Mood, Dimensional Personality, and Suicidality in a Longitudinal Sample of Patients with Bipolar Disorder and Controls

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151828/1/sltb12529_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151828/2/sltb12529.pd

Long-Term Corticosteroid-Sparing Immunosuppression for Cardiac Sarcoidosis.

Background Long-term corticosteroid therapy is the standard of care for treatment of cardiac sarcoidosis (CS). The efficacy of long-term corticosteroid-sparing immunosuppression in CS is unknown. The goal of this study was to assess the efficacy of methotrexate with or without adalimumab for long-term disease suppression in CS, and to assess recurrence and adverse event rates after immunosuppression discontinuation. Methods and Results Retrospective chart review identified treatment-naive CS patients at a single academic medical center who received corticosteroid-sparing maintenance therapy. Demographics, cardiac uptake of 18-fluorodeoxyglucose, and adverse cardiac events were compared before and during treatment and between those with persistent or interrupted immunosuppression. Twenty-eight CS patients were followed for a mean 4.1 (SD 1.5) years. Twenty-five patients received 4 to 8 weeks of high-dose prednisone (>30 mg/day), followed by taper and maintenance therapy with methotrexate±low-dose prednisone (low-dose prednisone, <10 mg/day). Adalimumab was added in 19 patients with persistently active CS or in those with intolerance to methotrexate. Methotrexate±low-dose prednisone resulted in initial reduction (88%) or elimination (60%) of 18-fluorodeoxyglucose uptake, and patients receiving adalimumab-containing regimens experienced improved (84%) or resolved (63%) 18-fluorodeoxyglucose uptake. Radiologic relapse occurred in 8 of 9 patients after immunosuppression cessation, 4 patients on methotrexate-containing regimens, and in no patients on adalimumab-containing regimens. Conclusions Corticosteroid-sparing regimens containing methotrexate with or without adalimumab is an effective maintenance therapy in patients after an initial response is confirmed. Disease recurrence in patients on and off immunosuppression support need for ongoing radiologic surveillance regardless of immunosuppression regimen

The double burden of age and disease on cognition and quality of life in bipolar disorder

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108337/1/gps4084.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/108337/2/gps4084-sup-0002-TableS1.pd

Equivalent linear change in cognition between individuals with bipolar disorder and healthy controls over 5 years

ObjectivesCognitive dysfunction is a key feature of bipolar disorder (BD). However, not much is known about its temporal stability, as some studies have demonstrated a neurodegenerative model in BD while others have shown no change in cognitive functioning over time. Building upon our prior work, which examined the natural course of executive functioning, the current study aimed to investigate the natural course of memory, emotion processing, and fine motor dexterity over a 5‐year period in BD and healthy control (HC) samples.MethodsUsing a 5‐year longitudinal cohort, 90 individuals with BD and 17 HCs were administered a battery of neuropsychological tests at study baseline and at 1 and 5 years after study entry that captured four areas of cognitive performance: visual memory, auditory memory, emotion processing, and fine motor dexterity.ResultsLatent growth curve modeling showed no group differences in the slopes of any of the cognitive factors between the BD and HC groups. Age at baseline was negatively associated with visual memory, emotion processing, and fine motor dexterity. Education level was positively associated with auditory and visual memory and fine motor. Female gender was negatively associated with emotion processing.ConclusionsExtending our prior work on longitudinal evaluation of executive functioning, individuals with BD show similar linear change in other areas of cognitive functioning including memory, emotion processing, and fine motor dexterity as compared to unaffected HCs. Age, education, and gender may have some differential effects on cognitive changes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142144/1/bdi12532.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142144/2/bdi12532_am.pd

Entropy in Black Hole Pair Production

Pair production of Reissner-Nordstrom black holes in a magnetic field can be described by a euclidean instanton. It is shown that the instanton amplitude contains an explicit factor of $e^{A/4}$, where $A$ is the area of the event horizon. This is consistent with the hypothesis that $e^{A/4}$ measures the number of black hole states.Comment: 24 pages (harvmac l mode

Pair Creation of Dilaton Black Holes

We consider dilaton gravity theories in four spacetime dimensions parametrised by a constant $a$, which controls the dilaton coupling, and construct new exact solutions. We first generalise the C-metric of Einstein-Maxwell theory ($a=0$) to solutions corresponding to oppositely charged dilaton black holes undergoing uniform acceleration for general $a$. We next develop a solution generating technique which allows us to ``embed" the dilaton C-metrics in magnetic dilaton Melvin backgrounds, thus generalising the Ernst metric of Einstein-Maxwell theory. By adjusting the parameters appropriately, it is possible to eliminate the nodal singularities of the dilaton C-metrics. For $a<1$ (but not for $a\ge 1$), it is possible to further restrict the parameters so that the dilaton Ernst solutions have a smooth euclidean section with topology $S^2\times S^2-{\rm\{pt\}}$, corresponding to instantons describing the pair production of dilaton black holes in a magnetic field. A different restriction on the parameters leads to smooth instantons for all values of $a$ with topology $S^2\times \R^2$.Comment: 22 pages, EFI-93-51, FERMILAB-Pub-93/272-A, UMHEP-393. (Asymptotics of Ernst solutions clarified, typos repaired

