happen due to the occurrence of spatter which suppressed the information associated with the generation of plasma plume as the product of high pulse energy. In this work, it was demonstrated that in some condition, the acoustic method was found to be potentially suitable to be used as a medium to monitor the depth of weld on online basis. To increase the robustness of this method to be used in wider range of parameter, it was believed that some other post processing method is needed in order to extract the specific information associated with the depth of penetration from the acquired sound.

Electroconvulsive therapy practice in Ukraine.

PubMed

Olekseev, Aleksey; Ungvari, Gabor S; Gazdag, Gábor

2014-09-01

Patterns of electroconvulsive therapy (ECT) use have recently been extensively surveyed in Central-Eastern Europe. However, data from post-USSR countries are limited. This study aimed to survey ECT practice in Ukraine. All psychiatric services in Ukraine were identified and contacted to obtain information on the use of ECT in 2011 using a 22-item questionnaire. Of the 146 psychiatric inpatient facilities, only 5 confirmed that they performed ECT in 2011. Three other services also performed ECT but refused to provide further information. In the only private psychiatric institute where ECT was offered, 14.28% of inpatients received this treatment in 2011, whereas the corresponding figure in the 6 public psychiatric facilities was a mere 0.4%. Three centers used unmodified ECT, and only 2 centers had equipment that monitored electroencephalogram. In 7 services, in line with international recommendations, affective disorders were the first indications for ECT in Ukraine, whereas uncommon indications such as anorexia or Parkinsonism were also reported. This was the first survey of ECT practice conducted in Ukraine. The provision of ECT in only 8 centers is clearly insufficient for a large country such as Ukraine, which is reflected in the low rate of inpatients treated with ECT. The very limited availability of this effective treatment modality should be addressed by the Ukrainian health authorities.

Incidence and risk factors for oxygen desaturation during recovery from modified electroconvulsive therapy: A prospective observational study.

PubMed

Surve, Rohini; Bansal, Sonia; Sriganesh, Kamath; Subbakrishna, Doddaballapur Kumaraswamy; Thirthalli, Jagadisha; Umamaheswara Rao, Ganne Sesha

2015-01-01

Electroconvulsive therapy (ECT) is an established modality of treatment for severe psychiatric illnesses. Among the various complications associated with ECT, oxygen desaturation is often under reported. None of the previous studies has evaluated the predictive factors for oxygen desaturation during ECT. The objective of this study was to evaluate the incidence of oxygen desaturation during recovery from anesthesia for modified ECT and evaluate its risk factors in a large sample. All patients aged above 15 years who were prescribed a modified ECT for their psychiatric illness over 1 year were prospectively included in this observational study. The association between age, body mass index (BMI), doses of thiopentone and suxamethonium, stimulus current, ECT session number, pre- and post-ECT heart rate and mean arterial pressure, seizure duration, and pre- and post ECT oxygen saturation, was systematically studied. The incidence of oxygen desaturation was 29% (93/316 patients). Seizure duration and BMI were found to be significantly correlated with post ECT desaturation. In this prospective observational study, the incidence of oxygen desaturation during recovery from anesthesia for ECT was high. The study identified obesity and duration of seizure as the independent predictors of this complication. This knowledge is likely to help in identifying and optimizing such patients before subsequent ECT sessions.

An 8-GW long-pulse generator based on Tesla transformer and pulse forming network

DOE Office of Scientific and Technical Information (OSTI.GOV)

Su, Jiancang; Zhang, Xibo; Li, Rui

A long-pulse generator TPG700L based on a Tesla transformer and a series pulse forming network (PFN) is constructed to generate intense electron beams for the purpose of high power microwave (HPM) generation. The TPG700L mainly consists of a 12-stage PFN, a built-in Tesla transformer in a pulse forming line, a three-electrode gas switch, a transmission line with a trigger, and a load. The Tesla transformer and the compact PFN are the key technologies for the development of the TPG700L. This generator can output electrical pulses with a width as long as 200 ns at a level of 8 GW andmore » a repetition rate of 50 Hz. When used to drive a relative backward wave oscillator for HPM generation, the electrical pulse width is about 100 ns on a voltage level of 520 kV. Factors affecting the pulse waveform of the TPG700L are also discussed. At present, the TPG700L performs well for long-pulse HPM generation in our laboratory.« less

An 8-GW long-pulse generator based on Tesla transformer and pulse forming network.

PubMed

Su, Jiancang; Zhang, Xibo; Li, Rui; Zhao, Liang; Sun, Xu; Wang, Limin; Zeng, Bo; Cheng, Jie; Wang, Ying; Peng, Jianchang; Song, Xiaoxin

2014-06-01

A long-pulse generator TPG700L based on a Tesla transformer and a series pulse forming network (PFN) is constructed to generate intense electron beams for the purpose of high power microwave (HPM) generation. The TPG700L mainly consists of a 12-stage PFN, a built-in Tesla transformer in a pulse forming line, a three-electrode gas switch, a transmission line with a trigger, and a load. The Tesla transformer and the compact PFN are the key technologies for the development of the TPG700L. This generator can output electrical pulses with a width as long as 200 ns at a level of 8 GW and a repetition rate of 50 Hz. When used to drive a relative backward wave oscillator for HPM generation, the electrical pulse width is about 100 ns on a voltage level of 520 kV. Factors affecting the pulse waveform of the TPG700L are also discussed. At present, the TPG700L performs well for long-pulse HPM generation in our laboratory.

Electroconvulsive therapy, the placebo effect and informed consent.

PubMed

Blease, Charlotte Rosalind

2013-03-01

Major depressive disorder is not only the most widespread mental disorder in the world, it is a disorder on the rise. In cases of particularly severe forms of depression, when all other treatment options have failed, the use of electroconvulsive therapy (ECT) is a recommended treatment option for patients. ECT has been in use in psychiatric practice for over 70 years and is now undergoing something of a restricted renaissance following a sharp decline in its use in the 1970s. Despite its success in treating severe depression there is continued debate as to the effectiveness of ECT: in some studies, it is argued that ECT is marginally more effective than sham ECT. In addition, there is still no clear explanation of how ECT works; among the range of hypotheses proposed it is claimed that ECT may work by harnessing placebo effects. In light of the uncertainties over the mechanism of action of ECT and given the risk of serious side effects that ECT may produce, I contend that the process of informed consent must include comprehensive accounts of these uncertainties. I examine the possible consequences of providing adequate information to potential ECT patients, including the consideration that ECT may still prove to be effective even if physicians are open about the possibility of it working as a placebo. I conclude that if we value patient autonomy as well as the professional reputation of medical practitioners, a fuller description of ECT must be provided to patients and their carers.

Electroconvulsive Therapy in Sweden 2013

PubMed Central

Nordanskog, Pia; Hultén, Martin; Landén, Mikael; Lundberg, Johan; von Knorring, Lars; Nordenskjöld, Axel

2015-01-01

Objectives The use of electroconvulsive therapy (ECT) varies across countries. The aim of this study was to describe and explore the use of ECT in Sweden in 2013. Methods The Swedish mandatory patient register of the National Board of Health and Welfare includes information on diagnoses and treatments, including ECT. All 56 hospitals that provide ECT in Sweden also report to the nonmandatory national quality register for ECT, which contains information on patient and treatment characteristics. In this study, we combined data from both registers. In addition, all hospitals responded to a survey concerning equipment and organization of ECT. Results We identified 3972 unique patients who received ECT in Sweden in 2013. This translates into 41 ECT-treated individuals per 100,000 inhabitants. Of these patients, 85% opted to participate in the quality register. The median age was 55 years (range, 15–94 years), and 63% were women. The indication was depression in 78% of the treatment series. Of 4 711 hospitalized patients with severe depression, 38% received ECT. The median number of treatments per index series was 7. Unilateral treatment was used in 86% of the series. Conclusions In Sweden, ECT is used at a relatively high rate as compared with other western countries, and the rate was unchanged from the last survey in 1975. However, there is room for improvement in the specificity of use and availability of ECT for disorders where ECT is considered a first-line treatment. PMID:25973769

Low medical morbidity and mortality after acute courses of electroconvulsive therapy in a population-based sample.

PubMed

Blumberger, D M; Seitz, D P; Herrmann, N; Kirkham, J G; Ng, R; Reimer, C; Kurdyak, P; Gruneir, A; Rapoport, M J; Daskalakis, Z J; Mulsant, B H; Vigod, S N

2017-12-01

To determine event rates for specific medical events and mortality among individuals receiving electroconvulsive therapy (ECT). Population-based cohort study using health administrative data of acute ECT treatments delivered in Ontario, Canada, from 2003 to 2011. We measured the following medical event rates, per 10 000 ECT treatments, up to 7 and 30 days post-treatment: stroke, seizure, acute myocardial infarction, arrhythmia, pneumonia, pulmonary embolus, deep vein thrombosis, gastrointestinal bleeding, falls, hip fracture, and mortality. A total of 135 831 ECT treatments were delivered to 8810 unique patients. Overall medical event rates were 9.1 and 16.8 per 10 000 ECT treatments respectively. The most common medical events were falls (2.7 and 5.5 per 10 000 ECT treatments) and pneumonia (1.8 and 3.8 per 10 000 ECT treatments). Fewer than six deaths occurred on the day of an ECT treatment. This corresponded to a mortality rate of less than 0.4 per 10 000 treatments. Deaths within 7 and 30 days of an ECT treatment, excluding deaths due to external causes (e.g., accidental and intentional causes of death), were 1.0 and 2.4 per 10 000 ECT treatments respectively. Morbidity and mortality events after ECT treatments were relatively low, supporting ECT as a low-risk medical procedure. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of Raman scattering on pulse dynamics in a fiber laser with narrow gain bandwidth

NASA Astrophysics Data System (ADS)

Uthayakumar, T.; Alsaleh, M.; Igbonacho, J.; Tchomgo Felenou, E.; Tchofo Dinda, P.; Grelu, Ph; Porsezian, K.

2018-06-01

We examine theoretically the multi-pulse dynamics in a dispersion-managed fiber laser, in which the pulse’s spectral width is controlled by a pass-band filter. We show that in the domain of stable states with very narrow spectral width, i.e. which is one order of magnitude smaller than the bandwidth of the Raman gain of the intra-cavity fiber system, the Raman scattering (RS) significantly alters the multi-pulse dynamics. RS is found to have a greater impact in the immediate vicinity of some critical values of the pump power of the intra-cavity gain medium, where processes of pulse fragmentation occur. As a result, all the borders between the zones of stability of the multi-pulse states are altered, i.e. either shifted or suppressed.

15 mJ single-frequency Ho:YAG laser resonantly pumped by a 1.9 µm laser diode

NASA Astrophysics Data System (ADS)

Na, Q. X.; Gao, C. Q.; Wang, Q.; Zhang, Y. X.; Gao, M. W.; Ye, Q.; Li, Y.

2016-09-01

A 2.09 µm injection-seeded single-frequency Ho:YAG laser resonantly pumped by a 1.91 µm laser diode is demonstrated for the first time. The seed laser is a continuous wave (CW) Ho:YAG non-planar ring oscillator. 15.15 mJ single-frequency output energy is obtained from the injection-seeded Q-switched Ho:YAG laser, with a pulse repetition rate of 200 Hz and a pulse width of 109 ns. The half-width of the pulse spectrum is measured to be 4.19 MHz by using the heterodyne technique. The fluctuation of the center frequency of the single-frequency pulses is 1.52 MHz (root mean square (RMS)) in 1 h.

Multiphoton correlations in parametric down-conversion and their measurement in the pulsed regime

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ivanova, O A; Iskhakov, T Sh; Penin, A N

2006-10-31

We consider normalised intensity correlation functions (CFs) of different orders for light emitted via parametric down-conversion (PDC) and their dependence on the number of photons per mode. The main problem in measuring such correlation functions is their extremely small width, which considerably reduces their contrast. It is shown that if the radiation under study is modulated by a periodic sequence of pulses that are short compared to the CF width, no decrease in the contrast occurs. A procedure is proposed for measuring normalised CFs of various orders in the pulsed regime. For nanosecond-pulsed PDC radiation, normalised second-order CF is measuredmore » experimentally as a function of the mean photon number. (nonlinear optical phenomena)« less

Pulse Width Dependence Of Pigment Cell Damage At 694 nm In Guinea Pig Skin

NASA Astrophysics Data System (ADS)

Dover, Jeffrey S.; Polla, Luigi L.; Margolis, Randall J.; Whitaker, Diana; Watanabe, Schinichi; Murphy, George F.; Parrish, John A.; Anderson, R. R.

1987-03-01

351 nm, 20-nsec XeF excimer laser irradiation has previously been shown to selectively target and damage melanosomes in human skin. In the following studies selective targeting with melanosomal photodisruption has been demonstrated in pigmented guinea pig skin with a Q-switched 40-nsec ruby laser, and a 750-nsec pulsed dye laser but not with a 400-usec pulsed dye laser. The pulse width dependence of melanosomal disruption, occurring only at pulsewidths shorter than the thermal relaxation time of the melanosome (0.5 - 1.0 usec), is in accordance with the theory of selective photothermolysis. Possible mechanisms of melanosomal photodisruption include development of sudden thermal gradients leading to cavitation or shock wave production.

ADJUSTABLE DOUBLE PULSE GENERATOR

DOEpatents

Gratian, J.W.; Gratian, A.C.

1961-08-01

>A modulator pulse source having adjustable pulse width and adjustable pulse spacing is described. The generator consists of a cross coupled multivibrator having adjustable time constant circuitry in each leg, an adjustable differentiating circuit in the output of each leg, a mixing and rectifying circuit for combining the differentiated pulses and generating in its output a resultant sequence of negative pulses, and a final amplifying circuit for inverting and square-topping the pulses. (AEC)

Use of ECT in the presence of acute bilateral posterior vitreous detachmanet.

PubMed

Taye, Tesema; Dobranici, Letitia; Fisher, Mark; Cullum, Sarah

2018-04-01

We describe a case of acute bilateral posterior vitreous detachment (PVD) in a 71-year-old female, which developed during a course of electroconvulsive therapy (ECT) for treatment-resistant depression. The risks and benefits of continuing ECT were assessed and the patient completed the full course of 16 ECT treatments without further ophthalmic complications. As the incidence of PVD increases with age, and ECT is used more frequently in elderly people with depression, we recommend paying attention to ophthalmic symptoms as part of the routine clinical monitoring of ECT side effects. If ophthalmic symptoms occur, the risks and benefits of ECT need to be weighed up including consultation with an ophthalmologist.

Relief of Expressed Suicidal Intent by ECT: A Consortium for Research in ECT Study

PubMed Central

Kellner, Charles H.; Fink, Max; Knapp, Rebecca; Petrides, Georgios; Husain, Mustafa; Rummans, Teresa; Mueller, Martina; Bernstein, Hilary; Rasmussen, Keith; O'Connor, Kevin; Smith, Glenn; Rush, A. John; Biggs, Melanie; McClintock, Shawn; Bailine, Samuel; Malur, Chitra

2013-01-01

Objective This study assessed the incidence, severity, and course of expressed suicidal intent in depressed patients who were treated with ECT. The data are from the first phase of an ongoing, collaborative multicenter study, the overall aim of which was to compare continuation ECT with pharmacotherapy in the prevention of relapse after a successful course of ECT. Method Suicidal intent, as expressed by patients during an interview, was scored at baseline and before each ECT session with item 3 on the 24-item Hamilton Depression Rating Scale in 444 patients with unipolar depression. Results One hundred thirty-one patients (29.5%) reported suicidal thoughts and acts (score of 3 or 4) at baseline. Scores decreased to 0 after 1 week (three ECT sessions) in 38.2% of the patients, after 2 weeks (six ECT sessions) in 61.1%, and in 80.9% at the end of the course of treatment. Conclusions Expressed suicidal intent in depressed patients was rapidly relieved with ECT. Evidence-based treatment algorithms for major depressive mood disorders should include dichotomization according to suicide risk, as assessed by interview. For patients at risk, ECT should be considered earlier than at its conventional “last resort” position. PMID:15863801

Does catatonic schizophrenia improve faster with electroconvulsive therapy than other subtypes of schizophrenia?

PubMed

Thirthalli, Jagadisha; Phutane, Vivek H; Muralidharan, Kesavan; Kumar, Channaveerachari Naveen; Munishwar, Bharat; Baspure, Prashant; Gangadhar, Bangalore N

2009-01-01

Electroconvulsive therapy (ECT) is generally recommended for treating catatonic schizophrenia. Non-catatonic schizophrenia patients also receive ECT. We compared the speed of response to ECT among patients with catatonic and other subtypes of schizophrenia. Consecutive schizophrenia patients referred for ECT within 3 months of starting antipsychotic treatment were studied (19 with catatonic and 34 with non-catatonic schizophrenia). Nurse's Observation Scale for Inpatient Evaluation (NOSIE-30) and Clinical Global Impression (CGI) were used to rate improvement. Referring psychiatrists stopped ECTs based on clinical impression of improvement. Total number of ECTs was taken as an indirect measure of speed of response. NOSIE-30 scores were compared using repeated measures analysis of variance. Catatonic schizophrenia patients required significantly fewer ECTs to achieve clinically significant improvement. There was a significant group x occasion effect in NOSIE scores, suggesting faster response to ECT in the catatonia group (F=41.6; P<0.001). Survival analysis suggested that patients with catatonic schizophrenia required significantly fewer ECTs (one less session on an average) to achieve clinical improvement (Log-rank statistic =5.31; P=0.02). Catatonic schizophrenia responds faster to ECT than non-catatonic schizophrenia. However, the magnitude of the difference is modest.

Predictors of readmission after successful electroconvulsive therapy for depression: a chart review study.

PubMed

Uchida, Takahito; Kishimoto, Taishiro; Koreki, Akihiro; Nakao, Shigetsugu; Owada, Ai; Koizumi, Teruki; Saito, Atsuyuki; Sato, Minako; Sawada, Shinya; Matsuzaki, Ryuta; Petrides, Georgios; Mimura, Masaru

2016-11-01

The study aimed to identify the predictors for readmission after a successful electroconvulsive therapy (ECT) course. Medical charts of patients who received ECT for major depressive episodes were reviewed. Patients' demographic characteristics and treatment parameters, such as ECT charge, seizure duration, the number of ECT sessions and pharmacotherapy, were extracted. We compared differences between those who were readmitted after successful ECT within 6 and 12 months, versus those not readmitted. We also conducted a multivariate logistic regression analysis to identify the predictors for readmission. Out of 51 patients who were discharged after ECT, 27 patients met the inclusion criteria and were included in the analysis. Eight patients were readmitted within 6 months after discharge, and four more patients were readmitted during the next 6-month follow up. Comparing patients who were and were not readmitted, we found no significant differences between groups, including ECT parameters such as the number of ECT sessions, average charge and final charge. No predictors for readmission were found through multivariate analysis. Although patients who require higher ECT charge and more sessions seem to be prone to readmission, our dataset suggested that none of these types of ECT parameters were risk factors for readmission.

Influence of electrocautery-induced electromagnetic interference on quantitative electroencephalographic monitoring of hypnosis during general anesthesia: comparison between the ADMS® and the BIS VISTATM.

PubMed

Kim, Dae-Hee; Yoo, Ji-Young; Kim, Jong-Yeop; Ahn, Soo-Hwan; Kim, Seongsu; Min, Sang-Kee

2018-04-24

Hypnosis monitors analyze small-amplitude electrical signals transmitted from the brain that could be exposed to the electromagnetic field that occurs around the body during electrocautery (ECT). We investigated the influence of ECT on hypnosis monitoring during anesthesia. We simultaneously monitored BIS and uCON during 50 gynecologic oncology surgeries. During the episodes of ECT, we compared the absolute difference (a-Diff) between the baseline index and the most deviated index after ECT over either 30-60 s (ECT30-60) or more than 60 s (ECT > 60) between the monitors. We also investigated the bias and the limits of agreement between the monitors. Between the two monitors, the a-Diff of ECT30-60 was 1.4 ± 1.1 for the BIS, which was significantly greater than 0.6 ± 0.9 for the uCON (P = 0.003), and the a-Diff of ECT > 60 was 16.5 ± 8.2 for the BIS, which was also significantly greater than 1.4 ± 1.3 for uCON (P < 0.001). The intra-monitor index differences showed that the BIS during ECT > 60 was significantly greater than that during ECT30-60 (P < 0.001), but the uCON showed no significant difference between ECT30-60 and ECT > 60 (P = 0.056). The estimated bias between the monitors was 6.3 ± 9.8 and 95% limits agreement was -12.3 to 25.0. Prolonged ECT intervention might lead to spurious estimations of quantitative EEG indexes. Therefore, hypnosis should be clinically assessed in combination with scrutinized judgment of relevant clinical symptoms and signs for hypnosis.

Use of ECT in Nepal: A One Year Study From the Country's Largest Psychiatric Facility.

PubMed

Subedi, Sandip; Aich, Tapas Kumar; Sharma, Niru

2016-02-01

Electro-Convulsive Therapy (ECT) refers to the electrical stimulation of the brain to produce seizures for therapeutic purpose. Since the development of ECT, it's use has been consistent. Inspite of the common use, data pertaining to the use of ECT in Nepal is lacking. This study was undertaken with the aim of exploring the clinico-demographic profile of patients treated with ECT in the largest psychiatry facility in the country. It is a retrospective descriptive study of patients who were treated with ECT after admission in the inpatient psychiatry unit of Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Nepal during a period of one year (August 2012 to July 2013). Out of 1095 patients admitted during the specified period, 81 (7.39%) patients received ECT. About 44.44% of the patients belonged to 20-29 years age group. Female patients constituted more than half of the subjects (55.56%). Review of diagnostic profile showed that majority of patients receiving ECT were suffering from Schizophrenia (44.4%), followed by Bipolar Affective Disorder/Mania (29.6%), Depressive disorder (11.1%), Acute and Transient Psychotic Disorder (6.2%), Post-partum Psychosis (3.7%) and substance induced mood/psychotic disorders (3.7%). A significant majority of subjects (75.3%) received about 5-7 ECT treatments. The mean seizure duration after ECT treatment was 31.13±5.79 seconds. No any major complications were noted during ECT treatment. This study suggests that ECT, use, as a treatment modality is common in young adults and females with Schizophrenia being the most common indication. Direct ECT is safe when used judiciously.

Use of ECT in Nepal: A One Year Study From the Country’s Largest Psychiatric Facility

PubMed Central

Aich, Tapas Kumar; Sharma, Niru

2016-01-01

Introduction Electro-Convulsive Therapy (ECT) refers to the electrical stimulation of the brain to produce seizures for therapeutic purpose. Since the development of ECT, it’s use has been consistent. Inspite of the common use, data pertaining to the use of ECT in Nepal is lacking. Aim This study was undertaken with the aim of exploring the clinico-demographic profile of patients treated with ECT in the largest psychiatry facility in the country. Materials and Methods It is a retrospective descriptive study of patients who were treated with ECT after admission in the inpatient psychiatry unit of Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Nepal during a period of one year (August 2012 to July 2013). Results Out of 1095 patients admitted during the specified period, 81 (7.39%) patients received ECT. About 44.44% of the patients belonged to 20-29 years age group. Female patients constituted more than half of the subjects (55.56%). Review of diagnostic profile showed that majority of patients receiving ECT were suffering from Schizophrenia (44.4%), followed by Bipolar Affective Disorder/Mania (29.6%), Depressive disorder (11.1%), Acute and Transient Psychotic Disorder (6.2%), Post-partum Psychosis (3.7%) and substance induced mood/psychotic disorders (3.7%). A significant majority of subjects (75.3%) received about 5-7 ECT treatments. The mean seizure duration after ECT treatment was 31.13±5.79 seconds. No any major complications were noted during ECT treatment. Conclusion This study suggests that ECT, use, as a treatment modality is common in young adults and females with Schizophrenia being the most common indication. Direct ECT is safe when used judiciously. PMID:27042563

Knowledge and Attitude of Patients with Psychiatric Disorders and their Relatives Toward Electroconvulsive Therapy

PubMed Central

Dan, Amitava; Grover, Sandeep; Chakrabarti, Subho

2014-01-01

Objective: Knowledge and attitude regarding electroconvulsive therapy (ECT) is one of the important parameters for acceptance of ECT as a safe and effective treatment option. Several factors shape the knowledge and attitude of general people such as previous experience of ECT, sources of their information about ECT and prevailing myths about ECT. The present study attempted to examine the knowledge and attitude concerning ECT among patients with psychiatric disorders and their relatives. Materials and Methods: Knowledge and attitudes regarding ECT were assessed using the Bengali version of the ECT knowledge and attitude questionnaires, between 100 clinically stable patients with mental illnesses and their healthy relatives. Results: Majority of the patients and relatives were unaware of the basic facts about ECT. Relatives were somewhat better informed and more positive about ECT than patients, but the differences between the two groups were not significant. Previous experience of ECT did not have any major impact in knowledge and attitude in both patients and relative groups. Patients obtained information, mostly from media (44%), doctors (23%), and from personal experiences (13%). On the other hand, relatives obtained information almost equally from media (26%), doctors (27%), and experience of friends or relatives (28%). No significant difference was observed in knowledge and attitude in patients who had obtained their facts from doctors (n=23) and from other sources (n=77). Among relatives, those who had obtained their information from doctors (n=27) were better informed than those who had obtained so from other sources (n=73). Conclusions: Since patients and relatives have poor knowledge and negative attitude toward ECT, medical professionals should impart proper information about ECT to patients and relatives to increase the acceptability of this treatment. PMID:25035549

Micro-fractional ablative skin resurfacing with two novel erbium laser systems.

PubMed

Dierickx, Christine C; Khatri, Khalil A; Tannous, Zeina S; Childs, James J; Cohen, Richard H; Erofeev, Andrei; Tabatadze, David; Yaroslavsky, Ilya V; Altshuler, Gregory B

2008-02-01

Fractional ablation offers the potential benefits of full-surface ablative skin resurfacing while minimizing adverse effects. The purpose of this study was to evaluate the safety, damage profile, and efficacy of erbium fractional lasers. Histology from animal and human skin as well as clinical evaluations were conducted with erbium YAG (2,940 nm) and erbium YSGG (2,790 nm) fractional lasers varying pulse width, microbeam (microb) energy, number of passes, and stacking of pulses. Single-pulse treatment parameters from 1 to 12 mJ per 50-70 microm diameter microbeam and 0.25-5 milliseconds pulse widths produced microcolumns of ablation with border coagulation of up to 100 microm width and 450 microm depth. Stacking of pulses generated deeper microcolumns. Clinical observations and in vivo histology demonstrate rapid re-epithelization and limited adverse side effects. Facial treatments were performed in the periorbital and perioral areas using 1-8 passes of single and stacked pulses. Treatments were well-tolerated and subjects could resume their normal routine in 4 days. A statistically significant reduction in wrinkle scores at 3 months was observed for both periorbital and perioral wrinkles using blinded grading. For periorbital treatments of four passes or more, over 90% had > or =1 score wrinkle reduction (0-9 scale) and 42% had > or =2. For perioral wrinkles, over 50% had substantial improvements (> or =2). The clinical observations and histology findings demonstrate that micro-fractional ablative treatment with 2,790 and 2,940 nm erbium lasers resulted in safe and effective wrinkle reduction with minimal patient downtime. The depth and width of the ablated microcolumns and varying extent of surrounding coagulation can be controlled and used to design new treatment procedures targeted for specific indications and areas such as moderate to severe rhytides and photodamaged skin.

Two-Photon Excited Fluorescence from Biological Aerosol Particles

DTIC Science & Technology

2010-09-29

in material damage. We overcame these limitations by building a band-limited Yb-doped fiber laser with no dispersion compensation [9], as the master...master oscillator was an all-normal- dispersion Yb-doped fiber laser [9], followed by high- dispersion fiber for stretching the pulses, a single-mode...of ~670 fs in duration, and its expected transform-limited pulse width for a normal- dispersion laser with this spectral width would be ~454 fs [10

Cost reduction with maintenance ECT in refractory bipolar disorder.

PubMed

Bonds, C; Frye, M A; Coudreaut, M F; Cunningham, M; Spearing, M; McGuire, M; Guze, B

1998-03-01

A case report of outpatient maintenance electroconvulsive therapy (ECT) is presented in a patient with bipolar disorder type I refractory to conventional medication treatment but responsive to ECT. A cost comparison is made showing substantial savings when outpatient maintenance ECT is used in lieu of inpatient hospitalization with ECT. A detailed life chart illustrating multiple medication trials that failed to stabilize the patient accompanies the financial summary. This case highlights the advantages of outpatient maintenance ECT for bipolar depression particularly with regard to safety, efficacy, and significant health care cost reduction.

Trends in use of electroconvulsive therapy in South London from 1949 to 2006.

PubMed

Lambe, Sinéad; Mogg, Andrew; Eranti, Savitha; Pluck, Graham; Hastilow, Sarah; McLoughlin, Declan M

2014-12-01

Electroconvulsive therapy (ECT) remains the most acutely effective treatment for severe depression, but its use has declined since its introduction more than 70 years ago. To provide some historical perspective on changes in ECT practice, the objective of the present study was to identify trends in ECT practice in selected teaching hospitals in South London, UK, between 1949 and 2006. Annual rates of ECT for 1949-1970 were estimated from the contemporary hospital reports of the Maudsley and Bethlem Royal hospitals in South London, UK. Case notes were also retrospectively reviewed to calculate annual rates of ECT administration and extract demographic and clinical information for approximately every 5 years between 1987 and 2006. The annual rate of ECT peaked at 35% of total admission in 1956 and declined gradually thereafter to 10.8% by 1970 and fell below 2.2% from 1991 onward. Depressed and female patients were more likely to receive ECT. Compared to previous years, patients were more severely ill and treatment resistant in 2006, whereas ethnic minorities made up 30% of patients receiving ECT compared to approximately 14% in the preceding years. Currently, ECT seems to be provided increasingly late in more severe illness episodes. The ethnicity of patients receiving ECT in South London may be becoming more representative of the background population, but ECT is being used relatively more frequently for nonaffective disorders in ethnic minorities.

What does the electroencephalogram tell us about the mechanisms of action of ECT in major depressive disorders?

PubMed

Farzan, Faranak; Boutros, Nash N; Blumberger, Daniel M; Daskalakis, Zafiris J

2014-06-01

Electroconvulsive therapy (ECT) remains to be one of the most effective treatment options in treatment-resistant major depressive disorder (MDD). From the early days, researchers have embarked on extracting information from electroencephalography (EEG) recordings before, during, and after ECT to identify neurophysiological targets of ECT and discover EEG predictors of response to ECT in patients with MDD. In this article, we provide an overview of visually detected and quantitative EEG features that could help in furthering our understanding of the mechanisms of action of ECT in MDD. We further discuss the EEG findings in the context of postulated hypotheses of ECT therapeutic pathways. We introduce an alternative and unifying hypothesis suggesting that ECT may exert its therapeutic efficacy through resetting the aberrant functional connectivity and promoting the generation of new and healthy connections in brain regions implicated in MDD pathophysiology, a mechanism that may be in part mediated by the ECT-induced activation of inhibitory and neuroplasticity mechanisms. We further discuss the added value of EEG markers in the larger context of ECT research and as complementary to neuroimaging and genetic markers. We conclude by drawing attention to the need for longitudinal studies in large cohort of patients and the need for standardization and validation of EEG algorithms of functional connectivity across studies to facilitate the translation of EEG correlates of ECT response in routine clinical practice.

What was learned: studies by the consortium for research in ECT (CORE) 1997-2011.

PubMed

Fink, M

2014-06-01

To review the findings of the four-hospital collaborative studies of electroconvulsive therapy (ECT) in unipolar depressed patients known as CORE between 1997 and 2011. Unipolar depressed patients were treated with bilateral ECT, and on remission were randomly assigned to a fixed schedule continuation ECT or to combined lithium and nortriptyline for 6 months. A second study compared three electrode placements in unipolar and bipolar depressed patients. Nineteen published reports were reviewed. The findings are compared with those of a parallel multi-hospital study of ECT led by a Columbia University Collaboration (CUC) team that studied right unilateral ECT in a similar population with similar inclusion/exclusion and remission criteria. Successful ECT was followed by placebo, nortriptyline alone, or combined lithium, and nortriptyline. Relapse rates after remission were similar with fixed schedule ECT as with medications. Predictors of outcome (psychosis, suicide risk, polarity, melancholia, atypical depression, age) and technical aspects (electrode placement, seizure threshold, speed of response) are discussed, The findings offer criteria to optimize the selection of patients, the technique, and outcome of ECT for unipolar and bipolar depressed patients. Continuation ECT is an effective alternative to continuation treatment with lithium and nortriptyline. Bilateral electrode placement is more efficient than alternative placements. ECT relieves both bipolar and unipolar depression. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

In-hospital mortality among electroconvulsive therapy recipients: A 17-year nationwide population-based retrospective study.

PubMed

Liang, C-S; Chung, C-H; Tsai, C-K; Chien, W-C

2017-05-01

Electroconvulsive therapy (ECT) remains irreplaceable in the treatment of several psychiatric conditions. However, evidence derived using data from a national database to support its safety is limited. The aim of this study was to investigate in-hospital mortality among patients with psychiatric conditions treated with and without ECT. Using data from the Taiwan National Health Insurance Research Database from 1997 to 2013, we identified 828,899 inpatients with psychiatric conditions, among whom 0.19% (n=1571) were treated with ECT. We found that ECT recipients were more frequently women, were younger and physically healthier, lived in more urbanized areas, were treated in medical centers, and had longer hospital stays. ECT recipients had lower odds of in-hospital mortality than did those who did not receive ECT. Moreover, no factor was identified as being able to predict mortality in patients who underwent ECT. Among all patients, ECT was not associated with in-hospital mortality after controlling for potential confounders. ECT was indicated to be safe and did not increase the odds of in-hospital mortality. However, ECT appeared to be administered only on physically healthy but psychiatrically compromised patients, a pattern that is in opposition with the scientific evidence supporting its safety. Moreover, our data suggest that ECT is still used as a treatment of last resort in the era of modern psychiatry. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The mortality rate of electroconvulsive therapy: a systematic review and pooled analysis.

PubMed

Tørring, N; Sanghani, S N; Petrides, G; Kellner, C H; Østergaard, S D

2017-05-01

Electroconvulsive therapy (ECT) remains underutilized because of fears of cognitive and medical risks, including the risk of death. In this study, we aimed to assess the mortality rate of ECT by means of a systematic review and pooled analysis. The study was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The ECT-related mortality rate was calculated as the total number of ECT-related deaths reported in the included studies divided by the total number of ECT treatments. Fifteen studies with data from 32 countries reporting on a total of 766 180 ECT treatments met the inclusion criteria. Sixteen cases of ECT-related death were reported in the included studies yielding an ECT-related mortality rate of 2.1 per 100 000 treatments (95% CI: 1.2-3.4). In the nine studies that were published after 2001 (covering 414 747 treatments), there was only one reported ECT-related death. The ECT-related mortality rate was estimated at 2.1 per 100 000 treatments. In comparison, a recent analysis of the mortality of general anesthesia in relation to surgical procedures reported a mortality rate of 3.4 per 100 000. Our findings document that death caused by ECT is an extremely rare event. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Safety considerations for outpatient electroconvulsive therapy.

PubMed

Reti, Irving M; Walker, Melinda; Pulia, Kathy; Gallegos, Jesus; Jayaram, Geetha; Vaidya, Punit

2012-03-01

As electroconvulsive therapy (ECT) requires general anesthesia and is associated with both cognitive and non-cognitive side effects, careful consideration must be given to the safety aspects of providing ECT on an outpatient basis. Drawing upon published literature and their clinical experience administering outpatient ECT, the authors propose best practices for safely providing ECT to outpatients. They review criteria for selecting patients for outpatient ECT as well as treatment and programmatic issues. The authors highlight the importance of educating referring clinicians as well as patients and their families about factors involved in the safe delivery of ECT for outpatients. Fiscal considerations and the drive toward reduced length of stay are prompting insurers and caregivers to choose outpatient over inpatient ECT. For each patient, such a choice merits a careful analysis of the risks of outpatient ECT, as well as the implementation of measures to ensure patient safety.

Dose rate effect on micronuclei induction in human blood lymphocytes exposed to single pulse and multiple pulses of electrons.

PubMed

Acharya, Santhosh; Bhat, N N; Joseph, Praveen; Sanjeev, Ganesh; Sreedevi, B; Narayana, Y

2011-05-01

The effects of single pulses and multiple pulses of 7 MV electrons on micronuclei (MN) induction in cytokinesis-blocked human peripheral blood lymphocytes (PBLs) were investigated over a wide range of dose rates per pulse (instantaneous dose rate). PBLs were exposed to graded doses of 2, 3, 4, 6, and 8 Gy of single electron pulses of varying pulse widths at different dose rates per pulse, ranging from 1 × 10(6) Gy s(-1) to 3.2 × 10(8) Gy s(-1). Different dose rates per pulse were achieved by changing the dose per electron pulse by adjusting the beam current and pulse width. MN yields per unit absorbed dose after irradiation with single electron pulses were compared with those of multiple pulses of electrons. A significant decrease in the MN yield with increasing dose rates per pulse was observed, when dose was delivered by a single electron pulse. However, no reduction in the MN yield was observed when dose was delivered by multiple pulses of electrons. The decrease in the yield at high dose rates per pulse suggests possible radical recombination, which leads to decreased biological damage. Cellular response to the presence of very large numbers of chromosomal breaks may also alter the damage.

Endurance Enhancement and High Speed Set/Reset of 50 nm Generation HfO2 Based Resistive Random Access Memory Cell by Intelligent Set/Reset Pulse Shape Optimization and Verify Scheme

NASA Astrophysics Data System (ADS)

Higuchi, Kazuhide; Miyaji, Kousuke; Johguchi, Koh; Takeuchi, Ken

2012-02-01

This paper proposes a verify-programming method for the resistive random access memory (ReRAM) cell which achieves a 50-times higher endurance and a fast set and reset compared with the conventional method. The proposed verify-programming method uses the incremental pulse width with turnback (IPWWT) for the reset and the incremental voltage with turnback (IVWT) for the set. With the combination of IPWWT reset and IVWT set, the endurance-cycle increases from 48 ×103 to 2444 ×103 cycles. Furthermore, the measured data retention-time after 20 ×103 set/reset cycles is estimated to be 10 years. Additionally, the filamentary based physical model is proposed to explain the set/reset failure mechanism with various set/reset pulse shapes. The reset pulse width and set voltage correspond to the width and length of the conductive-filament, respectively. Consequently, since the proposed IPWWT and IVWT recover set and reset failures of ReRAM cells, the endurance-cycles are improved.

Studies of drug delivery systems for a therapeutic agent used in osteoporosis. I. Pharmacodynamics (hypocalcemic effect) of elcatonin in rabbits following rectal administration of hollow-type suppositories containing elcatonin.

PubMed

Watanabe, Y; Mizufune, Y; Kubomura, A; Kiriyama, M; Utoguchi, N; Matsumoto, M

1998-11-01

In this study, we developed a new hollow-type suppository containing elcatonin ((Asu1,7)-eel calcitonin, ECT), a synthetic derivative of eel calcitonin, which produces hypocalcemia, as a pharmaceutical preparation for self administration, to be used instead of parenteral injections for patients with osteoporosis. The absorption of ECT from the rectal mucous membrane was evaluated by observation of the decrease in serum calcium (Ca) concentrations following rectal administration in rabbits. ECT was efficiently absorbed from the rectum and effectively decreased serum Ca concentrations. The data of the area under the percent decrease in serum Ca concentration (deltaCa%)-time curve (deltaCa%-AUC), assumed to be an index of the pharmacodynamics (pharmacological effect) of ECT, indicated that similar hypocalcemic effects were obtained following rectal and intravenous administrations of ECT. In regard to the effect of coadministration of other compounds on rectal absorption of ECT, no significant difference in the deltaCa%-AUC between rectal ECT administration with or without nafamostat mesilate (a protease inhibitor) was observed. However, the coadministration of ECT with cytochalasin B or monensin (endocytosis inhibitors) significantly decreased the deltaCa%-AUC, indicating that rectal ECT absorption is probably inhibited by endocytosis inhibitors. On the other hand, it was found that sodium decanoate, a medium-chain fatty acid (sodium salt), significantly enhanced the rectal absorption of ECT. We conclude that this ECT hollow-type suppository offers promise as a new method for the administration of ECT.

Identifying Recipients of Electroconvulsive Therapy: Data From Privately Insured Americans.

PubMed

Wilkinson, Samuel T; Agbese, Edeanya; Leslie, Douglas L; Rosenheck, Robert A

2018-05-01

Despite the effectiveness of electroconvulsive therapy (ECT), limited epidemiologic research has been conducted to identify rates of ECT use and characteristics of patients who receive ECT. Sociodemographic and clinical characteristics associated with ECT use were examined among patients with mood disorders in the MarketScan commercial insurance claims database. Among individuals with major depressive disorder or bipolar disorder, sociodemographic and clinical characteristics of those who received ECT and those who did not were compared by using bivariate effect size comparisons and multivariate logistic regression. Among unique individuals in the 2014 MarketScan database (N=47,258,528), the ECT utilization rate was 5.56 ECT patients per 100,000 in the population. Of the 969,277 patients with a mood disorder, 2,471 (.25%) received ECT. Those who received ECT had substantially higher rates of additional comorbid psychiatric disorders (risk ratio [RR]=5.70 for any additional psychiatric disorder), numbers of prescription fills for any psychotropic medication (Cohen's d=.77), rates of any substance use disorder (RR=1.97), and total outpatient psychotherapy visits (Cohen's d=.49). The proportion of patients with a mood disorder who received ECT in the West (.19%) was substantially lower than in other U.S. regions (.28%). This difference was almost entirely accounted for by one western state comprising 59.1% of patients in that region. Use of ECT is exceptionally uncommon and limited to patients with extensive multimorbidity and high levels of service use. ECT utilization is most limited in areas of the country where regulatory restrictions are greatest.

