Overlooked physical diagnoses in chronic pain patients involved in litigation, Part 2. The addition of MRI, nerve blocks, 3-D CT, and qualitative flow meter

This study followed 120 chronic pain patients referred to a multidisciplinary pain center. The referral diagnosis for many patients, such as "chronic pain," "psychogenic pain," or "lumbar strain," was frequently found to be incomplete or inaccurate (40%) following a multidisciplinary evaluation that used appropriate diagnostic studies, including magnetic resonance imaging, computed tomography, nerve blocks, and qualitative flowmeter. Significant abnormalities were discovered in 76% of the diagnostic tests. An organic origin for pain was found in 98% of these patients. The patients were discharged with objective verification of diagnoses including facet disease, nerve entrapment, temporomandibular joint disease, thoracic outlet syndrome, and herniated discs.     

Programmable logic construction kits for hyper-real-time neuronal modeling

Programmable logic designs are presented that achieve exact integration of leaky integrate-and-fire soma and dynamical synapse neuronal models and incorporate spike-time dependent plasticity and axonal delays. Highly accurate numerical performance has been achieved by modifying simpler forward-Euler-based circuitry requiring minimal circuit allocation, which, as we show, behaves equivalently to exact integration. These designs have been implemented and simulated at the behavioral and physical device levels, demonstrating close agreement with both numerical and analytical results. By exploiting finely grained parallelism and single clock cycle numerical iteration, these designs achieve simulation speeds at least five orders of magnitude faster than the nervous system, termed here hyper-real-time operation, when deployed on commercially available field-programmable gate array (FPGA) devices. Taken together, our designs form a programmable logic construction kit of commonly used neuronal model elements that supports the building of large and complex architectures of spiking neuron networks for real-time neuromorphic implementation, neurophysiological interfacing, or efficient parameter space investigations.     

Gastric and biliary excretion of meperidine in man

The role and importance of enterogastric secretion in the disposition and elimination of the weak base, meperidine (pKa 8.63), was studied after intravenous administration (50 mg) of the drug to 6 normal volunteers. Continuous collection of the gastric fluid over a 4-hr period demonstrated the establishment of high gastric fluid/plasma concentration ratios for meperidine (mean about 50, range, 10 to 200). However, the total amount of drug recovered, even after correction for incomplete collection, was only a small percentage of the administered dose. Under basal conditions a mean +/- SE of 1.9 +/- 0.3 mg, equivalent to 3.7% of the administered dose, was found in the total gastric aspirate. Stimulation of gastric secretion by subcutaneous injection of betazole (1.5 mg/kg) increased this recovery to 3.6 +/- 0.3 mg (7.2%) primarily due to the increase in gastric volumen output. Aspiration of the gastric fluid in either the basal or stimulated situation had no observable effect upon the plasma concentration/time profile of meperidine whether assessed by the terminal half-life, t 1/2 beta, or the plasma clearance; control values were 3.8 +/- hr and 1,190 +/- 130 ml/min, respectively. In 2 subjects "bile fluid" was also collected for 2.5 hr and found to contain less than 0.2% of the administered dose. Enterosystemic recycling is therefore of minor importance in the disposition and elimination of meperidine in man.     

The heroin epidemic in San Francisco: estimates of incidence and prevalence

Much attention has recently been focused on the question of the extent of heroin use in America. In a worthwhile effort to call public attention to the problem, many estimates of its size have evidenced a tendency toward exaggeration and aggrandizement. This paper presents methods of estimation of the extent of heroin addiction which, when carefully employed, should effectively correct such distorted estimates. Two general types of estimation are employed, incidence and prevalence. Incidence estimates are concerned with new cases of heroin addiction that occur in a specific population within a given amount of time. These estimates are based upon self-report data from addicts regarding date of first addiction. When corrected for the "lag phase" (that period of time between onset of first addiction and eventual visit to a treatment program), these data permit accurate retrospective charting of incidence trends. Prevalence estimates focus on all known cases of heroin addiction in a specific population within a given amount of time. Three separate types of prevalence estimates from three separate sources are outlined in this article: estimates based on overdose death data, estimates based on crime statistics, and estimates of "unknown" addicts. In outlining these methods, this article describes the fluctuations in heroin addiction in one major American city, San Francisco, California. After analyzing data gathered from a sample of 2,367 addicts contacted over a 3-year period, this study suggests that the incidence of heroin addiction seems to have declined after 1970. Possible factors underlying this apparent decline in heroin addiction are then discussed, including the post-1970 maturation of the "population at risk," the effectiveness of antidrug media messages, the changing drug fashions in the heroin subculture, and the gradual deterioration of the quality and potency of street heroin.     

