Emergency department-based peer support for opioid use disorder: Emergent functions and forms

Emergency department (ED)-based peer support programs aimed at linking persons with opioid use disorder (OUD) to medication for addiction treatment and other recovery services are a promising approach to addressing the opioid crisis. This brief report draws on experiences from three states' experience with such programs funded by the SAMHSA Opioid State Targeted Repose (STR) grants. Core functions of such programs include: Integration of peer supports in EDs; Alerting peers of eligible patients and making the patient aware of peer services; and connecting patients with recovery services. Qualitative data were analyzed using a general inductive approach conducted in 3 steps in order to identify forms utilized to fulfill these functions. Peer integration differed in terms of peer's physical location and who hired and supervised peers. Peers often depend on ED staff to alert them to potential patients while people other than the peers often first introduce potential patients to programming. Programs generally schedule initial appointments for recovery services for patients, but some programs provide a range of other services aimed at supporting participation in recovery services. Future effectiveness evaluations of ED-based peer support programs for OUD should consistently report on forms used to fulfill core functions

GCIP water and energy budget synthesis (WEBS)

As part of the World Climate Research Program\u27s (WCRPs) Global Energy and Water-Cycle Experiment (GEWEX) Continental-scale International Project (GCIP), a preliminary water and energy budget synthesis (WEBS) was developed for the period 1996–1999 from the “best available” observations and models. Besides this summary paper, a companion CD-ROM with more extensive discussion, figures, tables, and raw data is available to the interested researcher from the GEWEX project office, the GAPP project office, or the first author. An updated online version of the CD-ROM is also available at http://ecpc.ucsd.edu/gcip/webs.htm/. Observations cannot adequately characterize or “close” budgets since too many fundamental processes are missing. Models that properly represent the many complicated atmospheric and near-surface interactions are also required. This preliminary synthesis therefore included a representative global general circulation model, regional climate model, and a macroscale hydrologic model as well as a global reanalysis and a regional analysis. By the qualitative agreement among the models and available observations, it did appear that we now qualitatively understand water and energy budgets of the Mississippi River Basin. However, there is still much quantitative uncertainty. In that regard, there did appear to be a clear advantage to using a regional analysis over a global analysis or a regional simulation over a global simulation to describe the Mississippi River Basin water and energy budgets. There also appeared to be some advantage to using a macroscale hydrologic model for at least the surface water budgets

Statistical Learning Methods to Identify Nonwear Periods From Accelerometer Data

Background: Accelerometers are used to objectively measure movement in free-living individuals. Distinguishing nonwear from sleep and sedentary behavior is important to derive accurate measures of physical activity, sedentary behavior, and sleep. We applied statistical learning approaches to examine their promise in detecting nonwear time and compared the results with commonly used wear time (WT) algorithms. Methods: Fifteen children, aged 4–17, wore an ActiGraph wGT3X- BT monitor on their hip during overnight polysomnography. We applied Hidden Markov Models (HMM) and Gaussian Mixture Models (GMM) to classify states of nonwear and wear in triaxial acceleration data. Performance of methods was compared with WT algorithms across two conditions with differing amounts of consecutive nonwear. Clinical scoring of polysomnography served as the gold standard. Results: When the length of nonwear was less than or equal to WT algorithms’ predefined thresholds for consecutive nonwear time, GMM methods yielded improved classification error, specificity, positive predictive value, and negative predictive value over commonly used algorithms. HMM was superior to one algorithm for sensitivity and negative predictive value. When the length of nonwear was longer, results were mixed, with the commonly used algorithms performing better on some parameters but GMM with the greatest specificity. However, all approached the upper limits of performance for almost all metrics. Conclusions: GMM and HMM demonstrated robust, consistently strong performance across multiple conditions, surpassing or remaining competitive with commonly used WT algorithms which had marked inaccuracy when nonwear time periods were shorter. Of the two statistical learning algorithms, GMM was superior to HMM

Garden and landscape-scale correlates of moths of differing conservation status: significant effects of urbanization and habitat diversity

Moths are abundant and ubiquitous in vegetated terrestrial environments and are pollinators, important herbivores of wild plants, and food for birds, bats and rodents. In recent years, many once abundant and widespread species have shown sharp declines that have been cited by some as indicative of a widespread insect biodiversity crisis. Likely causes of these declines include agricultural intensification, light pollution, climate change, and urbanization; however, the real underlying cause(s) is still open to conjecture. We used data collected from the citizen science Garden Moth Scheme (GMS) to explore the spatial association between the abundance of 195 widespread British species of moth, and garden habitat and landscape features, to see if spatial habitat and landscape associations varied for species of differing conservation status. We found that associations with habitat and landscape composition were species-specific, but that there were consistent trends in species richness and total moth abundance. Gardens with more diverse and extensive microhabitats were associated with higher species richness and moth abundance; gardens near to the coast were associated with higher richness and moth abundance; and gardens in more urbanized locations were associated with lower species richness and moth abundance. The same trends were also found for species classified as increasing, declining and vulnerable under IUCN (World Conservation Union) criteria

