An efficient algorithm for accelerating the convergence of oscillatory series, useful for computing the polylogarithm and Hurwitz zeta functions

This paper sketches a technique for improving the rate of convergence of a general oscillatory sequence, and then applies this series acceleration algorithm to the polylogarithm and the Hurwitz zeta function. As such, it may be taken as an extension of the techniques given by Borwein's "An efficient algorithm for computing the Riemann zeta function", to more general series. The algorithm provides a rapid means of evaluating Li_s(z) for general values of complex s and the region of complex z values given by |z^2/(z-1)|<4. Alternatively, the Hurwitz zeta can be very rapidly evaluated by means of an Euler-Maclaurin series. The polylogarithm and the Hurwitz zeta are related, in that two evaluations of the one can be used to obtain a value of the other; thus, either algorithm can be used to evaluate either function. The Euler-Maclaurin series is a clear performance winner for the Hurwitz zeta, while the Borwein algorithm is superior for evaluating the polylogarithm in the kidney-shaped region. Both algorithms are superior to the simple Taylor's series or direct summation. The primary, concrete result of this paper is an algorithm allows the exploration of the Hurwitz zeta in the critical strip, where fast algorithms are otherwise unavailable. A discussion of the monodromy group of the polylogarithm is included.Comment: 37 pages, 6 graphs, 14 full-color phase plots. v3: Added discussion of a fast Hurwitz algorithm; expanded development of the monodromy v4:Correction and clarifiction of monodrom

The Sensitivity and Psychometric Properties of a Brief Computer-Based Cognitive Screening Battery in a Depression Clinic

At present, there is poor accuracy in assessing cognitive and vegetative symptoms in depression using clinician or self-rated measures, suggesting the need for development of standardized tasks to assess these functions. The current study assessed the psychometric properties and diagnostic specificity of a brief neuropsychological screening battery designed to assess core signs of depression; psychomotor retardation, attention and executive functioning difficulties, and impaired emotion perception within an outpatient psychiatry setting. Three hundred eighty-four patients with mood disorders and 77 healthy volunteers participated. A large percentage of patients met diagnostic criteria for Major Depressive Disorder alone (49%) or with another comorbid psychiatric disorder (24%). A brief, 25-min battery of computer-based tests was administered to control participants and patients measuring the constructs of inhibitory control, attention, visual perception, and both executive and visual processing speed. The patient groups performed significantly worse than the control group regardless of diagnosis on visual perception and attention accuracy and processing speed factors. Surprisingly, the anxiety disorder group performed better than several other psychiatric disorder groups in inhibitory control accuracy. Developing valid and reliable measures of cognitive signs in mood disorders creates excellent opportunities for tracking cognitive status prior to initiation of treatment, and allows for reliable retest following treatment

Self‐Reported Health and Safety Awareness Improves Prediction of Level of Care Needs in Veterans Discharged From a Postacute Unit

ObjectivesTo evaluate the differential value of a self‐reported health and safety awareness measure relative to other medical, psychosocial, and cognitive factors in predicting level of care (LOC) needs after hospital discharge.DesignRetrospective medical record review.SettingCommunity living center postacute care (CLC‐PAC) unit at a Veterans Affairs hospital.ParticipantsA total of 175 veterans admitted to the Veterans Affairs hospital or directly to the CLC‐PAC from home.MethodsCognitive status was assessed with the Mini‐Mental State Examination, Digit Span Backward subtest, Trail Making Test (Part B), and Hopkins Verbal Learning Test‐Revised. Self‐report of health and safety awareness was measured with the Independent Living Scales Health and Safety (ILS‐HS) subscale. Additional demographic and admission‐related variables were coded, along with medical comorbidity, with the Charlson Comorbidity Index and depression using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision Depression Checklist.Main Outcome MeasurementsIncreased level of care was collected from social work and occupational therapy notes and defined as increased assistance with activities of daily living or nursing home placement comparing prehospitalization with CLC‐PAC discharge.ResultsA total of 19% (n = 34) of residents required increased LOC on CLC‐PAC discharge. The ILS‐HS was a significant predictor of increased LOC above and beyond age and Mini Mental Status Examination score; for each standard deviation decrease in ILS‐HS, there was an increased likelihood of greater LOC (odds ratio 0. 54, 95% confidence interval 0.35‐0.83). Other neuropsychological tests (memory, executive functioning) did not significantly improve the model.ConclusionsThe inclusion of the ILS‐HS to a standard cognitive screen (Mini Mental Status Examination) can improve prediction of increased LOC. Although select aspects of memory and executive functioning independently contribute to increased LOC prediction, the ILS‐HS likely measures a unique aspect of cognitive functioning that may be specific to discharge planning needs in CLC‐PAC residents.Level of EvidenceIIPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146814/1/pmr21122.pd

