Rapid improvement in beliefs, mood, and performance following an experimental success experience in an analogue test of recovery-oriented cognitive therapy.

BACKGROUND: Negative symptoms significantly contribute to disability and lack of community participation for low functioning individuals with schizophrenia. Cognitive therapy has been shown to improve negative symptoms and functional outcome in this population. Elucidation of the mechanisms of the therapy would lead to a better understanding of negative symptoms and the development of more effective interventions to promote recovery. The objective of this study was to determine (1) whether guided success at a card-sorting task will produce improvement in defeatist beliefs, positive beliefs about the self, mood, and card-sorting performance, and (2) whether these changes in beliefs and mood predict improvements in unguided card-sorting. METHODS: Individuals with schizophrenia having prominent negative symptoms and impaired neurocognitive performance (N = 35) were randomized to guided success (n = 19) or a control (n = 16) condition. RESULTS: Controlling for baseline performance, the experimental group performed significantly better, endorsed defeatist beliefs to a lesser degree, reported greater positive self-concept, and reported better mood than the control condition immediately after the experimental session. A composite index of change in defeatist beliefs, self-concept, and mood was significantly correlated with improvements in card-sorting. CONCLUSIONS: This analogue study supports the rationale of cognitive therapy and provides a general therapeutic model in which experiential interventions that produce success have a significant immediate effect on a behavioral task, mediated by changes in beliefs and mood. The rapid improvement is a promising indicator of the responsiveness of this population, often regarded as recalcitrant, to cognitively-targeted behavioral interventions.

From neurocognition to community participation in serious mental illness: the intermediary role of dysfunctional attitudes and motivation.

BACKGROUND: Evidence for a relationship between neurocognition and functional outcome in important areas of community living is robust in serious mental illness research. Dysfunctional attitudes (defeatist performance beliefs and asocial beliefs) have been identified as intervening variables in this causal chain. This study seeks to expand upon previous research by longitudinally testing the link between neurocognition and community participation (i.e. time in community-based activity) through dysfunctional attitudes and motivation. METHOD: Adult outpatients with serious mental illness (N = 175) participated, completing follow-up assessments approximately 6 months after initial assessment. Path analysis tested relationships between baseline neurocognition, emotion perception, functional skills, dysfunctional attitudes, motivation, and outcome (i.e. community participation) at baseline and follow-up. RESULTS: Path models demonstrated two pathways to community participation. The first linked neurocognition and community participation through functional skills, defeatist performance beliefs, and motivation. A second pathway linked asocial beliefs and community participation, via a direct path passing through motivation. Model fit was excellent for models predicting overall community participation at baseline and, importantly, at follow-up. CONCLUSIONS: The existence of multiple pathways to community participation in a longitudinal model supports the utility of multi-modal interventions for serious mental illness (i.e. treatment packages that build upon individuals' strengths while addressing the array of obstacles to recovery) that feature dysfunctional attitudes and motivation as treatment targets.

Take a walk in the park? A cross-over pilot trial comparing brisk walking in two different environments: park and urban.

OBJECTIVE: The objective of the present study is to investigate whether differences exist between a 30 minute brisk walk taken in two different environments in order to determine which environment best facilitates current physical activity guidelines: park or urban. METHODS: In this randomised cross-over pilot study, participants performed a self-timed 30 minute brisk walk in two different environments, park and urban, in Glasgow, Scotland (October 2009 to January 2010). Cadence, recorded using the activPAL™ activity monitor, was used to measure intensity. Outcome measures were: mean cadence; moderate-to-vigorous physical activity time accumulated in bouts lasting ≥ 10 min; number of walking breaks; and duration. RESULTS: A convenience sample of 40 healthy adults was recruited: 16 males, 24 females, mean age 22.9 (5.5) years. The mean cadence for the whole walk was higher in the park: 119.3 (8.3) vs. 110.9 (8.9) steps/min. Participants accumulated more moderate-to-vigorous physical activity in ≥ 10 minute bouts during park walks: 25.5 (9.6) [median (interquartile range)] vs. 14.0 (20.3) min. There was no difference in self-timed duration between locations. CONCLUSION: Participants accumulated more moderate-to-vigorous physical activity in bouts ≥ 10 min in duration on park walks due to the lack of interruptions in walking. Hence the park environment better facilitated the achievement of current physical activity guidelines. Further research involving a larger, more heterogeneous sample is recommended.

Enhancement of a virtual reality wheelchair simulator to include qualitative and quantitative performance metrics.