New Insights into White-Light Flare Emission from Radiative-Hydrodynamic Modeling of a Chromospheric Condensation

(abridged) The heating mechanism at high densities during M dwarf flares is poorly understood. Spectra of M dwarf flares in the optical and near-ultraviolet wavelength regimes have revealed three continuum components during the impulsive phase: 1) an energetically dominant blackbody component with a color temperature of T $\sim$ 10,000 K in the blue-optical, 2) a smaller amount of Balmer continuum emission in the near-ultraviolet at lambda $<$ 3646 Angstroms and 3) an apparent pseudo-continuum of blended high-order Balmer lines. These properties are not reproduced by models that employ a typical "solar-type" flare heating level in nonthermal electrons, and therefore our understanding of these spectra is limited to a phenomenological interpretation. We present a new 1D radiative-hydrodynamic model of an M dwarf flare from precipitating nonthermal electrons with a large energy flux of $10^{13}$ erg cm$^{-2}$ s$^{-1}$. The simulation produces bright continuum emission from a dense, hot chromospheric condensation. For the first time, the observed color temperature and Balmer jump ratio are produced self-consistently in a radiative-hydrodynamic flare model. We find that a T $\sim$ 10,000 K blackbody-like continuum component and a small Balmer jump ratio result from optically thick Balmer and Paschen recombination radiation, and thus the properties of the flux spectrum are caused by blue light escaping over a larger physical depth range compared to red and near-ultraviolet light. To model the near-ultraviolet pseudo-continuum previously attributed to overlapping Balmer lines, we include the extra Balmer continuum opacity from Landau-Zener transitions that result from merged, high order energy levels of hydrogen in a dense, partially ionized atmosphere. This reveals a new diagnostic of ambient charge density in the densest regions of the atmosphere that are heated during dMe and solar flares.Comment: 50 pages, 2 tables, 13 figures. Accepted for publication in the Solar Physics Topical Issue, "Solar and Stellar Flares". Version 2 (June 22, 2015): updated to include comments by Guest Editor. The final publication is available at Springer via http://dx.doi.org/10.1007/s11207-015-0708-

A Direct Detection of Dust in the Outer Disks of Nearby Galaxies

We measure the extent of 100 micron galactic emission in two independent galaxy samples using the IRAS 100 micron Sky Survey images and constrain the distribution of dust at large (\ltsim30 kpc) radii. The first sample consists of 90 nearby (v < 6000 km/s) galaxies from the RC3 catalog with similar angular sizes and absolute luminosities (5 arcmin $\leq$D$_{25} \leq$ 10 arcmin and $-22.5 \leq$M$_{B} \leq -18$) that are isolated in the 100 micron images. The second sample consists of 24 local galaxies (v < 1500 km/s, 10 arcmin $\leq$D$_{25} \leq$ 30 arcmin). We rescale the 100 micron images of these galaxies using their optical diameters, D$_{25}$, rotate the images using their optical major axis position angle, construct the mean and median image, and rebin the final images into polar coordinates to study the 100 micron emission as a function of radius and azimuthal angle. We find that the 100 micron emission extends at least to radii of 27 kpc (2$\sigma$ detection) for the typical galaxy in the 5 arcmin - 10 arcmin sample and to 21 kpc (2$\sigma$ detection) in the 10 arcmin - 30 arcmin sample (H$_{0} =$75 km/s/Mpc). In both samples, the emission is preferentially elongated along the optical major axis. We fit an exponential to the 100 micron emission along the major axis and measure a scale length of $2.5 \pm$ 0.8 kpc (90% confidence interval). Using a simple model that relates the far-IR emission to the stellar distribution, we examine the range of acceptable dust mass distributions allowed by our data and conclude that the dust is more extended than the starlight.Comment: 31 pages, 9 figures, AASTEX (aaspp4), accepted for publication in the Astronomical Journa

Cross-frequency coupling of brain oscillations in studying motivation and emotion

Research has shown that brain functions are realized by simultaneous oscillations in various frequency bands. In addition to examining oscillations in pre-specified bands, interactions and relations between the different frequency bandwidths is another important aspect that needs to be considered in unraveling the workings of the human brain and its functions. In this review we provide evidence that studying interdependencies between brain oscillations may be a valuable approach to study the electrophysiological processes associated with motivation and emotional states. Studies will be presented showing that amplitude-amplitude coupling between delta-alpha and delta-beta oscillations varies as a function of state anxiety and approach-avoidance-related motivation, and that changes in the association between delta-beta oscillations can be observed following successful psychotherapy. Together these studies suggest that cross-frequency coupling of brain oscillations may contribute to expanding our understanding of the neural processes underlying motivation and emotion