Distinguishing between depression and dementia in the elderly: A review of neuropsychological findings

Distinguishing between cognitive deficits seen in depression and progressive dementing, diseases is complex and often difficult clinically. We review recent neuropsychological studies comparing normal elderly individuals, depressed patients, and patients with progressive dementias. Findings from these studies suggest that the distinction between depression and dementia is fairly straightforward and facilitated by neuropsychological evaluation. Data from neuroimaging studies of depressed elderly are reviewed and integrated with the neuropsychological findings. A descriptive scheme for categorizing elderly patients is proposed. It is suggested that the label "pseudodementia" be discarded in favor of more thorough description of cognitive deficits associated with various clinical presentations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30936/1/0000606.pd

Algal toxins in the food chain – a comparative study of Chesapeake Bay and Baltic coastal food webs

Microcystin (MC) is a hepatotoxin produced by cyanobacteria (blue-green algae) which is found globally in eutrophic waters including lakes, lagoons and estuaries (Paerl and Paul 2012). The presence of MC in food webs is of concern due to adverse effects on biota and exposure to humans via commercial and recreational fisheries (Paerl and Otten 2013). Little is known regarding the factors which determine MC accumulation in food webs. We hypothesized that dietary exposure would be determined in part by sources of organic matter supporting the food web. We undertook a comparative study of the James River Estuary, a sub-estuary of Chesapeake Bay, and the Curonian Lagoon, a sub-estuary of the Baltic Sea and largest coastal lagoon in Europe. Both sites experience cyanobacteria blooms known to produce MC (Wood et al. 2014; Lesutienė et al. 2014), but differ in their sources of organic matter. The James receives large inputs of terrestrial organic matter due to the draining of a mountainous catchment. The Curonian Lagoon is fed by a lowland river which delivers low concentrations of terrestrial organic matter. We hypothesized that high internal production in the lagoon, coupled with lower dilution by terrestrial organic matter inputs, would results in greater exposure to MC among biota of the Curonian Lagoon

Could versus should: A reply to Sammons

Sammons (1994) believes that our critique of organized psychology's efforts to gain limited prescriptive privileges (Adams & Bieliauskas, 1994) is comprised of pseudo-problems (e.g., the noncurative nature of psychopharmacology) or issues that can readily be handled (e.g., malpractice exposure). We disagree and attempt herein to inject some reality into the picture of the bright new world of psychologists armed with prescription pads. Most importantly, the seemingly vanished distinction between what could be done politically or legislatively and what should be done for the profession and the public good is redrawn.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44852/1/10880_2005_Article_BF01989622.pd

Streamlining screening of emotional function in Veterans with traumatic brain injury

ObjectivesThis study examined how depression, anxiety, and sleep items from the Neurobehavioral Symptom Inventory (NSI) predict results from longer inventories.MethodThis was a retrospective review from 484, predominantly male (96.1%) Veterans, mean age 29.7 years, who underwent brief neuropsychological screening during a comprehensive, multidisciplinary evaluation for mild traumatic brain injury (TBI). Participants completed the NSI, insomnia severity index (ISI), and hospital anxiety and depression scale (HADS).Results: Overall,97.1% who endorsed “severe”/“very severe” anxiety on the NSI had significant anxiety on the HADS; 85% reporting “severe”/“very severe” depression on the NSI, had significant depression on the HADS; and 97.7% reporting “severe”/“very severe” sleep problems on the NSI, had significant sleep difficulties on the ISI.ConclusionClose correspondence between “severe”/“very severe” symptoms on the NSI and lengthier checklists suggests additional checklists may be eliminated and individuals can be referred for mental health treatment. NSI reports of “mild”/“moderate” require further screening.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144598/1/jclp22595_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144598/2/jclp22595.pd