The Relationship between Therapeutic Alliance and Service User Satisfaction in Mental Health Inpatient Wards and Crisis House Alternatives: A Cross-Sectional Study

Background Poor service user experiences are often reported on mental health inpatient wards. Crisis houses are an alternative, but evidence is limited. This paper investigates therapeutic alliances in acute wards and crisis houses, exploring how far stronger therapeutic alliance may underlie greater client satisfaction in crisis houses. Methods and Findings Mixed methods were used. In the quantitative component, 108 crisis house and 247 acute ward service users responded to measures of satisfaction, therapeutic relationships, informal peer support, recovery and negative events experienced during the admission. Linear regressions were conducted to estimate the association between service setting and measures, and to model the factors associated with satisfaction. Qualitative interviews exploring therapeutic alliances were conducted with service users and staff in each setting and analysed thematically. Results We found that therapeutic alliances, service user satisfaction and informal peer support were greater in crisis houses than on acute wards, whilst self-rated recovery and numbers of negative events were lower. Adjusted multivariable analyses suggest that therapeutic relationships, informal peer support and negative experiences related to staff may be important factors in accounting for greater satisfaction in crisis houses. Qualitative results suggest factors that influence therapeutic alliances include service user perceptions of basic human qualities such as kindness and empathy in staff and, at service level, the extent of loss of liberty and autonomy. Conclusions and Implications We found that service users experience better therapeutic relationships and higher satisfaction in crisis houses compared to acute wards, although we cannot exclude the possibility that differences in service user characteristics contribute to this. This finding provides some support for the expansion of crisis house provision. Further research is needed to investigate why acute ward service users experience a lack of compassion and humanity from ward staff and how this could be changed

Pontryagin invariants and integral formulas for Milnor's triple linking number

To each three-component link in the 3-sphere, we associate a geometrically natural characteristic map from the 3-torus to the 2-sphere, and show that the pairwise linking numbers and Milnor triple linking number that classify the link up to link homotopy correspond to the Pontryagin invariants that classify its characteristic map up to homotopy. This can be viewed as a natural extension of the familiar fact that the linking number of a two-component link in 3-space is the degree of its associated Gauss map from the 2-torus to the 2-sphere. When the pairwise linking numbers are all zero, we give an integral formula for the triple linking number analogous to the Gauss integral for the pairwise linking numbers. The integrand in this formula is geometrically natural in the sense that it is invariant under orientation-preserving rigid motions of the 3-sphere, while the integral itself can be viewed as the helicity of a related vector field on the 3-torus.Comment: 60 pages, 37 figure

1973

Skunks Shoot Back by William Stewart (page 1) The Daily Plan: A Management Factor by Rob McIntyre (2) Teed Off by Samuel Pavadore (3) A Responsible Neighbor by Gerald Moscato (4) Drainage by David Clement (A-1) Fairway Renovation at Baltusrol Golf Club by Joseph R. Flaherty (A-4) Converting to Kentucky Bluegrass Fairways by Thomas Rewinski (A-10) Grooming the Golf Course by Melvin B. Lucas, Jr. (A-12) Turf Diseases of 1972, Controls and Prevention for 1973 by Stanley J. Zontek (A-13) Noncropland Weed Control by John E. Gallagher (A-16) Soil Factors Affecting Arsenic Toxicity by Robert N. Carrow (A-24) The Necessity of Cart Paths and Traffic Regulations by William G. Buchanan (A-27) Herbicides for Turfgrass Areas by John A. Jagschitz (A-29) Perspectives on Lawn Making and Keeping by Robert Schery (A-33) Stadium Turf Maintenance by George P. Toma (A-39) Highway Turfgrass by Robert W. Duell (A-44) Cemetery Maintenance by Martin Stolpe (A-50) Keeping Records by Al Barauskas (A-54) Planning Capital Expenditures by Sherwood A. Moore (A-59) British Golf Course Architecture -Historical Influences- Current Trends by F.W. Hawtree (A-64) Golf Course Architecture in North America By Geoffrey S. Cornish (A-70