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Search Results: 1 - 10 of 208445 matches for " Remington L. Nevin "
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Low validity of self-report in identifying recent mental health diagnosis among U.S. service members completing Pre-Deployment Health Assessment (PreDHA) and deployed to Afghanistan, 2007: a retrospective cohort study
Remington L Nevin
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-376
Abstract: A retrospective cohort study was conducted on 15,195 U.S. service members deployed in support of combat and reconstruction operations in Afghanistan. The Defense Medical Surveillance System (DMSS), the DoD's longitudinal medical surveillance database, was queried to identify cases among the cohort with a recent diagnosis of a pertinent mental health disorder and to obtain those subjects' responses to the PreDHA.Of the study cohort, 11,179 (73.6%) subjects had a PreDHA available within the DMSS at the time of analysis. A total of 615 subjects (4.0%) had one or more mental health disorder diagnoses during the pre-deployment period. Out the 615 subjects with diagnosed mental health disorders, 465 had a PreDHA. Among these, only 224, not quite half, answered in the affirmative to the PreDHA question: "During the past year, have you sought counseling or care for your mental health?"This study demonstrates that the self-reported PreDHA has low validity for identifying service members with diagnosed mental health disorders. The development of electronic decision-support systems which automatically screen electronic health records to identify high-risk service members may prove a valuable component of improved pre-deployment screening processes.Within the U.S. military, commanders and medical staff have a shared obligation to ensure that service members under their command or care are free of potentially disqualifying or significant mental health disorders that might affect their suitability for and stability during prolonged deployments. Pre-deployment screening programs that identify service members with a recent history of mental health disorder might therefore be a useful adjunct to the existing multilayered process of screening and selection that occurs during accession into the military [1] and during training and service prior to deployment [2].The Pre-Deployment Health Assessment (PreDHA) screening questionnaire was introduced by the U.S. Department of Defense (DoD)
Epileptogenic potential of mefloquine chemoprophylaxis: a pathogenic hypothesis
Remington L Nevin
Malaria Journal , 2009, DOI: 10.1186/1475-2875-8-188
Abstract: Studies have demonstrated that mefloquine at doses consistent with chemoprophylaxis accumulates at high levels in brain tissue, which results in altered neuronal calcium homeostasis, altered gap-junction functioning, and contributes to neuronal cell death. This paper reviews the scientific evidence associating mefloquine with alterations in neuronal function, and it suggests the novel hypothesis that among those with the prevalent EPM1 mutation, inherited and mefloquine-induced impairments in neuronal physiologic safeguards might increase risk of GABAergic seizure during mefloquine chemoprophylaxis.Consistent with case reports of tonic-clonic seizures occurring during mefloquine chemoprophylaxis among those with family histories of epilepsy, it is proposed here that a new contraindication to mefloquine use be recognized for people with EPM1 mutation and for those with a personal history of myoclonus or ataxia, or a family history of degenerative neurologic disorder consistent with EPM1. Recommendations and directions for future research are presented.Mefloquine (Lariam?) is a commonly prescribed anti-malarial. Although historically the long-term use of mefloquine for malaria chemoprophylaxis has been considered safe and well-tolerated [1,2], careful prescribing is needed to minimize the potential for severe neurological adverse events, including myoclonus and seizure, for which individuals with certain neurological histories appear to be at highest risk [3]. In particular, case-report [4], case-series [5], and retrospective cohort [6,7] studies define a well-characterized pattern of increased susceptibility to seizure and other movement disorders including nystagmus and ataxia [4] with use of mefloquine among those with a personal [4-6] or family history [7] of such conditions. Additional case-reports describe, in the absence of personal or family history, the occurrence of multifocal myoclonus [8], convulsions, and seizures following both therapeutic [9] and prophy
Prevalence of contraindications to mefloquine use among USA military personnel deployed to Afghanistan
Remington L Nevin, Paul P Pietrusiak, Jennifer B Caci
Malaria Journal , 2008, DOI: 10.1186/1475-2875-7-30
Abstract: Military medical surveillance and pharmacosurveillance databases were utilized to identify contraindications to mefloquine use among a cohort of 11,725 active duty U.S. military personnel recently deployed to Afghanistan.A total of 9.6% of the cohort had evidence of a contraindication. Females were more than twice as likely as males to have a contraindication (OR = 2.48, P < 0.001).These findings underscore the importance of proper systematic screening prior to prescribing and dispensing mefloquine, and the need to provide alternatives to mefloquine suitable for long-term administration among deployed U.S. military personnel.Malaria poses a continued threat to U.S. military personnel. At least 423 blood-smear confirmed cases of malaria were diagnosed among members of the U.S. military between January 1st, 2000 and December 31st, 2005; of which at least 64 represent cases attributable to service in Afghanistan [1]. Outbreaks of malaria among U.S. military personnel attributable to service in Afghanistan are well described [1,2], of which infection due to Plasmodium vivax is the principal cause. To protect against the threat of malaria, U.S. military personnel deploying to Afghanistan may be prescribed mefloquine, which must be taken continuously throughout deployments lasting as long as 15 months. Although the long-term use of mefloquine for malaria chemoprophylaxis has historically been considered safe and well-tolerated among civilian travelers [3,4] and deployed military personnel [5], careful prescribing is needed to minimize the potential for severe neuropsychiatric adverse events, which may include acute psychoses, anxiety, depression, paranoia, myoclonus, and seizures [5]. Although the underlying mechanism of these adverse events is unknown, individuals with certain psychiatric and neurological histories appear to be at highest risk [4,5]. The U.S. package insert cautions that mefloquine "should not be prescribed for prophylaxis in patients with active depress
