A comparison of treatment outcomes for individuals with substance use disorder alone and individuals with probable dual diagnosis

The co-occurrence of substance use and mental health problems, often referred to as dual diagnosis (DD), is increasingly recognised as commonplace within substance abuse treatment programs. Two-hundred and thirty-four individuals from 9 Australian Salvation Army drug and alcohol rehabilitation programs completed a 3-month post-discharge telephone follow-up. Using a cut-off score from the Psychiatric Subscale of the Addiction Severity Index (5th ed.), 66.7% were classified as likely to have DD and 33.3% as substance use disorder only (SUD). Both groups reported comparable and decreased substance use levels at follow-up, yet DD individuals perceived less improvement in substance use problems. Comparable improvements were reported in the areas of: symptom distress and recovery from symptoms. This was despite greater scope for improvement in individuals with DD. Duration of treatment and access to post treatment services were also assessed. Understanding factors effecting treatment outcomes is imperative for the implementation of effective, evidence based treatment programs

Nondestructive characterization of UHMWPE armor materials

Ultra-high molecular weight polyethylene (UHMWPE) is a material increasingly used for fabricating helmet and body armor. In this work, plate specimens consolidated from thin fiber sheets in series 3124 and 3130 were examined with ultrasound, X-ray and terahertz radiation. Ultrasonic through-transmission scans using both air-coupled and immersion modes revealed that the 3130 series material generally had much lower attenuation than the 3124 series, and that certain 3124 plates had extremely high attenuation. Due to the relatively low inspection frequencies used, pulse-echo immersion ultrasonic testing could not detect distinct flaw echoes from the interior. To characterize the nature of the defective condition that was responsible for the high ultrasonic attenuation, terahertz radiation in the time-domain spectroscopy mode were used to image the flaws. Terahertz scan images obtained on the high attenuation samples clearly showed a distribution of a large number of defects, possibly small planar delaminations, throughout the volume of the interior. Their precise nature and morphology are to be verified by optical microscopy of the sectioned surface

Optimal City Hierarchy: A Dynamic Programming Approach to Central Place Theory

Published in Journal of Economic Theory, 2014, 154, 245-273. DOI: 10.1016/j.jet.2014.09.018. Full text at: https://ink.library.smu.edu.sg/soe_research/1642</p

Magnetic Tower Outflows from a Radial Wire Array Z-pinch

We present the first results of high energy density laboratory astrophysics experiments which explore the evolution of collimated outflows and jets driven by a toroidal magnetic field. The experiments are scalable to astrophysical flows in that critical dimensionless numbers such as the Mach number, the plasma beta and the magnetic Reynolds number are all in the astrophysically appropriate ranges. Our experiments use the MAGPIE pulsed power machine and allow us to explore the role of magnetic pressure in creating and collimating the outflow as well as showing the creation of a central jet within the broader outflow cavity. We show that currents flow along this jet and we observe its collimation to be enhanced by the additional hoop stresses associated with the generated toroidal field. Although at later times the jet column is observed to go unstable, the jet retains its collimation. We also present simulations of the magnetic jet evolution using our two-dimensional resistive magneto-hydrodynamic (MHD) laboratory code. We conclude with a discussion of the astrophysical relevance of the experiments and of the stability properties of the jet.Comment: Accepted by MNRAS. 17 pages without figures. Full version with figures can be found at http://www.pas.rochester.edu/~afrank/labastro/MF230rv.pd

Simultaneous confidence tubes in multivariate linear regression

Simultaneous confidence bands have been shown in the statistical literature as powerful inferential tools in univariate linear regression. While the methodology of simultaneous confidence bands for univariate linear regression has been extensively researched and well developed, no published work seems available for multivariate linear regression. This paper fills this gap by studying one particular simultaneous confidence band for multivariate linear regression. Because of the shape of the band, the word ‘tube’ is more pertinent and so will be used to replace the word ‘band’. It is shown that the construction of the tube is related to the distribution of the largest eigenvalue. A simulation-based method is proposed to compute the 1 − α quantile of this eigenvalue. With the computation power of modern computers, the simultaneous confidence tube can be computed fast and accurately. A real-data example is used to illustrate the method, and many potential research problems have been pointed out

Predictors of Successful Decannulation Using a Tracheostomy Retainer in Patients with Prolonged Weaning and Persisting Respiratory Failure

