Progress in a Mental Health Court

The purpose of this study was to examine the progress of individuals enrolled in the Washington County Mental Health Court (MHC) and factors that may be related to their progress. Participants in the MHC were interviewed and information was obtained about factors that may be related to progress. To determine progress of the participants, a newly implemented tool called the Results Assessment and Monitoring Progress (RAMP) was utilized. Initial scores were determined at the time that the participant entered the MHC and a current score was determined at the time of the interview. A significant positive correlation was found that indicated that participants who were involved in the MHC for a greater number of days had a greater improvement on the RAMP. Also, positive correlations were found among measures of perceived procedural justice, impact of court, and average ratings of MHC staff. Participant variables were examined to determine whether they appeared to be related to an improvement in RAMP scores. No significant results were found, but noticeably large differences indicated that individuals who were employed, those with an education level of 12th grade or less, those who had been set back to Phase I, those with an adequate support system, and those who lived in a group home or treatment facility appeared to have a larger RAMP difference score than other groups for these variables. Finally, observations were made to examine trends for several categories of participants: participants in Phase III, those set back to Phase I, participants with a large RAMP difference score, those with a small RAMP difference score, individuals who were not satisfied with the MHC, individuals who had been enrolled for more than 800 days, and those who had been enrolled for less than 200 days

Introducing Dialectic Mechanics

This paper introduces a new method for mechanical systems with its own interface that enables the object-oriented formulation of very stiff contacts. It thereby suppresses high frequencies and yields stable replacement dynamics leading to an equivalent steady state. Potential applications are the efficient modeling and simulation of robotic manipulation or the easier handling of what formerly have been variable-structure systems

Dialectic Mechanics: Extension for Real-Time Simulation

Dialectic mechanics was introduced as an approximative modeling alternative to the classic Newtonian formulation of mechanics. It allows for additional freedom in placing a systems eigenvalues to facilitate simulation of systems, that are not suitable for most integration methods, when modeled according to the classic approach. The original idea of dialectic mechanics enables the suppression of high frequencies, but may still yield very stiff systems unsuitable for explicit integration methods. An additional term is added to enable real-time simulation with explicit methods. The goal of this paper is an analysis of the resulting equations and a comparison to the classic Newtonian formulation, aiming for an understanding of which applications most benefit from using dialectic mechanics

Dealing with complex models and how to use the idealization of physics to our advantage.

The complexity of models can be assessed in different ways. We can look at the complexity in terms of computational time it takes for simulation. We can also look at the complexity in terms of the underlying program size. There is a trade-off between these two forms and it is often unclear where the optimum is. How we perform this trade-off is determined by the way we choose to idealize the underlying physical system. To become better modelers, we will hence revisit the familiar schemes of idealization and then investigate a new approach that is favorable for many applications and offers new opportunities for code generation

A meta-analysis of N-acetylcysteine in contrast-induced nephrotoxicity: unsupervised clustering to resolve heterogeneity

<p>Abstract</p> <p>Background</p> <p>Meta-analyses of N-acetylcysteine (NAC) for preventing contrast-induced nephrotoxicity (CIN) have led to disparate conclusions. Here we examine and attempt to resolve the heterogeneity evident among these trials.</p> <p>Methods</p> <p>Two reviewers independently extracted and graded the data. Limiting studies to randomized, controlled trials with adequate outcome data yielded 22 reports with 2746 patients.</p> <p>Results</p> <p>Significant heterogeneity was detected among these trials (<it>I</it>²= 37%; <it>p </it>= 0.04). Meta-regression analysis failed to identify significant sources of heterogeneity. A modified L'Abbé plot that substituted groupwise changes in serum creatinine for nephrotoxicity rates, followed by model-based, unsupervised clustering resolved trials into two distinct, significantly different (<it>p </it>< 0.0001) and homogeneous populations (<it>I</it>²= 0 and <it>p </it>> 0.5, for both). Cluster 1 studies (<it>n </it>= 18; 2445 patients) showed no benefit (relative risk (RR) = 0.87; 95% confidence interval (CI) 0.68–1.12, <it>p </it>= 0.28), while cluster 2 studies (<it>n </it>= 4; 301 patients) indicated that NAC was highly beneficial (RR = 0.15; 95% CI 0.07–0.33, <it>p </it>< 0.0001). Benefit in cluster 2 was unexpectedly associated with NAC-induced decreases in creatinine from baseline (<it>p </it>= 0.07). Cluster 2 studies were relatively early, small and of lower quality compared with cluster 1 studies (<it>p </it>= 0.01 for the three factors combined). Dialysis use across all studies (five control, eight treatment; <it>p </it>= 0.42) did not suggest that NAC is beneficial.</p> <p>Conclusion</p> <p>This meta-analysis does not support the efficacy of NAC to prevent CIN.</p

