Predicting post-treatment-initiation alcohol use among patients with severe mental illness and alcohol use disorders.

Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of alcohol use outcomes were examined in 278 individuals diagnosed with a current schizophrenia-spectrum or bipolar disorder and an alcohol use disorder (AUD). At 6-months follow-up, 144 of 228 available participants (63%) had good clinical outcomes. The results of structural equation modeling indicated that type of pretreatment residential setting was directly related to treatment, with participants who lived in supervised settings (41%) reporting significantly more days of treatment (β = .34, p     

Hydrogen evolution reaction measurements of dealloyed porous NiCu

Porous metals are of interest for their high surface area and potential for enhanced catalytic behavior. Electrodeposited NiCu thin films with a range of compositions were electrochemically dealloyed to selectively remove the Cu component. The film structure, composition, and reactivity of these samples were characterized both before and after the dealloying step using scanning electron microscopy, energy-dispersive spectroscopy, and electrochemical measurements. The catalytic behavior of the dealloyed porous Ni samples towards the hydrogen evolution reaction was measured and compared to that of the as-deposited samples. The dealloyed samples were generally more reactive than their as-deposited counterparts at low overpotentials, making the dealloying procedure a promising area of exploration for improved hydrogen evolution catalysts.     

Assessing the Floristic Diversity of Hedge Networks: A landscape perspective

The type of land cover adjacent to hedges has been shown to influence the species composition of the ground flora. An assessment of the contribution of hedge networks to the biodiversity of landscapes therefore requires information on the relative lengths of hedge associated with different land covers. In the River Tyne catchment, Northern England, the association between hedges and land cover types differed between four landscapes. Overall, the greatest length of hedge was adjacent to arable crops, improved grasslands and roads. Hedges next to improved grassland and roads were the most species-rich, while those adjacent to arable crops were the least species-rich. Species which were common adjacent to arable crops were also common adjacent to other land covers. Hedges adjacent to improved grassland, roads and semi-natural broadleaved woodland supported species which were not common elsewhere in the hedge network. It was also found that hedges with different land cover on each side supported different floras on each side. When planning landscape-scale surveys of hedge biodiversity, it is important to survey both sides of hedges, and sampling should be stratified to include hedges adjacent to the different types of land cover present.     

Dissolved gases as partitioning tracers for determination of hydrogeological parameters

In this study, dissolved Kr and SF6 gases were used to determine various hydrogeological parameters of laboratory columns under water-saturated and partially saturated conditions as a function of the flow velocity. The dissolved gases behaved conservatively in saturated columns but were significantly retarded in unsaturated conditions as a direct function of the Henry's law constant (KH) and the ratio of column pore spaces filled with air and water (Vg/Vw). Lower aqueous diffusion coefficients for SF6 compared to that for Kr also resulted in significant rate-limited mass transport across gas-water interface. This effect was exacerbated at higher flow velocities as was indicated by the asymmetric shape of breakthrough curves, more so in the case of SF6. A nonequilibrium advective-dispersive transport model accurately described tracer breakthrough and was used to estimate parameters such as final Vg/Vw under partially saturated conditions and partitioning rates. Internally consistent model results were obtained for both dissolved gases despite the wide range in physical properties (e.g., KH and aqueous diffusion coefficients), suggesting that dissolved Kr and SF6 may be used in conjunction to delineate and validate aquifer characteristics simultaneously from a single pulse injection of the tracer.     

A nurse practitioner intervention model to maximize efficient use of telemetry resources