Electroconvulsive Therapy and All-Cause Mortality in Texas, 1998-2013.

PubMed

Dennis, Nora M; Dennis, Paul A; Shafer, Alan; Weiner, Richard D; Husain, Mustafa M

2017-03-01

Electroconvulsive therapy (ECT) remains an effective treatment for major depressive disorder. Since 1995, Texas has maintained an ECT database including patient diagnoses and outcomes, and reporting any deaths within 14 days of receiving an ECT treatment, encompassing a total of 166,711 ECT treatments administered in Texas over the previously unreported period of 1998 to 2013. Descriptive analysis summarized information on deaths reported during the 16-year period-cause of death, type of treatment (index or maintenance) and patient demographics. Multiple logistic regression of death incidence by treatment session was performed to determine whether patient age, sex, race, diagnosis, or year of treatment was associated with death after ECT. Of those deaths occurring within 1 day of an ECT treatment, the death rate was 2.4 per 100,000 treatments. Looking at all deaths within 14 days of an ECT treatment, the death rate increased to 18 per 100,000 treatments but included all deaths regardless of likelihood of causal association with ECT, for example, accidents and suicides, the latter a leading cause of death among individuals with severe major depression or other disorders for which ECT is indicated. Death rate increased significantly with increasing patient age (P = 0.001) and male sex (P = 0.009), and there was a nonsignificant trend toward increased death amongst patients with bipolar disorder or schizophrenia (P = 0.058) versus depression. Our data indicate that ECT is in general a safe procedure with respect to the likelihood of immediate death. Suicide remains a significant risk in ECT patients, despite evidence that ECT reduces suicidal ideation.

Short- and long-term neurocognitive functioning after electroconvulsive therapy in depressed elderly: a prospective naturalistic study.

PubMed

Verwijk, Esmée; Comijs, Hannie C; Kok, Rob M; Spaans, Harm-Pieter; Tielkes, Caroline E M; Scherder, Erik J A; Stek, Max L

2014-02-01

It is generally assumed that the elderly patients are more vulnerable to cognitive side effects after electroconvulsive therapy (ECT) than younger depressed patients. The current study aims to evaluate the nature and extent of changes across multiple domains of neurocognitive functioning in a group of elderly depressed patients after ECT. In this prospective naturalistic study, we included 42 depressed patients aged ≥55 years. Global cognitive function, memory, and executive function were assessed before ECT treatment and within one week (short-term post-ECT) and six months after ECT (long-term post-ECT). Associations between cognitive functioning and electrode placement, total number of treatment sessions, age, and the severity of depression at the time of cognitive measurement were studied. Our data offered no evidence of decline for any of the neurocognitive tests after ECT, given its power to detect the difference. Post-ECT improvement of neurocognitive functioning was statistically significant for the Mini-Mental State Examination, Visual Association Test, 10 Words Verbal Learning Test, and Expanded Mental Control Test. Effect sizes were medium to large. After six months, compared with post-ECT performance, statistically significant improvement was found only for the Trail Making Test-A and the Letter Fluency Test with small to medium effect sizes. In our severely depressed elderly patients, neurocognitive performance improved or did not change after ECT. Patients with poor cognitive function were not able to participate in neuropsychological assessment before ECT started. Consequently these results may not apply to patients with more severe cognitive impairment prior to the start of ECT.

"Side effects" of ECT are mainly depressive phenomena and are independent of age.

PubMed

Brodaty, H; Berle, D; Hickie, I; Mason, C

2001-10-01

The aetiology of reported side effects of electroconvulsive therapy (ECT) is unclear. We examined the interaction of depression and age on adverse neuropsychological and putative side effects of ECT. Inpatients (N=81; median age 70 years) with major depression were assessed prospectively pre-ECT, immediately post-ECT and 1-3 years later. Patients were administered the Hamilton Rating Scale for Depression (HRSD), the Global Assessment of Functioning scale (GAF) and neuropsychological tests from the Wechsler Memory Scale. Side effects and total burden scores were rated pre- and post-treatment. HRSD and GAF scores improved with treatment after ECT, but the prevalence and total burden of side effects were unchanged. Side effect burden was related to depression level before and after ECT. Improvement in depression correlated with reduction in side effect burden. There was a significant decline in side effect burden after controlling for change in depression. Patients' scores on neuropsychological measures did not appear to change after ECT or between pre-ECT and follow-up. Re-analysis, allowing for age, chronicity of depression, medication use and development of dementia, did not alter the findings. lack of a control group, lack of information on ECT technique, incomplete data sets and limited neuropsychological testing. ECT, an effective treatment for depression, does not cause significant side effects or neuropsychological impairment, which are more likely to be depressive phenomena. ECT appears to be safe for old (> or =65 years) and very old (> or =75 years) patients, who do not appear to be more susceptible to adverse effects.

Hitomi X-ray studies of giant radio pulses from the Crab pulsar

NASA Astrophysics Data System (ADS)

Hitomi Collaboration; Aharonian, Felix; Akamatsu, Hiroki; Akimoto, Fumie; Allen, Steven W.; Angelini, Lorella; Audard, Marc; Awaki, Hisamitsu; Axelsson, Magnus; Bamba, Aya; Bautz, Marshall W.; Blandford, Roger; Brenneman, Laura W.; Brown, Gregory V.; Bulbul, Esra; Cackett, Edward M.; Chernyakova, Maria; Chiao, Meng P.; Coppi, Paolo S.; Costantini, Elisa; de Plaa, Jelle; de Vries, Cor P.; den Herder, Jan-Willem; Done, Chris; Dotani, Tadayasu; Ebisawa, Ken; Eckart, Megan E.; Enoto, Teruaki; Ezoe, Yuichiro; Fabian, Andrew C.; Ferrigno, Carlo; Foster, Adam R.; Fujimoto, Ryuichi; Fukazawa, Yasushi; Furuzawa, Akihiro; Galeazzi, Massimiliano; Gallo, Luigi C.; Gandhi, Poshak; Giustini, Margherita; Goldwurm, Andrea; Gu, Liyi; Guainazzi, Matteo; Haba, Yoshito; Hagino, Kouichi; Hamaguchi, Kenji; Harrus, Ilana M.; Hatsukade, Isamu; Hayashi, Katsuhiro; Hayashi, Takayuki; Hayashida, Kiyoshi; Hiraga, Junko S.; Hornschemeier, Ann; Hoshino, Akio; Hughes, John P.; Ichinohe, Yuto; Iizuka, Ryo; Inoue, Hajime; Inoue, Yoshiyuki; Ishida, Manabu; Ishikawa, Kumi; Ishisaki, Yoshitaka; Iwai, Masachika; Kaastra, Jelle; Kallman, Tim; Kamae, Tsuneyoshi; Kataoka, Jun; Katsuda, Satoru; Kawai, Nobuyuki; Kelley, Richard L.; Kilbourne, Caroline A.; Kitaguchi, Takao; Kitamoto, Shunji; Kitayama, Tetsu; Kohmura, Takayoshi; Kokubun, Motohide; Koyama, Katsuji; Koyama, Shu; Kretschmar, Peter; Krimm, Hans A.; Kubota, Aya; Kunieda, Hideyo; Laurent, Philippe; Lee, Shiu-Hang; Leutenegger, Maurice A.; Limousin, Olivier O.; Loewenstein, Michael; Long, Knox S.; Lumb, David; Madejski, Greg; Maeda, Yoshitomo; Maier, Daniel; Makishima, Kazuo; Markevitch, Maxim; Matsumoto, Hironori; Matsushita, Kyoko; McCammon, Dan; McNamara, Brian R.; Mehdipour, Missagh; Miller, Eric D.; Miller, Jon M.; Mineshige, Shin; Mitsuda, Kazuhisa; Mitsuishi, Ikuyuki; Miyazawa, Takuya; Mizuno, Tsunefumi; Mori, Hideyuki; Mori, Koji; Mukai, Koji; Murakami, Hiroshi; Mushotzky, Richard F.; Nakagawa, Takao; Nakajima, Hiroshi; Nakamori, Takeshi; Nakashima, Shinya; Nakazawa, Kazuhiro; Nobukawa, Kumiko K.; Nobukawa, Masayoshi; Noda, Hirofumi; Odaka, Hirokazu; Ohashi, Takaya; Ohno, Masanori; Okajima, Takashi; Oshimizu, Kenya; Ota, Naomi; Ozaki, Masanobu; Paerels, Frits; Paltani, Stéphane; Petre, Robert; Pinto, Ciro; Porter, Frederick S.; Pottschmidt, Katja; Reynolds, Christopher S.; Safi-Harb, Samar; Saito, Shinya; Sakai, Kazuhiro; Sasaki, Toru; Sato, Goro; Sato, Kosuke; Sato, Rie; Sawada, Makoto; Schartel, Norbert; Serlemtsos, Peter J.; Seta, Hiromi; Shidatsu, Megumi; Simionescu, Aurora; Smith, Randall K.; Soong, Yang; Stawarz, Łukasz; Sugawara, Yasuharu; Sugita, Satoshi; Szymkowiak, Andrew; Tajima, Hiroyasu; Takahashi, Hiromitsu; Takahashi, Tadayuki; Takeda, Shiníchiro; Takei, Yoh; Tamagawa, Toru; Tamura, Takayuki; Tanaka, Takaaki; Tanaka, Yasuo; Tanaka, Yasuyuki T.; Tashiro, Makoto S.; Tawara, Yuzuru; Terada, Yukikatsu; Terashima, Yuichi; Tombesi, Francesco; Tomida, Hiroshi; Tsuboi, Yohko; Tsujimoto, Masahiro; Tsunemi, Hiroshi; Tsuru, Takeshi Go; Uchida, Hiroyuki; Uchiyama, Hideki; Uchiyama, Yasunobu; Ueda, Shutaro; Ueda, Yoshihiro; Uno, Shiníchiro; Urry, C. Megan; Ursino, Eugenio; Watanabe, Shin; Werner, Norbert; Wilkins, Dan R.; Williams, Brian J.; Yamada, Shinya; Yamaguchi, Hiroya; Yamaoka, Kazutaka; Yamasaki, Noriko Y.; Yamauchi, Makoto; Yamauchi, Shigeo; Yaqoob, Tahir; Yatsu, Yoichi; Yonetoku, Daisuke; Zhuravleva, Irina; Zoghbi, Abderahmen; Terasawa, Toshio; Sekido, Mamoru; Takefuji, Kazuhiro; Kawai, Eiji; Misawa, Hiroaki; Tsuchiya, Fuminori; Yamazaki, Ryo; Kobayashi, Eiji; Kisaka, Shota; Aoki, Takahiro

2018-03-01

To search for giant X-ray pulses correlated with the giant radio pulses (GRPs) from the Crab pulsar, we performed a simultaneous observation of the Crab pulsar with the X-ray satellite Hitomi in the 2-300 keV band and the Kashima NICT radio telescope in the 1.4-1.7 GHz band with a net exposure of about 2 ks on 2016 March 25, just before the loss of the Hitomi mission. The timing performance of the Hitomi instruments was confirmed to meet the timing requirement and about 1000 and 100 GRPs were simultaneously observed at the main pulse and inter-pulse phases, respectively, and we found no apparent correlation between the giant radio pulses and the X-ray emission in either the main pulse or inter-pulse phase. All variations are within the 2 σ fluctuations of the X-ray fluxes at the pulse peaks, and the 3 σ upper limits of variations of main pulse or inter-pulse GRPs are 22% or 80% of the peak flux in a 0.20 phase width, respectively, in the 2-300 keV band. The values for main pulse or inter-pulse GRPs become 25% or 110%, respectively, when the phase width is restricted to the 0.03 phase. Among the upper limits from the Hitomi satellite, those in the 4.5-10 keV and 70-300 keV bands are obtained for the first time, and those in other bands are consistent with previous reports. Numerically, the upper limits of the main pulse and inter-pulse GRPs in the 0.20 phase width are about (2.4 and 9.3) × 10-11 erg cm-2, respectively. No significant variability in pulse profiles implies that the GRPs originated from a local place within the magnetosphere. Although the number of photon-emitting particles should temporarily increase to account for the brightening of the radio emission, the results do not statistically rule out variations correlated with the GRPs, because the possible X-ray enhancement may appear due to a >0.02% brightening of the pulse-peak flux under such conditions.

Representations of ECT in English-Language Film and Television in the New Millennium.

PubMed

Matthews, Avery Madeleine; Rosenquist, Peter B; McCall, William Vaughn

2016-09-01

The aim of the study was to survey the media landscape to determine whether visual depictions of electroconvulsive therapy (ECT) are becoming more or less medically accurate in the new millennium. English-language film and television shows depicting ECT were analyzed for patient demographics, administrator roles, indication, consent, anesthesia, paralytics, bite block, lead placement, electroencephalogram, and outcome. Thirty-nine ECT scenes were viewed, and just 3 included all 5 essential tools of modern ECT: anesthesia, paralytic, electrodes, electroencephalogram, and a bite block. Media depictions of ECT do not reflect current practice. Too often, ECT is portrayed as a torture technique rather than an evidenced-based therapy, and even in a therapeutic setting, it is too often shown with outdated techniques.

Acute bilateral ECT in a depressed patient with a hip-aztreonam-spacer and subsequent maintenance ECT after prosthesis collocation.

PubMed

Gálvez, Verònica; de Arriba Arnau, Aida; Martínez-Amorós, Erika; Ribes, Carmina; Urretavizcaya, Mikel; Cardoner, Narcís

2014-11-10

ABSTRACT Electroconvulsive Therapy (ECT) has been demonstrated to be a safe and effective treatment for geriatric depression, although its application might be challenging when medical comorbidities exist. The present case reports a 78-year-old man diagnosed with recurrent unipolar major depressive disorder (MDD), who presented with a severe depressive episode with psychotic features (DSM IV). He successfully received a course of bitemporal (BT) ECT with a hip-aztreonam-spacer due to a hip fracture that occurred during hospitalization. This was followed by maintenance ECT (M-ECT) with a recent prosthesis collocation. This particular case illustrates the importance of a multidisciplinary approach in geriatric patients with somatic complications receiving ECT.

Full Spectrum Conversion Using Traveling Pulse Wave Quantization

DTIC Science & Technology

2017-03-01

Full Spectrum Conversion Using Traveling Pulse Wave Quantization Michael S. Kappes Mikko E. Waltari IQ-Analog Corporation San Diego, California...temporal-domain quantization technique called Traveling Pulse Wave Quantization (TPWQ). Full spectrum conversion is defined as the complete...pulse width measurements that are continuously generated hence the name “traveling” pulse wave quantization. Our TPWQ-based ADC is composed of a

Effects of pulsed electrical field processing on microbial survival, quality change and nutritional characteristics of blueberries

USDA-ARS?s Scientific Manuscript database

Whole fresh blueberries were treated using a parallel pulsed electric field (PEF) treatment chamber and a sanitizer solution (60 ppm peracetic acid [PAA]) as PEF treatment medium with square wave bipolar pulses at 2 kV/cm electric field strength, 1us pulse width, and 100 pulses per second for 2, 4, ...

Advanced Orion Optimized Laser System Analysis

NASA Technical Reports Server (NTRS)

1996-01-01

Contractor shall perform a complete analysis of the potential of the solid state laser in the very long pulse mode (100 ns pulse width, 10-30 hz rep-rate) and in the very short pulse mode (100 ps pulse width 10-30 hz rep rate) concentrating on the operation of the device in the 'hot-rod' mode, where no active cooling the laser operation is attempted. Contractor's calculations shall be made of the phase aberrations which develop during the repped-pulse train, and the results shall feed into the adaptive optics analyses. The contractor shall devise solutions to work around ORION track issues. A final report shall be furnished to the MSFC COTR including all calculations and analysis of estimates of bulk phase and intensity aberration distribution in the laser output beam as a function of time during the repped-pulse train for both wave forms (high-energy/long-pulse, as well as low-energy/short-pulse). Recommendations shall be made for mitigating the aberrations by laser re-design and/or changes in operating parameters of optical pump sources and/or designs.

Repetitive Transcranial Magnetic Stimulator with Controllable Pulse Parameters

PubMed Central

Peterchev, Angel V; Murphy, David L; Lisanby, Sarah H

2013-01-01

The characteristics of transcranial magnetic stimulation (TMS) pulses influence the physiological effect of TMS. However, available TMS devices allow very limited adjustment of the pulse parameters. We describe a novel TMS device that uses a circuit topology incorporating two energy storage capacitors and two insulated-gate bipolar transistor (IGBT) modules to generate near-rectangular electric field pulses with adjustable number, polarity, duration, and amplitude of the pulse phases. This controllable pulse parameter TMS (cTMS) device can induce electric field pulses with phase widths of 10–310 μs and positive/negative phase amplitude ratio of 1–56. Compared to conventional monophasic and biphasic TMS, cTMS reduces energy dissipation by up to 82% and 57%, and decreases coil heating by up to 33% and 41%, respectively. We demonstrate repetitive TMS trains of 3,000 pulses at frequencies up to 50 Hz with electric field pulse amplitude and width variability less than the measurement resolution (1.7% and 1%, respectively). Offering flexible pulse parameter adjustment and reduced power consumption and coil heating, cTMS enhances existing TMS paradigms, enables novel research applications, and could lead to clinical applications with potentially enhanced potency. PMID:21540487

High resolution time interval counter

DOEpatents

Condreva, Kenneth J.

1994-01-01

A high resolution counter circuit measures the time interval between the occurrence of an initial and a subsequent electrical pulse to two nanoseconds resolution using an eight megahertz clock. The circuit includes a main counter for receiving electrical pulses and generating a binary word--a measure of the number of eight megahertz clock pulses occurring between the signals. A pair of first and second pulse stretchers receive the signal and generate a pair of output signals whose widths are approximately sixty-four times the time between the receipt of the signals by the respective pulse stretchers and the receipt by the respective pulse stretchers of a second subsequent clock pulse. Output signals are thereafter supplied to a pair of start and stop counters operable to generate a pair of binary output words representative of the measure of the width of the pulses to a resolution of two nanoseconds. Errors associated with the pulse stretchers are corrected by providing calibration data to both stretcher circuits, and recording start and stop counter values. Stretched initial and subsequent signals are combined with autocalibration data and supplied to an arithmetic logic unit to determine the time interval in nanoseconds between the pair of electrical pulses being measured.

High resolution time interval counter

DOEpatents

Condreva, K.J.

1994-07-26

A high resolution counter circuit measures the time interval between the occurrence of an initial and a subsequent electrical pulse to two nanoseconds resolution using an eight megahertz clock. The circuit includes a main counter for receiving electrical pulses and generating a binary word--a measure of the number of eight megahertz clock pulses occurring between the signals. A pair of first and second pulse stretchers receive the signal and generate a pair of output signals whose widths are approximately sixty-four times the time between the receipt of the signals by the respective pulse stretchers and the receipt by the respective pulse stretchers of a second subsequent clock pulse. Output signals are thereafter supplied to a pair of start and stop counters operable to generate a pair of binary output words representative of the measure of the width of the pulses to a resolution of two nanoseconds. Errors associated with the pulse stretchers are corrected by providing calibration data to both stretcher circuits, and recording start and stop counter values. Stretched initial and subsequent signals are combined with autocalibration data and supplied to an arithmetic logic unit to determine the time interval in nanoseconds between the pair of electrical pulses being measured. 3 figs.

ECT treatment outcomes following performance improvement changes.

PubMed

Pulia, Kathy; Vaidya, Punit; Jayaram, Geetha; Hayat, Matthew J; Reti, Irving M

2013-11-01

Differences in electroconvulsive therapy (ECT) outcomes were explored following changes in ECT administration at our institution. Two changes were introduced: (a) switching the anesthetic agent from propofol to methohexital, and (b) using a more aggressive ECT charge dosing regimen for right unilateral (RUL) electrode placement. Length of stay (LOS) and number of treatments administered per patient were monitored. A retrospective analysis was performed of two inpatient groups treated on our Mood Disorders Unit: those who underwent ECT in the 12 months prior to the changes (n = 40) and those who underwent treatment in the 12 months after the changes (n = 38). Compared with patients receiving ECT with RUL placement prior to the changes, patients who received RUL ECT after the changes had a significantly shorter inpatient LOS (27.4 versus 18 days, p = 0.028). Treatment efficacy monitored by the Montgomery Asberg Depression Rating Scale was not impacted. The change in anesthetic agent and charge dosing each accounted for 11% of the variance in LOS among patients receiving RUL ECT. The implemented changes in ECT administration positively impacted outcome for patients receiving treatment with RUL electrode placement. Copyright 2013, SLACK Incorporated.

Memantine in the prevention or alleviation of electroconvulsive therapy induces cognitive disorders: A placebo controlled trial.

PubMed

Abbasinazari, Mohammad; Adib-Eshgh, Ladan; Rostami, Azin; Beyraghi, Narges; Dabir, Shideh; Jafari, Reyhaneh

2015-06-01

The purpose of this study was to evaluate the effect of memantine administration on the adverse cognitive effects of electroconvulsive therapy (ECT). Forty patients diagnosed with a major depressive disorder for which ECT was indicated as a treatment for their current episode were randomly allocated to either the memantine (5mg/day) group or the placebo group. All patients underwent the same protocol for anaesthesia and ECT procedures. The patients received memantine or the placebo for the whole period of ECT treatment, starting the day before ECT and continuing until the fourth session of ECT. The Modified Mental State Examination (MMSE) was used for the assessment of cognition before and after the trial. Regarding MMSE and item 3 MMSE (related to recent memory), the memantine group scored significantly higher at the end of ECT sessions than the control group (P=0.02, P<0.001, respectively). Our data support the hypothesis that memantine may reduce cognitive impairment following ECT. Memantine could be both a safe and well-tolerated treatment for use with ECT. Copyright © 2015 Elsevier B.V. All rights reserved.

Numerical simulation of passively mode-locked fiber laser based on semiconductor optical amplifier

NASA Astrophysics Data System (ADS)

Yang, Jingwen; Jia, Dongfang; Zhang, Zhongyuan; Chen, Jiong; Liu, Tonghui; Wang, Zhaoying; Yang, Tianxin

2013-03-01

Passively mode-locked fiber laser (MLFL) has been widely used in many applications, such as optical communication system, industrial production, information processing, laser weapons and medical equipment. And many efforts have been done for obtaining lasers with small size, simple structure and shorter pulses. In recent years, nonlinear polarization rotation (NPR) in semiconductor optical amplifier (SOA) has been studied and applied as a mode-locking mechanism. This kind of passively MLFL has faster operating speed and makes it easier to realize all-optical integration. In this paper, we had a thorough analysis of NPR effect in SOA. And we explained the principle of mode-locking by SOA and set up a numerical model for this mode-locking process. Besides we conducted a Matlab simulation of the mode-locking mechanism. We also analyzed results under different working conditions and several features of this mode-locking process are presented. Our simulation shows that: Firstly, initial pulse with the peak power exceeding certain threshold may be amplified and compressed, and stable mode-locking may be established. After about 25 round-trips, stable mode-locked pulse can be obtained which has peak power of 850mW and pulse-width of 780fs.Secondly, when the initial pulse-width is greater, narrowing process of pulse is sharper and it needs more round-trips to be stable. Lastly, the bias currents of SOA affect obviously the shape of mode-locked pulse and the mode-locked pulse with high peak power and narrow width can be obtained through adjusting reasonably the bias currents of SOA.

Delay-tunable gap-soliton-based slow-light system

NASA Astrophysics Data System (ADS)

Mok, Joe T.; de Sterke, C. Martijn; Eggleton, Benjamin J.

2006-12-01

We numerically and analytically evaluate the delay of solitons propagating slowly, and without broadening, in an apodized Bragg grating. Simulations indicate that a 100 mm Bragg grating with Δn = 10-3 can delay sub-nanosecond pulses by nearly 20 pulse widths without any change in the output pulse width. Delay tunability is achieved by simultaneously adjusting the launch power and detuning. A simple analytic model is developed to describe the monotonic dependence of delay on Δn and compared with simulations. As the intensity may be greatly enhanced due to a reduced velocity, a procedure for improving the delay while avoiding material damage is outlined.

Current status of electroconvulsive therapy for mood disorders: a clinical review.

PubMed

Kolar, Dusan

2017-02-01

Electroconvulsive therapy (ECT) is an effective treatment for mood disorders and a viable treatment option especially when urgency of clinical situation requires a prompt treatment response. After acute series of ECT, the ECT long-term treatment may be considered, although this practice may vary significantly between countries or even within the same country, because there is no universal consensus about its indications, duration and frequency of administration. Continuation or maintenance ECT is common in routine clinical practice and clinicians should be aware of the risks of using ECT long term. Neuropsychological assessment should be an essential part of a good clinical practice in ECT services. Cognitive side effects of ECT are sometimes underestimated and may last much longer after completed treatment than it is usually expected. These cognitive impairments associated with ECT may cause significant functional difficulties and prevent patients to return to work. Cognitive assessment during ECT treatment is usually not comprehensive enough and is limited to bedside assessment. A more proactive approach to careful neuropsychological assessment and consideration of combined maintenance medication treatment after ECT are essential. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

1030-nm diode-laser-based light source delivering pulses with nanojoule energies and picosecond duration adjustable by mode locking or pulse gating operation

NASA Astrophysics Data System (ADS)

Klehr, A.; Liero, A.; Wenzel, H.; Bugge, F.; Brox, O.; Fricke, J.; Ressel, P.; Knigge, A.; Heinrich, W.; Tränkle, G.

2017-02-01

A new compact 1030 nm picosecond light source which can be switched between pulse gating and mode locking operation is presented. It consists of a multi-section distributed Bragg reflector (DBR) laser, an ultrafast multisection optical gate and a flared power amplifier (PA), mounted together with high frequency electronics and optical elements on a 5×4 cm micro bench. The master oscillator (MO) is a 10 mm long ridge wave-guide (RW) laser consisting of 200 μm long saturable absorber, 1500 μm long gain, 8000 μm long cavity, 200 μm long DBR and 100 μm long monitor sections. The 2 mm long optical gate consisting of several RW sections is monolithically integrated with the 4 mm long gain-guided tapered amplifier on a single chip. The light source can be switched between pulse gating and passive mode locking operation. For pulse gating all sections of the MO (except of the DBR and monitor sections) are forward biased and driven by a constant current. By injecting electrical pulses into one section of the optical gate the CW beam emitted by the MO is converted into a train of optical pulses with adjustable widths between 250 ps and 1000 ps. Peak powers of 20 W and spectral linewidths in the MHz range are achieved. Shorter pulses with widths between 4 ps and 15 ps and peak powers up to 50 W but larger spectral widths of about 300 pm are generated by mode locking where the saturable absorber section of the MO is reversed biased. The repetition rate of 4.2 GHz of the pulse train emitted by the MO can be reduced to values between 1 kHz and 100 MHz by utilizing the optical gate as pulse picker. The pulse-to-pulse distance can be controlled by an external trigger source.

A laser-Compton scattering prototype experiment at 100 MeV linac of Shanghai Institute of Applied Physics.

PubMed

Luo, W; Xu, W; Pan, Q Y; Cai, X Z; Chen, J G; Chen, Y Z; Fan, G T; Fan, G W; Guo, W; Li, Y J; Liu, W H; Lin, G Q; Ma, Y G; Shen, W Q; Shi, X C; Xu, B J; Xu, J Q; Xu, Y; Zhang, H O; Yan, Z; Yang, L F; Zhao, M H

2010-01-01

As a prototype of the Shanghai Laser Electron Gamma Source in the Shanghai Synchrotron Radiation Facility, an x-ray source based on laser-Compton scattering (LCS) has been installed at the terminal of the 100 MeV linac of the Shanghai Institute of Applied Physics. LCS x-rays are generated by interactions between Q-switched Nd:yttrium aluminum garnet laser pulses [with wavelength of 1064 nm and pulse width of 21 ns (full width at half maximum)] and electron bunches [with energy of 108 MeV and pulse width of 0.95 ns (rms)] at an angle of 42 degrees between laser and electron beam. In order to measure the energy spectrum of LCS x-rays, a Si(Li) detector along the electron beam line axis is positioned at 9.8 m away from a LCS chamber. After background subtraction, the LCS x-ray spectrum with the peak energy of 29.1+/-4.4|(stat)+/-2.1|(syst) keV and the peak width (rms) of 7.8+/-2.8|(stat)+/-0.4|(syst) keV is observed. Normally the 100 MeV linac operates with the electron macropulse charge of 1.0 nC/pulse, and the electron and laser collision repetition rate of 20 Hz. Therefore, the total LCS x-ray flux of (5.2+/-2.0) x 10(2) Hz can be achieved.

Broadband optical frequency comb generator based on driving N-cascaded modulators by Gaussian-shaped waveform

NASA Astrophysics Data System (ADS)

Hmood, Jassim K.; Harun, Sulaiman W.

2018-05-01

A new approach for realizing a wideband optical frequency comb (OFC) generator based on driving cascaded modulators by a Gaussian-shaped waveform, is proposed and numerically demonstrated. The setup includes N-cascaded MZMs, a single Gaussian-shaped waveform generator, and N-1 electrical time delayer. The first MZM is driven directly by a Gaussian-shaped waveform, while delayed replicas of the Gaussian-shaped waveform drive the other MZMs. An analytical model that describes the proposed OFC generator is provided to study the effect of number and chirp factor of cascaded MZM as well as pulse width on output spectrum. Optical frequency combs at frequency spacing of 1 GHz are generated by applying Gaussian-shaped waveform at pulse widths ranging from 200 to 400 ps. Our results reveal that, the number of comb lines is inversely proportional to the pulse width and directly proportional to both number and chirp factor of cascaded MZMs. At pulse width of 200 ps and chirp factor of 4, 67 frequency lines can be measured at output spectrum of two-cascaded MZMs setup. Whereas, increasing the number of cascaded stages to 3, 4, and 5, the optical spectra counts 89, 109 and 123 frequency lines; respectively. When the delay time is optimized, 61 comb lines can be achieved with power fluctuations of less than 1 dB for five-cascaded MZMs setup.

Potential of discrete Gaussian edge feathering method for improving abutment dosimetry in eMLC-delivered segmented-field electron conformal therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eley, John G.; Hogstrom, Kenneth R.; Matthews, Kenneth L.

2011-12-15

Purpose: The purpose of this work was to investigate the potential of discrete Gaussian edge feathering of the higher energy electron fields for improving abutment dosimetry in the planning volume when using an electron multileaf collimator (eMLC) to deliver segmented-field electron conformal therapy (ECT). Methods: A discrete (five-step) Gaussian edge spread function was used to match dose penumbras of differing beam energies (6-20 MeV) at a specified depth in a water phantom. Software was developed to define the leaf eMLC positions of an eMLC that most closely fit each electron field shape. The effect of 1D edge feathering of themore » higher energy field on dose homogeneity was computed and measured for segmented-field ECT treatment plans for three 2D PTVs in a water phantom, i.e., depth from the water surface to the distal PTV surface varied as a function of the x-axis (parallel to leaf motion) and remained constant along the y-axis (perpendicular to leaf motion). Additionally, the effect of 2D edge feathering was computed and measured for one radially symmetric, 3D PTV in a water phantom, i.e., depth from the water surface to the distal PTV surface varied as a function of both axes. For the 3D PTV, the feathering scheme was evaluated for 0.1-1.0-cm leaf widths. Dose calculations were performed using the pencil beam dose algorithm in the Pinnacle{sup 3} treatment planning system. Dose verification measurements were made using a prototype eMLC (1-cm leaf width). Results: 1D discrete Gaussian edge feathering reduced the standard deviation of dose in the 2D PTVs by 34, 34, and 39%. In the 3D PTV, the broad leaf width (1 cm) of the eMLC hindered the 2D application of the feathering solution to the 3D PTV, and the standard deviation of dose increased by 10%. However, 2D discrete Gaussian edge feathering with simulated eMLC leaf widths of 0.1-0.5 cm reduced the standard deviation of dose in the 3D PTV by 33-28%, respectively. Conclusions: A five-step discrete Gaussian edge spread function applied in 2D improves the abutment dosimetry but requires an eMLC leaf resolution better than 1 cm.« less

Effects of the pulse width on the reactive species production and DNA damage in cancer cells exposed to atmospheric pressure microsecond-pulsed helium plasma jets

NASA Astrophysics Data System (ADS)

Joh, Hea Min; Choi, Ji Ye; Kim, Sun Ja; Kang, Tae Hong; Chung, T. H.

2017-08-01

Plasma-liquid and plasma-cell interactions were investigated using an atmospheric pressure dc microsecond-pulsed helium plasma jet. We investigated the effects of the electrical parameters such as applied voltage and pulse width (determined by the pulse frequency and duty ratio) on the production of reactive species in the gas/liquid phases and on the DNA damage responses in the cancer cells. The densities of reactive species including OH radicals were estimated inside the plasma-treated liquids using a chemical probe method, and the nitrite concentration was detected by Griess assay. Importantly, the more concentration of OH resulted in the more DNA base oxidation and breaks in human lung cancer A549 cells. The data are very suggestive that there is strong correlation between the production of OH in the plasmas/liquids and the DNA damage.

Effect of second harmonic in pulse-width-modulation-based DAC for feedback of digital fluxgate magnetometer

NASA Astrophysics Data System (ADS)

Belyayev, Serhiy; Ivchenko, Nickolay

2018-04-01

Digital fluxgate magnetometers employ processing of the measured pickup signal to produce the value of the compensation current. Using pulse-width modulation with filtering for digital to analog conversion is a convenient approach, but it can introduce an intrinsic source of nonlinearity, which we discuss in this design note. A code shift of one least significant bit changes the second harmonic content of the pulse train, which feeds into the pick-up signal chain despite the heavy filtering. This effect produces a code-dependent nonlinearity. This nonlinearity can be overcome by the specific design of the timing of the pulse train signal. The second harmonic is suppressed if the first and third quarters of the excitation period pulse train are repeated in the second and fourth quarters. We demonstrate this principle on a digital magnetometer, achieving a magnetometer noise level corresponding to that of the sensor itself.

Passively mode-locked soliton femtosecond pulses employing graphene saturable absorber

NASA Astrophysics Data System (ADS)

Lau, K. Y.; Muhammad, F. D.; Latif, A. A.; Abu Bakar, M. H.; Yusoff, Z.; Mahdi, M. A.

2017-09-01

We demonstrate a passively mode-locked fiber laser incorporating graphene thin film (GTF) as saturable absorber (SA). The SA is fabricated by sandwiching the GTF between two single mode fiber ferrules through a fiber adaptor. The transmission loss at 1560 nm and non-linear saturation absorption modulation depth for GTF-SA are 0.8 dB and 2.90%, respectively. An erbium-doped fiber laser cavity is constructed to verify the functionality of GTF-SA and is designed to have net anomalous dispersion. It generates large spectral width of 4.99 nm with pulse repetition rate of 9.655 MHz and pulse width of 670 fs. Net anomalous dispersion and time bandwidth product higher than the sech2 transform-limited pulse validate the experimental result. In short, we demonstrate high performance GTF-SA that is able to generate ultrafast pulse duration in femtosecond range effortlessly with simple and green SA fabrication procedures.

Clinical efficacy and cognitive side effects of bifrontal versus right unilateral electroconvulsive therapy (ECT): a short-term randomised controlled trial in pharmaco-resistant major depression.

PubMed

Eschweiler, Gerhard W; Vonthein, Reinhard; Bode, Ruediger; Huell, Michael; Conca, Andreas; Peters, Oliver; Mende-Lechler, Stefan; Peters, Julia; Klecha, Dorothee; Prapotnik, Michael; DiPauli, Jan; Wild, Barbara; Plewnia, Christian; Bartels, Mathias; Schlotter, Wilfried

2007-08-01

In most studies right unilateral electroconvulsive therapy (ECT) has been shown to cause fewer cognitive side effects but less antidepressant efficacy compared with bi(fronto)temporal ECT at certain intensities. To compare the short-term efficacy and side effects of right unilateral ECT and bifrontal ECT. In a double-blind randomised controlled clinical trial, 92 patients diagnosed with pharmaco-resistant major depression received either six right unilateral ECT treatments (250% stimulus intensity of titrated threshold) or six bifrontal ECT (150% of threshold) treatments over a 3-week period. Concomitant psychotropic medications were continued during ECT treatments. The severity of depression and cognitive status was assessed prior to the first ECT and one day after the sixth ECT using the 21-item Hamilton Depression Rating Scale and the modified Mini Mental State Examination. Eight patients did not complete the course of the study due to minor side effects or withdrawal of consent. The mean Hamilton Depression score decreased from 27 to 17 points in both groups of 46 patients, resulting in 12 responders (primary endpoint defined as a decrease >50%) in each patient group (95% confidence interval for the odds ratio from 0.35 to 2.8). There was no reduction in the modified Mini Mental State score (mean score 86 of 100 points). Both bifrontal and right unilateral electrode placements in ECT were reasonably safe and moderately efficacious in reducing symptoms of pharmaco-resistant major depression.

Generation of programmable temporal pulse shape and applications in micromachining

NASA Astrophysics Data System (ADS)

Peng, X.; Jordens, B.; Hooper, A.; Baird, B. W.; Ren, W.; Xu, L.; Sun, L.

2009-02-01

In this paper we presented a pulse shaping technique on regular solid-state lasers and the application in semiconductor micromachining. With a conventional Q-switched laser, all of the parameters can be adjusted over only limited ranges, especially the pulse width and pulse shape. However, some laser link processes using traditional laser pulses with pulse widths of a few nanoseconds to a few tens of nanoseconds tend to over-crater in thicker overlying passivation layers and thereby cause IC reliability problems. Use of a laser pulse with a special shape and a fast leading edge, such as tailored pulse, is one technique for controlling link processing. The pulse shaping technique is based on light-loop controlled optical modulation to shape conventional Q-switched solid-state lasers. One advantage of the pulse shaping technique is to provide a tailored pulse shape that can be programmed to have more than one amplitude value. Moreover, it has the capability of providing programmable tailored pulse shapes with discrete amplitude and time duration components. In addition, it provides fast rising and fall time of each pulse at fairly high repetition rate at 355nm with good beam quality. The regular-to-shaped efficiency is up to 50%. We conclude with a discussion of current results for laser processing of semiconductor memory link structures using programmable temporal pulse shapes. The processing experiments showed promising results with shaped pulse.

Maintenance ECT in schizophrenia: A systematic review.

PubMed

Ward, Heather Burrell; Szabo, Steven T; Rakesh, Gopalkumar

2018-03-20

Relapse after discontinuation of ECT is significant in patients with schizophrenia. The purpose of this systematic review was to examine use of M-ECT in schizophrenia to guide clinical decision making for relapse prevention in schizophrenia. We reviewed studies examining the role of continuation (C-ECT) and maintenance electroconvulsive therapy (M-ECT) in schizophrenia. Following PRISMA guidelines, we included randomized controlled trials, open label trials, retrospective chart reviews, case reports, and case series in this review. We evaluated adjunctive pharmacological regimens; ECT treatment parameters, including frequency, duration of continued treatment, electrode placement; clinical outcomes including cognitive side effects and relapse rates from included studies. Our findings suggest M-ECT could provide an effective form of relapse prevention in these patients and persistent cognitive side effects are minimal. Copyright © 2018 Elsevier B.V. All rights reserved.

How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms

PubMed Central

Singh, Amit; Kar, Sujita Kumar

2017-01-01

Electroconvulsive therapy (ECT) is a time tested treatment modality for the management of various psychiatric disorders. There have been a lot of modifications in the techniques of delivering ECT over decades. Despite lots of criticisms encountered, ECT has still been used commonly in clinical practice due to its safety and efficacy. Research evidences found multiple neuro-biological mechanisms for the therapeutic effect of ECT. ECT brings about various neuro-physiological as well as neuro-chemical changes in the macro- and micro-environment of the brain. Diverse changes involving expression of genes, functional connectivity, neurochemicals, permeability of blood-brain-barrier, alteration in immune system has been suggested to be responsible for the therapeutic effects of ECT. This article reviews different neurobiological mechanisms responsible for the therapeutic efficacy of ECT. PMID:28783929

Electroconvulsive Therapy Part II: A Biopsychosocial Perspective

PubMed Central

Payne, Nancy A.; Prudic, Joan

2011-01-01

The myths surrounding electroconvulsive therapy (ECT) and the misconceptions held by the general public, clinicians, and patients have interfered with acceptance of this treatment throughout its history. Misunderstandings surrounding ECT, and its consequent stigmatization, are reviewed, including negative depictions of ECT in film, print media, and on the Internet. Clinicians involved in the delivery of ECT benefit from gaining an understanding of how ECT may be perceived by patients and other mental health professionals; they can play a vital role in educating patients and helping ensure the delivery of a successful course of ECT. Guidance is provided for clinicians on how to support patients and families through the ECT process using a model team approach. Anxiety reduction, meeting individual needs, patient and family psychoeducation, assessment of psychosocial supports, and discharge planning are discussed. PMID:19820554

Generation of 70 fs broadband pulses in a hybrid nonlinear amplification system with mode-locked Yb:YAG ceramic oscillator

NASA Astrophysics Data System (ADS)

Liu, Yang; Wang, Chao; Luo, Daping; Yang, Chao; Li, Jiang; Ge, Lin; Pan, Yubai; Li, Wenxue

2017-12-01

We demonstrate the passively mode-locked laser performances of bulk Yb:YAG ceramic prepared by non-aqueous tape casting, which generates initial pulses in temporal width of 3 ps and spectrum width of 3 nm without intra-cavity dispersion management. The ceramic laser is further used as seeding oscillator in a fiber nonlinear amplification system, where ultrashort pulses in maximum output power of ˜100 W and pulse duration of 70 fs are achieved. Moreover, the laser spectrum is broadened to be ˜41 nm due to self-phase modulation effects in the gain fiber, overcoming the narrow spectrum limitations of ceramic materials. Our approach opens a new avenue for power-scaling and spectrum-expanding of femtosecond ceramic lasers.