The Hepatitis C Cascade of Care: Identifying Priorities to Improve Clinical Outcomes

Background: As highly effective hepatitis C virus (HCV) therapies emerge, data are needed to inform the development of interventions to improve HCV treatment rates. We used simulation modeling to estimate the impact of loss to follow-up on HCV treatment outcomes and to identify intervention strategies likely to provide good value for the resources invested in them. Methods: We used a Monte Carlo state-transition model to simulate a hypothetical cohort of chronically HCV-infected individuals recently screened positive for serum HCV antibody. We simulated four hypothetical intervention strategies (linkage to care; treatment initiation; integrated case management; peer navigator) to improve HCV treatment rates, varying efficacies and costs, and identified strategies that would most likely result in the best value for the resources required for implementation. Main measures Sustained virologic responses (SVRs), life expectancy, quality-adjusted life expectancy (QALE), costs from health system and program implementation perspectives, and incremental cost-effectiveness ratios (ICERs). Results: We estimate that imperfect follow-up reduces the real-world effectiveness of HCV therapies by approximately 75%. In the base case, a modestly effective hypothetical peer navigator program maximized the number of SVRs and QALE, with an ICER compared to the next best intervention of $48,700/quality-adjusted life year. Hypothetical interventions that simultaneously addressed multiple points along the cascade provided better outcomes and more value for money than less costly interventions targeting single steps. The 5-year program cost of the hypothetical peer navigator intervention was$14.5 million per 10,000 newly diagnosed individuals. Conclusions: We estimate that imperfect follow-up during the HCV cascade of care greatly reduces the real-world effectiveness of HCV therapy. Our mathematical model shows that modestly effective interventions to improve follow-up would likely be cost-effective. Priority should be given to developing and evaluating interventions addressing multiple points along the cascade rather than options focusing solely on single points

Predicting, Preparing for, and Creating the Future: What Will Happen to Internal Medicine?

It is the year 2025. During the past 20 years, internal medicine as a discipline continued to become less prestigious, less respected, and more fragmented. As fewer medical students chose internal medicine as a career, residency programs began to close. Those that remained open filled with fewer graduates of US medical schools but filled with more US citizens who graduated from international medical schools, more graduates of osteopathic medical schools, and more foreign graduates of international medical schools. Due to lack of adequate remuneration and a shift of primary care provision from generalist physicians to nurse practitioners and physician assistants, training in general internal medicine as a patient care specialty ceased. Generalist internal medicine careers have been replaced by tracks designed to foster health services research or academic careers; internal medicine training graduates subspecialty physicians. Although the projected collapse of Medicare in 2019 was avoided, severe cuts in federal funding for undergraduate and graduate medical education programs forced medical schools and residency programs to compete for federal funds. As a result, medical school tuition became prohibitive, for-profit health care systems viewed medical education as a significant cost center and chose to limit the size of their residency programs, and community-based training programs could not withstand the financial pressures and closed. The result was a reduced supply of internists. Furthermore, compliance with the regulatory burden imposed by accrediting organizations—such as the Accreditation Council for Graduate Medical Education—drove individuals from sustained careers in education, further impacting the viability of training programs

On perhaps becoming what you had previously despised: Psychologists as prescribers of medication

The authors contend that organized psychology's efforts to gain limited prescriptive privileges may be misguided. The modification of psychology's traditional scope of practice may produce harm in the form of lessened patient regard, devaluation of nonpharmacologic elements of practice, and markedly increased exposure to claims of malpractice. The authors also decry the disingenuous use of psychopharmacologically “underserved” populations as rationales for the pursuit of prescriptive privileges. Psychology may mount a major effort to make this change without sufficient justification, in the view of the authors.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44851/1/10880_2005_Article_BF01989620.pd