Exploring the Impacts of Predictor Variables on Success in a Mental Health Diversion Program

Since the first Mental Health Court (MHC) in 1997, there has been a steady increase of MHCs all over the country. With the introduction of these new specialty courts have also come to introduction of diversion programs. Diversion programs work to connect offenders who have mental illnesses to community-based mental health treatment services as an alternative to incarceration. Typically, with the completion of the program comes with the benefit of having their charges dropped. Diversion programs aim to reduce recidivism in offenders with mental illness and improve their access to treatment

Accounting for heterogeneous invasion rates reveals management impacts on the spatial expansion of an invasive species

Success of large-scale control programs for established invasive species is challenging to evaluate because of spatial variability in expansion rates, management techniques, and the strength of management intensity. For a well-established invasive species in the spreading phase of invasion, a useful metric of impact is the magnitude by which control slows the rate of spatial spread. The prevention of spatial spreading likely results in substantial benefits in terms of ecosystem or economic damage that is prevented by an expanding invasive species. To understand how local management actions could impact the spatial spread of an established invasive species, we analyzed distribution and management data for feral swine across contiguous United States using occupancy analysis. We quantified changes in the rate of spatial expansion of feral swine and its relationship to local management actions. We found that after 4 yr of enhanced control, invasion probability decreased by 8% on average relative to pre-program rates. This decrease was as high as 15% on average in states with low-density populations of feral swine. The amount of decrease in invasion rate was attributed to removal intensity in neighboring counties and depended on the extent of neighboring counties with feral swine (spatial heterogeneity in local invasion pressure). Although we did not find a significant overall increase in the probability of elimination, increased elimination probability tended to occur in regions with low invasion pressure. Accounting for spatial heterogeneity in invasion pressure was important for quantifying management impacts (i.e., the relationship between management intensity and spatial spreading processes) because management impacts changed depending on the strength of invasion pressure from neighboring counties. Predicting reduction in spatial spread of an invasive species is an important first step in valuation of overall damage reduction for invasive species control programs by providing estimates of where a species may be, and thus which natural and agricultural resources would be affected, if the control program had not been operating. For minimizing losses from spatial expansion of an invasive species, our framework can be used for adaptive resource prioritization to areas where spatial expansion and underlying damage potential are concurrently highest

Accounting for heterogeneous invasion rates reveals management impacts on the spatial expansion of an invasive species

Success of large-scale control programs for established invasive species is challenging to evaluate because of spatial variability in expansion rates, management techniques, and the strength of management intensity. For a well-established invasive species in the spreading phase of invasion, a useful metric of impact is the magnitude by which control slows the rate of spatial spread. The prevention of spatial spreading likely results in substantial benefits in terms of ecosystem or economic damage that is prevented by an expanding invasive species. To understand how local management actions could impact the spatial spread of an established invasive species, we analyzed distribution and management data for feral swine across contiguous United States using occupancy analysis. We quantified changes in the rate of spatial expansion of feral swine and its relationship to local management actions. We found that after 4 yr of enhanced control, invasion probability decreased by 8% on average relative to pre-program rates. This decrease was as high as 15% on average in states with low-density populations of feral swine. The amount of decrease in invasion rate was attributed to removal intensity in neighboring counties and depended on the extent of neighboring counties with feral swine (spatial heterogeneity in local invasion pressure). Although we did not find a significant overall increase in the probability of elimination, increased elimination probability tended to occur in regions with low invasion pressure. Accounting for spatial heterogeneity in invasion pressure was important for quantifying management impacts (i.e., the relationship between management intensity and spatial spreading processes) because management impacts changed depending on the strength of invasion pressure from neighboring counties. Predicting reduction in spatial spread of an invasive species is an important first step in valuation of overall damage reduction for invasive species control programs by providing estimates of where a species may be, and thus which natural and agricultural resources would be affected, if the control program had not been operating. For minimizing losses from spatial expansion of an invasive species, our framework can be used for adaptive resource prioritization to areas where spatial expansion and underlying damage potential are concurrently highest

Topological Field Theory and Rational Curves

We analyze the superstring propagating on a Calabi-Yau threefold. This theory naturally leads to the consideration of Witten's topological non-linear sigma-model and the structure of rational curves on the Calabi-Yau manifold. We study in detail the case of the world-sheet of the string being mapped to a multiple cover of an isolated rational curve and we show that a natural compactification of the moduli space of such a multiple cover leads to a formula in agreement with a conjecture by Candelas, de la Ossa, Green and Parkes.Comment: 20 page

A Unique Radiation Scheme for the Treatment of High-Grade Non-Metastatic Soft Tissue Sarcoma: The Detroit Medical Center Experience

Purpose:This is the initial report on the utilization of combined photon irradiation followed by a neutron boost irradiation for the initial management of patients with high-grade non-metastatic soft tissue sarcoma (STS). We present data on local control, complications, disease-free survival and overall survival in patients at high risk for local relapse

Improving the accessibility and transferability of machine learning algorithms for identification of animals in camera trap images: MLWIC2