A Systematic Review of the Combined Use of Electroconvulsive Therapy and Psychotherapy for Depression

PubMed Central

McClintock, Shawn M.; Brandon, Anna R.; Husain, Mustafa M.; Jarrett, Robin B.

2011-01-01

Objective Electroconvulsive therapy (ECT) is one of the most effective treatments for severe Major Depressive Disorder (MDD). However, after acute phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations. This systematic review synthesizes extant data regarding the combined use of psychotherapy with ECT for the treatment of patients with severe MDD and offers the hypothesis that augmenting ECT with depression-specific psychotherapy represents a promising strategy for future investigation. Methods The authors performed two independent searches in PsychInfo (1806 – 2009) and MEDLINE (1948 – 2009) using combinations of the following search terms: Electroconvulsive Therapy (including ECT, ECT therapy, electroshock therapy, EST, shock therapy) and Psychotherapy (including cognitive behavioral, interpersonal, group, psychodynamic, psychoanalytic, individual, eclectic, and supportive). We included in this review a total of six articles (English language) that mentioned ECT and psychotherapy in the abstract, and provided a case report, series, or clinical trial. We examined the articles for data related to ECT and psychotherapy treatment characteristics, cohort characteristics, and therapeutic outcome. Results Although research over the past seven decades documenting the combined use of ECT and psychotherapy is limited, the available evidence suggests that testing this combination has promise and may confer additional, positive functional outcomes. Conclusions Significant methodological variability in ECT and psychotherapy procedures, heterogeneous patient cohorts, and inconsistent outcome measures prevent strong conclusions; however, existing research supports the need for future investigations of combined ECT and psychotherapy in well-designed, controlled clinical studies. Depression-specific psychotherapy approaches may need special adaptations in view of the cognitive effects following ECT. PMID:21206376

Concurrent Electroconvulsive Therapy and Bupropion Treatment.

PubMed

Takala, Christopher R; Leung, Jonathan G; Murphy, Lauren L; Geske, Jennifer R; Palmer, Brian A

2017-09-01

Bupropion is associated with a dose-dependent increased risk of seizures. Use of concomitant bupropion and electroconvulsive therapy (ECT) remains controversial because of an increased risk of prolonged seizures. This is the first systematic evaluation of the effect of bupropion on ECT. A case group (n = 119), patients treated with concomitant ECT and bupropion, was compared with an age and gender frequency-matched control group (n = 261), treated with only ECT. Electroconvulsive therapy treatment data including seizure length, number of treatments, and concurrent medications were extracted. Longitudinal mixed models examined ECT versus ECT + bupropion group differences over the course of treatments measured by seizure duration (electroencephalogram [EEG] and motor). Multivariable models examined the total number of treatments and first and last seizure duration. All models considered group differences with ECT treatment measures adjusted for age, gender, benzodiazepine treatment, lead placement, and setting. Electroconvulsive therapy treatment with bupropion led to shorter motor seizure duration (0.047) and EEG seizure duration (P = 0.001). The number of ECT treatments (7.3 vs 7.0 treatments; P = 0.23), respectively, or the probability of a prolonged seizure (P = 0.15) was not significantly different. Benzodiazepine use was significantly more common in control subjects (P = 0.01). This is a retrospective analysis limited in part by unavailable variables (seizure threshold, nature of EEG and motor seizure monitoring, type of ECT device, dosing and formulation of bupropion, and duration of the current depressive illness). This study revealed a significantly shorter duration in seizure length with ECT + concomitant bupropion, but not in the number of required treatments in those treated compared with ECT without bupropion. There remains a critical need to reevaluate the efficacy of concomitant use of psychotropic medications + ECT.

EFFICACY AND LONG-TERM CLINICAL OUTCOME OF COMORBID POSTTRAUMATIC STRESS DISORDER AND MAJOR DEPRESSIVE DISORDER AFTER ELECTROCONVULSIVE THERAPY.

PubMed

Ahmadi, Naser; Moss, Lori; Simon, Edwin; Nemeroff, Charles B; Atre-Vaidya, Nutan

2016-07-01

Many patients fulfill criteria for both posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Electroconvulsive therapy (ECT) is generally acknowledged to be the most-effective treatment for refractory MDD. This study investigated the efficacy of ECT on long-term clinical outcome of comorbid PTSD and MDD. This retrospective nested matched case-control study is inclusive of 22,164 subjects [3,485 with comorbid MDD and PTSD (92 with ECT and 3,393 without ECT) and 18,679 without MDD and PTSD]. Using the clinical global impression scale (CGI) to assess efficacy, more-robust improvement of PTSD and MDD symptoms was observed with ECT (90%), compared to antidepressant-treatment alone(50%) (P = 0.001). During the median of 8 years of follow-up, the death-rate was 8% in subjects without PTSD and MDD, 9.7% in PTSD and MDD treated with ECT and 18% in PTSD and MDD without ECT (P < 0.05). The suicide-rate was 2.2 and 5.9% in PTSD and MDD with and without ECT-treatment, respectively (P < 0.05). Survival-analyses revealed that the relative-risk of cardiovascular and all-cause mortality is not significantly different in patients with comorbid MDD and PTSD treated with ECT, compared to a matched-cohort without PTSD and MDD (P > 0.05). The relative risk of suicidality, all-cause, and cardiovascular mortality was reduced 64, 65, and 46% in MDD and PTSD patients treated with ECT, compared to those without ECT (P < 0.05). ECT is associated with a significant reduction of symptoms of PTSD and MDD, as well as reduction in risk of suicidality, cardiovascular, and all-cause mortality in MDD and PTSD, an effect more robust than antidepressant-therapy alone. © 2015 Wiley Periodicals, Inc.

Effects of combined elcatonin and alendronate treatment on the architecture and strength of bone in ovariectomized rats.

PubMed

Ogawa, Koko; Hori, Masayuki; Takao, Ryoko; Sakurada, Toyozo

2005-01-01

We examined the combined effects of elcatonin (ECT) and alendronate (ALN) on bone mass, architecture, and strength in ovariectomized (OVX) rats. Fifty female Sprague Dawley rats, aged 13 weeks, were divided into Sham, OVX, OVX+ECT, OVX+ALN, and OVX+ECT+ALN groups (n = 10). Immediately after ovariectomy, ECT was administered at a dose of 15 units (U)/kg three times a week, and ALN was administered daily at a dose of 2.0 microg/kg, subcutaneously for 12 weeks. The three-dimensional architecture of the bone in the distal femoral metaphysis was analyzed using a microfocus X-ray computed tomography system (microCT), and bone strength was measured using a material-testing machine. Trabecular bone volume (BV/TV) and number (Tb.N) were significantly greater in the OVX+ECT and OVX+ALN groups than in the OVX group. In the OVX+ECT+ALN group, BV/TV and Tb.N were significantly greater when compared with those in the OVX+ECT and OVX+ALN groups. Trabecular thickness (Tb.Th) was significantly greater in the OVX+ECT+ALN group than in the OVX+ALN group. With regard to bone strength, the compression strength in the femoral metaphysis was significantly lower in the OVX group than in the Sham group. The reduction of compression strength was slightly lower in the OVX+ECT and OVX+ALN groups. In the OVX+ECT+ALN group, the compression strength in the femoral metaphysis significantly increased when compared with the OVX and OVX+ECT groups. These results suggest that the combined treatment of ECT and ALN does not alter the individual effects of each drug and that it exerts an additive effect on trabecular architecture and bone strength in OVX rats.

Type-I frequency-doubling characteristics of high-power, ultrafast fiber laser in thick BIBO crystal.

PubMed

Chaitanya N, Apurv; Aadhi, A; Singh, R P; Samanta, G K

2014-09-15

We report on experimental realization of optimum focusing condition for type-I second-harmonic generation (SHG) of high-power, ultrafast laser in "thick" nonlinear crystal. Using single-pass, frequency doubling of a 5 W Yb-fiber laser of pulse width ~260 fs at repetition rate of 78 MHz in a 5-mm-long bismuth triborate (BIBO) crystal we observed that the optimum focusing condition is more dependent on the birefringence of the crystal than its group-velocity mismatch (GVM). A theoretical fit to our experimental results reveals that even in the presence of GVM, the optimum focusing condition matches the theoretical model of Boyd and Kleinman, predicted for continuous-wave and long-pulse SHG. Using a focusing factor of ξ=1.16 close to the estimated optimum value of ξ=1.72 for our experimental conditions, we generated 2.25 W of green radiation of pulse width 176 fs with single-pass conversion efficiency as high as 46.5%. Our study also verifies the effect of pulse narrowing and broadening of angular phase-matching bandwidth of SHG at tighter focusing. This study signifies the advantage of SHG in "thick" crystal in controlling SH-pulse width by changing the focusing lens while accessing high conversion efficiency and broad angular phase-matching bandwidth.

Energy-conserving programming of VVI pacemakers: a telemetry-supported, long-term, follow-up study.

PubMed

Klein, H H; Knake, W

1990-06-01

Thirty patients with VVI pacemakers (Quantum 253-09, 253-19, Intermedics Inc., Freeport, TX) were observed for a mean of 65 months. Within 12 months after implantation, optimized output programming was performed in 29 patients. This included a decrease in pulse amplitude (22 patients), pulse width (4 patients), and/or pacing rate (11 patients). After 65 months postimplantation, telemetered battery voltage and battery impedance were compared with the predicted values expected when the pulse generator constantly stimulates at nominal program conditions (heart rate 72.3 beats/min, pulse amplitude 5.4 V, pulse width 0.61 ms). Instead of an expected cell voltage of 2.6 V and a cell impedance of 10 k omega mean telemetered values amounted to 2.78 V and 1.4 k omega, respectively. These data correspond to a battery age of 12-15 months at nominal program conditions. This long-term follow-up study suggests that adequate programming will extend battery longevity and thus pulse generator survival in many patients.

Selective two-photon excitation of a vibronic state by correlated photons.

PubMed

Oka, Hisaki

2011-03-28

We theoretically investigate the two-photon excitation of a molecular vibronic state by correlated photons with energy anticorrelation. A Morse oscillator having three sets of vibronic states is used, as an example, to evaluate the selectivity and efficiency of two-photon excitation. We show that a vibrational mode can be selectively excited with high efficiency by the correlated photons, without phase manipulation or pulse-shaping techniques. This can be achieved by controlling the quantum correlation so that the photon pair concurrently has two pulse widths, namely, a temporally narrow width and a spectrally narrow width. Though this concurrence is seemingly contradictory, we can create such a photon pair by tailoring the quantum correlation between two photons.

A Numerical Investigation of the Electric and Thermal Cell Kill Distributions in Electroporation-Based Therapies in Tissue

PubMed Central

Garcia, Paulo A.; Davalos, Rafael V.; Miklavcic, Damijan

2014-01-01

Electroporation-based therapies are powerful biotechnological tools for enhancing the delivery of exogeneous agents or killing tissue with pulsed electric fields (PEFs). Electrochemotherapy (ECT) and gene therapy based on gene electrotransfer (EGT) both use reversible electroporation to deliver chemotherapeutics or plasmid DNA into cells, respectively. In both ECT and EGT, the goal is to permeabilize the cell membrane while maintaining high cell viability in order to facilitate drug or gene transport into the cell cytoplasm and induce a therapeutic response. Irreversible electroporation (IRE) results in cell kill due to exposure to PEFs without drugs and is under clinical evaluation for treating otherwise unresectable tumors. These PEF therapies rely mainly on the electric field distributions and do not require changes in tissue temperature for their effectiveness. However, in immediate vicinity of the electrodes the treatment may results in cell kill due to thermal damage because of the inhomogeneous electric field distribution and high current density during the electroporation-based therapies. Therefore, the main objective of this numerical study is to evaluate the influence of pulse number and electrical conductivity in the predicted cell kill zone due to irreversible electroporation and thermal damage. Specifically, we simulated a typical IRE protocol that employs ninety 100-µs PEFs. Our results confirm that it is possible to achieve predominant cell kill due to electroporation if the PEF parameters are chosen carefully. However, if either the pulse number and/or the tissue conductivity are too high, there is also potential to achieve cell kill due to thermal damage in the immediate vicinity of the electrodes. Therefore, it is critical for physicians to be mindful of placement of electrodes with respect to critical tissue structures and treatment parameters in order to maintain the non-thermal benefits of electroporation and prevent unnecessary damage to surrounding healthy tissue, critical vascular structures, and/or adjacent organs. PMID:25115970

Electroconvulsive treatment--more than electricity?: An Odyssey of facilities.

PubMed

Berg, John E

2009-12-01

To investigate whether the practice of electroconvulsive treatment (ECT) today is done in a comparable way in different hospitals on several continents. During visits to the ECT facilities of 14 hospitals on 3 continents, comparisons were made, and responsible health professionals were interviewed using a semistructured guide. It is emphasized that the present article is not the result of a well-structured research, but of reflections after observing a lack of homogeneity among facilities. A total of more than 18,000 modified ECT sessions were given per year in the 14 hospitals. The opinion of the public and regulatory bodies on ECT strongly influences the possibility of giving ECT to patients. Indications for ECT are wider than the cases of depression in most facilities visited. A psychiatrist gives ECT in all but 1 facility. Anesthesia is given by an anesthesiologist in all but 1 facility. A mouthpiece was not used in 2 (or 3) facilities, although the rationale was the same as in facilities using mouthpieces. No facility gave unmodified ECT. Holding on to the patient during seizures was judged unnecessary in 12 of 14 facilities. In severe mental illness, the practice of using ECT seems to have its merit also in cases with debilitating illnesses other than unipolar and bipolar depression. Giving ECT may be done by qualified or specially certified nurses, but the giving of anesthesia should be the realm of the anesthesiologist. Mouthpieces are judged by some facilities to be a superfluous device. The holding of patients during seizure can be omitted. Some of the facilities visited give ECT to a huge number of patients each year. They differ in the practice of ECT and could be the focus of comparative research. Despite the differences observed, and procedures that could be altered, giving ECT in a modified way effectively relieves suffering in the patients.

Evaluative studies in nuclear medicine research. Progress report, October 1, 1979-June 30, 1980

DOE Office of Scientific and Technical Information (OSTI.GOV)

Potchen, E.J.

Effort since the last progress report (September 1979) has been directed toward assessing the potential short and long term benefits of continued development and application and medical research of emission computed tomograhy (ECT). This report contains a review of existing ECT technology, including functional descriptions of current and proposed image systems, for both sngle-photon ECT (SPECT) and positron ECT (PECT) approaches. Medical research and clinical topics to which ECT has been, or may be, applied are presented. One such area of investigation involves the effects of stroke. The application of ECT to laboratory research, and to clinical diagnosis and prognosis,more » of stroke may result in improved management of the disease. An illustration of the potential savings in the cost of management of stroke due to the effects of applied ECT research is included. The results represent a compilation of data collected from conversations with, and conference presentations by, ECT users, researchers and image system designers, and from a review of the literature.« less

I was told it restarts your brain: knowledge, power, and women's experiences of ECT.

PubMed

Ejaredar, Maede; Hagen, Brad

2014-02-01

A discrepancy exists between clinician-led studies of people's experience of electroconvulsive therapy (ECT) and consumer-led studies, with the former typically being much more positive about the efficacy and side effects of ECT compared with the latter. Qualitative in-depth explorations of people's experiences of ECT are relatively rare, particularly those looking specifically at women's experience of ECT. The aim of this qualitative study was to explore women's experiences of ECT, particularly their experience of knowledge and power related to ECT. Qualitative analysis of the interviews with nine women resulted in four main themes emerging from the interviews with the women: (i) "he really didn't say much," (ii) "I'm going to be very upset with you," (iii) "I was just desperate," and (iv) "it was like we were cattle." Overall, participants found their experiences with ECT to be quite negative, and characterized by a lack of knowledge during the procedure, and a lack of power throughout the entire process.

Medical student knowledge and attitudes regarding ECT prior to and after viewing ECT scenes from movies.

PubMed

Walter, Garry; McDonald, Andrew; Rey, Joseph M; Rosen, Alan

2002-03-01

We surveyed samples of medical students in the United Kingdom (U.K.) and Australia, prior to their psychiatry placement, to ascertain views about electroconvulsive therapy (ECT) and the effect on those views of watching ECT scenes in movies. A 26-item questionnaire was constructed by the authors and administered to the students. At set times during the questionnaire, students were asked to view five movie clips showing, or making reference to, ECT. The clips were from Return to Oz, The Hudsucker Proxy, Ordinary People, One Flew Over the Cuckoo's Nest, and Beverly Hillbillies. Ninety-four students participated in the study. Levels of knowledge about the indications, side effects, and mode of administration were poor, and attitudes were generally negative. Viewing the ECT scenes influenced attitudes toward the treatment; after viewing, one-third of the students decreased their support for ECT, and the proportion of students who would dissuade a family member or friend from having ECT rose from less than 10% to almost 25%.

Electroconvulsive therapy and nursing care.

PubMed

Kavanagh, Adam; McLoughlin, Declan M

Modified electroconvulsive therapy (ECT) is a controlled medical procedure in which a seizure is induced in an anaesthetized patient to produce a therapeutic effect. ECT is the most acutely effective treatment available for affective disorders and is more effective than antidepressant drugs. Although in use for 70 years, ECT continues to attract controversy and there is considerable stigma associated with its use that often overshadows the empirical evidence for its effectiveness. One way to overcome this is for health professionals to be educated about contemporary ECT practice. Patients need to make informed decisions when consenting to ECT and this process can be influenced by preconceived ideas and scientific fact. It is, therefore, essential that nurses possess sufficient information to help patients make rational and informed treatment decisions and be able to care for both the clinical and psychological needs of patients treated with ECT. This review outlines the nursing role in ECT and summarizes the main aspects of contemporary ECT practice relevant to general and psychiatric nursing practice.

Clinical and biological predictors of response to electroconvulsive therapy (ECT): a review.

PubMed

Pinna, Martina; Manchia, Mirko; Oppo, Rossana; Scano, Filomena; Pillai, Gianluca; Loche, Anna Paola; Salis, Piergiorgio; Minnai, Gian Paolo

2018-03-16

Electroconvulsive therapy (ECT), developed in the 30's by Bini and Cerletti, remains a key element of the therapeutic armamentarium in psychiatry, particularly for severe and life-threatening psychiatric symptoms. However, despite its well-established clinical efficacy, the prescription of ECT has declined constantly over the years due to concerns over its safety (cognitive side effects) and an increasingly negative public perception. As for other treatments in the field of psychiatry, ECT is well suited to a personalized approach that would increment its efficacy, as well as reducing the impact of side effects. This should be based on the priori identification of sub-populations of patients sharing common clinical and biological features that predict a good response to ECT. In this review we have selectively reviewed the evidence on clinical and biological predictors of ECT response. Clinical features such as an older age, presence of psychotic and melancholic depression, a high severity of suicide behavior, and speed of response, appear to be shared by ECT good responders with depressive symptoms. In mania, a greater severity of the index episode, and a reduction of whole brain cortical blood flow are associated with ECT good response. Biological determinants of ECT response in depressive patients are the presence of pre-treatment hyperconnectivity between key areas of brain circuitry of depression, as well as of reduced glutamine/glutamate levels, particularly in the anterior cingulated cortex (ACC). Furthermore, pre ECT high plasma homovanillic acid (HVA) levels, as well as of tumor necrosis factor (TNF)-α, and low pre-ECT levels of S-100B protein, appear to predict ECT response. Finally, polymorphisms within the genes encoding for the brain-derived neurotrophic factor (BDNF), the dopamine 2 receptor gene (DRD2), the dopamine receptor 3 gene (DRD3), the cathechol-o-methyltransferase (COMT), the serotonin-transporter (5-HTT), the 5-hydroxytryptamine 2A receptor (5-HT 2A ), and the norepinephrine transporter (NET), appear to predict a good response to ECT. The integration of these data in specific treatment algorithm might facilitate a personalized approach in ECT. Copyright © 2016. Published by Elsevier B.V.

Ictal EEG fractal dimension in ECT predicts outcome at 2 weeks in schizophrenia.

PubMed

Abhishekh, Hulegar A; Thirthalli, Jagadisha; Manjegowda, Anusha; Phutane, Vivek H; Muralidharan, Kesavan; Gangadhar, Bangalore N

2013-09-30

Studies of electroconvulsive therapy (ECT) have found an association between ictal electroencephalographic (EEG) measures and clinical outcome in depression. Such studies are lacking in schizophrenia. Consenting schizophrenia patients receiving ECT were assessed using the Brief Psychiatric Rating Scale (BPRS) before and 2 weeks after the start of ECT. The patients' seizure was monitored using EEG. In 26 patients, completely artifact-free EEG derived from the left frontal-pole (FP1) channel and electrocardiography (ECG) were available. The fractal dimension (FD) was computed to assess 4-s EEG epochs, and the maximal value from the earliest ECT session (2nd, 3rd or 4th) was used for analysis. There was a significant inverse correlation between the maximum FD and the total score following 6th ECT. An inverse Inverse correlation was also observed between the maximum FD and the total number of ECTs administered as well as the maximum heart rate (HR) and BPRS scores following 6th ECT. In patients with schizophrenia greater intensity of seizures (higher FD) during initial sessions of ECT is associated with better response at the end of 2 weeks. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Short-term effect of ECT in middle-aged and elderly patients with intractable catatonic schizophrenia.

PubMed

Suzuki, Kazumasa; Awata, Shuichi; Matsuoka, Hiroo

2003-06-01

The management of middle-aged and elderly patients with catatonic schizophrenia has long been a major problem in clinical geriatric psychiatry. Most cases are intractable because of medication resistance, medication intolerance, or severe medical conditions. Electroconvulsive therapy (ECT) is recognized as one of the most efficacious therapies for catatonic schizophrenia. Thus, we conducted a prospective study of the short-term effect of acute ECT on middle-aged and elderly patients with intractable catatonic schizophrenia. Subjects were nine consecutive patients older than 45 years who had fulfilled the DSM-IV criteria for catatonic-type schizophrenia and had been referred for first-time acute ECT after other treatments had failed. The patients were treated at Tohoku University Hospital between January 1998 and March 2002. We evaluated the clinical response of these patients to acute ECT by means of the brief psychiatric rating scale (BPRS). We also evaluated adverse effects of acute ECT. The response rate was 100%. The total BPRS score was improved in all nine subjects at the end of the ECT course and 1 week after the final session in comparison with the total pre-ECT BPRS score (11.9 +/- 7.5 and 9.3 +/- 9.2 versus 57.1 +/- 13.1, respectively, p = 0.008, p = 0.008). The total Global Assessment of Functioning score was also improved significantly (from 10.8 +/- 9.4 just before ECT to 61.6 +/- 18.9 1 week after ECT, p = 0.008). Guy's five factors (thought disturbance, activation, anxiety-depression, hostility-suspiciousness, and anergia) improved significantly (p = 0.008, p = 0.008, p = 0.018, p = 0.012, p = 0.008, respectively). One patient showed supraventricular premature contractions (SVPCs) during an ECT seizure. After some ECT sessions, three patients exhibited mild to moderate delirium that disappeared within 3 days. However, no patient experienced a severe cognitive or physical adverse effect during the course of ECT. Acute ECT has a good short-term effect on middle-aged and elderly patients with intractable catatonic schizophrenia and appears to be safe. Our results indicate that systematic studies on a large scale are warranted for further investigation of the efficacy and safety of acute ECT for treating middle-aged and elderly patients with catatonic schizophrenia.

A hybrid pulse combining topology utilizing the combination of modularized avalanche transistor Marx circuits, direct pulse adding, and transmission line transformer.

PubMed

Li, Jiangtao; Zhao, Zheng; Sun, Yi; Liu, Yuhao; Ren, Ziyuan; He, Jiaxin; Cao, Hui; Zheng, Minjun

2017-03-01

Numerous applications driven by pulsed voltage require pulses to be with high amplitude, high repetitive frequency, and narrow width, which could be satisfied by utilizing avalanche transistors. The output improvement is severely limited by power capacities of transistors. Pulse combining is an effective approach to increase the output amplitude while still adopting conventional pulse generating modules. However, there are drawbacks in traditional topologies including the saturation tendency of combining efficiency and waveform oscillation. In this paper, a hybrid pulse combining topology was adopted utilizing the combination of modularized avalanche transistor Marx circuits, direct pulse adding, and transmission line transformer. The factors affecting the combining efficiency were determined including the output time synchronization of Marx circuits, and the quantity and position of magnetic cores. The numbers of the parallel modules and the stages were determined by the output characteristics of each combining method. Experimental results illustrated the ability of generating pulses with 2-14 kV amplitude, 7-11 ns width, and a maximum 10 kHz repetitive rate on a matched 50-300 Ω resistive load. The hybrid topology would be a convinced pulse combining method for similar nanosecond pulse generators based on the solid-state switches.

A hybrid pulse combining topology utilizing the combination of modularized avalanche transistor Marx circuits, direct pulse adding, and transmission line transformer

NASA Astrophysics Data System (ADS)

Li, Jiangtao; Zhao, Zheng; Sun, Yi; Liu, Yuhao; Ren, Ziyuan; He, Jiaxin; Cao, Hui; Zheng, Minjun

2017-03-01

Numerous applications driven by pulsed voltage require pulses to be with high amplitude, high repetitive frequency, and narrow width, which could be satisfied by utilizing avalanche transistors. The output improvement is severely limited by power capacities of transistors. Pulse combining is an effective approach to increase the output amplitude while still adopting conventional pulse generating modules. However, there are drawbacks in traditional topologies including the saturation tendency of combining efficiency and waveform oscillation. In this paper, a hybrid pulse combining topology was adopted utilizing the combination of modularized avalanche transistor Marx circuits, direct pulse adding, and transmission line transformer. The factors affecting the combining efficiency were determined including the output time synchronization of Marx circuits, and the quantity and position of magnetic cores. The numbers of the parallel modules and the stages were determined by the output characteristics of each combining method. Experimental results illustrated the ability of generating pulses with 2-14 kV amplitude, 7-11 ns width, and a maximum 10 kHz repetitive rate on a matched 50-300 Ω resistive load. The hybrid topology would be a convinced pulse combining method for similar nanosecond pulse generators based on the solid-state switches.

Electroconvulsive Therapy Practice in Spain: A National Survey.

PubMed

Vera, Ignacio; Sanz-Fuentenebro, Javier; Urretavizcaya, Mikel; Verdura, Ernesto; Soria, Virginia; Martínez-Amorós, Erika; Bernardo, Miquel

2016-03-01

The use of electroconvulsive therapy (ECT) in Spain has not been systematically evaluated since 2000 to 2001. The aim of this study is to assess the current use of ECT in Spain. A cross-sectional survey was conducted covering every psychiatric unit in Spain as of December 31, 2012. About 93.2% of the centers answered the questionnaire. About 54.9% of the psychiatric units applied ECT at a rate of 0.66 patients per 10,000 inhabitants. Wide variations existed among the different autonomous communities and provinces. Written informed consent was obtained in all the facilities. About 38.2% of ECT-treated patients were 65 years or older. About 55.7% were women. Depressive episodes were the main indication for ECT (80.2%). All the facilities applied modified ECT. No sine wave current devices are currently used in Spain. Bifrontotemporal ECT was elective in 85% of the hospitals, bifrontal in 13.3%, and unilateral in 1.8%. Stimulus titration methods were elective in 8.6% of the centers. The decision to end ECT relied on the psychiatrist's clinical impression in 89.4% of the centers and on rating scales in 10.6%. The ECT training was mandatory in 56.5% of the centers. The ECT practice has significantly improved in Spain in recent years. Overall, Spanish facilities seem to comply with established clinical guidelines; however, specific concerns were identified, meaning there is still further scope for improvement.

Rocuronium-sugammadex use for electroconvulsive therapy in a hemodialysis patient: a case report.

PubMed

Kurita, Shigeaki; Moriwaki, Katsuyuki; Shiroyama, Kazuhisa; Sanuki, Mikako; Toyota, Yukari; Takebayashi, Minoru

2016-01-01

Recently, rocuronium with subsequent use of sugammadex was proposed for electroconvulsive therapy (ECT) as an alternative to succinylcholine. Because sugammadex is cleared via the kidney with no metabolism, it is unknown that rocuronium-sugammadex use is safe in hemodialysis patients who received ECT. In this case report, we used rocuronium with subsequent administration of sugammadex in a 69-year-old female, hemodialysis patient, scheduled for ten ECT sessions for severe major depression. In the initial eight sessions, we tested the feasibility of rocuronium-sugammadex use for ECT. During the series of four ECT sessions, we measured plasma concentrations for the sum of sugammadex and sugammadex-rocuronium complex and observed whether possible residual sugammadex affected muscle relaxation during subsequent sessions of ECT. The results showed the feasibility of rocuronium-sugammadex use as muscle relaxants for ECT in patients undergoing hemodialysis. However, an accumulation of sugammadex did occur even after two sessions of hemodialysis, and residual sugammadex decreased the effect of the rocuronium given in the subsequent ECT sessions. Rocuronium-sugammadex was successfully utilized as muscle relaxants for ECT in this patient. Our experience in this case may indicate that if succinylcholine is contraindicated, rocuronium-sugammadex can be an alternative method for muscle relaxation during ECT in patients undergoing hemodialysis. When this rocuronium-sugammadex procedure is used, the effect of residual sugammadex after hemodialysis on the subsequently administered rocuronium should be considered.

A Hybrid Fiber/Solid-State Regenerative Amplifier with Tunable Pulse Widths for Satellite Laser Ranging

NASA Technical Reports Server (NTRS)

Coyle, Barry; Poulios, Demetrios

2013-01-01

A fiber/solid-state hybrid seeded regenerative amplifier, capable of achieving high output energy with tunable pulse widths, has been developed for satellite laser ranging applications. The regenerative amplifier cavity uses a pair of Nd:YAG zigzag slabs oriented orthogonally to one another in order to make thermal lensing effects symmetrical and simplify optical correction schemes. The seed laser used is a fiber-coupled 1,064-nm narrowband (<0.02 nm) diode laser that is discretely driven in a new short-pulsed mode, enabling continuously tunable seed pulse widths in the 0.2-to-0.4-ns range. The amplifier gain unit consists of a pair of Brewster-cut 6-bounce zigzag Nd:YAG laser slabs, oriented 90deg relative to each other in the amplifier head. This arrangement creates a net-symmetrical thermal lens effect (an opposing singleaxis effect in each slab), and makes thermo-optical corrections simple by optimizing the curvature of the nearest cavity mirror. Each slab is pumped by a single 120-W, pulsed 808-nm laser diode array. In this configuration, the average pump beam distribution in the slabs had a 1-D Gaussian shape, which matches the estimated cavity mode size. A half-wave plate between the slabs reduces losses from Fresnel reflections due to the orthogonal slabs Brewster-cut end faces. Successful "temporal" seeding of the regenerative amplifier cavity results in a cavity Q-switch pulse envelope segmenting into shorter pulses, each having the width of the input seed, and having a uniform temporal separation corresponding to the cavity round-trip time of approx. =10 ns. The pulse energy is allowed to build on successive passes in the regenerative amplifier cavity until a maximum is reached, (when cavity gains and losses are equal), after which the pulse is electro- optically switched out on the next round trip The overall gain of the amplifier is approx. =82 dB (or a factor of 1.26 million). After directing the amplified output through a LBO frequency doubling crystal, approx. = 2.1 W of 532-nm output (>1 mJ) was measured. This corresponds to a nonlinear conversion efficiency of >60%. Furthermore, by pulse pumping this system, a single pulse per laser shot can be created for the SLR (satellite laser ranging) measurement, and this can be ejected into the instrument. This is operated at the precise frequency needed by the measurement, as opposed to commercial short-pulsed, mode-locked systems that need to operate in a continuous fashion, or CW (continuous wave), and create pulses at many MHz. Therefore, this design does not need to throw away or dump 99% of the laser energy to produce what is required; this system can be far smaller, more efficient, cheaper, and readily deployed in the field when packaged efficiently. Finally, by producing custom diode seed pulses electronically, two major advantages over commercial systems are realized: First, this pulse shape is customizable and not affected by the cavity length or gain of the amplifier cavity, and second, it can produce adjustable (selectable) pulse widths by simply adding multiple seed diodes and coupling each into commercial, low-cost fiber-optic combiners.

All-optical controlled switching of solitons

NASA Astrophysics Data System (ADS)

Man, Wai Sing

1999-11-01

In this dissertation, we have numerically investigated various method of switching solitons using two different nonlinear optical switching devices, namely the twin core nonlinear directional coupler (TCNLDC) and the nonlinear optical loop mirror (NOLM). In the case of TCNLDC, four different schemes were explored where the polarization of the controlling pulse is either parallel or orthogonal to that of the signal soliton, or the controlling pulse may be launched into either of the input ports or it may have a wavelength different from that of the signal. It has been shown that high switching efficiency and distortionless propagation of the signal pulse through the coupler can only be achieved for the case in which the control pulse is launched into the adjacent port of the directional coupler and that its dispersion has equal magnitude but opposite sign as that of the signal. The effect of varying pulse width, walk-off and timing jitter were also investigated for this particular scheme for signal pulse width of 1 ps wide. In the case of NOLM, a control pulse having central wavelength located at the normal dispersion region is used to switch the soliton. The control pulse width and the NOLM's loop length were varied to obtain the switched soliton with minimum distortion and high switching efficiency. In this analysis, Raman effect is included because the control pulse transfers part of its energy to the co-propagating signal pulse in the optical loop. A compact soliton laser has also been developed for this project and its performance was analyzed experimentally and numerically. In our analysis of this soliton laser, we found that the wavelength of the mode-locked pulse can be tuned by varying the polarization elements in the laser and this is entirely due to the birefringence in the laser cavity. In summary, our works have shown that optical solitons can be switched effectively by TCNLDC and NOLM in the high bit-rate and low switching energy regime. (Abstract shortened by UMI.)

Oral Health in Electroconvulsive Therapy: A Neglected Topic.

PubMed

Muzyka, Brian C; Glass, Magdalena; Glass, Oliver M

2017-03-01

Psychiatric medications may have serious and untoward adverse effects such as blurred vision, restlessness, agranulocytosis, muscle rigidity, and tremors. When compared to medications, electroconvulsive therapy (ECT) is becoming a more acceptable treatment due to its efficacy, tolerability, and minimal adverse effect profile. Oral trauma can be an ECT-related adverse effect. We reviewed the published literature on oral health and dental protection in patients undergoing ECT, and found that there are deficits in all guidelines on dental protection during ECT. Dental assessment and treatment before and after ECT is warranted. Given the increased risk of poor oral health in psychiatric patients, and the continued evolution of ECT as a mainstay treatment, it is important that studies be conducted to determine the optimal method of oral protection. If adequate care can be ensured, the risks of ECT-induced oral trauma will be minimized.

Development of non-destructive testing technology for the crack of steam generator tubes

NASA Astrophysics Data System (ADS)

Cheong, Yong Moo; Chung, Tae Eon; Yim, Chang Jae; Kang, Ki Won

1993-01-01

The artificial defects of slot type with width of 0.2 mm were manufactured by EDM to simulate the axial and the circumferential cracks located at the region of expansion transition of the steam generator tubes. The defect signals of ECT using MRPC were analyzed. It is possible to suppress satisfactorily the malign effects of the variation of the geometry of the tubes on the inspection of cracks by using the MRPC probe. The optimum exciting frequency for the detection of cracks by MRPC is greater than 200 kHz and is less than 400 kHz. The direction of crack has little effect on the detectability of the defect.

Using the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess the cognitive impact of electroconvulsive therapy on visual and visuospatial memory.

PubMed

Falconer, D W; Cleland, J; Fielding, S; Reid, I C

2010-06-01

The cognitive impact of electroconvulsive therapy (ECT) is rarely measured systematically in everyday clinical practice even though patient and clinician acceptance is limited by its adverse affect on memory. If patients are tested it is often with simple paper and pencil tests of visual or verbal memory. There are no reported studies of computerized neuropsychological testing to assess the cognitive impact of ECT on visuospatial memory. Twenty-four patients with severe depression were treated with a course of bilateral ECT and assessed with a battery of visual memory tests within the Cambridge Neuropsychological Test Automated Battery (CANTAB). These included spatial and pattern recognition memory, pattern-location associative learning and a delayed matching to sample test. Testing was carried out before ECT, during ECT, within the week after ECT and 1 month after ECT. Patients showed significant impairments in visual and visuospatial memory both during and within the week after ECT. Most impairments resolved 1 month following ECT; however, significant impairment in spatial recognition memory remained. This is one of only a few studies that have detected anterograde memory deficits more than 2 weeks after treatment. Patients receiving ECT displayed a range of visual and visuospatial deficits over the course of their treatment. These deficits were most prominent for tasks dependent on the use of the right medial temporal lobe; frontal lobe function may also be implicated. The CANTAB appears to be a useful instrument for measuring the adverse cognitive effects of ECT on aspects of visual and visuospatial memory.

Influence of depressed patients' expectations prior to electroconvulsive therapy on its effectiveness and tolerability (Exp-ECT): a prospective study.

PubMed

Krech, Lisa; Belz, Michael; Besse, Matthias; Methfessel, Isabel; Wedekind, Dirk; Zilles, David

2017-09-22

Electroconvulsive therapy (ECT) is the most effective therapy for severe depressive disorders. Though there are known clinical predictors of response (e.g., higher age, presence of psychotic symptoms), there is a lack of knowledge concerning the impact of patients' expectations on treatment outcome and tolerability in terms of possible placebo/nocebo effects. In 31 patients with unipolar or bipolar depressive disorder, we used a questionnaire to investigate the patients' expectations of ECT effectiveness and tolerability prior to and in the course of the treatment. Additionally, the questionnaire was used after the ECT course for a final assessment. Depressive symptoms and putative side-effects were measured at each time point. General linear models were used to analyze the course of depressive symptoms and patients' expectation of ECT effectiveness and tolerability. ECT significantly reduced depressive symptoms with large effect sizes. Patients' rating of ECT effectiveness decreased in parallel: While responders' rating of ECT effectiveness remained stable on a high level, non-responders' rating decreased significantly. Group difference was significant after, but not prior to and during the treatment. Regarding tolerability, there was a (temporary) significant increase in the severity of self-rated symptoms such as headache and memory impairment. In contrast, patients' expectation and assessment of ECT tolerability remained unchanged, and their expectations prior to ECT had no impact on the occurrence of side-effects. These findings contradict the presence of relevant placebo/nocebo effects in the context of ECT when investigating a population of mostly chronic or treatment resistant patients with moderate to severe depressive disorder.

Efficacy of ECT in bipolar and unipolar depression in a real life hospital setting.

PubMed

Narayanaswamy, Janardhanan C; Viswanath, Biju; Reddy, Preethi V; Kumar, K Raghavendra; Thirthalli, Jagadisha; Gangadhar, Bangalore N

2014-04-01

It has been debated as to whether the polarity of mood disorder (bipolar versus unipolar) has prognostic significance for electroconvulsive therapy (ECT) outcome. In the treatment guidelines, ECT is recommended more readily for unipolar depression and not so for bipolar depression. This study aims to examine efficacy of bipolar and unipolar depression to ECT in a real life naturalistic setting. We studied the ECT parameters of all consecutive patients with a diagnosis of unipolar depression (recurrent depressive disorder, ≥2 episodes of depression) and bipolar depression referred for ECT between the months of July 2008 and December 2010 (BP-D: n=44) and (UP-D: n=106). When bipolar depression was compared to unipolar depression, the average motor seizure duration (mean=46.9 and 46.7, t=-0.06, p=0.94), number of ECTs required for improvement (mean=6.4 and 6.5, t=0.17, p=0.86), duration of inpatient stay after ECT initiation in days (mean=16.2 and 16.6, t=0.23, p=0.81) and improvement as assessed using a Likert scale (Mann-Whitney U, Z=-0.09, p=0.92) were not statistically different between the groups. We did not find any difference in efficacy of ECT between the two forms of depression in real life setting. This calls for justification of use of ECT in all patients with depression irrespective of the type of illness polarity and inclusion of ECT as a routine treatment option in bipolar depression guidelines. Copyright © 2013 Elsevier B.V. All rights reserved.

MADRS symptom subtypes in ECT-treated depressed patients: relationship to response and subsequent ECT.

PubMed

Spashett, Renee; Fernie, Gordon; Reid, Ian C; Cameron, Isobel M

2014-09-01

This study aimed to explore the relationship of Montgomery-Åsberg Depression Rating Scale (MADRS) symptom subtypes with response to electroconvulsive therapy (ECT) and subsequent ECT treatment within 12 months. A consecutive sample of 414 patients with depression receiving ECT in the North East of Scotland was assessed by retrospective chart review. Response rate was defined as greater than or equal to 50% decrease in pretreatment total MADRS score or a posttreatment total MADRS less than or equal to 10. Principal component analyses were conducted on a sample with psychotic features (n = 124) and a sample without psychotic features (n = 290). Scores on extracted factor subscales, clinical and demographic characteristics were assessed for association with response and subsequent ECT treatment within 12 months. Where more than 1 variable was associated with response or subsequent ECT, logistic regression analysis was applied. MADRS symptom subtypes formed 3 separate factors in both samples. Logistic regression revealed older age and high "Despondency" subscale score predicted response in the nonpsychotic group. Older age alone predicted response in the group with psychotic features. Nonpsychotic patients subsequently re-treated with ECT were older than those not prescribed subsequent ECT. No association of variables emerged with subsequent ECT treatment in the group with psychotic features. Being of older age and the presence of psychotic features predicted response. Presence of psychotic features alone predicted subsequent retreatment. Subscale scores of the MADRS are of limited use in predicting which patients with depression will respond to ECT, with the exception of "Despondency" subscale scores in patients without psychotic features.