The Effectiveness of Telephone-Based Continuing Care in the Clinical Management of Alcohol and Cocaine Use Disorders: 12-Month Outcomes.

This study of continuing care for substance dependent patients compared a telephone-based monitoring and brief counseling intervention (TEL) with 2 face-to-face interventions, relapse prevention (RP) and standard 12-step group counseling (STND). The participants were graduates of intensive outpatient programs who had current dependence on alcohol and/or cocaine. Self-report, collateral, and biological measures of alcohol and cocaine use were obtained over a 12-month follow-up. The treatment groups did not differ on abstinence-related outcomes in the complete sample (N = 359) or on cocaine use outcomes in participants with cocaine dependence (n = 268). However, in participants with alcohol dependence only (n = 91), TEL produced better alcohol use outcomes than STND on all measures examined and better outcomes than RP on some of the measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multi-institutional, multinational study of programming concepts using card sort data

Abstract: This paper presents a case study of the use of a repeated single‐criterion card sort with an unusually large, diverse participant group. The study, whose goal was to elicit novice programmers' knowledge of programming concepts, involved over 20 researchers from four continents and 276 participants drawn from 20 different institutions. In this paper we present the design of the study and the unexpected result that there were few discernible systematic differences in the population. The study was one of the activities of the National Science Foundation funded Bootstrapping Research in Computer Science Education project (2003).     

Extreme appraisals of internal states and bipolar symptoms: The Hypomanic Attitudes and Positive Predictions Inventory.

The Hypomanic Attitudes and Positive Predictions Inventory (HAPPI; W. Mansell, 2006) was developed to assess multiple, extreme, self-relevant appraisals of internal states. The present study aimed to validate the HAPPI in a clinical sample. Participants (N = 50) with a diagnosis of bipolar disorder (confirmed by a structured clinical interview) completed a series of questionnaires pertaining to clinical factors, reward motivation, cognitive style, symptoms, and functioning at baseline, in addition to the HAPPI. Over the following 4 weeks, participants were asked to complete self-report measures of symptoms (activation, perceived conflict, depression, and well-being), as well as work and social functioning, twice weekly. The authors hypothesized that the HAPPI would be associated with prospective bipolar symptoms and functioning, when controlling for baseline symptoms and potentially confounding measures. The HAPPI was positively, independently associated with activation and conflict after 4 weeks. Furthermore, individual HAPPI factors were associated with activation, conflict, and depression. The results provided preliminary support for the predictive validity of the HAPPI in a clinical sample. The HAPPI could be used in the future as a tool in cognitive behavioral therapy for bipolar disorder to identify problematic beliefs and guide formulation. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Efficient location and allocation strategies for undesirable facilities considering their fundamental properties

The phrase “not in my backyard” (NIMBY) refers to the well-known social phenomena in which residents oppose the construction or location of undesirable facilities near their homes. Examples of such facilities include electric transmission lines, recycling centers and crematoria. Due to the opposition typically encountered in constructing an undesirable facility, the facility planner should understand the nature of the NIMBY phenomena and consider it as a key factor in determining facility location. We examine the characteristics of NIMBY phenomena and suggest two alternative mathematical optimization models with the objective of minimizing the total degree of NIMBY sentiments. Genetic algorithms are proposed to solve our linear and nonlinear integer programs. The results obtained via genetic algorithms for our linear integer programs are compared with those of CPLEX to evaluate their performance. The nonlinear programs are tested with various allocation policies. Sensitivity analysis is conducted about several system parameters.