Outbreak of H3N2 Influenza at a US Military Base in Djibouti during the H1N1 Pandemic of 2009
Michael T. Cosby, Guillermo Pimentel, Remington L. Nevin, Salwa Fouad Ahmed, John D. Klena, Ehab Amir, Mary Younan, Robert Browning, Peter J. Sebeny
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0082089
Abstract: Background Influenza pandemics have significant operational impact on deployed military personnel working in areas throughout the world. The US Department of Defense global influenza-like illness (ILI) surveillance network serves an important role in establishing baseline trends and can be leveraged to respond to outbreaks of respiratory illness. Objective We identified and characterized an operationally unique outbreak of H3N2 influenza at Camp Lemonnier, Djibouti occurring simultaneously with the H1N1 pandemic of 2009 [A(H1N1)pdm09]. Methods Enhanced surveillance for ILI was conducted at Camp Lemonnier in response to local reports of a possible outbreak during the A(H1N1)pdm09 pandemic. Samples were collected from consenting patients presenting with ILI (utilizing a modified case definition) and who completed a case report form. Samples were cultured and analyzed using standard real-time reverse transcriptase PCR (rt-RT-PCR) methodology and sequenced genetic material was phylogenetically compared to other published strains. Results rt-RT-PCR and DNA sequencing revealed that 25 (78%) of the 32 clinical samples collected were seasonal H3N2 and only 2 (6%) were A(H1N1)pdm09 influenza. The highest incidence of H3N2 occurred during the month of May and 80% of these were active duty military personnel. Phylogenetic analysis revealed that sequenced H3N2 strains were genetically similar to 2009 strains from the United States of America, Australia, and South east Asia. Conclusions This outbreak highlights challenges in the investigation of influenza among deployed military populations and corroborates the public health importance of maintaining surveillance systems for ILI that can be enhanced locally when needed.
The Biology of Nearctic Lepidoptera—Part I: Foodplants and Life-Histories of Colorado Papilionoidea
Charles L. Remington
Psyche , 1952, DOI: 10.1155/1952/61092
The Biology of Nearctic Lepidoptera—Part II: Foodplant and Pupa of Hemiargus Isolus
Charles L. Remington
Psyche , 1952, DOI: 10.1155/1952/81347
Inter-causal Independence and Heterogeneous Factorization
Nevin Lianwen Zhang,David L Poole
Computer Science , 2013,
Abstract: It is well known that conditional independence can be used to factorize a joint probability into a multiplication of conditional probabilities. This paper proposes a constructive definition of inter-causal independence, which can be used to further factorize a conditional probability. An inference algorithm is developed, which makes use of both conditional independence and inter-causal independence to reduce inference complexity in Bayesian networks.
Sidestepping the Triangulation Problem in Bayesian Net Computations
Nevin Lianwen Zhang,David L. Poole
Computer Science , 2013,
Abstract: This paper presents a new approach for computing posterior probabilities in Bayesian nets, which sidesteps the triangulation problem. The current state of art is the clique tree propagation approach. When the underlying graph of a Bayesian net is triangulated, this approach arranges its cliques into a tree and computes posterior probabilities by appropriately passing around messages in that tree. The computation in each clique is simply direct marginalization. When the underlying graph is not triangulated, one has to first triangulated it by adding edges. Referred to as the triangulation problem, the problem of finding an optimal or even a ?good? triangulation proves to be difficult. In this paper, we propose to first decompose a Bayesian net into smaller components by making use of Tarjan's algorithm for decomposing an undirected graph at all its minimal complete separators. Then, the components are arranged into a tree and posterior probabilities are computed by appropriately passing around messages in that tree. The computation in each component is carried out by repeating the whole procedure from the beginning. Thus the triangulation problem is sidestepped.
Latent Tree Models and Approximate Inference in Bayesian Networks
Yi Wang,Nevin L. Zhang,Tao Chen
Computer Science , 2014, DOI: 10.1613/jair.2530
Abstract: We propose a novel method for approximate inference in Bayesian networks (BNs). The idea is to sample data from a BN, learn a latent tree model (LTM) from the data offline, and when online, make inference with the LTM instead of the original BN. Because LTMs are tree-structured, inference takes linear time. In the meantime, they can represent complex relationship among leaf nodes and hence the approximation accuracy is often good. Empirical evidence shows that our method can achieve good approximation accuracy at low online computational cost.
CMS Detector Sensitivity for the Discovery of Supersymmetry with Two Same-sign Leptons, Jets and MET
Ronald Remington
Physics , 2009, DOI: 10.1063/1.3327579
Abstract: There is strong theoretical motivation for the study of events with 2 same-sign leptons, jets, and missing transverse energy (MET) at the Large Hadron Collider (LHC). There are many compelling models, for instance, supersymmetry and extra dimensions, which predict such signatures. On the other hand, same-sign lepton production is very suppressed in the Standard Model. Preparations are underway for this search using the Compact Muon Solenoid (CMS) experiment, which will take data at the LHC, scheduled to start running in 2009. The CMS detector has very good measurement capabilities for muons, electrons, jets and MET, and methods are being developed to perform sensitive searches using the first collected data. Using results from a previous Monte Carlo study based on this signature at a center-of-mass energy of 14 TeV, we make discovery potential projections for the early 10 TeV LHC runs. While the results of these extrapolations are encouraging, they are based purely on Monte Carlo and, as such, should be considered only as a rough guide. Data-driven background estimations will be critical for the success of this analysis and are under development.
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