High peak power actively Q-switched mid-infrared fiber lasers at 3 μm

NASA Astrophysics Data System (ADS)

Shen, Yanlong; Wang, Yishan; Luan, Kunpeng; Chen, Hongwei; Tao, Mengmeng; Si, Jinhai

2017-04-01

Diode-pumped pulsed Er3+-doped ZBLAN fiber lasers at 2.8 μm actively Q-switched by using an mechanical Q-switch with feedbacks of a protected gold mirror and a blazing grating were investigated, respectively. A pulse energy of 0.13 mJ and repetition rate of 10 kHz with a pulse width of 127.3 ns at 2.78 μm was obtained when using a protected gold mirror as the feedback. By replacing the mirror with a blazing grating in Littrow configuration, the wavelength of the Q-switched pulse train was tunable with over 100 nm tuning range from 2.71 to 2.82 μm and a linewidth of 1.5 nm. A maxinmum pulse energy of up to 0.15 mJ and repetition rate of 10 kHz with a pulse width of 92.6 ns was achieved, yielding the maximum peak power of exceeding 1.6 kW. The pulse energy and peak power, to our knowledge, are the highest ever reported in the mid-infrared Q-switched fiber lasers.

Reinjection laser oscillator and method

DOEpatents

McLellan, Edward J.

1984-01-01

A uv preionized CO.sub.2 oscillator with integral four-pass amplifier capable of providing 1 to 5 GW laser pulses with pulse widths from 0.1 to 0.5 ns full width at half-maximum (FWHM) is described. The apparatus is operated at any pressure from 1 atm to 10 atm without the necessity of complex high voltage electronics. The reinjection technique employed gives rise to a compact, efficient system that is particularly immune to alignment instabilities with a minimal amount of hardware and complexity.

CORE SATURATION BLOCKING OSCILLATOR

DOEpatents

Spinrad, R.J.

1961-10-17

A blocking oscillator which relies on core saturation regulation to control the output pulse width is described. In this arrangement an external magnetic loop is provided in which a saturable portion forms the core of a feedback transformer used with the thermionic or semi-conductor active element. A first stationary magnetic loop establishes a level of flux through the saturation portion of the loop. A second adjustable magnet moves the flux level to select a saturation point giving the desired output pulse width. (AEC)

Supraventricular tachycardia in a patient receiving ECT, clozapine, and caffeine.

PubMed

Beale, M D; Pritchett, J T; Kellner, C H

1994-09-01

A patient receiving electroconvulsive therapy (ECT), clozapine, and intravenous caffeine sodium benzoate developed supraventricular tachycardia. This was rapidly treated with intravenous verapamil. Subsequent maintenance ECT given without caffeine was well tolerated. We believe the combination of clozapine and caffeine at the time of ECT was responsible for the arrhythmia.

[Maintenance electroconvulsive therapy and treatment of refractory schizophrenia].

PubMed

Lévy-Rueff, M; Jurgens, A; Lôo, H; Olié, J-P; Amado, I

2008-10-01

Electroconvulsive therapy, a standard treatment in mood disorders, is sometimes also indicated in psychotic disorders, especially in the treatment of refractory schizophrenia. In this instance, maintenance electroconvulsive therapy (M-ECT) can also become a long-term treatment. This paper presents the effects of M-ECT in the treatment of refractory schizophrenia using a retrospective analysis. Previous works showed that electroconvulsive therapy is effective on catatonia, anxiety with somatisation, lack of compliance, opposition, delusions especially with hallucinations and persecution, anorexia, agitation, carelessness, aggressive behaviour and moral pain. It is ineffective on bewilderment, somatic complaints and negative symptoms. A retrospective analysis of a clinical cohort of patients treated with M-ECT was carried out to determine the specific indications of M-ECT, its effectiveness on clinical symptoms, quality of life, relapse rates and use of medication. Nineteen patients with DSM-IV diagnosis of paranoid schizophrenia (n=5), schizophrenia with neurotic symptoms (n=3), disorganized schizophrenia (n=1), hebephrenia (n=3) and schizoaffective disorder (n=8), treated in the department of the University Hospital of Sainte-Anne in Paris, received M-ECT between 1991 and 2005. Seven patients are still under this treatment. Their mean age at the beginning of treatment was 47.5 years with a mean duration of the illness of 24 years. The indication of M-ECT was the increase of acute episodes, an increase of symptoms intensity, the inefficiency or intolerance to pharmacological treatments or an early relapse after ECT discontinuation. All patients had previously been successfully treated by ECT during an acute episode. Each patient received an average of 47 bilateral M-ECT under general anaesthesia at one to five weeks' intervals for a mean period of 43 months. All of them were also treated by antipsychotics; in addition, 30% received mood stabilizers and 10% antidepressants. The dosage of antidepressants and mood stabilizers was reduced during M-ECT treatment, especially in patients with schizoaffective disorder, probably in relation with the effectiveness of ECT on mood symptoms. During M-ECT, the mean duration of yearly hospitalizations was decreased by 80% and the mean duration of each hospitalization by 40% with a better ability to take part in activities, sometimes even to return home or go back to work. There was also a positive effect on quality of life considering the severity of symptoms and the long psychiatric history of these patients. The possibility to go from a full time hospitalization to a day-care facility or to live in a halfway house can be considered as a huge progress. M-ECT was efficient on mood symptoms, delusions, anorexia, suicidal impetus, anxiety symptoms and increased cooperation and treatment compliance. Efficacy on obsessive compulsive symptoms was less obvious. There was no effect on dissociation and negative symptoms. Relapses essentially occurred after a stressful life event, a too long interval between the M-ECT sessions or, in 50% of the cases, without any obvious etiology. It required a revision of the M-ECT program and, most of the time, an hospitalization for full ECT treatment. There is no consensus on the rate and number of M-ECT as it varies from patient to patient and depends upon the extent of the clinical response and side effects. The discontinuation of M-ECT will depend on the clinical symptoms, compliance and tolerance to ECT. As it is the case with ECT treatment for an acute episode, available evidence suggests that treatment with antipsychotics should continue during the maintenance ECT course. Maintenance electroconvulsive therapy combined with medication may be an efficient alternative to pharmacological treatment alone in refractory schizophrenia. Alternative therapeutical strategies are crucial in this domain, due to the important public health problem it raises. There are few randomised prospective controlled clinical trials regarding this treatment and further clinical investigations are necessary, notably to define standardized criteria for M-ECT programs.

Measured pulse width of sonoluminescence flashes in the form of resonance radiation

NASA Astrophysics Data System (ADS)

Giri, Asis; Arakeri, Vijay H.

1998-09-01

Recent studies have shown that the measured flash widths from single and multibubble sonoluminescence are in subnanosecond or even picosecond regime. Here, we provide conclusive evidence for the existence of nanosecond multibubble sonoluminescence. This has become possible by our ability to find a medium from which exclusive sodium D line resonance radiation as a form of sonoluminescence is possible. The measured flash width of this emission is found to be in the range of tens of nanoseconds and is sensitively dependent on experimental parameters. Our finding is important since all the earlier pulse width measurements have been limited to emission with the physical source or species responsible for observed optical radiation not being clearly identified. We propose that the presently observed resonance radiation is from ``soft'' bubble collapse as analyzed by V. Kamath et al. [J. Acoust. Soc. Am. 94, 248 (1993)].

Electromagnetic Field Modeling of Transcranial Electric and Magnetic Stimulation: Targeting, Individualization, and Safety of Convulsive and Subconvulsive Applications

NASA Astrophysics Data System (ADS)

Deng, Zhi-De

The proliferation of noninvasive transcranial electric and magnetic brain stimulation techniques and applications in recent years has led to important insights into brain function and pathophysiology of brain-based disorders. Transcranial electric and magnetic stimulation encompasses a wide spectrum of methods that have developed into therapeutic interventions for a variety of neurological and psychiatric disorders. Although these methods are at different stages of development, the physical principle underlying these techniques is the similar. Namely, an electromagnetic field is induced in the brain either via current injection through scalp electrodes or via electromagnetic induction. The induced electric field modulates the neuronal transmembrane potentials and, thereby, neuronal excitability or activity. Therefore, knowledge of the induced electric field distribution is key in the design and interpretation of basic research and clinical studies. This work aims to delineate the fundamental physical limitations, tradeoffs, and technological feasibility constraints associated with transcranial electric and magnetic stimulation, in order to inform the development of technologies that deliver safer, and more spatially, temporally, and patient specific stimulation. Part I of this dissertation expounds on the issue of spatial targeting of the electric field. Contrasting electroconvulsive therapy (ECT) and magnetic seizure therapy (MST) configurations that differ markedly in efficacy, side effects, and seizure induction efficiency could advance our understanding of the principles linking treatment parameters and therapeutic outcome and could provide a means of testing hypotheses of the mechanisms of therapeutic action. Using the finite element method, we systematically compare the electric field characteristics of existing forms of ECT and MST. We introduce a method of incorporating a modality-specific neural activation threshold in the electric field models that can inform dosage requirements in convulsive therapies. Our results indicate that the MST electric field is more focal and more confined to the superficial cortex compared to ECT. Further, the conventional ECT current amplitude is much higher than necessary for seizure induction. One of the factors important to clinical outcome is seizure expression. However, it is unknown how the induced electric field is related to seizure onset and propagation. In this work, we explore the effect of the electric field distribution on the quantitative ictal electroencephalography and current source density in ECT and MST. We further demonstrate how the ECT electrode shape, size, spacing, and current can be manipulated to yield more precise control of the induced electric field. If desirable, ECT can be made as focal as MST while using simpler stimulation equipment. Next, we demonstrate how the electric field induced by transcranial magnetic stimulation (TMS) can be controlled. We present the most comprehensive comparison of TMS coil electric field penetration and focality to date. The electric field distributions of more than 50 TMS coils were simulated. We show that TMS coils differ markedly in their electric field characteristics, but they all are subject to a consistent depth-focality tradeoff. Specifically, the ability to directly stimulate deeper brain structures is obtained at the expense of inducing wider electric field spread. Figure-8 type coils are fundamentally more focal compared to circular type coils. Understanding the depth-focality tradeoff can help researchers and clinicians to appropriately select coils and interpret TMS studies. This work also enables the development of novel TMS coils with electronically switchable active and sham modes as well as for deep TMS. Design considerations of these coils are extensively discussed. Part II of the dissertation aims to quantify the effect of individual, sex, and age differences in head geometry and conductivity on the induced neural stimulation strength and focality of ECT and MST. Across and within ECT studies, there is marked unexplained variability in seizure threshold and clinical outcomes. It is not known to what extent the age and sex effects on seizure threshold are mediated by interindividual variation in neural excitability and/or anatomy of the head. Addressing this question, we examine the effect on ECT and MST induced field characteristics of the variability in head diameter, scalp and skull thicknesses and conductivities, as well as brain volume, in a range of values that are representative of the patient population. Variations in the local tissue properties such as scalp and skull thickness and conductivity affect the existing ECT configurations more than MST. On the other hand, the existing MST coil configurations show greater sensitivity to head diameter variation compared to ECT. Due to the high focality of MST compared to ECT, the stimulated brain volume in MST is more sensitive to variation in tissue layer thicknesses. We further demonstrate how individualization of the stimulus pulse current amplitude, which is not presently done in ECT or MST, can be used as a means of compensating for interindividual anatomical variability, which could lead to better and more consistent clinical outcomes. Part III of the dissertation aims to systemically investigate, both computationally and experimentally, the safety of TMS and ECT in patients with a deep-brain stimulation system, and propose safety guidelines for the dual-device therapy. We showed that the induction of significant voltages in the subcutaneous leads in the scalp during TMS could result in unintended and potentially dangerous levels of electrical currents in the DBS electrode contacts. When applying ECT in patients with intracranial implants, we showed that there is an increase in the electric field strength in the brain due to conduction through the burr holes, especially when the burr holes are not fitted with nonconductive caps. Safety concerns presently limit the access of patients with intracranial electronic devices to therapies involving transcranial stimulation technology, which may preclude them from obtaining appropriate medical treatments. Gaining better understanding of the interactions between transcranial and implanted stimulation devices will demarcate significant safety risks from benign interactions, and will provide recommendations for reducing risk, thus enhancing the patient's therapeutic options.

Inference and analysis of xenon outflow curves under multi-pulse injection in two-dimensional chromatography.

PubMed

Shu-Jiang, Liu; Zhan-Ying, Chen; Yin-Zhong, Chang; Shi-Lian, Wang; Qi, Li; Yuan-Qing, Fan

2013-10-11

Multidimensional gas chromatography is widely applied to atmospheric xenon monitoring for the Comprehensive Nuclear-Test-Ban Treaty (CTBT). To improve the capability for xenon sampling from the atmosphere, sampling techniques have been investigated in detail. The sampling techniques are designed by xenon outflow curves which are influenced by many factors, and the injecting condition is one of the key factors that could influence the xenon outflow curves. In this paper, the xenon outflow curves of single-pulse injection in two-dimensional gas chromatography has been tested and fitted as a function of exponential modified Gaussian distribution. An inference formula of the xenon outflow curve for six-pulse injection is derived, and the inference formula is also tested to compare with its fitting formula of the xenon outflow curve. As a result, the curves of both the one-pulse and six-pulse injections obey the exponential modified Gaussian distribution when the temperature of the activated carbon column's temperature is 26°C and the flow rate of the carrier gas is 35.6mLmin(-1). The retention time of the xenon peak for one-pulse injection is 215min, and the peak width is 138min. For the six-pulse injection, however, the retention time is delayed to 255min, and the peak width broadens to 222min. According to the inferred formula of the xenon outflow curve for the six-pulse injection, the inferred retention time is 243min, the relative deviation of the retention time is 4.7%, and the inferred peak width is 225min, with a relative deviation of 1.3%. Copyright © 2013 Elsevier B.V. All rights reserved.

The influence of laser pulse duration and energy on ICP-MS signal intensity, elemental fractionation, and particle size distribution in NIR fs-LA-ICP-MS

PubMed Central

Diwakar, Prasoon K.; Harilal, Sivanandan S.; LaHaye, Nicole L.; Hassanein, Ahmed; Kulkarni, Pramod

2015-01-01

Laser parameters, typically wavelength, pulse width, irradiance, repetition rate, and pulse energy, are critical parameters which influence the laser ablation process and thereby influence the LA-ICP-MS signal. In recent times, femtosecond laser ablation has gained popularity owing to the reduction in fractionation related issues and improved analytical performance which can provide matrix-independent sampling. The advantage offered by fs-LA is due to shorter pulse duration of the laser as compared to the phonon relaxation time and heat diffusion time. Hence the thermal effects are minimized in fs-LA. Recently, fs-LA-ICP-MS demonstrated improved analytical performance as compared to ns-LA-ICP-MS, but detailed mechanisms and processes are still not clearly understood. Improvement of fs-LA-ICP-MS over ns-LA-ICP-MS elucidates the importance of laser pulse duration and related effects on the ablation process. In this study, we have investigated the influence of laser pulse width (40 fs to 0.3 ns) and energy on LA-ICP-MS signal intensity and repeatability using a brass sample. Experiments were performed in single spot ablation mode as well as rastering ablation mode to monitor the Cu/Zn ratio. The recorded ICP-MS signal was correlated with total particle counts generated during laser ablation as well as particle size distribution. Our results show the importance of pulse width effects in the fs regime that becomes more pronounced when moving from femtosecond to picosecond and nanosecond regimes. PMID:26664120

Graphene Oxide: A Perfect Material for Spatial Light Modulation Based on Plasma Channels

PubMed Central

Tan, Chao; Wu, Xinghua; Wang, Qinkai; Tang, Pinghua; Shi, Xiaohui; Zhan, Shiping; Xi, Zaifang; Fu, Xiquan

2017-01-01

The graphene oxide (GO) is successfully prepared from a purified natural graphite through a pressurized oxidation method. We experimentally demonstrate that GO as an optical media can be used for spatial light modulation based on plasma channels induced by femtosecond pulses. The modulated beam exhibits good propagation properties in free space. It is easy to realize the spatial modulation on the probe beam at a high concentration of GO dispersion solutions, high power and smaller pulse width of the pump beam. We also find that the spatial modulation on the probe beam can be conveniently adjusted through the power and pulse width of pump lasers, dispersion solution concentration. PMID:28772712

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen Weicheng; Chen Guojie; Han Dingan

A fibre laser with a SESAM as a passive mode-locker is constructed for obtaining a vector soliton with the Kelly sidebands. The analysis of the peculiarities of the sidebands shows that the polarisation states are nonuniform across the entire pulse spectral profile from the leading edge to the trailing edge. Polarisation filtering effect is proposed to obtain a vector soliton with a uniform polarisation state. It is shown that during the polarisation filtering by a polariser incorporated into the laser cavity, the spectral width of the vector solitons gradually broadens and the pulse power decreases. It is found that atmore » a maximum spectral width and a minimum pulse power, vector solitons with a uniform polarisation state are generated. (nonlinear optical phenomena)« less

Pre- and Post-Clerkship Knowledge, Perceptions, and Acceptability of Electroconvulsive Therapy (ECT) in 3rd Year Medical Students.

PubMed

Ithman, Muaid; O'Connell, Chris; Ogunleye, Ayodeji; Lee, Suhwon; Chamberlain, Brett; Ramalingam, Anupama

2018-05-26

To examine the impact of the third year psychiatry clerkship on medical students' knowledge and opinion of ECT at University of Missouri-Columbia School of Medicine. Despite overwhelming evidence of ECT's efficacy and safety for refractory affective illnesses, (among other conditions), it remains a misunderstood and underutilized intervention. Several studies indicate that ECT stigma and misinformation, unfortunately, does not spare the medical community. Medical students are an optimal group to study, as they are forming their perspectives on different specialties. Few studies have measured the effect of education programs (e.g., clerkships, lectures, observation of ECT) on medical students' perspectives on ECT.

Study on automatic ECT data evaluation by using neural network

DOE Office of Scientific and Technical Information (OSTI.GOV)

Komatsu, H.; Matsumoto, Y.; Badics, Z.

1994-12-31

At the in--service inspection of the steam generator (SG) tubings in Pressurized Water Reactor (PWR) plant, eddy current testing (ECT) has been widely used at each outage. At present, ECT data evaluation is mainly performed by ECT data analyst, therefore it has the following problems. Only ECT signal configuration on the impedance trajectory is used in the evaluation. It is an enormous time consuming process. The evaluation result is influenced by the ability and experience of the analyst. Especially, it is difficult to identify the true defect signal hidden in background signals such as lift--off noise and deposit signals. Inmore » this work, the authors performed the study on the possibility of the application of neural network to ECT data evaluation. It was demonstrated that the neural network proved to be effective to identify the nature of defect, by selecting several optimum input parameters to categorize the raw ECT signals.« less

Response to Electroconvulsive Therapy in Patients With Autism Spectrum Disorder and Intractable Challenging Behaviors Associated With Symptoms of Catatonia.

PubMed

Sajith, Sreedharan Geetha; Liew, Siew Fai; Tor, Phern Chern

2017-03-01

There are several reports of electroconvulsive therapy (ECT) used in autism spectrum disorder (ASD) in the context of catatonic symptoms. We describe response to ECT in two adults with ASD and intellectual disability with intractable aggression and self-injurious behaviors associated with catatonic symptoms who had not responded to standard interventions. Unilateral ECT at a frequency of 3 times a week was given followed by weekly maintenance ECT. Patients' catatonic symptoms included episodes of agitation and echophenomena. Electroconvulsive therapy resulted in significant improvement in their behavior problems but 1 patient relapsed when the ECT was discontinued or frequency of treatment reduced. The second patient required 2 courses of ECT before improvement which was maintained on weekly ECT. Electroconvulsive therapy could be a potentially beneficial intervention in patients with ASD and severe challenging behaviors associated with catatonic symptoms including agitated or excited forms of catatonia.

Electroconvulsive treatment during pregnancy: a systematic review.

PubMed

Pompili, Maurizio; Dominici, Giovanni; Giordano, Gloria; Longo, Lucia; Serafini, Gianluca; Lester, David; Amore, Mario; Girardi, Paolo

2014-12-01

Pharmacological treatment of severe psychiatric disorders during pregnancy is complicated by the potential harmful effects of treatment for the fetus. Electroconvulsive therapy (ECT) has been demonstrated to be effective for the treatment of several mental disorders. The aim of this study was to investigate the safety of ECT in the treatment of psychiatric disorders during pregnancy; to compare its efficacy with medication; and to identify the main indications for use in pregnancy. We performed a careful and systematic review of the literature on ECT and pregnancy was conducted. Almost all patients demonstrated total or at least partial remission of symptoms after ECT treatment. No deaths were reported in ECT-treated pregnant women. We conclude that ECT is probably currently under-used in many psychiatric settings because of its stigmatized perception by patients and by mental health professionals. ECT seems to be effective for treating major psychiatric disorders during pregnancy, and the risks of adverse events are low.

Relationship between somatization and remission with ECT.

PubMed

Rasmussen, Keith G; Snyder, Karen A; Knapp, Rebecca G; Mueller, Martina; Yim, Eunsil; Husain, Mustafa M; Rummans, Teresa A; Sampson, Shirlene M; O'Connor, M Kevin; Bernstein, Hilary J; Kellner, Charles H

2004-12-30

Patients treated with electroconvulsive therapy (ECT) were divided into those with less severe depression and those with more severe depression. In the less severely depressed group, high somatic anxiety and hypochondriasis predicted a low likelihood of sustained remission with ECT. In the more severely depressed group, these traits were not predictive of ECT outcome.

Impact on Psychiatric Interns of Watching Live Electroconvulsive Treatment

ERIC Educational Resources Information Center

Gazdag, Gabor; Sebestyen, Gabor; Ungvari, Gabor S.; Tolna, Judit

2009-01-01

Objective: Watching a live electroconvulsive treatment (ECT) has both positive and negative effects on spectators. The authors aim to survey the attitude change towards ECT in interns after watching a live ECT session. Methods: A 23-item questionnaire was administered to 66 interns before and after watching ECT. Results: In five statements, the…

Bilateral ECT induces bilateral increases in regional cortical thickness.

PubMed

van Eijndhoven, P; Mulders, P; Kwekkeboom, L; van Oostrom, I; van Beek, M; Janzing, J; Schene, A; Tendolkar, I

2016-08-23

Electroconvulsive therapy (ECT) is the most effective treatment for patients suffering from severe or treatment-resistant major depressive disorder (MDD). Unfortunately its underlying neurobiological mechanisms are still unclear. One line of evidence indicates that the seizures produced by ECT induce or stimulate neuroplasticity effects. Although these seizures also affect the cortex, the effect of ECT on cortical thickness is not investigated until now. We acquired structural magnetic resonance imaging data in 19 treatment-resistant MDD patients before and after a bilateral ECT course, and 16 healthy controls at 2 time points, and compared changes in cortical thickness between the groups. Our results reveal that ECT induces significant, bilateral increases in cortical thickness, including the temporal pole, inferior and middle temporal cortex and the insula. The pattern of increased cortical thickness was predominant in regions that are associated with seizure onset in ECT. Post hoc analyses showed that the increase in thickness of the insular cortex was larger in responders than in non-responders, which may point to a specific relationship of this region with treatment effects of ECT.

A prospective comparative study of interaction between lithium and modified electroconvulsive therapy.

PubMed

Thirthalli, Jagadisha; Harish, Thippeswamy; Gangadhar, Bangalore N

2011-03-01

To compare patients on lithium and those not on lithium with regard to adverse effects while receiving ECT. Inpatients with schizophrenia, non-organic psychosis, mania and depression, who were prescribed ECTs either on (n=27) or not (n=28) on lithium were studied. Clinicians blind to lithium-status recorded seizure parameters, interaction with succinyl choline, cardiovascular response, recovery from ECT and immediate post-ECT complications. The lithium group showed no significant difference in terms of seizure variables, apnea time, and recovery from anaesthesia when compared to the non-lithium group. Average maximum heart rate, average maximum systolic blood pressure and average maximum rate pressure product were significantly lower in patients who had combined lithium and ECT. In lithium patients the average time to post-ECT recovery was directly correlated with serum lithium level. Though concurrent lithium is by and large safe during ECT, it benefits to maintain serum lithium level at lower end of therapeutic range. However, the findings can be applied to relatively young patients with no risk factors for ECT-complications.

Laser micro-machining strategies for transparent brittle materials using ultrashort pulsed lasers

NASA Astrophysics Data System (ADS)

Bernard, Benjamin; Matylitsky, Victor

2017-02-01

Cutting and drilling of transparent materials using short pulsed laser systems are important industrial production processes. Applications ranging from sapphire cutting, hardened glass processing, and flat panel display cutting, to diamond processing are possible. The ablation process using a Gaussian laser beam incident on the topside of a sample with several parallel overlapping lines leads to a V-shaped structured groove. This limits the structuring depth for a given kerf width. The unique possibility for transparent materials to start the ablation process from the backside of the sample is a well-known strategy to improve the aspect ratio of the ablated features. This work compares the achievable groove depth depending on the kerf width for front-side and back-side ablation and presents the best relation between the kerf width and number of overscans. Additionally, the influence of the number of pulses in one burst train on the ablation efficiency is investigated. The experiments were carried out using Spirit HE laser from Spectra-Physics, with the features of adjustable pulse duration from <400 fs to 10 ps, three different repetition rates (100 kHz, 200 kHz and 400 kHz) and average output powers of >16 W ( at 1040 nm wavelength).

Laser Pulse Width Dependence and Ionization Mechanism of Matrix-Assisted Laser Desorption/Ionization

NASA Astrophysics Data System (ADS)

Liang, Sheng-Ping; Lu, I.-Chung; Tsai, Shang-Ting; Chen, Jien-Lian; Lee, Yuan Tseh; Ni, Chi-Kung

2017-10-01

Ultraviolet laser pulses at 355 nm with variable pulse widths in the region from 170 ps to 1.5 ns were used to investigate the ionization mechanism of matrix-assisted laser desorption/ionization (MALDI) for matrices 2,5-dihydroxybenzoic acid (DHB), α-cyano-4-hydroxycinnamic acid (CHCA), and sinapinic acid (SA). The mass spectra of desorbed ions and the intensity and velocity distribution of desorbed neutrals were measured simultaneously for each laser shot. These quantities were found to be independent of the laser pulse width. A comparison of the experimental measurements and numerical simulations according to the multiphoton ionization, coupled photophysical and chemical dynamics (CPCD), and thermally induced proton transfer models showed that the predictions of thermally induced proton transfer model were in agreement with the experimental data, but those of the multiphoton ionization model were not. Moreover, the predictions of the CPCD model based on singlet-singlet energy pooling were inconsistent with the experimental data of CHCA and SA, but were consistent with the experimental data of DHB only when some parameters used in the model were adjusted to extreme values. [Figure not available: see fulltext.

New hybrid reverse differential pulse position width modulation scheme for wireless optical communication

NASA Astrophysics Data System (ADS)

Liao, Renbo; Liu, Hongzhan; Qiao, Yaojun

2014-05-01

In order to improve the power efficiency and reduce the packet error rate of reverse differential pulse position modulation (RDPPM) for wireless optical communication (WOC), a hybrid reverse differential pulse position width modulation (RDPPWM) scheme is proposed, based on RDPPM and reverse pulse width modulation. Subsequently, the symbol structure of RDPPWM is briefly analyzed, and its performance is compared with that of other modulation schemes in terms of average transmitted power, bandwidth requirement, and packet error rate over ideal additive white Gaussian noise (AWGN) channels. Based on the given model, the simulation results show that the proposed modulation scheme has the advantages of improving the power efficiency and reducing the bandwidth requirement. Moreover, in terms of error probability performance, RDPPWM can achieve a much lower packet error rate than that of RDPPM. For example, at the same received signal power of -28 dBm, the packet error rate of RDPPWM can decrease to 2.6×10-12, while that of RDPPM is 2.2×10. Furthermore, RDPPWM does not need symbol synchronization at the receiving end. These considerations make RDPPWM a favorable candidate to select as the modulation scheme in the WOC systems.

Control Systems with Pulse Width Modulation in Matrix Converters

NASA Astrophysics Data System (ADS)

Bondarev, A. V.; Fedorov, S. V.; Muravyova, E. A.

2018-03-01

In this article, the matrix frequency converter for the system of the frequency control of the electric drive is considered. Algorithms of formation of an output signal on the basis of pulse width modulation were developed for the quantitative analysis of quality of an output signal on the basis of mathematical models. On the basis of simulation models of an output signal, assessment of quality of this signal was carried out. The analysis of harmonic composition of the voltage output received on the basis of pulse width modulation was made for the purpose of determination of opportunities of the control system for improving harmonic composition. The result of such analysis led to the fact that the device formation of switching functions of the control system on the basis of PWM does not lead to a distortion reduction of a harmonic of the control signal, and leads to offset of harmonic in the field of frequencies, the multiple relatively carrier frequency.

Frequency-resolved optical gating system with a tellurium crystal for characterizing free-electron lasers in the wavelength range of 10-30 {mu}m

DOE Office of Scientific and Technical Information (OSTI.GOV)

Iijima, Hokuto; Nagai, Ryoji; Nishimori, Nobuyuki

2009-12-15

A second-harmonic generation frequency-resolved optical gating (SHG-FROG) system has been developed for the complete characterization of laser pulses in the wavelength range of 10-30 {mu}m. A tellurium crystal is used so that spectrally resolved autocorrelation signals with a good signal-to-noise ratio are obtained. Pulses (wavelength {approx}22 {mu}m) generated from a free-electron laser are measured by the SHG-FROG system. The SHG intensity profile and the spectrum obtained by FROG measurements are well consistent with those of independent measurements of the pulse length and spectrum. The pulse duration and spectral width determined from the FROG trace are 0.6 ps and 5.2 THzmore » at full width half maximum, respectively.« less

Optically powered oil tank multichannel detection system with optical fiber link

NASA Astrophysics Data System (ADS)

Yu, Zhijing

1998-08-01

A novel oil tanks integrative parameters measuring system with optically powered are presented. To realize optical powered and micro-power consumption multiple channels and parameters detection, the system has taken the PWM/PPM modulation, ratio measurement, time division multiplexing and pulse width division multiplexing techniques. Moreover, the system also used special pulse width discriminator and single-chip microcomputer to accomplish signal pulse separation, PPM/PWM signal demodulation, the error correction of overlapping pulse and data processing. This new transducer has provided with high characteristics: experimental transmitting distance is 500m; total consumption of the probes is less than 150 (mu) W; measurement error: +/- 0.5 degrees C and +/- 0.2 percent FS. The measurement accuracy of the liquid level and reserves is mainly determined by the pressure accuracy. Finally, some points of the experiment are given.

Electroconvulsive Therapy - What Do Patients Think Of Their Treatment?

PubMed

Maguire, S; Rea, S M; Convery, P

2016-09-01

The Regulation and Quality Improvement Authority (RQIA) monitors the administration of electroconvulsive therapy (ECT) in Northern Ireland (NI). As part of their inspection methodology RQIA wished to include feedback from ECT patients. The aim of this report is to summarise the opinions of ECT patients over a 1-year period and to compare their feedback about treatment with the standards of best practice, as defined by the Electroconvulsive Therapy Accreditation Service (ECTAS). RQIA was granted permission to use the ECTAS patient questionnaire. The questionnaire was distributed to all the ECT clinics in NI and staff were requested to give them to patients who had received a course of ECT. A total of 42 individuals returned questionnaires, 24 females (57.1%) and 18 (42.9%) males. The response rate was 26%. Almost half of respondents were detained under the Mental Health (Northern Ireland) Order 1986 (n=19, 45.2%), with one third receiving ECT as a day patient (n=14, 33.3%). Respondents reported having detailed information about ECT, with ECTAS standards 4.2 and 4.3 being affirmed in over 80% of cases. Eighty percent of respondents (n=34) believed they benefited from ECT. The results are mainly favourable towards ECT. The majority felt they benefited from treatment.

Knowledge of and attitudes toward electroconvulsive therapy among medical students, psychology students, and the general public.

PubMed

Aki, Ozlem Erden; Ak, Sertac; Sonmez, Yunus Emre; Demir, Basaran

2013-03-01

Electroconvulsive therapy (ECT) is safe and effective for the treatment of various psychiatric disorders. Despite being a well-known treatment method among health care professionals, lay people generally have a negative opinion of ECT. The present study aimed to examine knowledge of and attitudes toward ECT among medical students, psychology students, and the general public. Psychology students were included because they are among the important groups in mental health care in Turkey. A Likert-type questionnaire was administered to fifth-year medical students (n = 28), master of science and doctor of philosophy clinical psychology students (n = 35), and a sample of the general public (n = 26). The questionnaire included questions about the general principles of and indications for ECT, and sources of knowledge of and attitudes toward ECT. The medical students were the most knowledgeable about ECT, as expected. The medical students also had a more positive attitude toward ECT than the other 2 groups. More psychology students had negative attitudes on some aspects than general public sample, despite being more knowledgeable. Medical school theoretical and practical training in ECT played an important role in increasing the level of knowledge of and decreasing the prevalence of negative attitudes toward ECT among the medical students; similar training for psychology students is required to achieve similar results.

Electroconvulsive therapy--efficacy and side-effects.

PubMed

Moksnes, Kjell Martin; Ilner, Stein Opjordsmoen

2010-12-16

Efficacy of electroconvulsive therapy (ECT) and duration of associated side effects is uncertain. We wanted to study indications, efficacy, time to response and side effects. ECT-protocols and medical records (from the period 1960-95) in three psychiatric wards of Dikemark Mental Hospital, Norway were systematically assessed. 141 persons underwent 241 ECT series comprising 1960 treatment sessions. Major depressive disorder was the main diagnosis in most patients 124 [88 %]. Before ECT, 129 (91 %) patients had been treated with at least one antidepressant, 107 (76 %) with at least two and 67 (48 %) with two different classes of antidepressants without sufficient clinical recovery from the incident. 31 (22 %) had received lithium before ECT. Within four weeks after the first ECT, 120 (85 %) patients had recovered. 61 of these achieved remission and were discharged within four weeks. After the first ECT series, 92 patients showed signs of improvement. 71 (77 %) had signs of improvement within 6 days. Side effects were noted after 123 of totally 241 series (51 %). Five patients experienced serious complications. Interpretation. The immediate effect of ECT was good and signs of recovery were observed in most patients during the first week. Depressed psychotic patients and the elderly seemed to respond best. Considering these patients' serious and long-lasting disorders ECT was fairly safe and well tolerated.

Numerical analysis of breakdown dynamics dependence on pulse width in laser-induced damage in fused silica: Role of optical system

NASA Astrophysics Data System (ADS)

Hamam, Kholoud A.; Gamal, Yosr E. E.-D.

2018-06-01

We report a numerical investigation of the breakdown and damage in fused silica caused by ultra-short laser pulses. The study based on a modified model (Gaabour et al., 2012) that solves the rate equation numerically for the electron density evolution during the laser pulse, under the combined effect of both multiphoton and electron impact ionization processes. Besides, electron loss processes due to diffusion out of the focal volume and recombination are also considered in this analysis. The model is applied to investigate the threshold intensity dependence on laser pulse width in the experimental measurements that are given by Liu et al. (2005). In this experiment, a Ti-sapphire laser source operating at 800 nm with pulse duration varies between 240 fs and 2.5 ps is used to irradiate a bulk of fused silica with dimensions 10 × 5 × 3 mm. The laser beam was focused into the bulk using two optical systems with effective numerical apertures (NA) 0.126 and 0.255 to give beam spot radius at the focus of the order 2.0 μm and 0.95 μm respectively. Reasonable agreement between the calculated thresholds and the measured ones is attained. Moreover, a study is performed to examine the respective role of the physical processes of the breakdown of fused silica in relation to the pulse width and focusing optical system. The analysis revealed a real picture of the location and size of the generated plasma.

Pattern of electroconvulsive therapy use in Spain: Proposals for an optimal practice and equitable access.

PubMed

Sanz-Fuentenebro, Javier; Vera, Ignacio; Verdura, Ernesto; Urretavizcaya, Mikel; Martínez-Amorós, Erika; Soria, Virginia; Bernardo, Miquel

The main aims of our study were to estimate the current rates and pattern of electroconvulsive therapy (ECT) use in Spain, as well as exploring the causes that may be limiting its use in our country. A cross-sectional survey was conducted covering every psychiatric unit in Spain as of 31 December 2012. More than half (54.9%) of the psychiatric units applied ECT at a rate of 0.66 patients per 10,000 inhabitants. There are wide variations with regard to ECT application rates between the different autonomous communities (0.00-1.39) and provinces (0.00-3.90). ECT was prescribed to a mean of 25.5 patients per hospital that used the technique and 4.5 in referral centre (P=.000), but wide differences were reported in the number of patients who were prescribed ECT from hospital to hospital. Although the percentage of psychiatric units applying ECT in our country is among the highest in the world, the ECT application rate in Spain is among the lowest within western countries. Large differences in ECT use have been reported across the various autonomous communities, provinces and hospitals. Thus, health planning strategies need to be implemented, as well as promoting training in ECT among health professionals, if these differences in ECT use are to be reduced. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

ECT and Pronounced Impairment in Spatial Cognition: The Fallacy of Drawing Conclusions From a Single Case.

PubMed

Andrade, Chittaranjan; Prasad, Yameni; Devaraj, Aathira; Pinto, Ekta Franscina; Shukla, Lekhansh

2018-06-01

Electroconvulsive therapy (ECT) is associated with memory deficits on neuropsychological assessment. The association of ECT with nonmemory cognitive deficits has been poorly studied. We present a 40-year-old woman who showed a bizarre form of spatial cognition impairment on a subtest of the Tactual Performance Test (TPT) after recovering from depression with 6 alternate day, thrice-weekly, inpatient ECT treatments. This woman was part of a naturalistic, nonblind study that examined nonmemory cognitive deficits in antidepressant-treated depressed patients who did and did not receive ECT. The impairment was in the form of bizarrely drawn reproductions of differently shaped wooden blocks that had been presented to the patient when she was blindfolded. The impairment was still evident when she was retested (3 hours later) under substantially simplified conditions but was much attenuated approximately 2.5 weeks later. On the surface, it seems that ECT had induced severe impairment in spatial cognition and that the impairment showed the familiar pattern of attenuation with the passage of time. However, another recovered patient in the study, who did not receive ECT, also showed substantial spatial deficits on the same subtest of the TPT, and the attenuation of the deficits across time in the ECT-treated patient was probably a result of repeated exposure to the task. We suggest that not all patients who seem to experience spectacular cognitive impairment after ECT have deficits that are attributable to ECT.

Cognitive Performance Under Electroconvulsive Therapy (ECT) in ECT-Naive Treatment-Resistant Patients With Major Depressive Disorder.

PubMed

Ziegelmayer, Christoph; Hajak, Göran; Bauer, Anne; Held, Marion; Rupprecht, Rainer; Trapp, Wolfgang

2017-06-01

Although electroconvulsive therapy (ECT) is considered a safe and highly effective treatment option for major depressive disorder, there are still some reservations with regard to possible adverse cognitive adverse effects. This is the case despite a large body of evidence showing that these deficits are transient and that there even seems to be a long-term improvement of cognitive functioning level. However, most data concerning cognitive adverse effects stem from studies using mixed samples of treatment-resistant and non-treatment-resistant as well as ECT-naive and non-ECT-naive subjects. Furthermore, neurocognitive measures might partly be sensitive to practice effects and improvements in depressive symptom level. We examined neurocognitive performance in a sample of 20 treatment-resistant and ECT-naive subjects using repeatable neurocognitive tests, whereas changes in depressive symptom level were controlled. Cognitive functioning level was assessed before (baseline), 1 week, and 6 months (follow-up 1 and 2) after (12 to) 15 sessions of unilateral ECT treatment. No adverse cognitive effects were observed in any of the cognitive domains examined. Instead, a significant improvement in verbal working memory performance was found from baseline to follow-up 2. When changes in depressive symptom levels were controlled statistically, this improvement was no longer seen. Although findings that ECT does not lead to longer lasting cognitive deficits caused by ECT were confirmed, our study adds evidence that previous results of a beneficial effect of ECT on cognition might be questioned.

Position statement and guidelines on unmodified electroconvulsive therapy

PubMed Central

Andrade, Chittaranjan; Shah, N.; Tharyan, P.; Reddy, M. S.; Thirunavukarasu, M.; Kallivayalil, R. A.; Nagpal, R.; Bohra, N. K.; Sharma, A.; Mohandas, E.

2012-01-01

Background: In modern day psychiatric practice, it is assumed as a matter of fact that when electroconvulsive therapy (ECT) is administered, it will be administered under anesthesia and with succinylcholine (or its equivalent) modification. Yet, as surveys indicate, there is considerable practice of unmodified ECT in developing countries and, to a small extent, in the developed world, as well. Materials and Methods: This document examines historical and recent literature on the geographical practice, physiology, efficacy, and adverse effects of unmodified ECT. Particular attention is paid to musculoskeletal risks. Results: Although almost all the research is of poor methodological quality, there is a good reason to accept that unmodified ECT is associated with a wide range of adverse consequences, important among which are musculoskeletal complications, pre-ECT anxiety, and post-ECT confusion. However, it appears from recent data that these risks are not as large as historically portrayed. Possibly explanations are suggested, with seizure modification using parenteral benzodiazepines as a special possibility. Conclusions: Under exceptional circumstances, if ECT is strongly indicated and seizure modification with succinylcholine is not feasible, unmodified ECT, especially benzodiazepine-modified ECT, may be a viable option. A detailed set of recommendations for such use of unmodified ECT is proposed along with necessary checks and balances. This document has been approved by the Indian Psychatric Society, the Indian Association of Biological Psychiatry, and the Indian Association of Private Psychiatry (which commissioned the preparation of the document). PMID:22988318

Improvement of cycloid psychosis following electroconvulsive therapy.