The increasing importance of inclusive design and in particular accessibility guidelines established in the U.K. 1996 Disability Discrimination Act (DDA) has been a prime motivation for the work on wheelchair access, a subset of the DDA guidelines, described in this article. The development of these guidelines mirrors the long-standing provisions developed in the U.S. In order to raise awareness of these guidelines and in particular to give architects, building designers, and users a physical sensation of how a planned development could be experienced, a wheelchair virtual reality system was developed. This compares with conventional methods of measuring against drawings and comparing dimensions against building regulations, established in the U.K. under British standards. Features of this approach include the marriage of an electromechanical force-feedback system with high-quality immersive graphics as well as the potential ability to generate a physiological rating of buildings that do not yet exist. The provision of this sense of "feel" augments immersion within the virtual reality environment and also provides the basis from which both qualitative and quantitative measures of a building's access performance can be gained.

Evaluation sensitivity as a moderator of communication disorder in schizophrenia.

BACKGROUND: Communication disturbance (thought disorder) is a central feature of schizophrenia that predicts poor functioning. We investigated the hypothesis that memory and attention deficits interact with beliefs about the gravity of being rejected (i.e. evaluation sensitivity) to produce the symptoms of communication disorder. METHOD: Seventy-four individuals diagnosed with schizophrenia or schizo-affective disorder completed a battery of tests assessing neurocognition (attention, working and verbal memory, abstraction), symptomatology (positive, negative and affective), functioning, and dysfunctional beliefs. RESULTS: Patients with communication deviance (n=33) performed more poorly on the neurocognitive tests and reported a greater degree of sensitivity to rejection than patients with no thought disorder (n=41). In a logistic regression analysis, evaluation sensitivity moderated the relationship between cognitive impairment and the presence of communication disorder. This finding was independent of hallucinations, delusions, negative symptoms, depression and anxiety. CONCLUSIONS: We propose that negative appraisals about acceptance instigate communication anomalies in individuals with a pre-existing diathesis for imperfect speech production.

Mercury concentrations in museum specimens of tuna and swordfish.

The mercury levels of museum specimens of seven tuna caught 62 to 93 years ago and a swordfish caught 25 years ago have been determined by instrumental neutron activation analysis. These levels are in the same range as those found in specimens caught recently.

Fractionation of copper activation products in debris samples from the National Ignition Facility.

Nuclear fusion experiments performed at the National Ignition Facility produce radioactive debris, arising in reactions of fast neutrons with the target assembly. We have found that postshot debris collections are fractionated, such that isotope ratios in an individual debris sample may not be representative of the radionuclide inventory produced by the experiment. We discuss the potential sources of this fractionation and apply isotope-correlation techniques to calculate unfractionated isotope ratios that are used in measurements of nuclear reaction cross sections.

Distribution of collected target debris using the large area solid debris radiochemistry collector.

A large area solid radiochemistry collector was deployed at the National Ignition Facility (NIF) with a collection efficiency for post-shot, solid target debris of approximately 1% of the total 4π solid angle. The collector consisted of a 20-cm diameter vanadium foil surrounded by an aluminum side-enclosure and was fielded 50 cm from the NIF target. The collector was used on two NIF neutron yield shots, both of which had a monolayer of 238U embedded in the capsule ablator 10 µm from the inner surface. Fission and activation products produced in the 238U were collected, and subsequent analyses via gamma spectroscopy indicated that the distribution of fission products was not uniform, with peak and valley fission products preferentially collected on the vanadium and low- and high-mass fission products primarily located on the aluminum side-enclosure. The results from these shots will be used to design future nuclear data experiments at NIF.

The validation of a novel activity monitor in the measurement of posture and motion during everyday activities.

BACKGROUND: Accurate measurement of physical activity patterns can be used to identify sedentary behaviour and may facilitate interventions aimed at reducing inactivity. OBJECTIVE: To evaluate the activPAL physical activity monitor as a measure of posture and motion in everyday activities using observational analysis as the criterion standard. METHODS: Wearing three activPAL monitors, 10 healthy participants performed a range of randomly assigned everyday tasks incorporating walking, standing and sitting. Each trial was captured on a digital camera and the recordings were synchronised with the activPAL. The time spent in different postures was visually classified and this was compared with the activPAL output. RESULTS: Intraclass correlation coefficients (ICC 2,1) for interdevice reliability ranged from 0.79 to 0.99. Using the Bland and Altman method, the mean percentage difference between the activPAL monitor and observation for total time spent sitting was 0.19% (limits of agreement -0.68% to 1.06%) and for total time spent upright was -0.27% (limits of agreement -1.38% to 0.84%). The mean difference for total time spent standing was 1.4% (limits of agreement -6.2% to 9.1%) and for total time spent walking was -2.0% (limits of agreement -16.1% to 12.1%). A second-by-second analysis between observer and monitor found an overall agreement of 95.9%. CONCLUSION: The activPAL activity monitor is a valid and reliable measure of posture and motion during everyday physical activities.

The validity and reliability of a novel activity monitor as a measure of walking.

