Mortality post inpatient alcohol detoxification: a descriptive case series

<br>Background: Individuals with alcohol dependence often die prematurely. Scotland in particular has high rates of alcohol misuse compared to the rest of the UK and Europe. Although there is some evidence that rates of alcoholrelated harm and alcohol-related deaths are reducing in Europe, there is little evidence of this trend occurring in Scotland. Inpatient detoxification is an important, but expensive, option in the management of alcohol dependence. Little work has been done with regard possible clinical characteristics associated with mortality post discharge in this cohort of patients.</br> <br>Methods: Retrospective electronic records were used to identify patients admitted electively for alcohol detoxification into a psychiatric ward in a district general hospital under the care of a single consultant addiction psychiatrist between 1/1/05 and 31/12/07 inclusively. Demographic and clinical factors were recorded. 5-year mortality data was obtained by linkage to the National Records of Scotland.</br> <br>Results: 25.2% of patients admitted for elective alcohol detoxification died during the 5-year follow up period. 42.9% of deaths (n=12) were due to alcoholic liver disease, one death (3.6%) was of undetermined intent. A higher proportion of the deceased cohort was likely to have continued disulfiram (93% vs. 80%) and acamprosate (81% vs. 60%) than those surviving. There was no statistically significant difference in survival between individuals on medication and those not on medications in our cohort. The average consumption of units of alcohol per week in the deceased cohort was significantly higher than that calculated for the surviving cohort (298.8 units vs. 233.3 units p=0.0137).</br> <br>Conclusion: Inpatient detoxification was associated with significant mortality at 5-year follow up post- discharge. The majority of deaths were due to liver disease while deaths due to accidents and of undetermined intent were relatively infrequent. Increased education and practical strategies such as “space and pace” aimed both at an individual and societal level to reduce alcohol consumption may help to reduce mortality associated with alcohol dependence post inpatient detoxification.</br&gt

Effect of rurality on screening for breast cancer: a systematic review and meta-analysis comparing mammography

Introduction: The lower breast cancer survival rate observed among rural women may be related to differences in screening access and utilization. We evaluated existing evidence for rural and urban differences in mammography service use in adult women

Conservation of Mass and Preservation of Positivity with Ensemble-Type Kalman Filter Algorithms

This paper considers the incorporation of constraints to enforce physically based conservation laws in the ensemble Kalman filter. In particular, constraints are used to ensure that the ensemble members and the ensemble mean conserve mass and remain nonnegative through measurement updates. In certain situations filtering algorithms such as the ensemble Kalman filter (EnKF) and ensemble transform Kalman filter (ETKF) yield updated ensembles that conserve mass but are negative, even though the actual states must be nonnegative. In such situations if negative values are set to zero, or a log transform is introduced, the total mass will not be conserved. In this study, mass and positivity are both preserved by formulating the filter update as a set of quadratic programming problems that incorporate non-negativity constraints. Simple numerical experiments indicate that this approach can have a significant positive impact on the posterior ensemble distribution, giving results that are more physically plausible both for individual ensemble members and for the ensemble mean. In two examples, an update that includes a non-negativity constraint is able to properly describe the transport of a sharp feature (e.g., a triangle or cone). A number of implementation questions still need to be addressed, particularly the need to develop a computationally efficient quadratic programming update for large ensemble

The RRAT Trap: Interferometric Localization of Radio Pulses from J0628+0909

We present the first blind interferometric detection and imaging of a millisecond radio transient with an observation of transient pulsar J0628+0909. We developed a special observing mode of the Karl G. Jansky Very Large Array (VLA) to produce correlated data products (i.e., visibilities and images) on a time scale of 10 ms. Correlated data effectively produce thousands of beams on the sky that can localize sources anywhere over a wide field of view. We used this new observing mode to find and image pulses from the rotating radio transient (RRAT) J0628+0909, improving its localization by two orders of magnitude. Since the location of the RRAT was only approximately known when first observed, we searched for transients using a wide-field detection algorithm based on the bispectrum, an interferometric closure quantity. Over 16 minutes of observing, this algorithm detected one transient offset roughly 1' from its nominal location; this allowed us to image the RRAT to localize it with an accuracy of 1.6". With a priori knowledge of the RRAT location, a traditional beamforming search of the same data found two, lower significance pulses. The refined RRAT position excludes all potential multiwavelength counterparts, limiting its optical luminosity to L_i'<1.1x10^31 erg/s and excluding its association with a young, luminous neutron star.Comment: Submitted to ApJ, 7 pages, 5 figure

IC 3418: Star Formation in a Turbulent Wake

Galaxy Evolution Explorer observations of IC 3418, a low surface brightness galaxy in the Virgo Cluster, revealed a striking 17 kpc UV tail of bright knots and diffuse emission. H alpha imaging confirms that star formation is ongoing in the tail. IC 3418 was likely recently ram pressure stripped on its first pass through Virgo. We suggest that star formation is occurring in molecular clouds that formed in IC 3418's turbulent stripped wake. Tides and ram pressure stripping (RPS) of molecular clouds are both disfavored as tail formation mechanisms. The tail is similar to the few other observed star-forming tails, all of which likely formed during RPS. The tails' morphologies reflect the forces present during their formation and can be used to test for dynamical coupling between molecular and diffuse gas, thereby probing the origin of the star forming molecular gas.Comment: 5 pages, 4 figure

Luminosity-Diameter Relations for Globular Clusters and Dwarf Spheroidal Galaxies

It is shown that globular clusters and the dwarf spheroidal companions of the Galaxy have a different distribution of flattening values, and appear to occupy adjacent regions of the M_v versus log R_h plane that can be separated by what will be referred to as the Shapley line. Surprisingly, typical dwarf spheroidal companions to the Milky Way System are fainter than the average Galactic globular cluster.Comment: includes two colour figures; MNRAS (Letters) in pres

The Rights of Parents with Children in Foster Care: Removals Arising from Economic Hardship and the Predicative Power of Race

The following symposium at the Association of the Bar of the City of New York explores the predicament posed by the surge of child removals through neglect petitions, and the subsequent placement of those children in foster care. The panel, whose comments are published here, offer some poignant reflections on the crisis of the child welfare system