PubMed

Holm, Jonas; Brus, Ole; Båve, Ullvi; Landen, Mikael; Lundberg, Johan; Nordanskog, Pia; von Knorring, Lars; Nordenskjöld, Axel

2017-08-01

The treatment of choice for cycloid psychosis has traditionally been electroconvulsive therapy (ECT), but there is a lack of studies on its effectiveness. The primary aim of this register study was to determine the rates of remission and response after ECT for cycloid psychosis. The secondary aim was to examine possible predictors of outcome. Data were obtained from the National Quality Register for ECT in Sweden. The study population was patients (n = 42) who received ECT for acute polymorphic psychotic disorder without symptoms of schizophrenia or for cycloid psychosis between 2011-2015 in 13 hospitals. Remission and response rates were calculated using Clinical Global Impression-Severity (CGI-S) and -Improvement scores, respectively. Variables with possible predictive value were tested using Chi-square and Fisher's exact test. The response rate was 90.5%. The remission rate was 45.2%. Of 42 patients, 40 improved their CGI-S score after ECT (p < 0.001). The mean number of ECT treatments was 2.5 for non-responders and 7.0 for responders (p = 0.010). The mean number of ECT treatments did not differ significantly between remitters and non-remitters (7.2 vs 6.1, p = 0.31). None of the other investigated potential predictors was statistically significantly associated with outcome. ECT is an effective treatment for cycloid psychosis. Future studies need to compare the outcome of ECT to that of other treatment strategies. The high response rate with ECT indicates that cycloid psychosis is a clinically useful diagnosis.

The experience of electroconvulsive therapy and its impact on associated stigma: A meta-analysis.

PubMed

Aoki, Yuta; Yamaguchi, Sosei; Ando, Shuntaro; Sasaki, Natsuki; Bernick, Peter J; Akiyama, Tsuyoshi

2016-12-01

Despite its efficacy and safety, electroconvulsive therapy (ECT) is underutilized, in part due to stigma associated with the treatment. The aim of this study was to test the hypothesis that experiencing ECT has an impact on associated stigma, as measured by patient and family knowledge of and attitudes toward ECT. A comprehensive literature search was conducted using MEDLINE, EMBASE and PsycINFO. Studies with cross-sectional and/or longitudinal designs were identified. Studies were further categorized into subcategories based on participant type (patients or patient family members) and outcome domain (knowledge or attitudes). Effect size (Cohen's d) was calculated for each study and then integrated into each subcategory (participant type by outcome domain) using a random effect model. Eight studies were identified as being eligible for analysis. Two studies were cross-sectional, five were longitudinal and one incorporated both designs. Analysis of the longitudinal studies indicated that experiencing ECT both increased knowledge of and improved attitudes toward ECT in patients; in family members of patients, analysis showed significant positive change in knowledge of ECT, but no significant change in attitudes toward ECT. Experience with ECT may have a positive impact on knowledge of and attitudes toward ECT. However, the quality of evidence of included studies was low; further research is required in order to clarify the relationship and to identify information of use to individuals considering ECT as a treatment option. © The Author(s) 2016.

Electroconvulsive therapy and its relationships with clinical characteristics and quality of life in Chinese psychiatric patients.

PubMed

An, Feng-Rong; Zhang, Ling; Zhang, Qing-E; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Wu, Ping-Ping; Jin, Xin; Li, Lu; Lok, Grace K I; Xiang, Yu-Tao

2016-12-30

Little is known about the pattern of electroconvulsive therapy (ECT) use in the clinical population in China. This study examined the percentage of ECT use and its association with clinical characteristics and quality of life (QOL) in a psychiatric center in China that caters for a population of 20 million. A total sample of 1364 inpatients was consecutively recruited for the study. Demographic and clinical data including the use of ECT were collected. Psychopathology, activity of daily living and QOL were measured using standardized instruments. The percentage of ECT use was 52.1% in the whole sample; 53.4% in major depression, 57.8% in bipolar disorder, 57.0% in schizophrenia and 32.4% in other diagnoses. There was no significant difference between the ECT and non-ECT groups in any domain of QOL. Multivariate analyses revealed that ECT was independently associated with the diagnoses of major depression, bipolar disorder and schizophrenia, physical restraint, severe aggression, better activity of daily living skills, more frequent use of antipsychotics and less frequent use of benzodiazepines. The percentage of ECT use was much greater in a major psychiatric center in China than those reported from other parts of the world. Use of ECT had no influence on the short-term QOL. Further investigations are warranted to explore the reasons for the high percentage of ECT use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Routine Cross-Sectional Head Imaging Before Electroconvulsive Therapy: A Tertiary Center Experience.

PubMed

Sajedi, Payam I; Mitchell, Jason; Herskovits, Edward H; Raghavan, Prashant

2016-04-01

Electroconvulsive therapy (ECT) is generally contraindicated in patients with intracranial mass lesions or in the presence of increased intracranial pressure. The purpose of this study was to determine the prevalence of incidental abnormalities on routine cross-sectional head imaging, including CT and MRI, that would preclude subsequent ECT. This retrospective study involved a review of the electronic medical records of 105 patients (totaling 108 imaging studies) between April 27, 2007, and March 20, 2015, referred for cranial CT or MRI with the primary indication of pre-ECT evaluation. The probability of occurrence of imaging findings that would preclude ECT was computed. A cost analysis was also performed on the practice of routine pre-ECT imaging. Of the 105 patients who presented with the primary indication of ECT clearance (totaling 108 scans), 1 scan (0.93%) revealed findings that precluded ECT. None of the studies demonstrated findings that indicated increased intracranial pressure. A cost analysis revealed that at least $18,662.70 and 521.97 relative value units must be expended to identify one patient with intracranial pathology precluding ECT. The findings of this study demonstrate an extremely low prevalence of findings that preclude ECT on routine cross-sectional head imaging. The costs incurred in identifying a potential contraindication are high. The authors suggest that the performance of pre-ECT neuroimaging be driven by the clinical examination. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Fetal spasms after the administration of electroconvulsive therapy in pregnancy: our experience.

PubMed

Halmo, Martin; Spodniaková, Barbara; Nosáľová, Petra

2014-09-01

Most psychotropic drugs are not approved for use during pregnancy. Electroconvulsive therapy (ECT) might be an effective and safe treatment option for several psychiatric disorders in pregnant women. This study assessed ECT for treating major psychoses during pregnancy, taking all possible adverse effects into account. We scrutinized all biomedical reviews on ECT during pregnancy published within the past 10 years, and present our experience with 3 patients in different phases of pregnancy that were treated with ECT between December 2009 and July 2012. Four to 5 ECT sessions were administered to pregnant women (10th to 28th week of pregnancy) with severe psychoses, and fetal heartbeat and movements were monitored during ECT and for 2 hours afterward. Bizarre fetal spasms occurred in pregnant women treated with ECT. The authors are not aware of any similar description in the published reviews on this topic, to date. Still, all 3 women had successful deliveries, and the infants remained healthy during follow-ups ranging from 1 to 3.5 years. These data fill a lacking gap in the literature regarding long-term infant outcomes after ECT administration to pregnant women. This supports the theory that ECT may be an excellent treatment solution for pregnant women with certain severe mental disorders. Electroconvulsive therapy may be an acceptable approach for preventing pharmacotherapy risks or danger arising from injuries associated with mental illnesses in pregnant women. Nonetheless, careful monitoring of both mother and baby is absolutely necessary when considering ECT during pregnancy.

An m6A-YTH Module Controls Developmental Timing and Morphogenesis in Arabidopsis.

PubMed

Arribas-Hernández, Laura; Bressendorff, Simon; Hansen, Mathias Henning; Poulsen, Christian; Erdmann, Susanne; Brodersen, Peter

2018-04-11

Methylation of N6-adenosine (m6A) in mRNA is an important post-transcriptional gene regulatory mechanism in eukaryotes. m6A provides a binding site for effector proteins ("readers") that influence pre-mRNA splicing, mRNA degradation or translational efficiency. YT521-B homology (YTH) domain proteins are important m6A readers with established functions in animals. Plants contain more YTH domain proteins than other eukaryotes, but their biological importance remains unknown. Here, we show that the cytoplasmic Arabidopsis thaliana YTH domain proteins EVOLUTIONARILY CONSERVED C-TERMINAL REGION2/3 (ECT2/3) are required for the correct timing of leaf formation and for normal leaf morphology. These functions depend fully on intact m6A binding sites of ECT2 and ECT3, indicating that they function as m6A readers. Mutation of the close ECT2 homolog, ECT4, enhances the delayed leaf emergence and leaf morphology defects of ect2/ect3 mutants, and all three ECT proteins are expressed at leaf formation sites in the shoot apex of young seedlings and in the division zone of developing leaves. ECT2 and ECT3 are also highly expressed at early stages of trichome development and are required for trichome morphology, as previously reported for m6A itself. Overall, our study establishes the relevance of a cytoplasmic m6A-YTH regulatory module in the timing and execution of plant organogenesis. © 2018 American Society of Plant Biologists. All rights reserved.

Expression of a Rho guanine nucleotide exchange factor, Ect2, in the developing mouse pituitary.

PubMed

Islam, M S; Tsuji, T; Higashida, C; Takahashi, M; Higashida, H; Koizumi, K

2010-05-01

The pituitary gland is a highly mitotically active tissue after birth. Various cell types are known to undergo proliferation in the anterior pituitary. However, little is known about the mechanisms regulating mitotic activity in this tissue. When searching for genes specifically expressed in the pituitary gland among those that we previously screened in Drosophila, we found epithelial cell-transforming gene 2 (Ect2). Ect2 is a guanine nucleotide exchange factor for Rho GTPases, which is known to play an essential role in cytokinesis. Although there have been many cellular studies regarding the function of Ect2, the temporal and spatial expression patterns of Ect2 in vivo have not been determined. In the present study, we examined the postnatal developmental expression of Ect2 in the mouse pituitary. Enhanced Ect2 expression was detected in the mouse pituitary gland during the first 3 weeks after birth, which coincided well with the period of rapid pituitary expansion associated with increased growth rate. Immunostaining analysis showed that Ect2-expressing cells were distributed in the anterior and intermediate lobes, but not the posterior lobe, of the pituitary. These Ect2-expressing cells frequently incorporated the thymidine analogue, EdU (5-ethynyl-2'-deoxyuridine), indicating that these cells were mitotically active. Taken together, the results demonstrate the functional role of Ect2 in postnatal proliferating cells in the two lobes of the pituitary, thereby suggesting roles in developmental growth of the mammalian pituitary.

Benefits of Returning to Work After ECT.

PubMed

Berg, John Erik

2013-03-01

Severe unipolar or bipolar depression is often not helped by pharmacotherapy and/or psychotherapeutic treatment alone, whereas more than 80% of these patients remit after sessions of electroconvulsive treatment (ECT). Getting patients back to work after a severe depression may be important for maintaining the effect of ECT. Twenty consecutive patients remitted to an acute psychiatric hospital for depression underwent ECT. None of the patients had been working before the inpatient stay. Four patients were living on a permanent sickness allowance from the State (invalidity pension) before ECT, and thus were not expected to start work thereafter. Ten of the patients returned to work. Hospital treatment in Norway (including ECT) is provided free of charge with no copayments from the patient. The mean length of sick leave before ECT was 14.7 months. The 10 patients who returned to work had accrued public costs before their inpatient stays totalling NOK (Norwegian krone) 2,994,635 or a mean of NOK 299,463 per patient (&OV0556;1 = 9 NOK or $1 = 6 NOK ). The total public cost of their inpatient stays was NOK 1,680,000. During the first year after ECT, these 10 patients received NOK 2,680,000 in wages (NOK 3,238,300 during the mean number of months they were observed). Most of the patients (10 of 16) receiving ECT returned to work and within 2 years had earned more than the total cost both of their sick leave before admittance to hospital and the public cost of their 4 weeks' inpatient treatment. It is a pity that many countries, including Norway, only allow ECT as a treatment of last resort after failed psychotherapy or pharmacotherapy. Higher public spending is an inadvertent result of such a policy toward ECT.

Ectoine and 5-hydroxyectoine accumulation in the halophile Virgibacillus halodenitrificans PDB-F2 in response to salt stress.

PubMed

Tao, Ping; Li, Hui; Yu, Yunjiang; Gu, Jidong; Liu, Yongdi

2016-08-01

The moderately halophilic bacterium Virgibacillus halodenitrificans PDB-F2 copes with salinity by synthesizing or taking up compatible solutes. The main compatible solutes in this strain were ectoine and hydroxyectoine, as determined by (1)H nuclear magnetic resonance spectroscopy ((1)H-NMR). A high-performance liquid chromatography (HPLC) analysis showed that ectoine was the major solute that was synthesized in response to elevated salinity, while hydroxyectoine was a minor solute. However, the hydroxyectoine/ectoine ratio increased from 0.04 at 3 % NaCl to 0.45 at 15 % NaCl in the late exponential growth phase. A cluster of ectoine biosynthesis genes was identified, including three genes in the order of ectA, ectB, and ectC. The hydroxyectoine biosynthesis gene ectD was not part of the ectABC gene cluster. Reverse transcription-quantitative polymerase chain reactions (RT-qPCR) showed that the expression of the ect genes was salinity dependent. The expression of ectABC reached a maximum at 12 % NaCl, while ectD expression increased up to 15 % NaCl. Ectoine and hydroxyectoine production was growth phase dependent. The hydroxyectoine/ectoine ratio increased from 0.018 in the early exponential phase to 0.11 in the stationary phase at 5 % NaCl. Hydroxyectoine biosynthesis started much later than ectoine biosynthesis after osmotic shock, and the temporal expression of the ect genes differed under these conditions, with the ectABC genes being expressed first, followed by ectD gene. Increased culture salinity triggered ectoine or hydroxyectoine uptake when they were added to the medium. Hydroxyectoine was accumulated preferentially when both ectoine and hydroxyectoine were provided exogenously.

The Clonic Phase of Seizures in Patients Treated with Electroconvulsive Therapy is Related to Age and Stimulus Intensity.

PubMed

Wang, Chao-Chih; Lin, Ching-Hung; Chiu, Yao-Chu; Tseng, Chih-Chieh

2013-01-01

Electroconvulsive therapy (ECT) is effective in the treatment of major depressive disorder and schizophrenia in patients who are drug-naïve or less-receptive to antipsychotic drugs. Several studies have discussed the correlation between patient characteristics, input-current volume, and seizure duration. According to the present principle of ECT guidelines, the therapeutic effect of ECT mostly correlates with seizure duration. As the tonic phase is different from the clonic phase with respect to brain function and activity, it is informative to analyze both the tonic and clonic phases. Thus, this study sought to clarify the relationship between the features of the two phases, and to re-examine and refine guidelines regarding ECT treatment. ECT-course data from 44 schizophrenia or bipolar I patients were recollected, including the number of treatments that they had received, their gender, age, and the association of these characteristics with motor seizure duration was analyzed. A two-factor correlation was employed to test the relationship between each of the two factors. The post-analysis results indicate that seizure duration and age are significantly correlated. Older patients had relatively short seizure durations after ECT-treatment. Notably, a negative correlation was only found between age and the clonic phase of the seizure, not between age and the tonic phase. Furthermore, this study also found an inverse relationship between ECT-intensity and the clonic phase, but not between ECT-intensity and the tonic phase. This study demonstrated that age and ECT-intensity are negatively correlated with seizure duration, particularly in the clonic phase. The present observations are not fully consistent with the basic guidelines of the APA-ECT practical manual. Accordingly, the predictions regarding the therapeutic effect of ECT can be based on both the seizure duration and the clonic phase.

[Efficacy of continuation and maintenance electroconvulsive therapy (c/m ECT) in the treatment of patients with therapy-resistant affective disorders: a retrospective analysis].

PubMed

Post, Thomas; Kemmler, Georg; Krassnig, Tristan; Brugger, Anita; Hausmann, Armand

2015-01-01

Continuation and maintenance electroconvulsive therapy (c/m ECT) is a long-term treatment option in severely and chronically ill patients with mood disorders, who are unresponsive or intolerant to medication. Due to the current lack of empirical studies, c/m ECT is still a clinical tool with little evidence. We conducted a retrospective analysis of patients' charts who received c/m ECT over a 10-year period. Outcome was measured by comparing the number of pre-c/m ECT and post-c/m ECT hospitalizations, as well as inpatient days per year and mean duration of hospital stays. In 19 patients (63% female; mean age 53.5 ± 12.0 years) with either bipolar (42%) or unipolar (58%) mood disorder, with the majority of patients suffering from a depressive episode at hospital admission (95%), c/m ECT was initiated after a successful series of ECT. In a 5-year interval before and after starting c/m ECT the number of hospitalizations per year (0.87 vs. 0.28, p < 0.001), inpatient days per year (30.8 vs. 4.5 days, p < 0.001), as well as the mean duration of hospital days (30.5 vs. 16.7 days, p = 0.02) decreased significantly. Our data support previous results showing that c/m ECT is an efficacious option in treating and favourably altering the course of therapy-resistant affective disorders. Further research using a controlled study design and larger sample sizes are needed to convincingly define indication and performance of c/m ECT.

Performance index: A method for quantitative evaluation of filters used in clinical SPECT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Contino, J.; Touya, J.J.; Corbus, H.F.

1984-01-01

The purpose of this study was to design a method for optimal filter selection during the reconstruction of clinical SPECT images. Hamming, Bartlett, Parzen and Butterworth filters were evaluated at different cutoff frequencies when applied to reconstruction of the Jaszczak phantom and liver SPECTs. The phantom filled with 6 mCi of Tc-99m was imaged following 4 different protocols which varied in matrix sizes (128 x 128 or 64 x 64) and in number of steps (128 or 64). Total imaging time in the 4 protocols was 24 minutes. A total of 160 reconstructions were analyzed. Liver SPECTs from 2 patientsmore » with small metastatic lesions from colon Ca were similarly studied. An ECT Performance Index (ECT PI) was defined as the product of the contrast efficiency function (ECT C) and uniformity (ECT U). ECT C as a function of the radius was measured following Rollo's approach. ECT U was measured as the ratio between min. and max. counts per pixel in a known uniform region. ECT PI was computed on a slice through the void spheres region of the phantom. In liver SPECTs the ECT U was measured over the spleen. The most favorable ECT PI (0.35, radius 7.9 mm) was obtained with images in 128 x 128 matrices, 128 steps, processed with a Butterworth cutoff frequency of 0.19, filter order 4. When images were acquired in 64 x 64 matrices using 64 steps the ECT PI was lower and influenced to a lesser degree by both choice of filter and cutoff frequency. Results in the two liver SPECT examinations were parallel to those found in the phantom studies confirming the clinical usefulness of the ECT PI in the evaluation of filters for reconstruction of SPECT images.« less

Common Use of Electroconvulsive Therapy for Chinese Adolescent Psychiatric Patients.

PubMed

Zhang, Qing-E; Wang, Zhi-Min; Sha, Sha; Ng, Chee H; Seiner, Stephen J; Welch, Charles A; Lok, Grace K I; Chow, Ines H I; Wang, Fei; Li, Lu; Xiang, Yu-Tao

2016-12-01

Little is known about the use of electroconvulsive therapy (ECT) for adolescent psychiatric patients in China. This study examined the frequency of ECT and the demographic and clinical correlates of adolescent psychiatric patients hospitalized in a tertiary psychiatric hospital in China. This was a retrospective chart review of 954 inpatients aged between 13 and 17 years treated over a period of 8 years (2007-2013). Sociodemographic and clinical data were collected from the electronic chart management system for discharged patients. The rate of ECT use was 42.6% in the whole sample (46.5% for patients with schizophrenia, 41.8% for major depressive disorder, 57.8% for bipolar disorders, and 23.9% for other diagnoses). Use of ECT was independently and positively associated with older age, high aggression risk at time of admission, and use of antipsychotics and antidepressants. Compared with patients with schizophrenia, those with other psychiatric diagnoses were less likely to receive ECT. The above significant correlates explained 32% of the variance of ECT use (P < 0.001). Limitations of this study included the lack of data regarding the efficacy and side effects of ECT. Furthermore, the high rate of ECT applied only to 1 setting which limits the ability to extrapolate the implications of the results to other populations. The use of ECT was exceedingly high in adolescent patients treated in a tertiary clinical centre in China. It is unlikely that such a high rate of ECT use is found across China or that such practice reflects standard of care for psychiatrically ill adolescents. The underlying reasons for the high use of ECT at this center warrant urgent investigations.

Electroconvulsive therapy modulates plasma pigment epithelium-derived factor in depression: a proteomics study

PubMed Central

Ryan, K M; Glaviano, A; O'Donovan, S M; Kolshus, E; Dunne, R; Kavanagh, A; Jelovac, A; Noone, M; Tucker, G M; Dunn, M J; McLoughlin, D M

2017-01-01

Electroconvulsive therapy (ECT) is the most effective treatment for severe depression, yet its mechanism of action is not fully understood. Peripheral blood proteomic analyses may offer insights into the molecular mechanisms of ECT. Patients with a major depressive episode were recruited as part of the EFFECT-Dep trial (enhancing the effectiveness of electroconvulsive therapy in severe depression; ISRCTN23577151) along with healthy controls. As a discovery-phase study, patient plasma pre-/post-ECT (n=30) was analyzed using 2-dimensional difference in gel electrophoresis and mass spectrometry. Identified proteins were selected for confirmation studies using immunodetection methods. Samples from a separate group of patients (pre-/post-ECT; n=57) and matched healthy controls (n=43) were then used to validate confirmed changes. Target protein mRNA levels were also assessed in rat brain and blood following electroconvulsive stimulation (ECS), the animal model of ECT. We found that ECT significantly altered 121 protein spots with 36 proteins identified by mass spectrometry. Confirmation studies identified a post-ECT increase (P<0.01) in the antiangiogenic and neuroprotective mediator pigment epithelium-derived factor (PEDF). Validation work showed an increase (P<0.001) in plasma PEDF in depressed patients compared with the controls that was further increased post-ECT (P=0.03). PEDF levels were not associated with mood scores. Chronic, but not acute, ECS increased PEDF mRNA in rat hippocampus (P=0.02) and dentate gyrus (P=0.03). This study identified alterations in blood levels of PEDF in depressed patients and further alterations following ECT, as well as in an animal model of ECT. These findings implicate PEDF in the biological response to ECT for depression. PMID:28350398

The practice of electroconvulsive therapy in Greece.

PubMed

Kaliora, Styliani C; Braga, Raphael J; Petrides, Georgios; Chatzimanolis, John; Papadimitriou, George N; Zervas, Iannis M

2013-09-01

To describe the practice of electroconvulsive therapy (ECT) in Greece. A survey was conducted during the academic year 2008-2009. Electroconvulsive therapy use was investigated for 2007. All civilian institutions providing inpatient care were included. Centers that provided ECT completed a 57-item questionnaire. Centers that did not offer ECT completed a 13-item questionnaire. Fifty-five (82.1%) of 67 institutions responded. Electroconvulsive therapy was offered in 18 hospitals. Only 2 of 10 university hospitals offered ECT. Overall, 137 patients were treated with 1271 sessions in 2007. Only 1.47% discontinued treatment owing to adverse events. There were no deaths. Schizophrenia was the most common diagnosis (41.3%) among those receiving ECT, followed by major depression (28.9%), bipolar depression (9.1%), catatonia (4.1%), suicidal ideation (3.3%), and schizoaffective disorder (2.5%). Physicians considered major depression (93.8%), catatonia (86.5%), schizophrenia (56.3%), and mania (50%) the most appropriate indications. Written informed consent was required in 77.8% of the institutions, whereas the rest required verbal consent. Bilateral ECT was the preferred electrode placement (88.9%). Modified ECT was used exclusively. Propofol was the preferred anesthetic (44.4%), followed by thiopental (38.9%). Seven (38.9%) of 18 hospitals used a fixed stimulus dose at first treatment. Five (27.8%) of 18 hospitals used the half-age method. Continuation/maintenance ECT was used in 33.3% of the hospitals. Outpatient ECT was seldom used. Lack of training, difficult access to anesthesiology, billing issues, and stigma were cited as the main impediments to the practice of ECT. Electroconvulsive therapy is practiced in moderate numbers in Greece and almost exclusively on an inpatient basis. Lack of training and lack of availability of anesthesiologists were cited as the most common obstacles to providing ECT.

Electroconvulsive therapy modulates plasma pigment epithelium-derived factor in depression: a proteomics study.

PubMed

Ryan, K M; Glaviano, A; O'Donovan, S M; Kolshus, E; Dunne, R; Kavanagh, A; Jelovac, A; Noone, M; Tucker, G M; Dunn, M J; McLoughlin, D M

2017-03-28

Electroconvulsive therapy (ECT) is the most effective treatment for severe depression, yet its mechanism of action is not fully understood. Peripheral blood proteomic analyses may offer insights into the molecular mechanisms of ECT. Patients with a major depressive episode were recruited as part of the EFFECT-Dep trial (enhancing the effectiveness of electroconvulsive therapy in severe depression; ISRCTN23577151) along with healthy controls. As a discovery-phase study, patient plasma pre-/post-ECT (n=30) was analyzed using 2-dimensional difference in gel electrophoresis and mass spectrometry. Identified proteins were selected for confirmation studies using immunodetection methods. Samples from a separate group of patients (pre-/post-ECT; n=57) and matched healthy controls (n=43) were then used to validate confirmed changes. Target protein mRNA levels were also assessed in rat brain and blood following electroconvulsive stimulation (ECS), the animal model of ECT. We found that ECT significantly altered 121 protein spots with 36 proteins identified by mass spectrometry. Confirmation studies identified a post-ECT increase (P<0.01) in the antiangiogenic and neuroprotective mediator pigment epithelium-derived factor (PEDF). Validation work showed an increase (P<0.001) in plasma PEDF in depressed patients compared with the controls that was further increased post-ECT (P=0.03). PEDF levels were not associated with mood scores. Chronic, but not acute, ECS increased PEDF mRNA in rat hippocampus (P=0.02) and dentate gyrus (P=0.03). This study identified alterations in blood levels of PEDF in depressed patients and further alterations following ECT, as well as in an animal model of ECT. These findings implicate PEDF in the biological response to ECT for depression.

Episodic memory following deep brain stimulation of the ventral anterior limb of the internal capsule and electroconvulsive therapy.

PubMed

Bergfeld, Isidoor O; Mantione, Mariska; Hoogendoorn, Mechteld L C; Horst, Ferdinand; Notten, Peter; Schuurman, P Richard; Denys, Damiaan

Electroconvulsive Therapy (ECT) and Deep Brain Stimulation (DBS) are effective treatments for patients with treatment-resistant depression (TRD). However, a common side effect of ECT is autobiographical memory loss (e.g., personal experiences), whereas the impact of DBS on autobiographical memories has never been established. Comparing autobiographical memories following DBS and ECT. In two hospitals in The Netherlands, we interviewed 25 TRD patients treated with DBS of the ventral anterior limb of the internal capsule (vALIC), 14 TRD patients treated with ECT and 22 healthy controls (HC) with the Autobiographical Memory Inventory - Short Form (AMI-SF) in a prospective, longitudinal study between March 2010 and August 2016. Patients treated with DBS were interviewed before surgery, after surgery, and twice during treatment over 122.7 (SD: ±22.2) weeks. Patients treated with ECT were tested before ECT, after six right unilateral (RUL) ECT sessions and twice following ECT over 65.1 (±9.3) weeks. Controls were tested four times over 81.5 (±15.6) weeks. Compared to HC, the AMI-SF score decreased faster in both TRD groups (P < 0.001). More specifically, AMI-SF score decreased in a comparable rate as HC after DBS surgery, but decreased more during treatment. The AMI-SF decrease in the ECT group was larger than both the DBS and HC groups. Both ECT and vALIC DBS result in a faster autobiographical memory decline compared to HC. DBS might have a negative impact on autobiographical memories, although less so than ECT. Future work should dissect whether DBS or characteristics of TRD cause this decline. Copyright © 2017 Elsevier Inc. All rights reserved.

A Specialized Aspartokinase Enhances the Biosynthesis of the Osmoprotectants Ectoine and Hydroxyectoine in Pseudomonas stutzeriA1501▿ †

PubMed Central

Stöveken, Nadine; Pittelkow, Marco; Sinner, Tatjana; Jensen, Roy A.; Heider, Johann; Bremer, Erhard

2011-01-01

The compatible solutes ectoine and hydroxyectoine are widely produced by bacteria as protectants against osmotic and temperature stress. l-Aspartate-beta-semialdehyde is used as the precursor molecule for ectoine/hydroxyectoine biosynthesis that is catalyzed by the EctABCD enzymes. l-Aspartate-beta-semialdehyde is a central intermediate in different biosynthetic pathways and is produced from l-aspartate by aspartokinase (Ask) and aspartate-semialdehyde-dehydrogenase (Asd). Ask activity is typically stringently regulated by allosteric control to avoid gratuitous synthesis of aspartylphosphate. Many organisms have evolved multiple forms of aspartokinase, and feedback regulation of these specialized Ask enzymes is often adapted to the cognate biochemical pathways. The ectoine/hydroxyectoine biosynthetic genes (ectABCD) are followed in a considerable number of microorganisms by an askgene (ask_ect), suggesting that Ask_Ect is a specialized enzyme for this osmoadaptive biosynthetic pathway. However, none of these Ask_Ect enzymes have been functionally characterized. Pseudomonas stutzeriA1501 synthesizes both ectoine and hydroxyectoine in response to increased salinity, and it possesses two Ask enzymes: Ask_Lys and Ask_Ect. We purified both Ask enzymes and found significant differences with regard to their allosteric control: Ask_LysC was inhibited by threonine and in a concerted fashion by threonine and lysine, whereas Ask_Ect showed inhibition only by threonine. The ectABCD_askgenes from P. stutzeriA1501 were cloned and functionally expressed in Escherichia coli, and this led to osmostress protection. An E. colistrain carrying the plasmid-based ectABCD_askgene cluster produced significantly more ectoine/hydroxyectoine than a strain expressing the ectABCDgene cluster alone. This finding suggests a specialized role for Ask_Ect in ectoine/hydroxyectoine biosynthesis. PMID:21725014

Blood serum concentrations of kynurenic acid in patients diagnosed with recurrent depressive disorder, depression in bipolar disorder, and schizoaffective disorder treated with electroconvulsive therapy.

PubMed

Olajossy, Marcin; Olajossy, Bartosz; Wnuk, Sebastian; Potembska, Emilia; Urbańska, Ewa

2017-06-18

The aim of the present study was to compare blood serum kynurenic acid (KYNA) concentrations measured before ECT and after 1, 6 and 12 electroconvulsive treatment (ECT) sessions in patients with diagnoses of recurrent depressive disorder (RDD), depression in bipolar disorder (DBD) and schizoaffective disorder (SAD). The study group comprised of 50 patients with ICD-10 diagnoses of RDD, DBD and SAD. Blood serum KYNA concentrations were determined and clinical assessment was performed using the MADRS and the GAF scale. Significant differences were found in blood serum KYNA levels between RDD, DBD and SAD patients treated with electroconvulsive therapy and healthy controls: 1) KYNA concentrations in DBD patients measured before ECT and after 12 ECT sessions were significantly lower than in the control group; 2) KYNA concentrations in the serum of RDD patients measured before ECT and after one and 12 ECT sessions were significantly lower than in the control group, while those measured after 6 ECT session did not differ significantly from KYNA concentrations in healthy controls; 3) higher pre-treatment blood serum concentrations of KYNA in DBD patients correlated with a higher number of illness phases and poorer general functioning before treatment; 4) significant relationships were found between higher blood serum concentrations of KYNA in RDD patients after 1 ECT session and male gender, and between higher KYNA concentrations after 6 ECT sessions and increased depression and poorer functioning before treatment in those patients. Results show that KYNA concentrations in all diagnostic groups were lower before ECT (not statistically significant for the SAD group) and that there were no significant changes in those concentrations (compared with the baseline) during ECT.

Impact of hyperventilation on stimulus efficiency during the early phase of an electroconvulsive therapy course: a randomized double-blind study.

PubMed

Mayur, Prashanth; Bray, Amanda; Fernandes, Joanne; Bythe, Karen; Gilbett, David

2010-06-01

The question whether hyperventilation during electroconvulsive therapy (ECT) can improve stimulus efficiency is as yet unanswered. Twenty-five consecutive consenting patients (N = 25) with major depression who were administered ECT entered into the study. Right unilateral ECT at thrice the threshold dose was administered using Mecta spECTrum 5000Q (Mecta Corp, Lake Oswego, Ore), with standard titration procedures and stimulus configurations. At the second ECT session, they were randomly allocated to ECT either with hyperventilation or with no hyperventilation. Hyperventilation was actively administered by an anesthetist just after anesthetic paralysis and before the ECT stimulus during the second, third, and fourth ECT sessions. Assessments were double-blind and performed at baseline and 24 to 48 hours after the fourth ECT session. Time to reorient after ECT was assessed during the first up to the fourth ECT session. Ictal electroencephalogram (EEG) quality was visually assessed using standard scales. There were no significant differences across the 2 groups about depression severity and global cognitive impact. However, the orientation time was 34% longer among those who did not receive hyperventilation. The ratio of orientation time without hyperventilation to that with hyperventilation equals 1.34 (95% confidence interval, 0.94-1.92; P = 0.103). There was a significant increase in threshold over time across both groups (mean difference, 16.4; SE, 5.5; P = 0.006) with no significant main effect for the groups (P = 0.399). There were no significant group differences in the EEG quality. The addition of hyperventilation during the early phase of the ECT course shows a trend to lessen the impact on immediate orientation without impeding clinical response. This does not seem to be mediated by differential threshold changes or change to the ictal EEG quality.

Genetic analysis and CRISPR typing of Salmonella enterica serovar Enteritidis from different sources revealed potential transmission from poultry and pig to human.

PubMed

Li, Qiuchun; Wang, Xin; Yin, Kequan; Hu, Yachen; Xu, Haiyan; Xie, Xiaolei; Xu, Lijuan; Fei, Xiao; Chen, Xiang; Jiao, Xinan

2018-02-02

Salmonella enterica serovar Enteritidis (S. Enteritidis) is one of the most prevalent serotypes in Salmonella isolated from poultry and the most commonly reported cause of human salmonellosis. In this study, we aimed to assess the genetic diversity of 329 S. Enteritidis strains isolated from different sources from 2009 to 2016 in China. Clustered regularly interspaced short palindromic repeat (CRISPR) typing was used to characterize these 262 chicken clinical isolates, 38 human isolates, 18 pig isolates, six duck isolates, three goose isolates and two isolates of unknown source. A total of 18 Enteritidis CRISPR types (ECTs) were identified, with ECT2, ECT8 and ECT4 as the top three ECTs. CRISPR typing identified ECT2 as the most prevalent ECT, which accounted for 41% of S. Enteritidis strains from all the sources except duck. ECT9 and ECT13 were identified in both pig and human isolates and revealed potential transmission from pig to human. A cluster analysis distributed 18 ECTs, including the top three ECTs, into four lineages with LI as the predominant lineage. Forty-eight out of 329 isolates were subjected to whole genome sequence typing, which divided them into four clusters, with Cluster I as the predominant cluster. Cluster I included 92% (34/37) of strains located in LI identified from the CRISPR typing, confirming the good correspondence between both typing methods. In addition, the CRISPR typing also revealed the close relationship between ECTs and isolated areas, confirming that CRISPR spacers might be obtained by bacteria from the unique phage or plasmid pools in the environment. However, further analysis is needed to determine the function of CRISPR-Cas systems in Salmonella and the relationship between spacers and the environment. Copyright © 2017 Elsevier B.V. All rights reserved.

The use of electroconvulsive therapy in the elderly: a study from the psychiatric unit of a north Indian teaching hospital.

PubMed

Jain, Gaurav; Kumar, Vineet; Chakrabarti, Subho; Grover, Sandeep

2008-06-01

There are very little data on elderly patients receiving electroconvulsive therapy (ECT) in India. This study was a preliminary attempt at characterizing the clinical and demographic profile of elderly subjects (>or=60 years) who received ECT in the psychiatric department of a teaching hospital in north India. A retrospective case-note review was carried out to identify patients 60 years or older who had received ECT over an 8-year period at the Postgraduate Institute of Medical Education and Research, Chandigarh, India. Several details about their demographic and clinical profile, indications for ECT, response patterns, and adverse effects were extracted. Over the 8 years, 373 patients received ECT, of which 56 (15%) were 60 years or older. Complete records were available for only 50 of these patients. The majority (96%) had depression. The index depressive episode for which ECT was used was severe in 91.6% of the subjects, and 68% had not responded to adequate psychotropic treatment before ECT. Comorbid medical illnesses were present in 66% of cases and were associated with significantly higher risk of cognitive side effects. However, side effects were usually mild; there were no serious untoward events caused by ECT. About 80% to 90% showed some response to treatment. Those who had received inadequate antidepressant treatment before ECT were significantly more likely to respond to ECT. Elderly with depression constitute a substantial proportion of those receiving ECT in India. Use of ECT in this population seemed to be mainly restricted to those who were very severely ill and poorly responsive to medications. Electroconvulsive therapy seemed to be a safe and effective treatment in such situations. However, particular care may be required in the subgroup with comorbid physical problems that may be more vulnerable to cognitive adverse effects.

Cost-effectiveness of Electroconvulsive Therapy vs Pharmacotherapy/Psychotherapy for Treatment-Resistant Depression in the United States.

PubMed

Ross, Eric L; Zivin, Kara; Maixner, Daniel F

2018-05-09

Electroconvulsive therapy (ECT) is a highly effective treatment for depression but is infrequently used owing to stigma, uncertainty about indications, adverse effects, and perceived high cost. To assess the cost-effectiveness of ECT compared with pharmacotherapy/psychotherapy for treatment-resistant major depressive disorder in the United States. A decision analytic model integrating data on clinical efficacy, costs, and quality-of-life effects of ECT compared with pharmacotherapy/psychotherapy was used to simulate depression treatment during a 4-year horizon from a US health care sector perspective. Model input data were drawn from multiple meta-analyses, randomized trials, and observational studies of patients with depression. Where possible, data sources were restricted to US-based studies of nonpsychotic major depression. Data were analyzed between June 2017 and January 2018. Six alternative strategies for incorporating ECT into depression treatment (after failure of 0-5 lines of pharmacotherapy/psychotherapy) compared with no ECT. Remission, response, and nonresponse of depression; quality-adjusted life-years; costs in 2013 US dollars; and incremental cost-effectiveness ratios. Strategies with incremental cost-effectiveness ratios of $100 000 per quality-adjusted life-year or less were designated cost-effective. Based on the Sequenced Treatment Alternatives to Relieve Depression trial, we simulated a population with a mean (SD) age of 40.7 (13.2) years, and 62.2% women. Over 4 years, ECT was projected to reduce time with uncontrolled depression from 50% of life-years to 33% to 37% of life-years, with greater improvements when ECT is offered earlier. Mean health care costs were increased by $7300 to $12 000, with greater incremental costs when ECT was offered earlier. In the base case, third-line ECT was cost-effective, with an ICER of $54 000 per quality-adjusted life-year. Third-line ECT remained cost-effective in a range of univariate, scenario, and probabilistic sensitivity analyses. Incorporating all input data uncertainty, we estimate a 74% to 78% likelihood that at least 1 of the ECT strategies is cost-effective and a 56% to 58% likelihood that third-line ECT is the optimal strategy. For US patients with treatment-resistant depression, ECT may be an effective and cost-effective treatment option. Although many factors influence the decision to proceed with ECT, these data suggest that, from a health-economic standpoint, ECT should be considered after failure of 2 or more lines of pharmacotherapy/psychotherapy.

Electroconvulsive Therapy for Agitation in Schizophrenia: Metaanalysis of Randomized Controlled Trials.

PubMed

Gu, Xiaojing; Zheng, Wei; Guo, Tong; Ungvari, Gabor S; Chiu, Helen F K; Cao, Xiaolan; D'Arcy, Carl; Meng, Xiangfei; Ning, Yuping; Xiang, Yutao

2017-02-25

Agitation poses a significant challenge in the treatment of schizophrenia. Electroconvulsive therapy (ECT) is a fast, effective and safe treatment for a variety of psychiatric disorders, but no meta-analysis of ECT treatment for agitation in schizophrenia has yet been reported. To systematically evaluate the efficacy and safety of ECT alone or ECT-antipsychotics (APs) combination for agitation in schizophrenia. Systematic literature search of randomized controlled trials (RCTs) was performed. Two independent evaluators selected studies, extracted data about outcomes and safety with available data, conducted quality assessment and data synthesis. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to judge the level of the overall evidence of main outcomes. Seven RCTs from China, including ECT alone (4 RCTs with 5 treatment arms, n=240) and ECT-APs combination (3 RCTs, n=240), were identified. Participants in the studies were on average 34.3(4.5) years of age and lasted an average of 4.3(3.1) weeks of treatment duration. All 7 RCTs were non-blinded, and were rated as low quality based on Jadad scale. Meta-analysis of the pooled sample found no significant difference in the improvement of the agitation sub-score of the Positive and Negative Syndrome Scale (PANSS) when ECT alone (weighted mean difference=-0.90, (95% confidence interval (CI): -2.91, 1.11), p=0.38) or ECT-APs combination (WMD=-1.34, (95%CI: -4.07, 1.39), p=0.33) compared with APs monotherapy. However, ECT alone was superior to APs monotherapy regarding PANSS total score (WMD=-7.13, I 2 =0%, p =0.004) and its excitement sub-score (WMD=-1.97, p <0.0001) as well as the PANSS total score at 14 days (WMD=-7.13, I 2 =0%, p =0.004) and its excitement sub-score at 7 and 14 days (WMD=-1.97 to -1.92, p =0.002 to 0.0001) after ECT. The ECT-APs combination was superior to APs monotherapy with respect to the PANSS total score at treatment endpoint (WMD=-10.40, p=0.03) and 7 days (WMD=-5.01, p =0.02). Headache (number-needed-to-harm (NNH)=3, 95%CI=2-4) was more frequent in the ECT alone group compared to AP monotherapy. According to the GRADE approach, the evidence levels of main outcomes were rated as ''very low'' (37.5%) and "low" (50%). Pooling of the data based on 7 RCTs from China found no advantage of ECT alone or ECT-APs combination in the treatment of agitation related outcomes in schizophrenia patients. However, ECT alone or ECT-APs combination were associated with significant reduction in the PANSS total score. High-quality RCTs are needed to confirm the current interpretations.