BACKGROUND: Telemetry monitoring is widely used in hospitals; the importance of being able to monitor and examine dysrhythmias has been universally accepted. Yet it is often used for patients who do not actually require this technology. A model to improve the efficiency of telemetry use entailed the use of an advanced practice nurse (APN; identical to a nurse practitioner) to provide concurrent review and intervention of floating telemetry, which is available for patients independently of the floor location and who do not need an intensive care unit bed. ADDRESSING OVERUSE: The demand for floating telemetry at Hackensack University Medical Center had equaled or exceeded the telemetry availability virtually 100% of the time, even after local guidelines had been disseminated in 1998. The APN carried out concurrent monitoring and intervened with the attending physician when patients were on telemetry for longer than 48 hours and did not meet the local telemetry guidelines. RESULTS: The mean number (standard error [SE]) of hours per patient declined from 65.2 +/- 0.7 hours (95% confidence interval, 63.8 to 66.6 hours) for the 11 months before the intervention to a mean of 49.6 +/- 0.4 hours (95% confidence interval, 48.7 to 50.2 hours) for the 29 months after intervention--representing a decrease of 34% (p < 0.0001). This decrease led to an increase in the number of patients per month put on telemetry. DISCUSSION: The APN model, an aggressive approach that induced change almost immediately, was then applied to other quality improvement projects.     

Load Balancing Parallel Explicit State Model Checking

This paper first identifies some of the key concerns about the techniques and algorithms developed for parallel model checking; specifically, the inherent problem with load balancing and large queue sizes resultant in a static partition algorithm. This paper then presents a load balancing algorithm to improve the run time performance in distributed model checking, reduce maximum queue size, and reduce the number of states expanded before error discovery. The load balancing algorithm is based on generalized dimension exchange (GDE). This paper presents an empirical analysis of the GDE based load balancing algorithm on three different supercomputing architectures—distributed memory clusters, Networks of Workstations (NOW) and shared memory machines. The analysis shows increased speedup, lower maximum queue sizes and fewer total states explored before error discovery on each of the architectures. Finally, this paper presents a study of the communication overhead incurred by using the load balancing algorithm, which although significant, does not offset performance gains.     

The average-case identifiability and controllability of large scale systems

Needs for increased product quality, reduced pollution, and reduced energy and material consumption are driving enhanced process integration. This increases the number of manipulated and measured variables required by the control system to achieve its objectives. This paper addresses the question of whether processes tend to become increasingly more difficult to identify and control as the process dimension increases. Tools and results of multivariable statistics are used to show that, under a variety of assumed distributions on the elements, square processes of higher dimension tend to be more difficult to identify and control, whereas the expected controllability and identifiability of nonsquare processes depends on the relative numbers of measured and manipulated variables. These results suggest that the procedure of simplifying the control problem so that only a square process is considered is a poor practice for large scale systems.     

Challenges and solutions for recruiting pregnant smokers into a nicotine replacement therapy trial.

Improvements in smoking cessation interventions for pregnant smokers are needed. One major step is to examine the potential effectiveness of nicotine replacement therapy (NRT). The potential benefits of providing pregnant women with NRT to help them quit smoking are still unknown; early interventions to test the effectiveness and efficacy are vital to advancing the field. This paper describes recruitment efforts for a multiclinic trial to test the effectiveness of NRT use in addition to behavioral therapy in promoting cessation during pregnancy. The biggest challenge is recruiting sufficient numbers of pregnant women. This paper discusses specific obstacles for recruitment and solutions. Knowing the potential pitfalls to recruiting pregnant women into these trials can lead to better studies and thus improved outcomes.     

Coexpression of leptin receptor and preproneuropeptide Y mRNA in arcuate nucleus of mouse hypothalamus

Leptin, the protein product of the adipose tissue-specific ob (obese) gene (1), reduces the body weight, adiposity and food intake of obese ob/ob mice on peripheral or central injection (2, 3, 4). [125I]leptin binding has been detected in mouse choroid plexus (5), from which a leptin receptor gene was expression cloned (5). The gene has at least 6 splice variants (6, 7). Leptin receptor mRNA was localized in the hypothalamus by in situ hybridization being particularly abundantly expressed in the arcuate nucleus (8). There is evidence linking the physiological effects of injected leptin with hypothalamic neuropeptide Y (9, 10) (NPY), which has potent central effects on food intake and energy balance (11), and is also expressed in the arcuate nucleus. Here we report dual in situ hybridization studies for leptin receptor and NPY gene expression in the mouse arcuate nucleus, where the majority of cells examined expressed both genes. This provides the first direct evidence that leptin acts on cells that express NPY mRNA.