Background: For percutaneously tracheostomized patients with prolonged weaning and persisting respiratory failure, the adequate time point for safe decannulation and switch to noninvasive ventilation is an important clinical issue. Objectives: We aimed to evaluate the usefulness of a tracheostomy retainer (TR) and the predictors of successful decannulation. Methods: We studied 166 of 384 patients with prolonged weaning in whom a TR was inserted into a tracheostoma. Patients were analyzed with regard to successful decannulation and characterized by blood gas values, the duration of previous spontaneous breathing, Simplified Acute Physiology Score (SAPS) and laboratory parameters. Results: In 47 patients (28.3%) recannulation was necessary, mostly due to respiratory decompensation and aspiration. Overall, 80.6% of the patients could be liberated from a tracheostomy with the help of a TR. The need for recannulation was associated with a shorter duration of spontaneous breathing within the last 24/48 h (p < 0.01 each), lower arterial oxygen tension (p = 0.025), greater age (p = 0.025), and a higher creatinine level (p = 0.003) and SAPS (p < 0.001). The risk for recannulation was 9.5% when patients breathed spontaneously for 19-24 h within the 24 h prior to decannulation, but 75.0% when patients breathed for only 0-6 h without ventilatory support (p < 0.001). According to ROC analysis, the SAPS best predicted successful decannulation {[}AUC 0.725 (95% CI: 0.634-0.815), p < 0.001]. Recannulated patients had longer durations of intubation (p = 0.046), tracheostomy (p = 0.003) and hospital stay (p < 0.001). Conclusion: In percutaneously tracheostomized patients with prolonged weaning, the use of a TR seems to facilitate and improve the weaning process considerably. The duration of spontaneous breathing prior to decannulation, age and oxygenation describe the risk for recannulation in these patients. Copyright (c) 2012 S. Karger AG, Base

A Retrospective Interventional Cohort Study to Assess the Safety and Efficacy of Sandostatin LAR for Treatment of Recurrent and/or Refractory Meningiomas.

Background: Meningiomas are the most common adult primary intracranial tumors in the United States. Despite high recurrence rate of atypical and malignant subtypes, there is no approved drug indicated specifically for meningioma. Since the majority of meningiomas exhibit high density of somatostatin receptors subtypes, somatostatin analogs have been under close investigation. The aim of this study was to evaluate efficacy and safety of Sandostatin LAR (octreotide) in patients with progressive, and/or recurrent meningioma, and identify subset of patients who were more likely to benefit from this treatment. Methods: A total of 43 patients ≥ 18 years old were included in the retrospective chart review. The patients underwent treatment with Sandostatin LAR (octreotide) from 01.01.2010 to 06.01.2017 at the University of California, Irvine after confirmation of the diagnosis. Six months progression free survival (PFS6) was defined as a primary endpoint, and the overall survival (OS), safety, and toxicity were identified as secondary endpoints. Results: The OS for 6 months, 1, and 3 years for all WHO grades was 94.8, 88.1, and 67.0%, respectively. The PFS6 for WHO I, II, III, and all was 89.4, 89, 33.3, and 80% respectively. For patients with no prior surgeries, chemotherapy or radiation, the PFS6 was 88.9, 84.8, and 94.8%, respectively. Interestingly, the PFS6 was 90.5% for skull-based and 80% for 3-6 cm tumors. Patients with tumors in parasagittal location had PFS6 of 83.3% compared to PFS6 of 50.0% for patients with convexity tumors. Evaluation of PFS6 based on the effect of estrogen and progesterone on meningioma identified that ER-PR+ tumors had PFS6 of 87.8% while patients with ER-PR- meningiomas had PFS6 of 62.5%. Median TTP for WHO grade I, II, and III was 3.1, 2.40, and 0.26 years, respectively. Subgroup analysis showed that median TTP was 3.1 years for &lt;3 cm tumors, 3.22 years for skull-based tumors, 2.37 years for patients with prior surgeries and 3.10 years for patients with no history of chemotherapy. History of radiation had no effect on median TTP. Sandostatin LAR (octreotide) was well-tolerated. Conclusions:This is one of the largest retrospective analysis of meningioma patients treated with Sandostatin LAR (octreotide) suggesting that this treatment has minimal to no adverse events and could prolong overall survival, and progression free survival especially for patients with ER-PR+ tumors who underwent surgeries for small skull-based tumors

Phenolic Impregnated Carbon Ablators (PICA) as Thermal Protection Systems for Discovery Missions

This paper presents the development of the light weight Phenolic Impregnated Carbon Ablators (PICA) and its thermal performance in a simulated heating environment for planetary entry vehicles. The PICA material was developed as a member of the Light Weight Ceramic Ablators (LCA's), and the manufacturing process of this material has since been significantly improved. The density of PICA material ranges from 14 to 20 lbm/ft(exp 3), having uniform resin distribution with and without a densified top surface. The thermal performance of PICA was evaluated in the Ames arc-jet facility at cold wall heat fluxes from 375 to 2,960 BtU/ft(exp 2)-s and surface pressures of 0.1 to 0.43 atm. Heat loads used in these tests varied from 5,500 to 29,600 BtU/ft(exp 2) and are representative of the entry conditions of the proposed Discovery Class Missions. Surface and in-depth temperatures were measured using optical pyrometers and thermocouples. Surface recession was also measured by using a template and a height gage. The ablation characteristics and efficiency of PICA are quantified by using the effective heat of ablation, and the thermal penetration response is evaluated from the thermal soak data. In addition, a comparison of thermal performance of standard and surface densified PICA is also discussed

Non-adjacent dependency learning in humans and other animals

International audienc