Sub-Fourier characteristics of a δ-kicked-rotor resonance.

PubMed

Talukdar, I; Shrestha, R; Summy, G S

2010-07-30

We experimentally investigate the sub-Fourier behavior of a δ-kicked-rotor resonance by performing a measurement of the fidelity or overlap of a Bose-Einstein condensate exposed to a periodically pulsed standing wave. The temporal width of the fidelity resonance peak centered at the Talbot time and zero initial momentum exhibits an inverse cube pulse number (1/N3)-dependent scaling compared to a 1/N2 dependence for the mean energy width at the same resonance. A theoretical analysis shows that for an accelerating potential the width of the resonance in acceleration space depends on 1/N3, a property which we also verify experimentally. Such a sub-Fourier effect could be useful for high precision gravity measurements.

Voices of people who have received ECT.

PubMed

Rajkumar, A P; Saravanan, B; Jacob, K S

2007-01-01

Electroconvulsive therapy (ECT) is controversial but widely practised in India. We elicited perspectives, using qualitative interviews, from patients who received ECT and their relatives. Ethical issues related to personal autonomy, right to information, competence, informed consent and consent by proxy are discussed. We suggest strategies to ensure a basic minimum standard for obtaining informed consent for ECT in India.

Knowledge and Attitudes of Patients and Their Relatives Toward Electroconvulsive Therapy in China.

PubMed

Li, Yang; An, Feng-Rong; Zhu, Hui; Chiu, Helen F K; Ungvari, Gabor S; H Ng, Chee; Lai, Kelly Y C; Xiang, Yu-Tao

2016-10-01

To examine the knowledge and attitudes of patients and their relatives as well as patients' subjective experience with electroconvulsive therapy (ECT) in China. Up to 420 responders including patients receiving ECT (n = 210) and their relatives (n = 210) were assessed with self-reported questionnaires. Patients and their relatives did not receive adequate information before ECT, particularly about the mode of its delivery, risks, and adverse effects. The most common adverse effect of ECT reported by patients was memory impairment. Both patients and their relatives had positive attitudes toward ECT and appeared satisfied with its therapeutic effects. Mental health professionals need to address the inadequate information on ECT provided to patients and their relatives prior to the treatment. © 2015 Wiley Periodicals, Inc.

Informed Consent for Electroconvulsive Therapy--Finding Balance.

PubMed

Mankad, Mehul

2015-09-01

Informed consent underpins all medical decisions, including the decision to undergo electroconvulsive therapy (ECT). Written informed consent remains the standard before the initiation of ECT and requires the inclusion of several components to be considered valid. Prospective patients must be aware of risks and benefits of ECT as well as risks and benefits of alternate, and potentially less effective, interventions. Patients must also possess adequate decision-making capacity to make an informed choice about treatment. Consent for ECT may present unique issues, such as the interplay between potential cognitive adverse effects and informed consent. Options to address this concern include thorough explanation of this topic before the initiation of ECT, continued reassessment of consent during ECT, or some combination of approaches.

A New Measurement of the Spectral Lag of Gamma-Ray Bursts and its Implications for Spectral Evolution Behaviors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shao, Lang; Wang, Fu-Ri; Cheng, Ye-Hao

We carry out a systematical study of the spectral lag properties of 50 single-pulsed gamma-ray bursts (GRBs) detected by the Fermi Gamma-Ray Burst Monitor. By dividing the light curves into multiple consecutive energy channels, we provide a new measurement of the spectral lag that is independent of energy channel selections. We perform a detailed statistical study of our new measurements. We find two similar power-law energy dependencies of both the pulse arrival time and pulse width. Our new results on the power-law indices would favor the relativistic geometric effects for the origin of spectral lag. However, a complete theoretical frameworkmore » that can fully account for the diverse energy dependencies of both arrival time and pulse width revealed in this work is still lacking. We also study the spectral evolution behaviors of the GRB pulses. We find that a GRB pulse with negligible spectral lag would usually have a shorter pulse duration and would appear to have a “hardness-intensity tracking” behavior, and a GRB pulse with a significant spectral lag would usually have a longer pulse duration and would appear to have a “hard-to-soft” behavior.« less

Development of the dense plasma focus for short-pulse applications

NASA Astrophysics Data System (ADS)

Bennett, N.; Blasco, M.; Breeding, K.; Constantino, D.; DeYoung, A.; DiPuccio, V.; Friedman, J.; Gall, B.; Gardner, S.; Gatling, J.; Hagen, E. C.; Luttman, A.; Meehan, B. T.; Misch, M.; Molnar, S.; Morgan, G.; O'Brien, R.; Robbins, L.; Rundberg, R.; Sipe, N.; Welch, D. R.; Yuan, V.

2017-01-01

The dense plasma focus (DPF) has long been considered a compact source for pulsed neutrons and has traditionally been optimized for the total neutron yield. In this paper, we describe the efforts to optimize the DPF for short-pulse applications by introducing a reentrant cathode at the end of the coaxial plasma gun. The resulting neutron pulse widths are reduced by an average of 21 ±9 % from the traditional long-drift DPF design. Pulse widths and yields achieved from deuterium-tritium fusion at 2 MA are 61.8 ±30.7 ns FWHM and 1.84 ±0.49 ×1012 neutrons per shot. Simulations were conducted concurrently to elucidate the DPF operation and confirm the role of the reentrant cathode. A hybrid fluid-kinetic particle-in-cell modeling capability demonstrates correct sheath velocities, plasma instabilities, and fusion yield rates. Consistent with previous findings that the DPF is dominated by beam-target fusion from superthermal ions, we estimate that the thermonuclear contribution is at the 1% level.

Experimental investigation on a diode-pumped cesium-vapor laser stably operated at continuous-wave and pulse regime.

PubMed

Chen, Fei; Xu, Dongdong; Gao, Fei; Zheng, Changbin; Zhang, Kuo; He, Yang; Wang, Chunrui; Guo, Jin

2015-05-04

Employing a fiber-coupled diode-laser with a center wavelength of 852.25 nm and a line width of 0.17 nm, experimental investigation on diode-end-pumped cesium (Cs) vapor laser stably operated at continuous-wave (CW) and pulse regime is carried out. A 5 mm long cesium vapor cell filled with 60 kPa helium and 20 kPa ethane is used as laser medium. Using an output coupler with reflectivity of 48.79%, 1.26 W 894.57 nm CW laser is obtained at an incident pump power of 4.76 W, corresponding an optical-optical efficiency of 26.8% and a slope-efficiency of 28.8%, respectively. The threshold temperature is 67.5 °C. Stable pulsed cesium laser with a maximum average output power of 2.6 W is obtained at a repetition rate of 76 Hz, and the pulse repetition rate can be extend to 1 kHz with a pulse width of 18 μs.

Effects of copper vapor laser (CVL) on mice skin: histologic evaluation of damage and tissue stimulation

NASA Astrophysics Data System (ADS)

Nunes, Syllene; Moreno, E.; Oliveira, H.; Osaka, J.; Salvador, G.; Michalany, N.; Tolosa, E.

2002-10-01

This study was to evaluate the effects of the CVL with low energy and short pulse widths. 18 female mice, C57BL/6 (9-11 weeks old) were distributed into four groups. The control group (CG) wasn't exposed to laser beam . Group L1 had 2 laser expositions with 24 hours gap between them (0.5W). Group L2 had 3 expositions (0.5W and 0.25W) and group L3 had 4 expositions (0.25 W). It was used a CVL prototype (5lOnm, 13 Khz, pulse width of 20 ms and spot size of 0.8cm). 7 days after last laser pulse no groups presented actinic keratosis, tumors or collagen changes. CVL had effective action on pilosebaceous units. High energy with few short pulses induced hair follicles proliferation while low energy with many repetitive short pulses showed increased and specific tissue damage besides hair plugging.

Design and test of a simple fast electromagnetic inductive gas valve for planar pulsed inductive plasma thruster

NASA Astrophysics Data System (ADS)

Guo, Dawei; Cheng, Mousen; Li, Xiaokang

2017-10-01

In support of our planar pulsed inductive plasma thruster research, a fast electromagnetic inductive valve for a gas propellant injection system has been built and tested. A new and important design feature is the use of a conical diaphragm as the action part, which greatly contributes to the virtue of simplicity for adopting the resultant force of the diaphragm deformation as the closing force. An optical transmission technique is adopted to measure the opening and closing characters of the valve while the gas throughput is determined by measuring the pressure change per pulse in a test chamber with a capacitance manometer. The experimental results revealed that the delay time before the valve reaction is less than 40 μs, and the valve pulse width is no longer than 160 μs full width at half maximum. The valve delivers 0-2.5 mg of argon gas per pulse varied by adjusting the drive voltage and gas pressure.

Design and test of a simple fast electromagnetic inductive gas valve for planar pulsed inductive plasma thruster.

PubMed

Guo, Dawei; Cheng, Mousen; Li, Xiaokang

2017-10-01

In support of our planar pulsed inductive plasma thruster research, a fast electromagnetic inductive valve for a gas propellant injection system has been built and tested. A new and important design feature is the use of a conical diaphragm as the action part, which greatly contributes to the virtue of simplicity for adopting the resultant force of the diaphragm deformation as the closing force. An optical transmission technique is adopted to measure the opening and closing characters of the valve while the gas throughput is determined by measuring the pressure change per pulse in a test chamber with a capacitance manometer. The experimental results revealed that the delay time before the valve reaction is less than 40 μs, and the valve pulse width is no longer than 160 μs full width at half maximum. The valve delivers 0-2.5 mg of argon gas per pulse varied by adjusting the drive voltage and gas pressure.

Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013.

PubMed

Lemasson, Morgane; Haesebaert, Julie; Rochette, Louis; Pelletier, Eric; Lesage, Alain; Patry, Simon

2017-01-01

As part of a quality improvement process, we propose a model of routinely monitoring electroconvulsive therapy (ECT) in Canadian provinces using linked health administrative databases to generate provincial periodic reports, influence policy, and standardise ECT practices. ECT practice in Quebec was studied from 1996 to 2013, using longitudinal data from the Quebec Integrated Chronic Disease Surveillance System of the Institut National de Santé Publique du Québec, which links 5 health administrative databases. The population included all persons, aged 18 y and over, eligible for the health insurance registry, who received an ECT treatment at least once during the year. Among recorded cases, 75% were identified by physician claims and hospitalisation files, 19% exclusively by physician claims, and 6% by hospitalisation files. From 1996 to 2013, 8,149 persons in Quebec received ECT with an annual prevalence rate of 13 per 100,000. A decline was observed, which was more pronounced in women and in older persons. On average, each patient received 9.7 treatments of ECT annually. The proportion of acute ECT decreased whereas maintenance treatment proportions increased. A wide variation in the use of ECT was observed among regions and psychiatrists. This study demonstrates the profitable use of administrative data to monitor ECT use in Quebec, and provides a reliable method that could be replicated in other Canadian provinces. Although Quebec has one of the lowest utilisation rates reported in industrialized countries, regional disparities highlighted the need for a deeper examination of the quality and monitoring of ECT care and services.

Comparing ECT data of two different inpatient clinics: propofol or thiopental?

PubMed

Yazici, Esra; Bosgelmez, Sukriye; Tas, Halil Ibrahim; Karabulut, Umit; Yazici, Ahmet Bulent; Yildiz, Mustafa; Kirpinar, Ismet

2013-10-01

This study compares the data of (modified) electroconvulsive theraphy (ECT) applications from two different inpatient clinics in Turkey: Kocaeli Derince Training and Research Hospital (Clinic-I) and Kocaeli University (Clinic-II). Recorded files of patients from the two clinics were compared in terms of ECT indications, number and duration of seizures, and anesthetic agents used (propofol vs. thiopental). ECT applications occurring between January 2011 and January 2013 were included in the study. A total of 86 patients (9.5% of the inpatients) received ECT in Clinic-I and 103 patients (21.1% of the inpatients) in Clinic-II during the period studied. The yearly ECT rate (treated person rate per 10,000 per year) was 0.59/10,000 for Kocaeli (Turkey) as a whole. The overall number of ECT applications was 539 in Clinic-I and 999 in Clinic-II, and the average number of ECT sessions for each patient was 6.4 ± 2.33 in Clinic-I and 9.69 ± 4.66 in Clinic-II. The majority of indications were depressive disorders and insufficient response to medicine. Patients in the clinic which utilized thiopental as the anesthetic agent experienced more cardiovascular and respiratory side effects than the one which used propofol. The number of ECT sessions required was greater for patients with schizoaffective disorder than for others. The administration of ECT was considered to be a reliable method of treatment in these clinics. With respect to specific anesthetic agents, propofol was found to have less hemodynamic side effects and shorter seizure durations than thiopental.

Factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study.

PubMed

Shibasaki, Chiyo; Takebayashi, Minoru; Fujita, Yasutaka; Yamawaki, Shigeto

2015-01-01

Electroconvulsive therapy (ECT) is an effective treatment for depression and schizophrenia. However, there is a high rate of relapse after an initial response to ECT, even with antidepressant or antipsychotic maintenance therapy. This study was carried out to examine the factors that influence the risk of relapse in schizophrenic patients after a response to ECT. We retrospectively reviewed the records of 43 patients with schizophrenia who received and responded to an acute ECT course. We analyzed the associated clinical variables and relapse after response to the acute ECT. Relapse was defined as a Clinical Global Impressions Improvement score ≥6 or a psychiatric rehospitalization. All patients were treated with neuroleptic medication after the acute ECT course. The relapse-free rate of all 43 patients at 1 year was 57.3%, and the median relapse-free period was 21.5 months. Multivariate analysis showed that the number of ECT sessions was associated with a significant increase in the risk of relapse (hazard ratio: 1.159; P=0.033). Patients who were treated with adjunctive mood stabilizers as maintenance pharmacotherapy after the response to the acute ECT course were at a lower risk of relapse than were those treated without mood stabilizers (hazard ratio: 0.257; P=0.047). Our study on the recurrence of schizophrenia after a response to an acute ECT course suggests that the number of ECT sessions might be related to the risk of relapse and that adjunctive mood stabilizers might be effective in preventing relapse.

Controlling stimulation strength and focality in electroconvulsive therapy via current amplitude and electrode size and spacing: comparison with magnetic seizure therapy.

PubMed

Deng, Zhi-De; Lisanby, Sarah H; Peterchev, Angel V

2013-12-01

Understanding the relationship between the stimulus parameters of electroconvulsive therapy (ECT) and the electric field characteristics could guide studies on improving risk/benefit ratio. We aimed to determine the effect of current amplitude and electrode size and spacing on the ECT electric field characteristics, compare ECT focality with magnetic seizure therapy (MST), and evaluate stimulus individualization by current amplitude adjustment. Electroconvulsive therapy and double-cone-coil MST electric field was simulated in a 5-shell spherical human head model. A range of ECT electrode diameters (2-5 cm), spacing (1-25 cm), and current amplitudes (0-900 mA) was explored. The head model parameters were varied to examine the stimulus current adjustment required to compensate for interindividual anatomical differences. By reducing the electrode size, spacing, and current, the ECT electric field can be more focal and superficial without increasing scalp current density. By appropriately adjusting the electrode configuration and current, the ECT electric field characteristics can be made to approximate those of MST within 15%. Most electric field characteristics in ECT are more sensitive to head anatomy variation than in MST, especially for close electrode spacing. Nevertheless, ECT current amplitude adjustment of less than 70% can compensate for interindividual anatomical variability. The strength and focality of ECT can be varied over a wide range by adjusting the electrode size, spacing, and current. If desirable, ECT can be made as focal as MST while using simpler stimulation equipment. Current amplitude individualization can compensate for interindividual anatomical variability.

Computational models of Bitemporal, Bifrontal and Right Unilateral ECT predict differential stimulation of brain regions associated with efficacy and cognitive side effects.

PubMed

Bai, S; Gálvez, V; Dokos, S; Martin, D; Bikson, M; Loo, C

2017-03-01

Extensive clinical research has shown that the efficacy and cognitive outcomes of electroconvulsive therapy (ECT) are determined, in part, by the type of electrode placement used. Bitemporal ECT (BT, stimulating electrodes placed bilaterally in the frontotemporal region) is the form of ECT with relatively potent clinical and cognitive side effects. However, the reasons for this are poorly understood. This study used computational modelling to examine regional differences in brain excitation between BT, Bifrontal (BF) and Right Unilateral (RUL) ECT, currently the most clinically-used ECT placements. Specifically, by comparing similarities and differences in current distribution patterns between BT ECT and the other two placements, the study aimed to create an explanatory model of critical brain sites that mediate antidepressant efficacy and sites associated with cognitive, particularly memory, adverse effects. High resolution finite element human head models were generated from MRI scans of three subjects. The models were used to compare differences in activation between the three ECT placements, using subtraction maps. In this exploratory study on three realistic head models, Bitemporal ECT resulted in greater direct stimulation of deep midline structures and also left temporal and inferior frontal regions. Interpreted in light of existing knowledge on depressive pathophysiology and cognitive neuroanatomy, it is suggested that the former sites are related to efficacy and the latter to cognitive deficits. We hereby propose an approach using binarised subtraction models that can be used to optimise, and even individualise, ECT therapies. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Electroconvulsive Therapy in Women: A Retrospective Study from a Mental Health Hospital in Turkey.

PubMed

Özdemir, Armağan; Poyraz, Cana Aksoy; Erten, Evrim; Çırakoğlu, Emre; Tomruk, Nesrin

2016-12-01

The aim was to evaluate the clinical profile and effectiveness of ECT in women. A retrospective chart review was carried out to identify female patients who had received ECT during the period September 2013-February 2015. Details regarding their sociodemographic, clinical, and treatment data were extracted from these records for the present study. The total number of patients, admitted to our psychiatry inpatient clinic during the survey period, was 802. During this period, 26 (3.24 %) female patients received ECT. Patients who received ECT were mostly in age group of 25-44 years (76.9 %). Twenty percent of patients were in the postpartum period. Psychotic disorders (46.1 %) was the most common diagnosis for which ECT was used, followed by bipolar affective disorder, current episode manic (19.2 %). At the end of ECT courses, 70 % of the patients showed good response with a CGI-I of 1 or 2, and 30 % showed minimal response with a CGI-I score of 3. The most common side effects were post-ECT confusion (15.4 %) and prolonged seizure (11.5 %). This rate of prolonged seizure was higher the rates reported in the literature. The bronchospasm related with remifentanil, post-ECT bradycardia, hypertensive crisis and oligohydramnios were also reported in one case each. ECT is a safe and effective treatment option in women with severe psychiatric disorders and disorders in the perinatal/postpartum period are a major area of ECT use. The female gender may be a contributing factor for the higher rates of prolonged seizure.

Hippocampal volume changes following electroconvulsive therapy: a systematic review and meta-analysis.

PubMed

Wilkinson, Samuel T; Sanacora, Gerard; Bloch, Michael H

2017-05-01

Reduced hippocampal volume is one of the most consistent morphological findings in Major Depressive Disorder (MDD). Electroconvulsive therapy (ECT) is the most effective therapy for MDD, yet its mechanism of action remains poorly understood. Animal models show that ECT induces several neuroplastic processes, which lead to hippocampal volume increases. We conducted a meta-analysis of ECT studies in humans to investigate its effects on hippocampal volume. PubMed was searched for studies examining hippocampal volume before and after ECT. A random-effects model was used for meta-analysis with standardized mean difference (SMD) of the change in hippocampal volume before and after ECT as the primary outcome. Nine studies involving 174 participants were included. Total hippocampal volumes increased significantly following ECT compared to pre-treatment values (SMD=1.10; 95% CI 0.80-1.39; z=7.34; p<0.001; k=9). Both right (SMD=1.01; 95% CI 0.72-1.30; z=6.76; p<0.001; k=7) and left (SMD=0.87; 95% CI 0.51-1.23; z=4.69; p<0.001; k=7) hippocampal volumes were also similarly increased significantly following ECT. We demonstrated no correlation between improvement in depression symptoms with ECT and change in total hippocampal volume (beta=-1.28, 95% CI -4.51-1.95, z=-0.78, p=0.44). We demonstrate fairly consistent increases in hippocampal volume bilaterally following ECT treatment. The relationship among these volumetric changes and clinical improvement and cognitive side effects of ECT should be explored by larger, multisite studies with harmonized imaging methods.

Effectiveness and clinical predictors of response to combined ECT and antipsychotic therapy in patients with treatment-resistant schizophrenia and dominant negative symptoms.

PubMed

Pawełczyk, Tomasz; Kołodziej-Kowalska, Emilia; Pawełczyk, Agnieszka; Rabe-Jabłońska, Jolanta

2014-12-15

The effectiveness and predictors of response to electroconvulsive therapy (ECT) combined with antipsychotics (AP) in treatment-resistant schizophrenia patients with the dominance of negative symptoms (TRS-NS) have not been studied systematically so far. 29 patients aged 21-55 years diagnosed with TRS-NS underwent ECT combined with antipsychotics (ECT+AP). Prior to the ECT, the symptom profile and severity were evaluated using Positive and Negative Syndrome Scale (PANSS). Demographic and medical data was collected; ECT parameters and pharmacotherapy results were evaluated. After the combined ECT+AP therapy a significant decrease in symptom severity was found. A response to treatment was achieved by 60% of patients. The greatest reductions were obtained in general and positive PANSS subscale (median change: 11 and 7 pts.) and the smallest, but still significant, ones in negative symptoms subscale (median: 3.5 pts.). Patients who responded to ECT+AP demonstrated a significantly shorter duration of the current episode in comparison with patients who did not experience at least a 25% reduction in symptom severity (median: 4 vs. 8 months). A combination of ECT and antipsychotic therapy can provide a useful treatment option for patients with TRS-NS. The only significant predictor of response to treatment was a shorter duration of the current episode. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Electroconvulsive therapy in nonconsenting patients].

PubMed

Besse, M; Methfessel, I; Wiltfang, J; Zilles, D

2017-01-01

Electroconvulsive therapy (ECT) is a potent and successful method for the treatment of severe psychiatric disorders. Severe depressive and psychotic disorders may lead to legal incapacity and inability to consent. In Germany, administration of ECT against the patient's will is feasible under certain constellations and is regulated under the terms of the guardianship law. This article outlines the prevalence, effectiveness and tolerability of ECT when applied in nonconsenting patients. Case report and literature review. The literature on ECT as a treatment in nonconsenting patients is relatively sparse. In 2008 the prevalence in Germany was less than 0.5 % of all patients receiving ECT. Case reports and case series suggest a good and equal level of effectiveness when compared to consenting patients. In the course of treatment the majority of patients consented to receive further ECT and retrospectively judged ECT as helpful. The use of ECT is a highly effective treatment in severe psychiatric disorders even when administered as treatment in nonconsenting patients. It can be lifesaving and lead to a rapid improvement of symptoms and relief from severe suffering also from the patients' perspective. Thus, it seems unethical not to consider ECT as a treatment against the nonautonomous will of legally incompetent patients in individual cases. Nevertheless, physicians should always seek to obtain the patients' consent as soon as possible for both legal and ethical reasons.

Influence of GRIK4 genetic variants on the electroconvulsive therapy response.

PubMed

Minelli, Alessandra; Congiu, Chiara; Ventriglia, Mariacarla; Bortolomasi, Marco; Bonvicini, Cristian; Abate, Maria; Sartori, Riccardo; Gainelli, Giulio; Gennarelli, Massimo

2016-07-28

Several lines of evidence have shown the involvement of the glutamatergic system in the function of electroconvulsive therapy (ECT). In particular, patients with treatment resistant depression (TRD) and chronic depression have lower levels of glutamate/glutamine than controls, and ECT can reverse this deficit. Genetic factors might contribute to modulating the mechanisms underlying ECT. This study aimed to evaluate the relationship between three polymorphisms (rs1954787, rs4936554 and rs11218030) of the glutamate receptor ionotropic kainate 4 (GRIK4) gene and responsiveness to ECT treatment in a sample of one hundred individuals, TRD or depressive Bipolar Disorder patients resistant to pharmacological treatments. The results revealed that GRIK4 variants were significantly associated with the response to ECT. In particular, we found that patients carrying the G allele of the GRIK4 rs11218030 had a significantly poorer response to ECT (p=2.71×10(-4)), showing five times the risk of relapse after ECT compared to the AA homozygotes. Analogously, patients carrying the GG rs1954787 genotype and rs4936554A allele carriers presented a double risk of lack of response after ECT (p=0.013 and p=0.040, respectively). In conclusion, the current study provides new evidence, indicating that some GRIK4 variants modulate the response to ECT in patients with depression resistant to treatment, suggesting a role for kainate receptor modulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Electroconvulsive therapy for schizophrenia.

PubMed

Tharyan, P; Adams, C E

2005-04-18

Electroconvulsive therapy (ECT) involves the induction of a seizure for therapeutic purposes by the administration of a variable frequency electrical stimulus shock via electrodes applied to the scalp. The effects of its use in people with schizophrenia are unclear. To determine whether electroconvulsive therapy (ECT) results in clinically meaningful benefit with regard to global improvement, hospitalisation, changes in mental state, behaviour and functioning for people with schizophrenia, and to determine whether variations in the practical administration of ECT influences outcome. We undertook electronic searches of Biological Abstracts (1982-1996), EMBASE (1980-1996), MEDLINE (1966-2004), PsycLIT (1974-1996),SCISEARCH (1996) and the Cochrane Schizophrenia Group's Register (July 2004). We also inspected the references of all identified studies and contacted relevant authors. We included all randomised controlled clinical trials that compared ECT with placebo, 'sham ECT', non-pharmacological interventions and antipsychotics and different schedules and methods of administration of ECT for people with schizophrenia, schizoaffective disorder or chronic mental disorder. Working independently, we selected and critically appraised studies, extracted data and analysed on an intention-to-treat basis. Where possible and appropriate we calculated risk ratios (RR) and their 95% confidence intervals (CI) with the number needed to treat (NNT). For continuous data Weighted Mean Differences (WMD) were calculated. We presented scale data for only those tools that had attained pre-specified levels of quality. We also undertook tests for heterogeneity and publication bias. This review includes 26 trials with 50 reports. When ECT is compared with placebo or sham ECT, more people improved in the real ECT group (n=392, 10 RCTs, RR 0.76 random CI 0.59 to 0.98, NNT 6 CI 4 to 12) and though data were heterogeneous (chi-square 17.49 df=9 P=0.04), its impact on variability of data was not substantial (I-squared 48.5%). There was a suggestion that ECT resulted in less relapses in the short term than sham ECT (n=47, 2 RCTs, RR fixed 0.26 CI 0.03 to 2.2), and a greater likelihood of being discharged from hospital (n=98, 1 RCT, RR fixed 0.59, CI 0.34 to 1.01). There is no evidence that this early advantage for ECT is maintained over the medium to long term. People treated with ECT did not drop out of treatment earlier than those treated with sham ECT (n=495, 14 RCTs, RR fixed 0.71 CI 0.33 to 1.52, I-squared 0%). Very limited data indicated that visual memory might decline after ECT compared with sham ECT (n=24, 1 RCT, WMD -14.0 CI -23 to -5); the results of verbal memory tests were equivocal. When ECT is directly compared with antipsychotic drug treatments (total n=443, 10 RCTs) results favour the medication group (n=175, 3 RCTs, RR fixed 'not improved at the end of ECT course' 2.18 CI 1.31 to 3.63). Limited evidence suggests that ECT combined with antipsychotic drugs results in greater improvement in mental state (n= 40, 1 RCT, WMD, Brief Psychiatric Rating Scale -3.9 CI - 2.28 to -5.52) than with antipsychotic drugs alone. One small study suggested more memory impairment after a course of ECT combined with antipsychotics than with antipsychotics alone (n=20, MD serial numbers and picture recall -4.90 CI -0.78 to -9.02), though this proved transient. When continuation ECT was added to antipsychotic drugs, the combination was superior to the use of antipsychotics alone (n=30, WMD Global Assessment of Functioning 19.06 CI 9.65 to 28.47), or CECT alone (n=30, WMD -20.30 CI -11.48 to -29.12). Unilateral and bilateral ECT were equally effective in terms of global improvement (n=78, 2 RCTs, RR fixed 'not improved at end of course of ECT' 0.79 CI 0.45 to 1.39). One trial showed a significant advantage for 20 treatments over 12 treatments for numbers globally improved at the end of the ECT course (n=43, RR fixed 2.53 CI 1.13 to 5.66). The evidence in this review suggests that ECT, combined with treatment with antipsychotic drugs, may be considered an option for people with schizophrenia, particularly when rapid global improvement and reduction of symptoms is desired. This is also the case for those with schizophrenia who show limited response to medication alone. Even though this initial beneficial effect may not last beyond the short term, there is no clear evidence to refute its use for people with schizophrenia. The research base for the use of ECT in people with schizophrenia continues to expand, but even after more than five decades of clinical use, there remain many unanswered questions regarding its role in the management of people with schizophrenia.

Self-focusing and group-velocity dispersion of pulsed laser beams in the inhomogeneous atmosphere.

PubMed

Zhang, Yuqiu; Ji, Xiaoling; Zhang, Hao; Li, Xiaoqing; Wang, Tao; Wang, Huan; Deng, Yu

2018-05-28

We study self-focusing and group-velocity dispersion (GVD) effects in the inhomogeneous atmosphere on pulsed-laser space debris removal facilitated by a ground-based laser. It is found that changes of the pulse duration and the beam spot size with the propagation distance are noticeable due to the interplay of the GVD effect and the self-focusing effect, which is quite different from the behavior in the linear case. It is shown that the temporal pulse splitting may appear on the space debris, and the spatial side lobe usually appears together with the temporal pulse splitting. As compared with the linear case, the beam width and the pulse width on the debris target increase. On the other hand, crucial formulae of the modified focal length and the M 2 -factor for laser debris removal are also derived. It is found that the beam quality on the debris target becomes better if our modified focal length is adopted, and the beam quality on the debris target will be good if the value of M 2 -factor is less than 1.6.

Phase-matching of attosecond XUV supercontinuum

NASA Astrophysics Data System (ADS)

Gilbertson, Steve; Mashiko, Hiroki; Li, Chengquan; Khan, Sabih; Shakya, Mahendra; Moon, Eric; Chang, Zenghu

2008-05-01

Adding a weak second harmonic field to an ellipticity dependent polarization gating field allowed for the production of XUV supercontinua from longer (˜10 fs) input pulses in argon. The spectra support 200 as single isolated pulses. This technique, dubbed double optical gating (DOG), demonstrated a large enhancement of the harmonic yield as compared with polarization gating. These results can be attributed to the reduced depletion of the ground state of the target from the leading edge of the pulse and the increased intensity inside the polarization gate width. Through optimization of the harmonic generation process under the phase matching conditions, we were able to further increase the harmonic flux. The parameters included the target gas pressure, laser focus position, input pulse duration, and polarization gate width. By varying the CE phase of the pulse, we were able to verify that the results were indeed from DOG due to its unique 2 pi dependence on the harmonic spectrum. We were able to extend our results to neon. Its higher ionization potential allowed an extension of the harmonic cutoff for the production of even shorter pulses.

Laser one-dimensional range profile and the laser two-dimensional range profile of cylinders

NASA Astrophysics Data System (ADS)

Gong, Yanjun; Wang, Mingjun; Gong, Lei

2015-10-01

Laser one-dimensional range profile, that is scattering power from pulse laser scattering of target, is a radar imaging technology. The laser two-dimensional range profile is two-dimensional scattering imaging of pulse laser of target. Laser one-dimensional range profile and laser two-dimensional range profile are called laser range profile(LRP). The laser range profile can reflect the characteristics of the target shape and surface material. These techniques were motivated by applications of laser radar to target discrimination in ballistic missile defense. The radar equation of pulse laser is given in this paper. This paper demonstrates the analytical model of laser range profile of cylinder based on the radar equation of the pulse laser. Simulations results of laser one-dimensional range profiles of some cylinders are given. Laser range profiles of cylinder, whose surface material with diffuse lambertian reflectance, is given in this paper. Laser range profiles of different pulse width of cylinder are given in this paper. The influences of geometric parameters, pulse width, attitude on the range profiles are analyzed.

A simple fast pulse gas valve using a dynamic pressure differential as the primary closing mechanism

NASA Astrophysics Data System (ADS)

Thomas, J. C.; Hwang, D. Q.; Horton, R. D.; Rogers, J. H.; Raman, R.

1993-06-01

In this article we describe a simple fast pulse gas valve developed for use in a plasma discharge experiment. The valve delivers 1017-1019 molecules per pulse varied by changing the voltage on the electromagnetic driver power supply. Valve pulse widths are observed to be less than 300 μs full width at half maximum with a rise time of less than 100 μs resulting in a maximum gas flow rate of ˜1022 molecules per second. An optical transmission technique was used to determine the mechanical opening and closing characteristics of the valve piston. A fast ionization gauge (FIG) was used for diagnosis of the temporal character of the gas pulse while the total gas throughput was determined by measuring the change in pressure per pulse in a small test chamber with a convectron tube gauge. Calibration of the FIG was accomplished by comparing the net change in pressure in a large chamber as measured by the FIG to the net change in pressure in a small test chamber as measured by the convectron tube gauge.

What we have learned about electroconvulsive therapy and its relevance for the practising psychiatrist.

PubMed

Sienaert, Pascal

2011-01-01

In this narrative review, the current knowledge base on the efficacy and the practice of electroconvulsive therapy (ECT) is reviewed, and its relevance for the practising psychiatrist is appreciated. In the past decade, several large-scale studies have confirmed the significant superiority of ECT in the treatment of severe and refractory psychiatric conditions, such as major depressive disorder and bipolar disorder. However, the efficacy of ECT is not reflected in current treatment algorithms, where ECT is often reserved as a last resort. However, clinical characteristics, such as the presence of psychotic symptoms, suicidality, or catatonic signs, should prompt the clinician to consider ECT earlier in the treatment course. ECT is a safe procedure, without absolute contraindications for its use. Nevertheless, patients' fears and complaints should be acknowledged, and patients should be adequately informed about expected benefits and possible risks, such as memory problems, that are generally transient. Research focusing on further minimizing memory problems, while maintaining a superior efficacy, is ongoing. Adequate continuation treatment, either pharmacotherapy or continuation ECT, after a successful ECT course is of vital importance to maintain the benefits achieved and should be the focus of future research.

Public attitudes towards electroconvulsive therapy in the Chuvash Republic.

PubMed

Golenkov, Andrei; Ungvari, Gabor S; Gazdag, Gábor

2012-05-01

Public attitudes towards a given medical procedure can have a significant influence on the employment of that method. Electroconvulsive therapy (ECT) is a medical procedure that has received an exceptionally ambiguous public reception since its inception. To survey the level of information about and attitudes towards ECT in a general population sample of the Chuvash Republic of the Russian Federation. A randomly selected cohort of 5,373 people was contacted by telephone. The respondents were asked three closed and three open questions. The response rate was 74.7%. Only 35.2% of those interviewed said they knew anything about ECT. Health professionals and younger respondents were better informed. The two main sources of information about ECT were foreign films and the mass media. The main indication of ECT was thought to be schizophrenia. The majority (63.3%) of the respondents had negative opinions and emotions about ECT. Limited information about and generally negative attitudes towards ECT were found in the general population of the Chuvash Republic. Gender, age, education level, employment in the health industry, and information source were found to be the determining factors in the knowledge of and attitudes towards ECT.

Annexin V-induced rat Leydig cell proliferation involves Ect2 via RhoA/ROCK signaling pathway.

PubMed

Jing, Jun; Chen, Li; Fu, Hai-Yan; Fan, Kai; Yao, Qi; Ge, Yi-Feng; Lu, Jin-Chun; Yao, Bing

2015-03-24

This study investigated the effect of annexin V on the proliferation of primary rat Leydig cells and the potential mechanism. Our results showed that annexin V promoted rat Leydig cell proliferation and cell cycle progression in a dose- and time-dependent manner. Increased level of annexin V also enhanced Ect2 protein expression. However, siRNA knockdown of Ect2 attenuated annexin V-induced proliferation of rat Leydig cells. Taken together, these data suggest that increased level of annexin V induced rat Leydig cell proliferation and cell cycle progression via Ect2. Since RhoA activity was increased following Ect2 activation, we further investigated whether Ect2 was involved in annexin V-induced proliferation via the RhoA/ROCK pathway, and the results showed that annexin V increased RhoA activity too, and this effect was abolished by the knockdown of Ect2. Moreover, inhibition of the RhoA/ROCK pathway by a ROCK inhibitor, Y27632, also attenuated annexin V-induced proliferation and cell cycle progression. We thus conclude that Ect2 is involved in annexin V-induced rat Leydig cell proliferation through the RhoA/ROCK pathway.

Therapeutic and prophylactic utility of the memory-enhancing drug donepezil hydrochloride on cognition of patients undergoing electroconvulsive therapy: a randomized controlled trial.

PubMed

Prakash, Jyoti; Kotwal, Atul; Prabhu, Hra

2006-09-01

Substantial progress has been made in identifying how the treatment parameters used in electroconvulsive therapy (ECT) impact its cognitive side effects. However, there is limited information regarding the role of memory enhancers in post-ECT cognitive disturbances. We evaluated the therapeutic and prophylactic efficacy of the memory-enhancing drug donepezil hydrochloride on cognition of patients undergoing ECT. A triple blind (the study subjects, clinician assessing the cognition, and the data analyst were unaware of subject allocation for trial assessment) randomized controlled trial was carried out in a General Hospital Psychiatry Unit. Subjects were randomized into 2 groups. One group received ECT with placebo, whereas the other group received ECT and donepezil (a memory-enhancing drug). Study participants were assessed in post-ECT period to analyze cognitive deficits and to compare the differences in 2 groups, as regards recovery of various aspects of cognition. The post-ECT recovery of various components of cognition was more rapid in patients using donepezil as compared to those not given donepezil (P < 0.05). This significant improvement in recovery time among patients receiving donepezil bears therapeutic implication in immediate post-ECT cognitive deficits.

A systematic review of left unilateral electroconvulsive therapy.

PubMed

Kellner, C H; Farber, K G; Chen, X R; Mehrotra, A; Zipursky, G D N

2017-08-01

To systematically review the published clinical trials, case series, and case reports on left unilateral (LUL) electrode placement for clinical electroconvulsive therapy (ECT). PubMed, Ovid Medline, and the Cochrane Library were searched for articles concerning LUL ECT. Number of patients, efficacy, and cognitive outcomes were extracted from the papers that met our inclusion criteria. A total of 52 articles were included in this review, consisting of 33 clinical trials, seven case series, and 12 case reports. Overall, the efficacy of LUL electrode placement for the treatment of depression and psychosis is similar to that of right unilateral (RUL) and bilateral (BL) electrode placements. Patients receiving LUL ECT tend to experience more verbal memory impairment than patients receiving RUL ECT, but less verbal impairment than patients receiving BL ECT. In contrast, patients receiving LUL ECT tended to experience the least visual and nonverbal memory impairment, compared to patients receiving RUL or BL ECT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Delirium during the course of electroconvulsive therapy in a patient on lithium carbonate treatment.

PubMed

Sadananda, Suneetha Karkada; Narayanaswamy, Janardhanan C; Srinivasaraju, Ravindra; Math, Suresh Bada

2013-01-01

The safety of concurrent mood stabilizers during the course of electroconvulsive therapy (ECT) is yet to be clearly established. Delirium with concurrent administration of ECT and lithium carbonate is described in this case report. A 30-year-old male with a past history of significant head injury developed delirium during the course of bitemporal ECT. The clinical picture and the details of the cognitive impairment have been discussed in the report with a focus on relationship between the lithium carbonate administration and the concurrent ECT. Patients with preexisting organic brain damage could be prone to develop the cognitive adverse effect while on a combination of lithium and ECT. Possible interactions between lithium and ECT need further systematic evaluation. Copyright © 2013 Elsevier Inc. All rights reserved.

Compact biomedical pulsed signal generator for bone tissue stimulation

DOEpatents

Kronberg, J.W.

1993-06-08

An apparatus for stimulating bone tissue for stimulating bone growth or treating osteoporosis by applying directly to the skin of the patient an alternating current electrical signal comprising wave forms known to simulate the piezoelectric constituents in bone. The apparatus may, by moving a switch, stimulate bone growth or treat osteoporosis, as desired. Based on low-power CMOS technology and enclosed in a moisture-resistant case shaped to fit comfortably, two astable multivibrators produce the desired waveforms. The amplitude, pulse width and pulse frequency, and the subpulse width and subpulse frequency of the waveforms are adjustable. The apparatus, preferably powered by a standard 9-volt battery, includes signal amplitude sensors and warning signals indicate an output is being produced and the battery needs to be replaced.

Fabrication of narrow pulse passively Q-switched self-stimulated Raman laser with c-cut Nd:GdVO4

NASA Astrophysics Data System (ADS)

Shen, Gao; Li, Zuo-han; Han, Ming

2016-11-01

Combining the self-stimulated Raman scattering technology and saturable absorber of Cr4+:YAG, a 1.17 μm c-cut Nd:GdVO4 picosecond Q-switched laser is demonstrated in this paper. With an incident pump power of 10 W, the Q-switched laser with average power of 430 mW for 1.17 μm, pulse width of 270 ps, repetition rate of 13 kHz and the first order Stokes conversion efficiency of 4.3% is obtained. The Q-switched pulse width can be the narrowest in our research. In addition, the yellow laser at 0.58 μm is also achieved by using the LiB3O5 frequency doubling crystal.

