Heterogeneity in Youth Symptom Trajectories Following Psychiatric Crisis: Predictors and Placement Outcome.

The authors examined heterogeneity in symptom trajectories among youths following psychiatric crises as well as the psychosocial correlates and placement outcomes associated with identified trajectories. Using semiparametric mixture modeling with 156 youths approved for psychiatric hospitalization, the authors identified 5 trajectories based on symptoms over the 16 months following crisis: high improved, high unimproved, borderline improved, borderline unimproved, and subclinical. Membership in unimproved symptom groups was associated with less suicidality, younger age, more youth hopelessness, and more caregiver empowerment. Improved symptom group membership predicted long-term decreases in days in out-of-home placements. More important, and in contrast with general impressions from the existing literature, findings suggest that a substantive proportion of youths with serious emotional disturbance sustain high levels of symptomatology following intensive mental health services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EEG spectral abnormalities and psychosis as predictors of cognitive and functional decline in probable Alzheimer's disease

We examined whether either psychotic features (e.g., delusions and hallucinations) or EEG abnormalities are associated with more rapid progression of Alzheimer's disease (AD). AD patients with psychosis have exhibited more EEG abnormalities than those without psychosis, and both abnormal EEG and psychosis have been noted to be predictors of functional and cognitive decline in AD. Ninety-five probable AD patients participating in a longitudinal study of dementia had an EEG and a semistructured psychiatric interview at baseline. Using EEG spectral analysis, we classified records as normal/abnormal based on the parasagittal mean frequency. Patients with abnormal EEGs were more functionally (e.g., Blessed Rating Scale for activities of daily living) and cognitively (e.g., Mini-Mental State) impaired than patients with normal EEG. AD patients with psychosis were only more functionally impaired than patients without psychosis. A two-factor analysis showed no interaction between abnormal EEG and psychosis. In addition, using a Cox proportional hazard model adjusted for age and education, the presence of an abnormal EEG or psychotic symptom at study entry was associated with higher risk of reaching severe cognitive and functional impairment during follow-up. Neither abnormal EEG nor the presence of psychosis predicted death. These results indicate that both abnormal EEG and psychosis are independent predictors of disease progression but not of physical survival.     

Overcoming the challenges in deploying user provisioning/identity access management backbone

This paper sets out to share BT's leadership and experience by determining the identity management opportunities and issues, then document the lessons learnt in previous deployments and recommend strategies for all types and sizes of organisation. Today's ICT environment has created a mixed approach to access management across sectors. Browser-based any time, anywhere, anyone access, coupled with the business need to access more systems and services across a changing infrastructure of distributed platforms and networked services, has changed the administrative landscape. Enterprises are being forced to add administrative support staff or invest in technology-driven process change. At the same time, users are undergoing significant change, creating new expectations in service quality. Moreover, regulatory bodies are demanding confirmation that processes granting access are controlled and documented. In this world of increasing demands, complexity and expectation, the service management tools, techniques and options available to improve user access management are as varied and numerous as the issues faced by management in their deployment. Identity management is widely heralded as an opportunity to improve the end user experience, reduce costs, improve security and deliver regulatory compliance — but is often misunderstood. Projects regularly fail to achieve the expected benefits. These failures are the result of expectations being inappropriately set, deployment of solutions turning out to be more complex or taking longer than expected, and/or products selected before required functionality has been determined. For the larger more mature organisations, or those organisations that are the amalgamation of mergers and acquisitions, the dilemma is where to start and what approach to take.     

Hydrogen adsorption studies in micro-size cobalt dots

Hydrogen desorption curves were obtained from a sample composed of a square arrangement of Co dots with average diameter of 4.4 μm, separated by a distance of 11.6 μm. A macroscopic sample of Co dots grown on a 2.5 × 2.5 cm Si substrate was made by standard lithographic techniques and used in these experiments. Thermal programmed desorption (TPD) was performed under ultra-high vacuum conditions. Hydrogen TPD curves were obtained from a 1 × 1 cm Co dots samples displaying a maximum of intensity at 425 K. Hydrogen TPD curve was also obtained from 1 cm× 1 cm samples of Co films and Co foils for comparison. The hydrogen TPD curves have decreasing intensity from the Co foils to the Co dots and finally to the Co films. This indicates that there are more sites for hydrogen adsorption on the Co dots than in the Co films. This is a surprising result because there is approximately 8.7 times less Co atoms exposed in the Co dots that in the Co film sample. A desorption energy of 27 kcal/mol was obtained for the Co dots suggesting that hydrogen is adsorbed on an hcp hollow site of the Co dot crystalline structure.     

Making polyurethane foams from microemulsions

A remarkable correlation exists between the degree of expansion of polyurethane foams and the structure of the reacting premixes. Polyurethane foams obtained from reacting premixes containing microemulsions are highly expanded. The expansion rate is proportional to the volume fraction of microemulsion in the premix. The stability of premixes with and without microemulsion is completely different suggesting distinct creaming mechanisms. We apply this idea to synthesize polyurethane foams from microemulsions successfully. This approach can be used to rationalize the design of polyurethane formulations leading to highly expanded foams.     

Comparison of two methods of surfactant administration and the effect on dosing-associated hypoxemia

OBJECTIVE: The purpose of our study was to test the hypothesis that surfactant dosing through a proximal sideport adapter on an endotracheal tube leads to more dosing-associated hypoxemia compared with a method of dosing that uses a double-lumen endotracheal tube. STUDY DESIGN: Using adequate sample size to compare significant changes in O2 saturation (power > 0.8, alpha < 0.05) we enrolled 36 infants with respiratory distress syndrome in this randomized trial. A 10% change in O2 saturation was considered clinically significant. Nineteen infants received 38 doses of surfactant through the sideport adapter. Seventeen infants received 31 doses of surfactant through the nonventilation lumen of a double-lumen endotracheal tube. Two main outcome measures were assessed: time-averaged O2 saturation values 30 minutes after dosing and the largest absolute fall in O2 saturation for each patient. RESULTS AND CONCLUSIONS: Time-averaged O2 saturation measures were higher in the proximal sideport group (p = 0.02), but the magnitude of difference was probably not clinically significant. No significant difference was detected between groups when we compared largest absolute drop in O2 saturation. Secondary analyses found no effect of birth weight or dose number (second vs third dose) on either outcome measure.     

Using MineSet for knowledge discovery

MineSet aids knowledge discovery and supports decision making based on relational data. It uses visualization and data mining to arrive at interesting results. Providing diverse visualization tools lets users choose the most appropriate method for a given problem. The client-server architecture performs most of the computationally intensive tasks on a server, while the processed results return to the client for visualization. The paper discusses MineSet database visualization and data mining visualization