The complexity of interacting nutritional drivers behind food selection, a review of northern cervids

The research literature on food selection by large herbivores is extensive. Still, we are generally lacking in our knowledge of the influence of potentially interacting chemical contents of the food. We made a qualitative review of a systematic literature search of studies that empirically link chemical contents of food to the food selection by northern cervids (genera Alces, Capreolus, Cervus, Dama, Odocoileus, Rangifer). We found that although the majority of the 98 relevant studies measuring any given food constituent (energy, protein, fiber, minerals, plant secondary metabolites) provided support for it acting as a driver of food selection (in either a negative or positive way), there was little support for the traditional hypotheses of maximization or limitation of any single constituent. Rather, because of the animals’ need to acquire an appropriate intake of several constituents at the same time, our review highlights how new empirical stud- ies need to focus on several food constituents in synchrony: (1) Study designs should capture sufficient variation in the content of food constituents in order to tease apart their many co-variations; and (2) insights about nutritional drivers may be lost if one uses only composite currencies such as crude energy, crude fiber, ash, or tannins, which may mask contrasting selection patterns of the lumped constituents. Season had an apparent influence on the selection of some food constituents, particularly various fiber frac- tions. In contrast, our review revealed a lack of evidence that cervids more strongly select for protein in summer than they do in winter. Our overall conclusion of the review is that interacting chemical contents of food make the nutritional value of a given food type into a varying entity. To better elucidate this varia- tion, we need new technologies that non-invasively capture nutrient intake of free-ranging animals, across seasons.The complexity of interacting nutritional drivers behind food selection, a review of northern cervidspublishedVersio

Optimal foraging and community structure: implications for a guild of generalist grassland herbivores

A particular linear programming model is constructed to predict the diets of each of 14 species of generalist herbivores at the National Bison Range, Montana. The herbivores have body masses ranging over seven orders of magnitude and belonging to two major taxa: insects and mammals. The linear programming model has three feeding constraints: digestive capacity, feeding time and energy requirements. A foraging strategy that maximizes daily energy intake agrees very well with the observed diets. Body size appears to be an underlying determinant of the foraging parameters leading to diet selection. Species that possess digestive capacity and feeding time constraints which approach each other in magnitude have the most generalized diets. The degree that the linear programming models change their diet predictions with a given percent change in parameter values (sensitivity) may reflect the observed ability of the species to vary their diets. In particular, the species which show the most diet variability are those whose diets tend to be balanced between monocots and dicots. The community-ecological parameters of herbivore body-size ranges and species number can possibly be related to foraging behavior.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47765/1/442_2004_Article_BF00377109.pd

Prevention of acute kidney injury and protection of renal function in the intensive care unit

Acute renal failure on the intensive care unit is associated with significant mortality and morbidity. To determine recommendations for the prevention of acute kidney injury (AKI), focusing on the role of potential preventative maneuvers including volume expansion, diuretics, use of inotropes, vasopressors/vasodilators, hormonal interventions, nutrition, and extracorporeal techniques. A systematic search of the literature was performed for studies using these potential protective agents in adult patients at risk for acute renal failure/kidney injury between 1966 and 2009. The following clinical conditions were considered: major surgery, critical illness, sepsis, shock, and use of potentially nephrotoxic drugs and radiocontrast media. Where possible the following endpoints were extracted: creatinine clearance, glomerular filtration rate, increase in serum creatinine, urine output, and markers of tubular injury. Clinical endpoints included the need for renal replacement therapy, length of stay, and mortality. Studies are graded according to the international Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) group system Several measures are recommended, though none carries grade 1A. We recommend prompt resuscitation of the circulation with special attention to providing adequate hydration whilst avoiding high-molecular-weight hydroxy-ethyl starch (HES) preparations, maintaining adequate blood pressure using vasopressors in vasodilatory shock. We suggest using vasopressors in vasodilatory hypotension, specific vasodilators under strict hemodynamic control, sodium bicarbonate for emergency procedures administering contrast media, and periprocedural hemofiltration in severe chronic renal insufficiency undergoing coronary intervention

Analyse lichtinduzierter Prozesse in Cryptochromen mittels zeitaufgelöster UV/vis- und FTIR-Spektroskopie

Oldemeyer S. Analyse lichtinduzierter Prozesse in Cryptochromen mittels zeitaufgelöster UV/vis- und FTIR-Spektroskopie. Bielefeld; 2017