Compact biomedical pulsed signal generator for bone tissue stimulation

DOEpatents

Kronberg, James W.

1993-01-01

An apparatus for stimulating bone tissue for stimulating bone growth or treating osteoporosis by applying directly to the skin of the patient an alternating current electrical signal comprising wave forms known to simulate the piezoelectric constituents in bone. The apparatus may, by moving a switch, stimulate bone growth or treat osteoporosis, as desired. Based on low-power CMOS technology and enclosed in a moisture-resistant case shaped to fit comfortably, two astable multivibrators produce the desired waveforms. The amplitude, pulse width and pulse frequency, and the subpulse width and subpulse frequency of the waveforms are adjustable. The apparatus, preferably powered by a standard 9-volt battery, includes signal amplitude sensors and warning signals indicate an output is being produced and the battery needs to be replaced.

Pulse compression in an electro-optic Q-switched diode-pumped YVO4/Nd:YVO4 laser with a Cr4+:YAG saturable absorber.

PubMed

Li, Tao; Zhao, Shengzhi; Zhuo, Zhuang; Yang, Kejian; Li, Guiqiu; Li, Dechun

2009-04-20

A diode end-pumped doubly Q-switched YVO4/Nd:YVO4 laser has been realized for the first time to our knowledge by using both an electro-optic (EO) modulator and a Cr4):YAG saturable absorber. A 3.8 ns pulse width is generated by this laser under a pump power of 15 W at 2 kHz, which is obviously compressed in comparison with that of 8.8 ns from a single actively EO Q-switched laser. Under the same conditions, peak power values of 174.7 and 93 kW are also obtained. A coupled equation is given to theoretically analyze the experimental data. The experimental and theoretical results show that the doubly Q-switched laser has the advantages of a shorter pulse width and higher pulse peak power in contrast with a singly Q-switched laser.

Compact pulse generators with soft ferromagnetic cores driven by gunpowder and explosive.

PubMed

Ben, Chi; He, Yong; Pan, Xuchao; Chen, Hong; He, Yuan

2015-12-01

Compact pulse generators which utilized soft ferromagnets as an initial energy carrier inside multi-turn coil and hard ferromagnets to provide the initial magnetic field outside the coil have been studied. Two methods of reducing the magnetic flux in the generators have been studied: (1) by igniting gunpowder to launch the core out of the generator, and (2) by detonating explosives that demagnetize the core. Several types of compact generators were explored to verify the feasibility. The generators with an 80-turn coil that utilize gunpowder were capable of producing pulses with amplitude 78.6 V and the full width at half maximum was 0.41 ms. The generators with a 37-turn coil that utilize explosive were capable of producing pulses with amplitude 1.41 kV and the full width at half maximum was 11.68 μs. These two methods were both successful, but produce voltage waveforms with significantly different characteristics.

Conceptual design of sub-exa-watt system by using optical parametric chirped pulse amplification

NASA Astrophysics Data System (ADS)

Kawanaka, J.; Tsubakimoto, K.; Yoshida, H.; Fujioka, K.; Fujimoto, Y.; Tokita, S.; Jitsuno, T.; Miyanaga, N.; Gekko-EXA Design Team

2016-03-01

A 50 PW ultrahigh-peak-power laser has been conceptually designed, which is based on optical parametric chirped pulse amplification (OPCPA). A 250 J DPSSL and a flash- lamp-pumped kJ laser are adopted as new repeatable pump source. The existed LFEX-laser with more than ten kilo joules are used in the final amplifier stage and the OPCPA with the 2x2 tiled pump beams in random phase has been proposed with several ten centimeter aperture. A pulse duration of amplified pulses is set at less than 10 fs. A broadband OPCPA with ∼500 nm of the gain spectral width near 1 μm is required. A partially deuterated KDP (p-DKDP) crystal is one of the most promising nonlinear crystals and our numerical calculation ensured such ultra-broad gain width. p-DKDP crystals with several deuteration ratio have been successfully grown.

SAS-2 gamma-ray observations of PSR 1747-46. [radio pulsar

NASA Technical Reports Server (NTRS)

Thompson, D. J.; Fichtel, C. E.; Kniffen, D. A.; Ogelman, H. B.; Lamb, R. C.

1976-01-01

Evidence is reported for the observation of gamma-ray emission from the radio pulsar PSR 1747-46 by the gamma-ray telescope aboard SAS 2. The evidence is based on the presence of both an approximately 3-sigma enhancement of gamma rays at the pulsar's location and an approximately 4-sigma peak in the phase plot of 79 gamma-ray events whose phase was calculated from the pulsar's known period. The gamma-ray pulsation is found to appear at a phase lag of about 0.16 from that predicted by the radio observations. The pulsed gamma-ray fluxes above 35 MeV and 100 MeV are estimated, and it is shown that the gamma-ray pulse width is similar to the radio pulse width. It is concluded that PSR 1747-46 is a most likely candidate for pulsed gamma-ray emission.

Study of monopropellants for electrothermal thrusters

NASA Technical Reports Server (NTRS)

Kuenzly, J. D.

1974-01-01

A 333 mN electrothermal thruster designed to use MIL-grade hydrazine was demonstrated to be suitable for operation with low freezing point monopropellants containing hydrazine azide, monomethylhydrazine, unsymmetrical-dimethylhydrazine and ammonia. The steady-state specific impulse was greater than 200 sec for all propellants. The pulsed-mode specific impulse for an azide blend exceeded 175 sec for pulse widths greater than 50 msec; propellants containing carbonaceous species delivered 175 sec pulsed-mode specific impulses for pulse widths greater than 100 msec. Longer thrust chamber residence times were required for the carbonaceous propellants; the original thruster design was modified by increasing the characteristic chamber length and screen packing density. Specific recommendations were made for the work required to design and develop flight worthy thrusters, including methods to increase propellant dispersal at injection, thruster geometry changes to reduce holding power levels and methods to initiate the rapid decomposition of the carbonaceous propellants.

Comparison of symmetric and asymmetric double quantum well extended-cavity diode lasers for broadband passive mode-locking at 780  nm.

PubMed

Christopher, Heike; Kovalchuk, Evgeny V; Wenzel, Hans; Bugge, Frank; Weyers, Markus; Wicht, Andreas; Peters, Achim; Tränkle, Günther

2017-07-01

We present a compact, mode-locked diode laser system designed to emit a frequency comb in the wavelength range around 780 nm. We compare the mode-locking performance of symmetric and asymmetric double quantum well ridge-waveguide diode laser chips in an extended-cavity diode laser configuration. By reverse biasing a short section of the diode laser chip, passive mode-locking at 3.4 GHz is achieved. Employing an asymmetric double quantum well allows for generation of a mode-locked optical spectrum spanning more than 15 nm (full width at -20  dB) while the symmetric double quantum well device only provides a bandwidth of ∼2.7  nm (full width at -20  dB). Analysis of the RF noise characteristics of the pulse repetition rate shows an RF linewidth of about 7 kHz (full width at half-maximum) and of at most 530 Hz (full width at half-maximum) for the asymmetric and symmetric double quantum well devices, respectively. Investigation of the frequency noise power spectral density at the pulse repetition rate shows a white noise floor of approximately 2100  Hz 2 /Hz and of at most 170  Hz 2 /Hz for the diode laser employing the asymmetric and symmetric double quantum well structures, respectively. The pulse width is less than 10 ps for both devices.

Historical essay: electroconvulsive therapy, memory, and self in America.

PubMed

Hirshbein, Laura

2012-01-01

Electroconvulsive Therapy (ECT) practitioners and anti-ECT activists have divergent interpretations of both the treatment and its history. Despite claims by ECT opponents that practitioners do not acknowledge memory side effects, the published literature on the procedure demonstrates psychiatrists' awareness of this issue. And though current ECT practitioners claim that memory side effects were mostly the result of outmoded methods, investigators continue to publish studies that indicate ongoing memory problems. This article explores the conflict between pro- and anti-ECT groups around the issue of memory side effects in the broader context of changes in American psychiatry and society.

Characterization of an optimized light source and comparison to pulsed dye laser for superficial and deep vessel clearance.

PubMed

Weiss, Robert A; Ross, E Victor; Tanghetti, Emil A; Vasily, David B; Childs, James J; Smirnov, Mikhail Z; Altshuler, Gregory B

2011-02-01

An arc lamp-based device providing optimized spectrum and pulse shape was characterized and compared with two pulsed dye laser (PDL) systems using a vascular phantom. Safety and effectiveness for facial telangiectasia are presented in clinical case studies. An optimized pulsed light source's (OPL) spectral and power output were characterized and compared with two 595 nm PDL devices. Purpuric threshold fluences were determined for the OPL and PDLs on Fitzpatrick type II normal skin. A vascular phantom comprising blood-filled quartz capillaries beneath porcine skin was treated by the devices at their respective purpuric threshold fluences for 3 ms pulse widths, while vessel temperatures were monitored with an infrared (IR) camera. Patients with Fitzpatrick skin types II-III received a split-face treatment with the OPL and a 595 nm PDL. The OPL provided a dual-band output spectrum from 500 to 670 nm and 850-1,200 nm, pulse widths from 3 to 100 ms, and fluences to 80 J/cm(2). The smooth output power measured during all pulse widths provides unambiguous vessel size selectivity. Percent energy in the near infra-red increased with decreasing output power from 45% to 60% and contributed 15-26% to heating of deep vessels, respectively. At purpuric threshold fluences the ratio of OPL to PDL vessel temperature rise was 1.7-2.8. OPL treatments of facial telangiectasia were well-tolerated by patients demonstrating significant improvements comparable to PDL with no downtime. Intense pulsed light (IPL) and PDL output pulse and spectral profiles are important for selective treatment of vessels in vascular lesions. The OPL's margin between purpuric threshold fluence and treatment fluence for deeper, larger vessels was greater than the corresponding margin with PDLs. The results warrant further comparison studies with IPLs and other PDLs. Copyright © 2011 Wiley-Liss, Inc.

The role of defects in laser-induced modifications of silica coatings and fused silica using picosecond pulses at 1053 nm: I Damage morphology

DOE PAGES

Laurence, T. A.; Ly, S.; Shen, N.; ...

2017-06-22

Laser-induced damage with ps pulse widths straddles the transition from intrinsic, multi-photon ionization and avalanche ionization-based ablation with fs pulses to defect-dominated, thermal-based damage with ns pulses. We investigated the morphology of damage for fused silica and silica coatings between 1 ps and 60 ps at 1053 nm. Using calibrated laser-induced damage experiments, in situ imaging, and high-resolution optical microscopy, atomic force microscopy, and scanning electron microscopy, we show that defects play an important role in laser-induced damage down to 1 ps. Three types of damage are observed: ablation craters, ultra-high density pits, and smooth, circular depressions with central pits.more » For 10 ps and longer, the smooth, circular depressions limit the damage performance of fused silica and silica coatings. The observed high-density pits and material removal down to 3 ps indicate that variations in surface properties limit the laser-induced damage onset to a greater extent than expected below 60 ps. Below 3 ps, damage craters are smoother although there is still evidence as seen by AFM of inhomogeneous laser-induced damage response very near the damage onset. These results show that modeling the damage onset only as a function of pulse width does not capture the convoluted processes leading to laser induced damage with ps pulses. It is necessary to account for the effects of defects on the processes leading to laser-induced damage. In conclusion, the effects of isolated defects or inhomogeneities are most pronounced above 3 ps but are still discernible and possibly important down to the shortest pulse width investigated here.« less

The role of defects in laser-induced modifications of silica coatings and fused silica using picosecond pulses at 1053 nm: I Damage morphology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laurence, T. A.; Ly, S.; Shen, N.

Laser-induced damage with ps pulse widths straddles the transition from intrinsic, multi-photon ionization and avalanche ionization-based ablation with fs pulses to defect-dominated, thermal-based damage with ns pulses. We investigated the morphology of damage for fused silica and silica coatings between 1 ps and 60 ps at 1053 nm. Using calibrated laser-induced damage experiments, in situ imaging, and high-resolution optical microscopy, atomic force microscopy, and scanning electron microscopy, we show that defects play an important role in laser-induced damage down to 1 ps. Three types of damage are observed: ablation craters, ultra-high density pits, and smooth, circular depressions with central pits.more » For 10 ps and longer, the smooth, circular depressions limit the damage performance of fused silica and silica coatings. The observed high-density pits and material removal down to 3 ps indicate that variations in surface properties limit the laser-induced damage onset to a greater extent than expected below 60 ps. Below 3 ps, damage craters are smoother although there is still evidence as seen by AFM of inhomogeneous laser-induced damage response very near the damage onset. These results show that modeling the damage onset only as a function of pulse width does not capture the convoluted processes leading to laser induced damage with ps pulses. It is necessary to account for the effects of defects on the processes leading to laser-induced damage. In conclusion, the effects of isolated defects or inhomogeneities are most pronounced above 3 ps but are still discernible and possibly important down to the shortest pulse width investigated here.« less

Generation of spectrally stable continuous-wave emission and ns pulses with a peak power of 4 W using a distributed Bragg reflector laser and a ridge-waveguide power amplifier.

PubMed

Klehr, A; Wenzel, H; Fricke, J; Bugge, F; Erbert, G

2014-10-06

We have developed a diode-laser based master oscillator power amplifier (MOPA) light source which emits high-power spectrally stabilized and nearly-diffraction limited optical pulses in the nanoseconds range as required by many applications. The MOPA consists of a distributed Bragg reflector (DBR) laser as master oscillator driven by a constant current and a ridge waveguide power amplifier (PA) which can be driven by a constant current (DC) or by rectangular current pulses with a width of 5 ns at a repetition frequency of 200 kHz. Under pulsed operation the amplifier acts as an optical gate, converting the CW input beam emitted by the DBR laser into a train of short amplified optical pulses. With this experimental MOPA arrangement no relaxation oscillations occur. A continuous wave power of 1 W under DC injection and a pulse power of 4 W under pulsed operation are reached. For both operational modes the optical spectrum of the emission of the amplifier exhibits a peak at a constant wavelength of 973.5 nm with a spectral width < 10 pm.

A model Ni-Al-Mo superalloy studied by ultraviolet pulsed-laser-assisted local-electrode atom-probe tomography.

PubMed

Tu, Yiyou; Plotnikov, Elizaveta Y; Seidman, David N

2015-04-01

This study investigates the effects of the charge-state ratio of evaporated ions on the accuracy of local-electrode atom-probe (LEAP) tomographic compositional and structural analyses, which employs a picosecond ultraviolet pulsed laser. Experimental results demonstrate that the charge-state ratio is a better indicator of the best atom-probe tomography (APT) experimental conditions compared with laser pulse energy. The thermal tails in the mass spectra decrease significantly, and the mass resolving power (m/Δm) increases by 87.5 and 185.7% at full-width half-maximum and full-width tenth-maximum, respectively, as the laser pulse energy is increased from 5 to 30 pJ/pulse. The measured composition of this alloy depends on the charge-state ratio of the evaporated ions, and the most accurate composition is obtained when Ni2+/Ni+ is in the range of 0.3-20. The γ(f.c.c.)/γ'(L12) interface is quantitatively more diffuse when determined from the measured concentration profiles for higher laser pulse energies. Conclusions of the APT compositional and structural analyses utilizing the same suitable charge-state ratio are more comparable than those collected with the same laser pulse energy.

978-nm square-wave in an all-fiber single-mode ytterbium-doped fiber laser

NASA Astrophysics Data System (ADS)

Li, Shujie; Xu, Lixin; Gu, Chun

2018-01-01

A 978 nm single mode passively mode-locked all-fiber laser delivering square-wave pulses was demonstrated using a figure-8 cavity and a 75 cm commercial double-clad ytterbium-doped fiber. We found the three-level system near 978 nm was able to operate efficiently under clad pumping, simultaneously oscillation around 1030 nm well inhibited. The optimized nonlinear amplifying loop mirror made the mode locking stable and performed the square-pulses shaping. To the best of our knowledge, it is the first time to report the square-wave pulse fiber laser operating at 980 nm. The spectral width of the 978 mode-locked square pulses was about 4 nm, far greater than that of the mode-locked square pulses around 1060 nm reported before, which would be helpful to deeply understand the various square-wave pulses' natures and forming mechanisms. Compared with modulated single-mode or multimode 980 nm LDs, this kind of 980 nm square-wave sources having higher brightness, more steeper rising and falling edge and shorter pulse width, might have potential applications in pumping nanosecond ytterbium or erbium fiber lasers and amplifiers.

Prediction of Individual Response to Electroconvulsive Therapy via Machine Learning on Structural Magnetic Resonance Imaging Data.

PubMed

Redlich, Ronny; Opel, Nils; Grotegerd, Dominik; Dohm, Katharina; Zaremba, Dario; Bürger, Christian; Münker, Sandra; Mühlmann, Lisa; Wahl, Patricia; Heindel, Walter; Arolt, Volker; Alferink, Judith; Zwanzger, Peter; Zavorotnyy, Maxim; Kugel, Harald; Dannlowski, Udo

2016-06-01

Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. However, biomarkers that accurately predict a response to ECT remain unidentified. To investigate whether certain factors identified by structural magnetic resonance imaging (MRI) techniques are able to predict ECT response. In this nonrandomized prospective study, gray matter structure was assessed twice at approximately 6 weeks apart using 3-T MRI and voxel-based morphometry. Patients were recruited through the inpatient service of the Department of Psychiatry, University of Muenster, from March 11, 2010, to March 27, 2015. Two patient groups with acute major depressive disorder were included. One group received an ECT series in addition to antidepressants (n = 24); a comparison sample was treated solely with antidepressants (n = 23). Both groups were compared with a sample of healthy control participants (n = 21). Binary pattern classification was used to predict ECT response by structural MRI that was performed before treatment. In addition, univariate analysis was conducted to predict reduction of the Hamilton Depression Rating Scale score by pretreatment gray matter volumes and to investigate ECT-related structural changes. One participant in the ECT sample was excluded from the analysis, leaving 67 participants (27 men and 40 women; mean [SD] age, 43.7 [10.6] years). The binary pattern classification yielded a successful prediction of ECT response, with accuracy rates of 78.3% (18 of 23 patients in the ECT sample) and sensitivity rates of 100% (13 of 13 who responded to ECT). Furthermore, a support vector regression yielded a significant prediction of relative reduction in the Hamilton Depression Rating Scale score. The principal findings of the univariate model indicated a positive association between pretreatment subgenual cingulate volume and individual ECT response (Montreal Neurological Institute [MNI] coordinates x = 8, y = 21, z = -18; Z score, 4.00; P < .001; peak voxel r = 0.73). Furthermore, the analysis of treatment effects revealed a increase in hippocampal volume in the ECT sample (MNI coordinates x = -28, y = -9, z = -18; Z score, 7.81; P < .001) that was missing in the medication-only sample. A relatively small degree of structural impairment in the subgenual cingulate cortex before therapy seems to be associated with successful treatment with ECT. In the future, neuroimaging techniques could prove to be promising tools for predicting the individual therapeutic effectiveness of ECT.

A Generic Method for Distribution and Transfer of ECTS and Other Norm-Referenced Grades within Student Cohorts

ERIC Educational Resources Information Center

Warfvinge, Per

2008-01-01

The ECTS grade transfer scale is an interface grade scale to help European universities, students and employers to understand the level of student achievement. Hence, the ECTS scale can be seen as an interface, transforming local scales to a common system where A-E denote passing grades. By definition, ECTS should distribute the passing students…

Controllable pulse parameter transcranial magnetic stimulator with enhanced circuit topology and pulse shaping

NASA Astrophysics Data System (ADS)

Peterchev, Angel V.; DʼOstilio, Kevin; Rothwell, John C.; Murphy, David L.

2014-10-01

Objective. This work aims at flexible and practical pulse parameter control in transcranial magnetic stimulation (TMS), which is currently very limited in commercial devices. Approach. We present a third generation controllable pulse parameter device (cTMS3) that uses a novel circuit topology with two energy-storage capacitors. It incorporates several implementation and functionality advantages over conventional TMS devices and other devices with advanced pulse shape control. cTMS3 generates lower internal voltage differences and is implemented with transistors with a lower voltage rating than prior cTMS devices. Main results. cTMS3 provides more flexible pulse shaping since the circuit topology allows four coil-voltage levels during a pulse, including approximately zero voltage. The near-zero coil voltage enables snubbing of the ringing at the end of the pulse without the need for a separate active snubber circuit. cTMS3 can generate powerful rapid pulse sequences (\\lt 10 ms inter pulse interval) by increasing the width of each subsequent pulse and utilizing the large capacitor energy storage, allowing the implementation of paradigms such as paired-pulse and quadripulse TMS with a single pulse generation circuit. cTMS3 can also generate theta (50 Hz) burst stimulation with predominantly unidirectional electric field pulses. The cTMS3 device functionality and output strength are illustrated with electrical output measurements as well as a study of the effect of pulse width and polarity on the active motor threshold in ten healthy volunteers. Significance. The cTMS3 features could extend the utility of TMS as a research, diagnostic, and therapeutic tool.

Controllable pulse parameter transcranial magnetic stimulator with enhanced circuit topology and pulse shaping

PubMed Central

D’Ostilio, Kevin; Rothwell, John C; Murphy, David L

2014-01-01

Objective This work aims at flexible and practical pulse parameter control in transcranial magnetic stimulation (TMS), which is currently very limited in commercial devices. Approach We present a third generation controllable pulse parameter device (cTMS3) that uses a novel circuit topology with two energy-storage capacitors. It incorporates several implementation and functionality advantages over conventional TMS devices and other devices with advanced pulse shape control. cTMS3 generates lower internal voltage differences and is implemented with transistors with lower voltage rating than prior cTMS devices. Main results cTMS3 provides more flexible pulse shaping since the circuit topology allows four coil-voltage levels during a pulse, including approximately zero voltage. The near-zero coil voltage enables snubbing of the ringing at the end of the pulse without the need for a separate active snubber circuit. cTMS3 can generate powerful rapid pulse sequences (<10 ms inter pulse interval) by increasing the width of each subsequent pulse and utilizing the large capacitor energy storage, allowing the implementation of paradigms such as paired-pulse and quadripulse TMS with a single pulse generation circuit. cTMS3 can also generate theta (50 Hz) burst stimulation with predominantly unidirectional electric field pulses. The cTMS3 device functionality and output strength are illustrated with electrical output measurements as well as a study of the effect of pulse width and polarity on the active motor threshold in 10 healthy volunteers. Significance The cTMS3 features could extend the utility of TMS as a research, diagnostic, and therapeutic tool. PMID:25242286

Multiplexer and time duration measuring circuit

DOEpatents

Gray, Jr., James

1980-01-01

A multiplexer device is provided for multiplexing data in the form of randomly developed, variable width pulses from a plurality of pulse sources to a master storage. The device includes a first multiplexer unit which includes a plurality of input circuits each coupled to one of the pulse sources, with all input circuits being disabled when one input circuit receives an input pulse so that only one input pulse is multiplexed by the multiplexer unit at any one time.

Numerical Response Surfaces of Volume of Ablation and Retropulsion Amplitude by Settings of Ho:YAG Laser Lithotripter

PubMed Central

Rutherford, Jonathan; Solomon, Metasebya; Cheng, Brian; Xuan, Jason R.; Gong, Jason; Yu, Honggang; Xia, Michael L. D.; Yang, Xirong; Hasenberg, Thomas; Curran, Sean

2018-01-01

Objectives Although laser lithotripsy is now the preferred treatment option for urolithiasis due to shorter operation time and a better stone-free rate, the optimal laser settings for URS (ureteroscopic lithotripsy) for less operation time remain unclear. The aim of this study was to look for quantitative responses of calculus ablation and retropulsion by performing operator-independent experiments to determine the best fit versus the pulse energy, pulse width, and the number of pulses. Methods A lab-built Ho:YAG laser was used as the laser pulse source, with a pulse energy from 0.2 J up to 3.0 J and a pulse width of 150 μs up to 1000 μs. The retropulsion was monitored using a high-speed camera, and the laser-induced craters were evaluated with a 3-D digital microscope. The best fit to the experimental data is done by a design of experiment software. Results The numerical formulas for the response surfaces of ablation speed and retropulsion amplitude are generated. Conclusions The longer the pulse, the less the ablation or retropulsion, while the longer pulse makes the ablation decrease faster than the retropulsion. The best quadratic fit of the response surface for the volume of ablation varied nonlinearly with pulse duration and pulse number. PMID:29707187

Electroconvulsive Therapy in the Treatment of Mood Disorders: One-Year Follow-up.

PubMed

Çakir, Sibel; Çağlar, Nuran

2017-09-01

Electroconvulsive therapy (ECT) is known to be an effective option in the treatment of mood disorders, especially resistant depression. However, the remission achieved by ECT was reported to be not long lasting enough. The aim of the present study was to investigate the relapse/recurrence rates and associated risk factors during the first year after ECT in patients diagnosed with mood disorders. In a naturalistic observation, patients diagnosed with unipolar depressive disorder or a depressive episode of bipolar disorder and who had achieved remission by ECT were followed up for at least one year. The patients were evaluated with structured interviews during the follow-up period. The relapse/recurrence rates were the primary outcome measurements, while hospitalization and suicide attempts were the secondary outcome measurements. The remitted and non-remitted patients were compared regarding the clinical features, ECT, and pharmacological variables. Fifty of 62 patients who had achieved remission with ECT completed the one year follow-up period. Thirty-three patients (66%) had relapse/recurrence, while 17 (34%) patients remained in remission. The relapse rates were similar in patients with unipolar depression and bipolar disorders. The mean number of ECT sessions was higher in relapsed patients with bipolar disorders. Multiple episodes were more frequent in non-remitted patients with unipolar depression. Comorbid psychiatric diagnosis was higher in non-remitted patients with unipolar and bipolar disorders. The relapse/recurrence rate was found to be fairly high in the first year of follow-up in patients who had achieved remission with ECT. ECT decisions should be made carefully in patients with comorbid psychiatric diagnosis and multiple episodes as these are more risky. The ECT application procedure and successive maintenance treatment (maintenance ECT, pharmacotherapy, and psychotherapy) should be planned to sustain the remission for patients with mood disorders in long-term follow-up.

A randomized, double-blind, placebo-controlled trial on the role of preemptive analgesia with acetaminophen [paracetamol] in reducing headache following electroconvulsive therapy [ECT].

PubMed

Isuru, Amila; Rodrigo, Asiri; Wijesinghe, Chamara; Ediriweera, Dileepa; Premadasa, Shan; Wijesekara, Carmel; Kuruppuarachchi, Lalith

2017-07-28

Electroconvulsive therapy (ECT) is a safe and efficient treatment for several severe psychiatric disorders, but its use is limited by side effects. Post-ECT headache is one of the commonest side effects. Preemptive analgesia is effective in post-surgical pain management. The most commonly used analgesic is acetaminophen (paracetamol). However, acetaminophen as a preemptive analgesic for post-ECT headache has not been studied adequately. This study was conducted to compare the incidence and severity of post-ECT headache in patients who were administered acetaminophen pre-ECT with a placebo group. This study was a randomised, double-blind, placebo-controlled trial. Sixty-three patients received 1 g acetaminophen and 63 patients received a placebo identical to acetaminophen. The incidence and severity of headache 2 h before and after ECT were compared between placebo and acetaminophen groups. The severity was measured using a visual analog scale. Generalised linear models were used to evaluate variables associated with post ECT headache. Demographic and clinical variables of placebo and acetaminophen groups were comparable except for the energy level used to induce a seizure. Higher proportion of the placebo group (71.4%) experienced post-ECT headache when compared to the acetaminophen group (p < 0.001). The median pain score for headache was 0 (Inter quartile range: 0-2) in acetaminophen group whereas the score was 2 (IQR: 0-4) in placebo group (P < 0.001). Model fitting showed that the administration of acetaminophen is associated with less post-ECT headache (odds ratio = 0.23, 95% CI: 0.11-0.48, P < 0.001). A significant reduction was seen in both the incidence and severity of post-ECT headache with preemptive analgesia with acetaminophen. Ethical approval was granted by an Ethic review committee, University of Kelaniya, Sri Lanka (P/166/10/2015) and the trial was registered in the Sri Lanka Clinical Trials Registry ( SLCTR/2015/27 ).

NASA's RBSP-ECT Science Investigation of the Van Allen Probes Mission: Highlights of the Prime Mission Phase, Data Access Overview, and Opportunities to Collaborate in the Extended Mission Phase

NASA Astrophysics Data System (ADS)

Smith, S. S.; Friedel, R. H.; Larsen, B.; Reeves, G.; Spence, H. E.

2015-12-01

In this poster, we present a summary of access to the data products of the Radiation Belt Storm Probes - Energetic Particle Composition, and Thermal plasma (RBSP-ECT) suite of NASA's Van Allen Probes mission. The RBSP-ECT science investigation (http://rbsp-ect.sr.unh.edu) measures comprehensively the near-Earth charged particle environment in order to understand the processes that control the acceleration, global distribution, and variability of radiation belt electrons and ions. RBSP-ECT data products derive from the three instrument elements that comprise the suite, which collectively covers the broad energies that define the source and seed populations, the core radiation belts, and also their highest energy ultra-relativistic extensions. These RBSP-ECT instruments include, from lowest to highest energies: the Helium, Oxygen, Proton, and Electron (HOPE) sensor, the Magnetic Electron and Ion Spectrometer (MagEIS), and the Relativistic Electron and Proton Telescope (REPT). We provide a brief overview of their principles of operation, as well as a description of the Level 2-3 data products that the HOPE, MagEIS, and REPT instruments produce, both separately and together. We provide a summary of how to access these RBSP-ECT data products at our Science Operation Center and Science Data Center (http://www.rbsp-ect.lanl.gov/rbsp_ect.php ) as well as caveats for their use. Finally, in the spirit of efficiently and effectively promoting and encouraging new collaborations, we present a summary of past publications, current studies, and opportunities for your future participation in RBSP-ECT extended mission phase science.

NASA's Van Allen Probes RBSP-ECT Data Products and Access to Them: An Insider's Outlook on the Inner and Outer Belts (and We Don't Mean the Nation's Beltway...)

NASA Astrophysics Data System (ADS)

Smith, S. S.; Friedel, R. H. W.; Henderson, M. G.; Larsen, B.; Reeves, G. D.; Spence, H. E.

2014-12-01

In this poster, we present a summary of access to the data products of the Radiation Belt Storm Probes - Energetic Particle Composition, and Thermal plasma (RBSP-ECT) suite of NASA's Van Allen Probes mission. The RBSP-ECT science investigation (http://rbsp-ect.sr.unh.edu) measures comprehensively the near-Earth charged particle environment in order to understand the processes that control the acceleration, global distribution, and variability of radiation belt electrons and ions. RBSP-ECT data products derive from the three instrument elements that comprise the suite, which collectively covers the broad energies that define the source and seed populations, the core radiation belts, and also their highest energy ultra-relativistic extensions. These RBSP-ECT instruments include, from lowest to highest energies: the Helium, Oxygen, Proton, and Electron (HOPE) sensor, the Magnetic Electron and Ion Spectrometer (MagEIS), and the Relativistic Electron and Proton Telescope (REPT). We provide a brief overview of their principles of operation, as well as a description of the Level 1-3 data products that the HOPE, MagEIS, and REPT instruments produce, both separately and together. We provide a summary of how to access these RBSP-ECT data products at our Science Operation Center and Science Data Center (http://www.rbsp-ect.lanl.gov/rbsp_ect.php ) as well as caveats for their use. Finally, in the spirit of efficiently and effectively promoting and encouraging new collaborations, we present a summary of past publications, current studies, and opportunities for your future participation in RBSP-ECT science analyses.

Electroconvulsive Therapy Response in Major Depressive Disorder: A Pilot Functional Network Connectivity Resting State fMRI Investigation

PubMed Central

Abbott, Christopher C.; Lemke, Nicholas T.; Gopal, Shruti; Thoma, Robert J.; Bustillo, Juan; Calhoun, Vince D.; Turner, Jessica A.

2013-01-01

Major depressive disorder (MDD) is associated with increased functional connectivity in specific neural networks. Electroconvulsive therapy (ECT), the gold-standard treatment for acute, treatment-resistant MDD, but temporal dependencies between networks associated with ECT response have yet to be investigated. In the present longitudinal, case–control investigation, we used independent component analysis to identify distinct networks of brain regions with temporally coherent hemodynamic signal change and functional network connectivity (FNC) to assess component time course correlations across these networks. MDD subjects completed imaging and clinical assessments immediately prior to the ECT series and a minimum of 5 days after the last ECT treatment. We focused our analysis on four networks affected in MDD: the subcallosal cingulate gyrus, default mode, dorsal lateral prefrontal cortex, and dorsal medial prefrontal cortex (DMPFC). In an older sample of ECT subjects (n = 12) with MDD, remission associated with the ECT series reverses the relationship from negative to positive between the posterior default mode (p_DM) and two other networks: the DMPFC and left dorsal lateral prefrontal cortex (l_DLPFC). Relative to demographically healthy subjects (n = 12), the FNC between the p_DM areas and the DMPFC normalizes with ECT response. The FNC changes following treatment did not correlate with symptom improvement; however, a direct comparison between ECT remitters and non-remitters showed the pattern of increased FNC between the p_DM and l_DLPFC following ECT to be specific to those who responded to the treatment. The differences between ECT remitters and non-remitters suggest that this increased FNC between p_DM areas and the left dorsolateral prefrontal cortex is a neural correlate and potential biomarker of recovery from a depressed episode. PMID:23459749

Electroconvulsive therapy response in major depressive disorder: a pilot functional network connectivity resting state FMRI investigation.

PubMed

Abbott, Christopher C; Lemke, Nicholas T; Gopal, Shruti; Thoma, Robert J; Bustillo, Juan; Calhoun, Vince D; Turner, Jessica A

2013-01-01

Major depressive disorder (MDD) is associated with increased functional connectivity in specific neural networks. Electroconvulsive therapy (ECT), the gold-standard treatment for acute, treatment-resistant MDD, but temporal dependencies between networks associated with ECT response have yet to be investigated. In the present longitudinal, case-control investigation, we used independent component analysis to identify distinct networks of brain regions with temporally coherent hemodynamic signal change and functional network connectivity (FNC) to assess component time course correlations across these networks. MDD subjects completed imaging and clinical assessments immediately prior to the ECT series and a minimum of 5 days after the last ECT treatment. We focused our analysis on four networks affected in MDD: the subcallosal cingulate gyrus, default mode, dorsal lateral prefrontal cortex, and dorsal medial prefrontal cortex (DMPFC). In an older sample of ECT subjects (n = 12) with MDD, remission associated with the ECT series reverses the relationship from negative to positive between the posterior default mode (p_DM) and two other networks: the DMPFC and left dorsal lateral prefrontal cortex (l_DLPFC). Relative to demographically healthy subjects (n = 12), the FNC between the p_DM areas and the DMPFC normalizes with ECT response. The FNC changes following treatment did not correlate with symptom improvement; however, a direct comparison between ECT remitters and non-remitters showed the pattern of increased FNC between the p_DM and l_DLPFC following ECT to be specific to those who responded to the treatment. The differences between ECT remitters and non-remitters suggest that this increased FNC between p_DM areas and the left dorsolateral prefrontal cortex is a neural correlate and potential biomarker of recovery from a depressed episode.

The Incidence and Predictors of Headache and Myalgia in Patients After Electroconvulsive Therapy (ECT)

PubMed Central

Haghighi, Mohammad; Sedighinejad, Abbas; Naderi Nabi, Bahram; Emiralavi, Cyrus; Biazar, Gelareh; Mirmozaffari, Kaveh; Zahedan, Cyrus; Jafari, Mehdi

2016-01-01

Background: Electroconvulsive therapy (ECT) is a safe and effective mode of therapy for a wide variety of psychiatric disorders. However, it is associated with some disturbing side effects, such as nausea and vomiting, dental and tongue injury, confusion, dizziness, headache, and myalgia. Objectives: The present study focused on the evaluation of myalgia and headache and their predictors after ECT. Patients and Methods: A prospective analytical descriptive study was conducted from October 2014 to January 2015, in an academic hospital in northern Iran. Before sampling, the study was approved by the ethics committee of Guilan University of Medical Sciences. 621 patients with psychiatric disorders who were referred to Shafa hospital enrolled in the study. They were evaluated based on a verbal rating scale (4 point scales) 6 hours after ECT, regarding headache and myalgia side effects. Results: 6 hours after ECT, 126 patients (21.9%) reported headaches, and 56 patients (9%) reported myalgia. The presence of headache or myalgia 6 hours after ECT was not correlated to the duration of convulsion, treatment sessions, sex, or age. But myalgia at 2 hours after treatment was correlated with sex (0.04). Sex, age, duration of seizure, and treatment sessions were not predictors of headache and myalgia 6 hours after ECT (log regression, enter mode). The intensity and frequency of headaches decreased during 6 hours after ECT (P = 0.0001 and P = 0.0001, respectively), and myalgia frequency decreased (P = 0.062) but the intensity increased (P = 0.87). Conclusions: The results of the present study demonstrate that headache after ECT procedures was more common than myalgia, but it was mild, tolerable, and decreased within 6 hours of the treatment. It is also notable that we did not found any predictors for post-ECT headache and myalgia. PMID:27761416

Catatonia with schizophrenia: From ECT to rTMS.

PubMed

Stip, E; Blain-Juste, M-E; Farmer, O; Fournier-Gosselin, M-P; Lespérance, P

2018-04-01

Electroconvulsive therapy is indicated in cases of catatonic schizophrenia following a failure of the challenge test with lorazepam or Zolpidem ® . Some patients need maintenance treatment with ECT. Repetitive Transcranial Magnetic Stimulation (rTMS) and anodal Transcranial direct-current stimulation (tDCS) might be effective against catatonia. Consider an alternative to ECT for a refractory patient. Twenty-one articles were identified mainly based on case reports series were found using search on Medline, Google Scholar, PsychInfo, CAIRNS. Key words were:"catatonia", and "rTMS", and more generally with"ECT","tDCS","Zolpidem ® ". At the end there were only six case reports with rTMS and three with tDCS. We discussed the alternative to ECT and follow up rTMS strategies illustrated by these case reports. Patients mean age was 35; numbers of previous ECT vary from zero to 556; the most common motor threshold (MT) is 80%, with two patients with 110%, the most common treatment placement is L DLPFC. In one of them, ECT was the only acute-state or maintenance treatment effective in this patient, who underwent 556 ECT sessions over 20 years. High-frequency rTMS was considered as a possible alternative, given the potential adverse effects of chronic maintenance ECT in a patient with comorbid epilepsy. rTMS treatment was 3-4×/week and over time extended to once every two weeks. A persistent objective improvement in catatonia was observed on the Bush-Francis Catatonia Rating Scale. rTMS is helpful for acute and maintenance treatment for catatonic schizophrenia who both failed multiple pharmacologic interventions and had safety concerns with continuing maintenance ECT. Clinicians should consider rTMS as a potential treatment option for refractory catatonia. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

The Incidence and Predictors of Headache and Myalgia in Patients After Electroconvulsive Therapy (ECT).

PubMed

Haghighi, Mohammad; Sedighinejad, Abbas; Naderi Nabi, Bahram; Emiralavi, Cyrus; Biazar, Gelareh; Mirmozaffari, Kaveh; Zahedan, Cyrus; Jafari, Mehdi

2016-06-01

Electroconvulsive therapy (ECT) is a safe and effective mode of therapy for a wide variety of psychiatric disorders. However, it is associated with some disturbing side effects, such as nausea and vomiting, dental and tongue injury, confusion, dizziness, headache, and myalgia. The present study focused on the evaluation of myalgia and headache and their predictors after ECT. A prospective analytical descriptive study was conducted from October 2014 to January 2015, in an academic hospital in northern Iran. Before sampling, the study was approved by the ethics committee of Guilan University of Medical Sciences. 621 patients with psychiatric disorders who were referred to Shafa hospital enrolled in the study. They were evaluated based on a verbal rating scale (4 point scales) 6 hours after ECT, regarding headache and myalgia side effects. 6 hours after ECT, 126 patients (21.9%) reported headaches, and 56 patients (9%) reported myalgia. The presence of headache or myalgia 6 hours after ECT was not correlated to the duration of convulsion, treatment sessions, sex, or age. But myalgia at 2 hours after treatment was correlated with sex (0.04). Sex, age, duration of seizure, and treatment sessions were not predictors of headache and myalgia 6 hours after ECT (log regression, enter mode). The intensity and frequency of headaches decreased during 6 hours after ECT (P = 0.0001 and P = 0.0001, respectively), and myalgia frequency decreased (P = 0.062) but the intensity increased (P = 0.87). The results of the present study demonstrate that headache after ECT procedures was more common than myalgia, but it was mild, tolerable, and decreased within 6 hours of the treatment. It is also notable that we did not found any predictors for post-ECT headache and myalgia.