BACKGROUND: The accurate measurement of physical activity is crucial to understanding the relationship between physical activity and disease prevention and treatment. OBJECTIVE: The primary purpose of this study was to investigate the validity and reliability of the activPAL physical activity monitor in measuring step number and cadence. METHODS: The ability of the activPAL monitor to measure step number and cadence in 20 healthy adults (age 34.5+/-6.9 years; BMI 26.8+/-4.8 (mean+/-SD)) was evaluated against video observation. Concurrently, the accuracy of two commonly used pedometers, the Yamax Digi-Walker SW-200 and the Omron HJ-109-E, was compared to observation for measuring step number. Participants walked on a treadmill at five different speeds (0.90, 1.12, 1.33, 1.56, and 1.78 m/s) and outdoors at three self selected speeds (slow, normal, and fast). RESULTS: At all speeds, inter device reliability was excellent for the activPAL (ICC (2,1)> or =0.99) for both step number and cadence. The absolute percentage error for the activPAL was <1.11% for step number and cadence regardless of walking speed. The accuracy of the pedometers was adversely affected by slow walking speeds. CONCLUSION: The activPAL monitor is a valid and reliable measure of walking in healthy adults. Its accuracy is not influenced by walking speed. The activPAL may be a useful device in sports medicine.

Recent advances and results from the solid radiochemistry nuclear diagnostic at the National Ignition Facility.

The solid debris collection capability at the National Ignition Facility has been expanded to include a third line-of-sight assembly. The solid radiochemistry nuclear diagnostic measurement of the ratio of gold isotopes is dependent on the efficient collection of neutron-activated hohlraum debris by passive metal disks. The collection of target debris at this new location is more reliable in comparison to the historic locations, and it appears to be independent of collector surface ablation.

Note: Radiochemical measurement of fuel and ablator areal densities in cryogenic implosions at the National Ignition Facility.

A new radiochemical method for determining deuterium-tritium (DT) fuel and plastic ablator (CH) areal densities (ρR) in high-convergence, cryogenic inertial confinement fusion implosions at the National Ignition Facility is described. It is based on measuring the (198)Au/(196)Au activation ratio using the collected post-shot debris of the Au hohlraum. The Au ratio combined with the independently measured neutron down scatter ratio uniquely determines the areal densities ρR(DT) and ρR(CH) during burn in the context of a simple 1-dimensional capsule model. The results show larger than expected ρR(CH) values, hinting at the presence of cold fuel-ablator mix.

A 82Sr-82Rb isotope generator for use in nuclear medicine.

An improved 82Sr-82Rb generator system, based on the complexing ion-exchange resin Chelex-100, has been developed. Columns of this material can be easily and rapidly milked, and the rubidium-strontium separation factor for a fresh generator under the experimental conditions studied was found to be greater than 10-7. Approximately 80% of the 82Rb present can be delivered in a 15-ml volume of aqueous 0.2 M NH4Cl solution. After more than 6 liters of eluant had passed through the generator, the rubidium-strontium separation factor was still observed to greater than 10-5 and no unusual strontium breakthrough behavior was seen in the system over nearly three 82Sr half-lives.

Evaluation and application of alumina-based Rb-82 generators charged with high levels of Sr-82/85.

Generator-produced Rb-82, a 75-sec positron emitter with potential for myocardial blood-flow imaging, was studied with various ion-exchange columns to evaluate the characteristics of alumina as an adsorber for the 25-day Sr-82 parent. Test columns of alumina, Bio Rex 70, and Chelex 100 were loaded with multimillicurie amounts of no-carrier-added Sr-82/Sr-85 (Sr-85 is a production contaminant). The breakthrough of Sr-82/Sr-85, and the yield of Rb-82, were determined for long-term elutions from each column with up to 4 liter of 2% NaCl solution at pH 8 to 9. The breakthrough of Sr-82/85 was 10(-6)-10(-5) from aluminal 10(-6)-10(-4) from Chelex 100 and Bio Rex 70. The effects of eluent flow rate and concentration, and of alumina volume, on the breakthrough and yield were also studied. An improved and automated Rb-82 generator was used for myocardial and brain blood-flow studies in experimental animals and in man; it was equipped with solenoid flow-control valves and five in. of lead shielding for the alumina columns, which were charged with 25-50 mCi Sr-82 (100-150 mCi Sr-85). The Rb-82 generator with alumina column provided up to 20-40 mCi of Rb-82 as often as every 5-10 min with less than 10(-5) breakthrough of Sr-82/85 over the 2- to 3-mo, useful life of the generator.

Rubidium-82 generators for imaging studies.

Strontium-82, produced by spallation reaction with medium-energy proton beams, was used to evaluate Bio-Rex 70 and Chelex-100 ion-exchange resins for use in a compact Rb-82 generator. Adsorption of Sr-82 to the resin column, Rb-82 elution yields, Sr breakthrough, and 82Rb-Sr separation factors were determined for newly prepared columns and for longterm elution conditions. Separation factors of 10(7) to 10(8) were obtained with 2% NaCl elutions from Bio-Rex 70 resin columns while the separation factors was about 5 X 10(4) with the Chelex-100 resin column.