Motion-activated wildlife cameras (or “camera traps”) are frequently used to remotely and noninvasively observe animals. The vast number of images collected from camera trap projects has prompted some biologists to employ machine learning algorithms to automatically recognize species in these images, or at least filter-out images that do not contain animals. These approaches are often limited by model transferability, as a model trained to recognize species from one location might not work as well for the same species in different locations. Furthermore, these methods often require advanced computational skills, making them inaccessible to many biologists. We used 3 million camera trap images from 18 studies in 10 states across the United States of America to train two deep neural networks, one that recognizes 58 species, the “species model,” and one that determines if an image is empty or if it contains an animal, the “empty-animal model.” Our species model and empty-animal model had accuracies of 96.8% and 97.3%, respectively. Furthermore, the models performed well on some out-of-sample datasets, as the species model had 91% accuracy on species from Canada (accuracy range 36%–91% across all out-of-sample datasets) and the empty-animal model achieved an accuracy of 91%–94% on out-of-sample datasets from different continents. Our software addresses some of the limitations of using machine learning to classify images from camera traps. By including many species from several locations, our species model is potentially applicable to many camera trap studies in North America. We also found that our empty-animal model can facilitate removal of images without animals globally. We provide the trained models in an R package (MLWIC2: Machine Learning for Wildlife Image Classification in R), which contains Shiny Applications that allow scientists with minimal programming experience to use trained models and train new models in six neural network architectures with varying depths

The role of steroids in the management of brain metastases: a systematic review and evidence-based clinical practice guideline

Do steroids improve neurologic symptoms in patients with metastatic brain tumors compared to no treatment? If steroids are given, what dose should be used? Comparisons include: (1) steroid therapy versus none. (2) comparison of different doses of steroid therapy. Target population These recommendations apply to adults diagnosed with brain metastases. Recommendations Steroid therapy versus no steroid therapy Asymptomatic brain metastases patients without mass effect Insufficient evidence exists to make a treatment recommendation for this clinical scenario. Brain metastases patients with mild symptoms related to mass effect Level 3 Corticosteroids are recommended to provide temporary symptomatic relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. It is recommended for patients who are symptomatic from metastatic disease to the brain that a starting dose of 4–8 mg/day of dexamethasone be considered. Brain metastases patients with moderate to severe symptoms related to mass effect Level 3 Corticosteroids are recommended to provide temporary symptomatic relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. If patients exhibit severe symptoms consistent with increased intracranial pressure, it is recommended that higher doses such as 16 mg/day or more be considered. Choice of Steroid Level 3 If corticosteroids are given, dexamethasone is the best drug choice given the available evidence. Duration of Corticosteroid Administration Level 3 Corticosteroids, if given, should be tapered slowly over a 2 week time period, or longer in symptomatic patients, based upon an individualized treatment regimen and a full understanding of the long-term sequelae of corticosteroid therapy. Given the very limited number of studies (two) which met the eligibility criteria for the systematic review, these are the only recommendations that can be offered based on this methodology. Please see “Discussion” and “Summary” section for additional details

Pharmacokinetics of high-dose oral thiamine hydrochloride in healthy subjects

Background: High dose oral thiamine may have a role in treating diabetes, heart failure, and hypermetabolic states. The purpose of this study was to determine the pharmacokinetic profile of oral thiamine hydrochloride at 100 mg, 500 mg and 1500 mg doses in healthy subjects. Methods: This was a randomized, double-blind, single-dose, 4-way crossover study. Pharmacokinetic measures were calculated. Results: The $AUC_{0-10 hr}$ and $C_{max}$ values increased nonlinearly between 100 mg and 1500 mg. The slope of the $AUC_{0-10 hr}$ vs dose, as well as the $C_{max}$ vs dose, plots are steepest at the lowest thiamine doses. Conclusion: Our study demonstrates that high blood levels of thiamine can be achieved rapidly with oral thiamine hydrochloride. Thiamine is absorbed by both an active and nonsaturable passive process

Effect of standing posture during whole body vibration training on muscle morphology and function in older adults: A randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Whole body vibration (WBV) is a novel modality of exercise shown to improve musculoskeletal function. This study aims to examine the effects of standing posture during low magnitude WBV training on muscle function and muscle morphology in older adults.</p> <p>Methods</p> <p>Nineteen men and women (50-80 years) were recruited to a three month randomised controlled trial and allocated to one of three groups: WBV with flexed knees (FK), WBV with locked knees (LK), or sham WBV with flexed knees (CON). Exposure was intermittent (1 min WBV:1 min rest) for 20 min, three times per week for 13 weeks. Measurements were taken at baseline and at three months. Primary outcomes included upper and lower body muscle function (strength, power and velocity). Secondary outcomes were muscle morphology, balance, habitual and maximal gait velocity, stair climb power, and chair stand performance.</p> <p>Results</p> <p>Sixteen subjects completed the study. Relative (%) upper body contraction velocity improved significantly after WBV with FK compared to LK (FK 16.0%, LK -7.6%, CON 4.7, p = 0.01). Relative upper body strength (LK 15.1%, p = 0.02; FK 12.1%, p = 0.04; CON 4.7%) increased significantly following WBV compared to control. Absolute (p = 0.05) and relative (p = 0.03) lower leg strength significantly improved with both standing postures (LK 14.4%; FK 10.7%; CON 1.3%). Only the LK group differed significantly from CON in relative leg strength gains (p = 0.02). Potentially clinically meaningful but statistically non-significant improvements in lower leg muscle cross-sectional area (LK 3.7 cm², FK 2.4 cm², CON 2.2 cm²p = 0.13) were observed after WBV with LK compared to the other groups. No significant effects of WBV on any functional performance tests were observed.</p> <p>Conclusions</p> <p>Our results suggest that WBV may improve muscle strength and contraction velocity in some muscle groups in older adults. However, hypothesised differential adaptation to standing posture (FK > LK) was observed only for upper body contraction velocity, making recommendations regarding this prescriptive element inconclusive. The efficacy, mechanism of action and long term feasibility of WBV for musculoskeletal health in older adults warrants continued investigation in robustly designed, sufficiently powered future studies.</p> <p>Trial Registration</p> <p>ACTRN12609000353291.</p