Relationship Between Hippocampal Volume, Serum BDNF, and Depression Severity Following Electroconvulsive Therapy in Late-Life Depression

PubMed Central

Bouckaert, Filip; Dols, Annemiek; Emsell, Louise; De Winter, François-Laurent; Vansteelandt, Kristof; Claes, Lene; Sunaert, Stefan; Stek, Max; Sienaert, Pascal; Vandenbulcke, Mathieu

2016-01-01

Recent structural imaging studies have described hippocampal volume changes following electroconvulsive therapy (ECT). It has been proposed that serum brain-derived neurotrophic factor (sBDNF)-mediated neuroplasticity contributes critically to brain changes following antidepressant treatment. To date no studies have investigated the relationship between changes in hippocampal volume, mood, and sBDNF following ECT. Here, we combine these measurements in a longitudinal study of severe late-life unipolar depression (LLD). We treated 88 elderly patients with severe LLD twice weekly until remission (Montgomery–Åsberg Depression Rating Scale (MADRS) <10). sBDNF and MADRS were obtained before ECT (T0), after the sixth ECT (T1), 1 week after the last ECT (T2), 4 weeks after the last ECT (T3), and 6 months after the last ECT (T4). Hippocampal volumes were quantified by manual segmentation of 3T structural magnetic resonance images in 66 patients at T0 and T2 and in 23 patients at T0, T2, and T4. Linear mixed models (LMM) were used to examine the evolution of MADRS, sBDNF, and hippocampal volume over time. Following ECT, there was a significant decrease in MADRS scores and a significant increase in hippocampal volume. Hippocampal volume decreased back to baseline values at T4. Compared with T0, sBDNF levels remained unchanged at T1, T2, and T3. There was no coevolution between changes in MADRS scores, hippocampal volume, and sBDNF. Hippocampal volume increase following ECT is an independent neurobiological effect unrelated to sBDNF and depressive symptomatology, suggesting a complex mechanism of action of ECT in LLD. PMID:27272769

Alteration of immune markers in a group of melancholic depressed patients and their response to electroconvulsive therapy.

PubMed

Rush, Gavin; O'Donovan, Aoife; Nagle, Laura; Conway, Catherine; McCrohan, AnnMaria; O'Farrelly, Cliona; Lucey, James V; Malone, Kevin M

2016-11-15

Immune system dysfunction is implicated in the pathophysiology of major depression, and is hypothesized to normalize with successful treatment. We aimed to investigate immune dysfunction in melancholic depression and its response to ECT. 55 melancholic depressed patients and 26 controls participated. 33 patients (60%) were referred for ECT. Blood samples were taken at baseline, one hour after the first ECT session, and 48h after ECT series completion. At baseline, melancholic depressed patients had significantly higher levels of the pro-inflammatory cytokine IL-6, and lower levels of the regulatory cytokine TGF-β than controls. A significant surge in IL-6 levels was observed one hour after the first ECT session, but neither IL-6 nor TGF-β levels normalized after completion of ECT series. Seventy per cent (n=23) of ECT recipients showed clinical response and 42% (n=10) reached remission. Neither IL-6 nor TGF-β changes correlated with clinical improvement following ECT. No significant changes in IL-10, TNF-α and CRP levels were found in relation to melancholia or response to ECT. As a naturalistic study, some potential confounders could not be eliminated or controlled, including medication use. Melancholic depressed patients demonstrated a peripheral increase in IL-6 and reduction in TGF-β, which did not normalize despite clinical response to ECT. These findings may be consistent with emerging hypotheses of the role of inflammation in mediating neurotrophin expression. The implications of chronic inflammation in the melancholic depressed population for future medical health, particularly cardiovascular risk, are largely unknown and warrant further investigation. Copyright © 2016 Elsevier B.V. All rights reserved.

Electroconvulsive therapy and subsequent epilepsy in patients with affective disorders: A register-based Danish cohort study.

PubMed

Bøg, Fie Krossdal; Jørgensen, Martin Balslev; Andersen, Zorana Jovanovic; Osler, Merete

It has been suggested that Electroconvulsive Therapy (ECT) might increase the risk of epilepsy but the few patient studies with retrospective data from medical records do not support the hypothesis. The aim of this study was to examine the relationship between ECT and subsequent incident epilepsy in patients with affective disorder. We also explored whether any association varied with number of ECTs and time since last treatment. All 169,457 patients with first hospital contact for an affective disorder between January 2005 and December 2015 were identified in the Danish National Patient Registry and followed for incident epilepsy from January 2005 until November 2016. The association between ECT and epilepsy was examined using Cox proportional hazard regression with adjustment for gender, age, educational level, comorbid schizophrenia, previous stroke and antidepressant and antipsychotic medication use. A total of 5875 patients had at least one ECT and 1873 patients developed epilepsy (Incidence rate: 213 pr. 100,000 person years) during the follow-up of mean 5 years. In patients below age 40 years, ECT was associated with a higher rate of epilepsy after adjustment for covariables (Hazard Ratio (HR) = 1.84; 95% Confidence Intervals (CI) = [1.24-2.74]). In patients aged 41-60 years ECT was not associated with epilepsy, while for those above 60 treated with ECT the rate was lower (HR = 0.57; (95% CI = [0.37-0.89]). In patients with affective disorders, we found a weak positive association between ECT and subsequent diagnosis of epilepsy in those younger than 40 years, and a weak negative association in patients older than 60 years. The associations might be subject to residual confounding from risk factors related to ECT. Copyright © 2017 Elsevier Inc. All rights reserved.

Pretreatment With Caffeine Citrate to Increase Seizure Duration During Electroconvulsive Therapy: A Case Series.

PubMed

Pinkhasov, Aaron; Biglow, Michael; Chandra, Subhash; Pica, Tiffany

2016-04-01

Due to the shortage of parenteral caffeine and sodium benzoate, patients were pretreated with caffeine citrate to increase therapeutic seizure duration during electroconvulsive therapy (ECT). To date, no data are available on the use of caffeine citrate during ECT. This retrospective case series was done to demonstrate utilization of caffeine citrate as a substitute for caffeine and sodium benzoate in optimizing ECT. Medical records were reviewed to identify patients who received ECT and caffeine citrate. Physician notes were reviewed to determine the parameters of the ECT procedure, the seizure length, and the dose of caffeine citrate. Each chart was thoroughly studied to find the relationship between seizure duration and dose of caffeine citrate. Of the 12 ECT treatments utilizing caffeine citrate, 9 achieved at least 1 session lasting >30 seconds with an average seizure duration of 35 seconds. Increase in seizure duration ranged from -41% to 276% with an average increase of 48%. Only 3 treatment sessions utilizing caffeine citrate showed no increase in seizure duration. Doses ranged from 120 to 600 mg of both oral and parenteral caffeine citrate. Although increase in seizure duration was achieved for the majority of the ECT sessions, no dose-response correlation could be made. No significant adverse reactions were noted with the use of caffeine citrate during ECT. It was determined that, much like caffeine and sodium benzoate, caffeine citrate does increase the seizure duration. However, this response did vary due to many reasons including small sample size, concomitant medications, duration of illness, and number of ECTs they received in the past and how long ago they received the last ECT. Further research is required to elucidate the effect of these variables on seizure duration. © The Author(s) 2014.

Balance and gait in older electroconvulsive therapy recipients: a pilot study

PubMed Central

Plakiotis, Chris; Barson, Fay; Vengadasalam, Bharathi; Haines, Terry P; O’Connor, Daniel W

2013-01-01

Background Electroconvulsive therapy (ECT) is commonly used to treat depression in older adults. Despite its efficacy in this regard, an associated increase in the risk of falls in this population is a downside of treatment. ECT research has focused on the incidence of falls, but its effect on balance and gait – intrinsic factors in instability and falls – has not been studied. Our aim was to examine changes in balance and gait among older adults before and after a single ECT session and explore the effect of patient-related and treatment factors on any changes found. Methods Participants were 21 older adults requiring ECT for depression in public psychiatric services. Patients with clinically overt mobility problems (impairing test participation or increasing the risk of falls) were excluded. Balance and gait testing 1 hour pre-ECT and 1, 2 and 3 hours post-ECT included: (1) steady standing test; (2) perturbation of standing balance by self-initiated movements; (3) perturbation of standing balance by an external perturbation; and (4) timed up and go test. Results No deterioration in test performance was found, using one-way repeated measures analysis of variance. Conclusion Balance and gait did not deteriorate immediately after ECT. Exclusion of participants with clinically overt mobility problems and falls being better attributable to factors unrelated to balance and gait (such as post-ECT confusion) may account for our findings. This research does not repudiate the occurrence of ECT-related falls but calls into question the utility of introducing routine balance and gait assessment among older ECT recipients without pre-existing mobility problems as a means of preventing them. PMID:23766650

Lightning Optical Pulse Statistics from Storm Overflights During the Altus Cumulus Electrification Study

NASA Technical Reports Server (NTRS)

Mach, D. M.; Blakeslee, R. J.; Bailey, J. C.; Farrell, W. M.; Goldberg, R. A.; Desch, M. D.; Houser, J. G.

2004-01-01

The Altus Cumulus Electrification Study (ACES) was conducted during the month of August, 2002 in an area near Key West, Florida. One of the goals of this uninhabited aerial vehicle (UAV) study was to collect time resolved optical pulse data from thunderstorms. During the month long campaign, we acquired 5294 lightning generated optical pulses. Most of these observations were made while close to the top of the storms. We divided our data into two amplitude groups based on prior NASA U2 aircraft optical data and our pulse characteristics. The group of large pulses with radiance greater than 2.1 mW /sq m sr had mean and median 10 - 10% optical pulse widths of 765 and 735 microns respectively, the 50-50% pulse widths of 396 and 355 microns respectively, and 10-90% rise times of 290 and 260 microns. These values are very similar to the previous U2 based optical results The other group of pulses consisting of slightly more than a quarter of the total pulses observed had radiances less than the minimum values detected in the U2 study. The small pulses were narrower than the large pulses with 5040% mean and median values of 198 and 160 ps respectively. Only 12 % of the flashes contained only small pulses, minimizing the impact of this data on the estimates of detection efficiencies of the orbital instruments, the Lightning Imaging Sensor and Optical Transient Detector.

Evaluation of machine learning tools for inspection of steam generator tube structures using pulsed eddy current

NASA Astrophysics Data System (ADS)

Buck, J. A.; Underhill, P. R.; Morelli, J.; Krause, T. W.

2017-02-01

Degradation of nuclear steam generator (SG) tubes and support structures can result in a loss of reactor efficiency. Regular in-service inspection, by conventional eddy current testing (ECT), permits detection of cracks, measurement of wall loss, and identification of other SG tube degradation modes. However, ECT is challenged by overlapping degradation modes such as might occur for SG tube fretting accompanied by tube off-set within a corroding ferromagnetic support structure. Pulsed eddy current (PEC) is an emerging technology examined here for inspection of Alloy-800 SG tubes and associated carbon steel drilled support structures. Support structure hole size was varied to simulate uniform corrosion, while SG tube was off-set relative to hole axis. PEC measurements were performed using a single driver with an 8 pick-up coil configuration in the presence of flat-bottom rectangular frets as an overlapping degradation mode. A modified principal component analysis (MPCA) was performed on the time-voltage data in order to reduce data dimensionality. The MPCA scores were then used to train a support vector machine (SVM) that simultaneously targeted four independent parameters associated with; support structure hole size, tube off-centering in two dimensions and fret depth. The support vector machine was trained, tested, and validated on experimental data. Results were compared with a previously developed artificial neural network (ANN) trained on the same data. Estimates of tube position showed comparable results between the two machine learning tools. However, the ANN produced better estimates of hole inner diameter and fret depth. The better results from ANN analysis was attributed to challenges associated with the SVM when non-constant variance is present in the data.

The role of APOE-ɛ4 and beta amyloid in the differential rate of recovery from ECT: a review

PubMed Central

Sutton, T A; Sohrabi, H R; Rainey-Smith, S R; Bird, S M; Weinborn, M; Martins, R N

2015-01-01

Individual biological differences may contribute to the variability of outcomes, including cognitive effects, observed following electroconvulsive treatment (ECT). A narrative review of the research literature on carriage of the apolipoprotein E ɛ4 allele (APOE-ɛ4) and the protein biomarker beta amyloid (Aβ) with ECT cognitive outcome was undertaken. ECT induces repeated brain seizures and there is debate as to whether this causes brain injury and long-term cognitive disruption. The majority of ECT is administered to the elderly (over age 65 years) with drug-resistant depression. Depression in the elderly may be a symptom of the prodromal stage of Alzheimer's disease (AD). Carriage of the APOE-ɛ4 allele and raised cerebral Aβ are consistently implicated in AD, but inconsistently implicated in brain injury (and related syndromes) recovery rates. A paucity of brain-related recovery, genetic and biomarker research in ECT responses in the elderly was found: three studies have examined the effect of APOE-ɛ4 allele carriage on cognition in the depressed elderly receiving ECT, and two have examined Aβ changes after ECT, with contradictory findings. Cognitive changes in all studies of ECT effects were measured by a variety of psychological tests, making comparisons of such changes between studies problematic. Further, psychological test data-validity measures were not routinely administered, counter to current testing recommendations. The methodological issues of the currently available literature as well as the need for well-designed, hypothesis driven, longitudinal studies are discussed. PMID:25826114

The role of APOE-ɛ4 and beta amyloid in the differential rate of recovery from ECT: a review.

PubMed

Sutton, T A; Sohrabi, H R; Rainey-Smith, S R; Bird, S M; Weinborn, M; Martins, R N

2015-03-31

Individual biological differences may contribute to the variability of outcomes, including cognitive effects, observed following electroconvulsive treatment (ECT). A narrative review of the research literature on carriage of the apolipoprotein E ɛ4 allele (APOE-ɛ4) and the protein biomarker beta amyloid (Aβ) with ECT cognitive outcome was undertaken. ECT induces repeated brain seizures and there is debate as to whether this causes brain injury and long-term cognitive disruption. The majority of ECT is administered to the elderly (over age 65 years) with drug-resistant depression. Depression in the elderly may be a symptom of the prodromal stage of Alzheimer's disease (AD). Carriage of the APOE-ɛ4 allele and raised cerebral Aβ are consistently implicated in AD, but inconsistently implicated in brain injury (and related syndromes) recovery rates. A paucity of brain-related recovery, genetic and biomarker research in ECT responses in the elderly was found: three studies have examined the effect of APOE-ɛ4 allele carriage on cognition in the depressed elderly receiving ECT, and two have examined Aβ changes after ECT, with contradictory findings. Cognitive changes in all studies of ECT effects were measured by a variety of psychological tests, making comparisons of such changes between studies problematic. Further, psychological test data-validity measures were not routinely administered, counter to current testing recommendations. The methodological issues of the currently available literature as well as the need for well-designed, hypothesis driven, longitudinal studies are discussed.

Electroconvulsive Therapy Use in Youth in the Province of Quebec

PubMed Central

Loiseau, Annie; Harrisson, Marie-Claude; Beaudry, Vincent; Patry, Simon

2017-01-01

Objectives Electroconvulsive therapy’s (ECT) safety and tolerability is well-established in the treatment of severe psychiatric disorders in adults, but has been less studied in youth. The aim of the present study was to describe the use of ECT in youth in Quebec City and obtain Child and Adolescent Psychiatrists’ (CAP) perceptions in the province of Quebec. Methods The authors reviewed charts of minors who received ECT treatment in the Quebec City metropolitan area between 1995 and 2014 (part 1). Data was also collected on CAP perceptions and experience of ECT use in youth by means of a survey (part 2). Results Part 1 included four girls and two boys, aged between 15 and 17. The main diagnoses were: mood disorders and schizoaffective disorder. Patients received between four and twelve ECT sessions. Five patients responded to treatment, whereas one did not. Treatment and side effects are presented. For part 2, 53 CAP answered the survey. Forty-eight (91%) thought ECT is a good treatment option after failure of other therapeutic modalities and 12 (23%) had prescribed it. All respondents wished to receive additional training regarding ECT use in youth. Conclusion Our results are consistent with the notion that ECT use in youth with a refractory and complex disease is a safe and effective treatment, although rarely used. The majority of psychiatrists treating children and adolescents in Quebec favor ECT when all available therapeutic modalities have failed, but wished they had more training regarding its use. PMID:28331498

Electroconvulsive Therapy Use in Youth in the Province of Quebec.

PubMed

Loiseau, Annie; Harrisson, Marie-Claude; Beaudry, Vincent; Patry, Simon

2017-01-01

Electroconvulsive therapy's (ECT) safety and tolerability is well-established in the treatment of severe psychiatric disorders in adults, but has been less studied in youth. The aim of the present study was to describe the use of ECT in youth in Quebec City and obtain Child and Adolescent Psychiatrists' (CAP) perceptions in the province of Quebec. The authors reviewed charts of minors who received ECT treatment in the Quebec City metropolitan area between 1995 and 2014 (part 1). Data was also collected on CAP perceptions and experience of ECT use in youth by means of a survey (part 2). Part 1 included four girls and two boys, aged between 15 and 17. The main diagnoses were: mood disorders and schizoaffective disorder. Patients received between four and twelve ECT sessions. Five patients responded to treatment, whereas one did not. Treatment and side effects are presented. For part 2, 53 CAP answered the survey. Forty-eight (91%) thought ECT is a good treatment option after failure of other therapeutic modalities and 12 (23%) had prescribed it. All respondents wished to receive additional training regarding ECT use in youth. Our results are consistent with the notion that ECT use in youth with a refractory and complex disease is a safe and effective treatment, although rarely used. The majority of psychiatrists treating children and adolescents in Quebec favor ECT when all available therapeutic modalities have failed, but wished they had more training regarding its use.

Based on a True Story? The Portrayal of ECT in International Movies and Television Programs.

PubMed

Sienaert, Pascal

Movies and television (TV) programs are an important source of public information about ECT. To narratively review the portrayal of ECT in international movies and TV programs from 1948 until present. Several Internet movie databases and a database of phrases appearing in movies and TV programs were searched, supplemented with a Medline-search. No language restrictions were applied. ECT was portrayed in 52 movies (57 scenes), 21 TV programs (23 scenes), and 2 animated sitcoms (2 scenes). In movies, the main indication for ECT is behavioral control or torture (17/57, 29.8%), whereas in TV programs, the most frequent indication is erasing memories (7/25, 28%). In most scenes (47/82; 57.3%) ECT is given without consent, and without anesthesia (59/82; 72%). Unmodified ECT is depicted more frequently in American scenes (48/64, 75%), as opposed to scenes from other countries (11/18; 64.7%). Bilateral electrode placement is used in almost all (89%, 73/82) scenes. The vast majority of movies (46/57, 80.7%) and TV programs (18/25, 72%) show a negative and inaccurate image of the treatment. In the majority of scenes, ECT is used as a metaphor for repression, mind and behavior control, and is shown as a memory-erasing, painful and damaging treatment, adding to the stigma already associated with ECT. Only a few exceptions paint a truthful picture of this indispensable treatment in modern psychiatry. Copyright © 2016 Elsevier Inc. All rights reserved.

Isolated Attosecond Pulse Generation without the Need to Stabilize the Carrier-Envelope Phase of Driving Lasers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gilbertson, Steve; Khan, Sabih D.; Wu Yi

2010-08-27

Single isolated attosecond pulses can be extracted from a pulse train with an ultrafast gate in the generation target. By setting the gate width sufficiently narrow with the generalized double optical gating, we demonstrate that single isolated attosecond pulses can be generated with any arbitrary carrier-envelope phase value of the driving laser. The carrier-envelope phase only affects the photon flux, not the pulse duration or contrast. Our results show that isolated attosecond pulses can be generated using carrier-envelope phase unstabilized 23 fs pulses directly from chirped pulse amplifiers.

Migration of cell surface concanavalin A receptors in pulsed electric fields.

PubMed Central

Lin-Liu, S; Adey, W R; Poo, M M

1984-01-01

Concanavalin A (con A) receptors on the surface of cultured Xenopus myoblasts redistributed in response to monopolar, pulsed electric fields. The prefield uniform distribution of the receptors became asymmetrical, and was polarized toward the cathodal pole, in the same way as in DC fields. The extent of asymmetry depended on the duration of field exposure, pulse width (or alternatively, interpulse interval), frequency, and intensity. This relationship was most conveniently expressed by using duty cycle, a quantity determined by both pulse width and frequency. Pulses of average intensity 1.5 V/cm induced detectable asymmetry within 5 min. At the lowest average field intensity used, 0.8 V/cm, significant asymmetry was detected at 150 min. For pulses of high duty cycle (greater than 25%), steady state was reached after 30 min exposure and the steady state asymmetry was dependent on average field intensity. For low duty cycle fields, the time required to reach steady state was prolonged (greater than 50 min). Before reaching a steady state, effectiveness of the pulses, as compared with DC fields of equivalent intensity, was a function of duty cycle. A low duty cycle field (fixed number of pulses at low frequency or long interpulse interval) was less effective than high duty cycle fields or DC. PMID:6743751

Picosecond pulsed micro-module emitting near 560 nm using a frequency doubled gain-switched DBR ridge waveguide semiconductor laser

NASA Astrophysics Data System (ADS)

Kaltenbach, André; Hofmann, Julian; Seidel, Dirk; Lauritsen, Kristian; Bugge, Frank; Fricke, Jörg; Paschke, Katrin; Erdmann, Rainer; Tränkle, Günther

2017-02-01

A miniaturized picosecond pulsed semiconductor laser source in the spectral range around 560nm is realized by integrating a frequency doubled distributed Bragg reflector ridge waveguide laser (DBR-RWL) into a micromodule. Such compact laser sources are suitable for mobile application, e.g. in microscopes. The picosecond optical pulses are generated by gain-switching which allows for arbitrary pulse repetition frequencies. For frequency conversion a periodically poled magnesium doped lithium niobate ridge waveguide crystal (PPLN) is used to provide high conversion efficiency with single-pass second harmonic generation (SHG). The coupling of the pulsed radiation into the PPLN crystal is realized by a GRIN-lens. Such types of lenses collect the divergent laser radiation and focus it into the crystal waveguide providing high coupling efficiency at a minimum of space compared to the usage of fast axis collimator(FAC)/slow axis collimator (SAC) lens combinations. The frequency doubled output pulses show a pulse width of about 60 ps FWHM and a spectral width around 0.06nm FWHM at a central wavelength of 557nm at 15Å. The pulse peak power could be determined to be more than 300mW at a repetition frequency of 40 MHz.

Calibration approach for fluorescence lifetime determination for applications using time-gated detection and finite pulse width excitation.

PubMed

Keller, Scott B; Dudley, Jonathan A; Binzel, Katherine; Jasensky, Joshua; de Pedro, Hector Michael; Frey, Eric W; Urayama, Paul

2008-10-15

Time-gated techniques are useful for the rapid sampling of excited-state (fluorescence) emission decays in the time domain. Gated detectors coupled with bright, economical, nanosecond-pulsed light sources like flashlamps and nitrogen lasers are an attractive combination for bioanalytical and biomedical applications. Here we present a calibration approach for lifetime determination that is noniterative and that does not assume a negligible instrument response function (i.e., a negligible excitation pulse width) as does most current rapid lifetime determination approaches. Analogous to a transducer-based sensor, signals from fluorophores of known lifetime (0.5-12 ns) serve as calibration references. A fast avalanche photodiode and a GHz-bandwidth digital oscilloscope is used to detect transient emission from reference samples excited using a nitrogen laser. We find that the normalized time-integrated emission signal is proportional to the lifetime, which can be determined with good reproducibility (typically <100 ps) even for data with poor signal-to-noise ratios ( approximately 20). Results are in good agreement with simulations. Additionally, a new time-gating scheme for fluorescence lifetime imaging applications is proposed. In conclusion, a calibration-based approach is a valuable analysis tool for the rapid determination of lifetime in applications using time-gated detection and finite pulse width excitation.

N-butanol and isobutanol as alternatives to gasoline: Comparison of port fuel injector characteristics

NASA Astrophysics Data System (ADS)

Fenkl, Michael; Pechout, Martin; Vojtisek, Michal

2016-03-01

The paper reports on an experimental investigation of the relationship between the pulse width of a gasoline engine port fuel injector and the quantity of the fuel injected when butanol is used as a fuel. Two isomers of butanol, n-butanol and isobutanol, are considered as potential candidates for renewable, locally produced fuels capable of serving as a drop-in replacement fuel for gasoline, as an alternative to ethanol which poses material compatibility and other drawbacks. While the injected quantity of fuel is typically a linear function of the time the injector coil is energized, the flow through the port fuel injector is complex, non ideal, and not necessarily laminar, and considering that butanol has much higher viscosity than gasoline, an experimental investigation was conducted. A production injector, coupled to a production fueling system, and driven by a pulse width generator was operated at various pulse lengths and frequencies, covering the range of engine rpm and loads on a car engine. The results suggest that at least at room temperature, the fueling rate remains to be a linear function of the pulse width for both n-butanol and isobutanol, and the volumes of fuel injected are comparable for gasoline and both butanol isomers.

Electroconvulsive therapy regulates emotional memory bias of depressed patients.

PubMed

Bai, Tongjian; Xie, Wen; Wei, Qiang; Chen, Yang; Mu, Jingjing; Tian, Yanghua; Wang, Kai

2017-11-01

Emotional memory bias is considered to be an important base of the etiology of depression and can be reversed by antidepressants via enhancing the memory for positive stimuli. Another antidepressant treatment, electroconvulsive therapy (ECT), has rapid antidepressant effect and frequently causes short-term memory impairment. However, it is unclear about the short-term effect of ECT on memory bias. In this study, the incidental memory task with emotional pictures were applied to evaluate the emotional memory of twenty depressed patients at pre- and post-ECT (three days after ECT) compared to twenty healthy controls. The depressive symptoms were evaluated using the Hamilton rating scale of depression (HRSD). Before ECT, patients showed decreased recognition memory for positive pictures compared to controls and remembered negative pictures more easily than positive pictures in the recognition task. In patients, the main effect of session (pre-ECT and post-ECT) was significant for both recognition and recall memory with reduced memory performance. The interaction between valence (positive, neutral and negative) and session was significant for recognition memory, indicating that negative memory was impaired more severely than positive memory. Our study indicates that ECT relieves depressive symptoms and regulates emotional memory through more severe impairment on memory for negative stimuli. Copyright © 2017. Published by Elsevier B.V.

Electroconvulsive therapy changes the regional resting state function measured by regional homogeneity (ReHo) and amplitude of low frequency fluctuations (ALFF) in elderly major depressive disorder patients: An exploratory study.

PubMed

Kong, Xiao-Ming; Xu, Shu-Xian; Sun, Yan; Wang, Ke-Yong; Wang, Chen; Zhang, Ji; Xia, Jin-Xiang; Zhang, Li; Tan, Bo-Jian; Xie, Xin-Hui

2017-06-30

Electroconvulsive therapy (ECT) is the most effective and rapid treatment for severe major depressive disorder (MDD) in elderly patients. The mechanism of ECT is unclear, and studies on ECT in elderly MDD patients by resting-state functional magnetic resonance imaging are rare. Thirteen elderly MDD patients were scanned before and after ECT using a 3.0T MRI scanner. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) were processed to compare resting-state function before and after treatment. Depression and anxiety symptoms of all patients abated after ECT. Decreased ReHo values in the bilateral superior frontal gyrus (SFG) were observed after ECT, and the values of right SFG significantly correlated with an altered Hamilton depression rating scale score. Increased ALFF values in the left middle frontal gyrus, right middle frontal gyrus, orbital part, and decreased ALFF values in the left midcingulate area, left precentral gyrus, right SFG/middle frontal gyrus after ECT were also observed. These results support the hypothesis that ECT may affect the regional resting state brain function in geriatric MDD patients. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Pregnancy and Electroconvulsive Therapy: A Multidisciplinary Approach.

PubMed

Ray-Griffith, Shona L; Coker, Jessica L; Rabie, Nader; Eads, Lou Ann; Golden, Kimberly J; Stowe, Zachary N

2016-06-01

To scrutinize a series of pregnant women treated with electroconvulsive therapy (ECT) at a tertiary treatment center and combine these data with a literature review to refine the treatment guidelines for ECT during pregnancy. A retrospective chart review of mentally ill pregnant patients treated with ECT since the establishment of a formal women's mental health program. A total of 8 pregnant women treated with ECT were identified from January 2012 to August 2014. Information was extracted from the medical records of a total of 30 ECT treatments across this group. Subjects received an average of 3.75 ECT treatments (range, 1-7). All women were diagnosed as having a mood disorder (either unipolar or bipolar), and 5 of the 8 women had suicidal ideation. The treatment team for ECT was consistent across all treatments. Two women experienced significant complications after the initial treatment: 1) an acute episode of complete heart block; and 2) acute onset of mania after ECT. Obstetrical complications included 2 women with preterm delivery-one secondary to premature rupture of membranes. No other complications or adverse outcomes were recorded. The 5 women with suicidal ideation had symptom resolution, and significant symptom improvement was noted in 6 of the 8 women. Electroconvulsive therapy is a safe and effective treatment during pregnancy and of particular benefit in the acute treatment of suicidal ideation.

Use of electroconvulsive therapy in older Chinese psychiatric patients.

PubMed

Zhang, Xin-Qiao; Wang, Zhi-Min; Pan, Yan-Li; Chiu, Helen F K; Ng, Chee H; Ungvari, Gabor S; Lai, Kelly Y C; Cao, Xiao-Lan; Li, Yan; Zhong, Bao-Liang; Xiang, Yu-Tao

2015-08-01

Little is known about the use of electroconvulsive therapy (ECT) in older Chinese psychiatric patients. This study examined the frequency of ECT and the demographic and clinical correlates in older psychiatric patients hospitalized in a large psychiatric institution in Beijing, China. This was a retrospective chart review of 2339 inpatients aged 60 years and older treated over a period of 8 years (2007-2013) in a university-affiliated psychiatric institution in Beijing. Sociodemographic and clinical data were collected from the electronic chart management system for discharged patients. The rate of ECT use was 28.1% in the whole sample; 37.9% in those with bipolar disorders, 43.6% in major depression, 21.2% in schizophrenia, and 10.7% in other diagnoses. ECT ("ECT group") was associated with 60-65-year age group, high risk for suicide and low risk for falls at the time of admission, use of mood stabilizers and antidepressants, lack of health insurance, and having major medical conditions and diagnosis of major depression. The above significant correlates explained 24.9% of the variance of ECT use (p < 0.001). In a major psychiatric hospital in China, the use of ECT was common among older patients. ECT use in older patients treated in other clinical settings warrants further investigations. Copyright © 2014 John Wiley & Sons, Ltd.

Key updates in the clinical application of electroconvulsive therapy.

PubMed

Weiner, Richard D; Reti, Irving M

2017-04-01

ECT is the oldest and most effective therapy available for the treatment of severe major depression. It is highly effective in individuals with treatment resistance and when a rapid response is required. However, ECT is associated with memory impairment that is the most concerning side-effect of the treatment, substantially contributing to the controversy and stigmatization surrounding this highly effective treatment. There is overwhelming evidence for the efficacy and safety of an acute course of ECT for the treatment of a severe major depressive episode, as reflected by the recent FDA advisory panel recommendation to reclassify ECT devices from Class III to the lower risk category Class II. However, its application for other indications remains controversial, despite strong evidence to the contrary. This article reviews the indication of ECT for major depression, as well as for other conditions, including catatonia, mania, and acute episodes of schizophrenia. This study also reviews the growing evidence supporting the use of maintenance ECT to prevent relapse after an acute successful course of treatment. Although ECT is administered uncommonly to patients under the age of 18, the evidence supporting its use is also reviewed in this patient population. Finally, memory loss associated with ECT and efforts at more effectively monitoring and reducing it are reviewed.

Pulse oximeter plethysmographic waveform changes in awake, spontaneously breathing, hypovolemic volunteers.

PubMed

McGrath, Susan P; Ryan, Kathy L; Wendelken, Suzanne M; Rickards, Caroline A; Convertino, Victor A

2011-02-01

The primary objective of this study was to determine whether alterations in the pulse oximeter waveform characteristics would track progressive reductions in central blood volume. We also assessed whether changes in the pulse oximeter waveform provide an indication of blood loss in the hemorrhaging patient before changes in standard vital signs. Pulse oximeter data from finger, forehead, and ear pulse oximeter sensors were collected from 18 healthy subjects undergoing progressive reduction in central blood volume induced by lower body negative pressure (LBNP). Stroke volume measurements were simultaneously recorded using impedance cardiography. The study was conducted in a research laboratory setting where no interventions were performed. Pulse amplitude, width, and area under the curve (AUC) features were calculated from each pulse wave recording. Amalgamated correlation coefficients were calculated to determine the relationship between the changes in pulse oximeter waveform features and changes in stroke volume with LBNP. For pulse oximeter sensors on the ear and forehead, reductions in pulse amplitude, width, and area were strongly correlated with progressive reductions in stroke volume during LBNP (R(2) ≥ 0.59 for all features). Changes in pulse oximeter waveform features were observed before profound decreases in arterial blood pressure. The best correlations between pulse features and stroke volume were obtained from the forehead sensor area (R(2) = 0.97). Pulse oximeter waveform features returned to baseline levels when central blood volume was restored. These results support the use of pulse oximeter waveform analysis as a potential diagnostic tool to detect clinically significant hypovolemia before the onset of cardiovascular decompensation in spontaneously breathing patients.

Detection and Sizing of Defects in Structural Components of a Nuclear Power Plant by ECT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen Zhenmao; Miya, Kenzo

2005-04-09

In this paper, progress of ECT technique for inspection of stress corrosion cracks in a structural component of a nuclear power plant is reported. Access and scanning vehicle (robot), advanced probes for SG tube inspection, development and evaluation of new probes for welding joint, and ECT based crack sizing technique are described respectively. Based on these new techniques, it is clarified that ECT can play as a supplement of UT for the welding zone inspection. It is also proved in this work that new ECT sensors are efficient even for a stainless plate as thick as 15mm.

Short- and long-term evaluation of cognitive functions after electroconvulsive therapy in a Japanese population.

PubMed

Takagi, Shunsuke; Takeuchi, Takashi; Yamamoto, Naoki; Fujita, Munehisa; Furuta, Ko; Ishikawa, Hiroyo; Motohashi, Nobutaka; Nishikawa, Toru

2018-02-01

While electroconvulsive therapy (ECT) is a well-established, safe, and effective treatment for mental illnesses, the potential for adverse effects on cognitive functions remains controversial. We aimed to evaluate multiple cognitive functions in different time periods before and after ECT in a Japanese population. A battery of five neurocognitive tests was administered to patients who underwent a course of ECT treatment at three time points: before, immediately after, and 4 weeks after ECT. A transient but significant decline in letter fluency function was observed immediately after ECT, but had recovered well by 4 weeks. We also observed a significant improvement in the trail-making task at 4 weeks after ECT. In a Japanese population, adverse effects of ECT on verbal fluency function-related and other cognitive impairments were transient. Over the longer term, we detected significant improvements in the performance of tasks that presumably reflected information processing speed and executive functions. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

Ketamine as the anaesthetic for electroconvulsive therapy: the KANECT randomised controlled trial

PubMed Central

Fernie, Gordon; Currie, James; Perrin, Jennifer S.; Stewart, Caroline A.; Anderson, Virginica; Bennett, Daniel M.; Hay, Steven; Reid, Ian C.

2017-01-01

Background Ketamine has recently become an agent of interest as an acute treatment for severe depression and as the anaesthetic for electroconvulsive therapy (ECT). Subanaesthetic doses result in an acute reduction in depression severity while evidence is equivocal for this antidepressant effect with anaesthetic or adjuvant doses. Recent systematic reviews call for high-quality evidence from further randomised controlled trials (RCTs). Aims To establish if ketamine as the anaesthetic for ECT results in fewer ECT treatments, improvements in depression severity ratings and less memory impairment than the standard anaesthetic. Method Double-blind, parallel-design, RCT of intravenous ketamine (up to 2 mg/kg) with an active comparator, intravenous propofol (up to 2.5 mg/kg), as the anaesthetic for ECT in patients receiving ECT for major depression on an informal basis. (Trial registration: European Clinical Trials Database (EudraCT): 2011-000396-14 and clinicalTrials.gov: NCT01306760.) Results No significant differences were found on any outcome measure during, at the end of or 1 month following the ECT course. Conclusions Ketamine as an anaesthetic does not enhance the efficacy of ECT. PMID:28254962

Multifactorial Determinants of the Neurocognitive Effects of Electroconvulsive Therapy

PubMed Central

McClintock, Shawn M.; Choi, Jimmy; Deng, Zhi-De; Appelbaum, Lawrence G.; Krystal, Andrew D.; Lisanby, Sarah H.

2014-01-01

For many patients with neuropsychiatric illnesses, standard psychiatric treatments with mono or combination pharmacotherapy, psychotherapy, and transcranial magnetic stimulation are ineffective. For these patients with treatment resistant neuropsychiatric illnesses, a main therapeutic option is electroconvulsive therapy (ECT). Decades of research have found ECT to be highly effective; however, it can also result in adverse neurocognitive effects. Specifically, ECT results in disorientation after each session, anterograde amnesia for recently learned information, and retrograde amnesia for previously learned information. Unfortunately, the neurocognitive effects and underlying mechanisms of action of ECT remain poorly understood. The purpose of this paper is to synthesize the multiple moderating and mediating factors that are thought to underlie the neurocognitive effects of ECT into a coherent model. Such factors include demographic and neuropsychological characteristics, neuropsychiatric symptoms, ECT technical parameters, and ECT associated neurophysiological changes. Future research is warranted to evaluate and test this model, so that these findings may support the development of more refined clinical seizure therapy delivery approaches and efficacious cognitive remediation strategies to improve the utility of this important and widely used intervention tool for neuropsychiatric diseases. PMID:24820942

Transient febrile reaction after electroconvulsive therapy (ECT) in a young adult with intellectual disability and bipolar disorder.

PubMed

Majeske, Matthew F; Garakani, Amir; Maloutas, Eleni; Bryson, Ethan O; Kellner, Charles H

2013-12-01

We report the case of a 27-year-old man with mild-moderate intellectual disability (ID) and bipolar disorder treated with electroconvulsive therapy (ECT). He was psychiatrically hospitalized for agitation, aggression, and manic symptoms including insomnia, rapid and pressured speech, and hyperactivity. After multiple medication trials, ECT was recommended. The treatment was delayed owing to the need to obtain evaluation for incapacity and then substituted consent from the patient's mother. He received 2 ECT treatments with marked improvement but complicated by transient fevers, which resolved without treatment. Fever workup was unremarkable. The patient became calm and cooperative and was discharged home. He was readmitted 3 weeks later, again in an agitated manic state. He received 5 additional ECT treatments, but this time with no post-ECT fevers. Once again, his manic symptoms resolved, and he was safely discharged. Whereas patients with ID pose special challenges, our case is in keeping with the previous literature, which supports the use of ECT in patients with ID and comorbid psychiatric disorders.

Postpartum electroconvulsive therapy: a systematic review and case report.

PubMed

Gressier, Florence; Rotenberg, Samuel; Cazas, Odile; Hardy, Patrick

2015-01-01

Postpartum depression can have devastating consequences on the mother and child. Prompt treatment is challenging. Whereas electroconvulsive therapy (ECT) is considered to be an effective treatment modality in severe depression and brings about rapid clinical improvement, little is known about ECT during the postpartum period. We systematically reviewed the literature on the use of ECT during the postpartum period using PubMed, Institute for Scientific Information Web of Knowledge and PsycINFO databases until September 2014, using the search terms "electroconvulsive therapy" or "ECT" and "postpartum". Then, we described the successful treatment with ECT and the joint mother-baby hospitalization of a woman with severe depression. Eight case reports and 8 studies were identified. All of the studies reported that ECT is effective in the postpartum period. It is well tolerated, provides a fast response and allows for breastfeeding. In addition, our case report showed the benefits of the hospitalization of the mother-baby unit. Combined ECT and joint mother-baby hospitalization could be a valuable treatment by targeting both the mother-infant relationship and the maternal depressive symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

Electroconvulsive Therapy in Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Case Report and Review of the Literature.

PubMed

Coffey, M Justin; Cooper, Joseph J

2016-12-01

There is a growing scientific literature describing the neuropsychiatric symptoms of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, including the use of electroconvulsive therapy (ECT) to treat those symptoms. We sought to consolidate this literature into a review that highlights its relevance to ECT practitioners. We performed a PubMed search using the terms electroconvulsive therapy and encephalitis, autoimmune encephalitis, or anti-NMDA receptor encephalitis. We reviewed all relevant studies in detail, cross-referenced all bibliographies, and collected key clinical information related to the practice of ECT. We identified 6 studies offering patient-level descriptions of the use of ECT in patients with anti-NMDA receptor encephalitis. In all cases ECT was used to target symptoms of catatonia. Electroconvulsive therapy was delivered safely and effectively irrespective of the timing of diagnosis, tumor removal, or immunotherapy. There are no controlled data on the use of ECT in anti-NMDA receptor encephalitis. Further investigation is needed to determine whether ECT has a disease-modifying effect on this form of autoimmune encephalitis.

Multifactorial determinants of the neurocognitive effects of electroconvulsive therapy.

PubMed

McClintock, Shawn M; Choi, Jimmy; Deng, Zhi-De; Appelbaum, Lawrence G; Krystal, Andrew D; Lisanby, Sarah H

2014-06-01

For many patients with neuropsychiatric illnesses, standard psychiatric treatments with mono or combination pharmacotherapy, psychotherapy, and transcranial magnetic stimulation are ineffective. For these patients with treatment-resistant neuropsychiatric illnesses, a main therapeutic option is electroconvulsive therapy (ECT). Decades of research have found ECT to be highly effective; however, it can also result in adverse neurocognitive effects. Specifically, ECT results in disorientation after each session, anterograde amnesia for recently learned information, and retrograde amnesia for previously learned information. Unfortunately, the neurocognitive effects and underlying mechanisms of action of ECT remain poorly understood. The purpose of this paper was to synthesize the multiple moderating and mediating factors that are thought to underlie the neurocognitive effects of ECT into a coherent model. Such factors include demographic and neuropsychological characteristics, neuropsychiatric symptoms, ECT technical parameters, and ECT-associated neurophysiological changes. Future research is warranted to evaluate and test this model, so that these findings may support the development of more refined clinical seizure therapy delivery approaches and efficacious cognitive remediation strategies to improve the use of this important and widely used intervention tool for neuropsychiatric diseases.