Relation between regional myocardial uptake of rubidium-82 and perfusion: absolute reduction of cation uptake in ischemia.

Experiments were undertaken using rubidium-82 and position tomography to examine the relation between myocardial perfusion and cation uptake during acute ischemia. Rubidium-82 was repeatedly eluted from a strontium-82-rubidium-82 generator. In six dogs emission tomograms were used to measure the delivered arterial and myocardial concentrations at rest and after coronary stenosis, stress and ischemia. There was a poor overall relation between regional myocardial uptake and flow measured by microspheres and a large individual variability. Extraction of rubidium-82 was inversely related to flow. Significant regional reduction of cation uptake was detected in the tomograms when regional flow decreased by more than 35 percent. This reduction was significantly greater when ischemia was present. A small but significantly greater when ischemia was present. A small but significant decrease (33.0 +/- 9.1 percent, mean +/- standard deviation) in the myocardial uptake of rubidium-82 was detected only when flow was increased by more than 120 percent in relation to a control area after administration of dypiridamole. The technique using rubidum-82 and tomography was applied in five volunteers and five patients with angina pectoris and coronary artery disease. Myocardial tomograms recorded at rest and after exercise in the volunteers showed homogeneous uptake of cation in reproducible and repeatable scans. In contrast, the patients with coronary artery disease showed an absolute mean decrease of 36 +/- 14 percent in regional myocardial uptake of rubidium-82 after exercise. These abnormalities persisted in serial tomograms for more than 20 minutes after the symptoms and electrocardiographic signs of ischemia.

Time-frequency and time-scale techniques for the classification of native and bioprosthetic heart valve sounds.

The determination of diagnostic features in recorded heart sounds was investigated with Carpentier-Edwards (CE) bioprosthetic valves. Morphological features, extracted using the Choi-Williams distribution, achieved between 96 and 61% correct classification. The time-scale wavelet-transform feature set achieved 100% correct classification with native valve populations, and 87% with the CE replacements.

Spectral characterization and classification of Carpentier-Edwards heart valves implanted in the aortic position.

This paper demonstrates an improvement in the performance of spectral phonocardiography, combined with pattern recognition techniques for monitoring the condition of bioprosthetic heart valves. The analysis of the heart sounds is performed using a modified forward-backward overdetermined Prony's method. Results show that the condition of the bioprosthesis affects mostly the higher part of the spectrum (i.e., above 250 Hz) where no frequency components were found for malfunctioning cases. Therefore, the amplitudes of the three highest frequency components are used as the input vector of an adaptive single layer perceptron-based classifier to identify normal and malfunctioning classes. For the sample set examined, this method gives 100% correct discrimination between normal and malfunctioning Carpentier-Edwards (C-E) valves.

A possible chemical explanation for the events associated with the death of Gloria Ramirez at Riverside General Hospital.

The events associated with the death of Gloria Ramirez at Riverside General Hospital on 19 February 1994 have been portrayed as a major medical mystery. A potential chemical explanation for this incident has been developed. The hypothetical scenario depends upon the oxidation of a common solvent, dimethyl sulfoxide, through dimethyl sulfone to dimethyl sulfate. The latter compound is a volatile and highly toxic agent that can be quite hazardous to humans in small amounts. It is also environmentally nonpersistent. Much of the mystery surrounding the circumstances at the hospital may be explainable if this postulated metabolic pathway took place at the time of the emergency room incident. Although dimethyl sulfate was not detected in any analyses pertinent to this event, there are plausible scientific explanations to account for that fact. The sulfate anion, a hydrolysis product of dimethyl sulfate, was measured at an appreciably elevated concentration in Ramirez' blood. The descriptions of the symptoms of the hospital-staff victims appear quite consistent with dimethyl sulfate exposures. This paper attempts to make some sense of the reported data and eyewitness accounts, and perhaps provide new insight for any future research that could further explain this reported occurrence of toxic exposure.

A clustering technique for digital communications channel equalization using radial basis function networks.

The application of a radial basis function network to digital communications channel equalization is examined. It is shown that the radial basis function network has an identical structure to the optimal Bayesian symbol-decision equalizer solution and, therefore, can be employed to implement the Bayesian equalizer. The training of a radial basis function network to realize the Bayesian equalization solution can be achieved efficiently using a simple and robust supervised clustering algorithm. During data transmission a decision-directed version of the clustering algorithm enables the radial basis function network to track a slowly time-varying environment. Moreover, the clustering scheme provides an automatic compensation for nonlinear channel and equipment distortion. Computer simulations are included to illustrate the analytical results.