Probabilities Of Recovery Research Articles

Rare Events Analysis for High-Frequency Equity Data

In this work we present a methodology to detect rare events which are defined as large price movements relative to the volume traded. We analyze the behavior of equity after the detection of these rare events. We provide methods to calibrate trading rules based on the detection of these events and illustrate for a particular trading rule. We apply the methodology to tick data for thousands of equities over a period of five days. In order to draw comprehensive conclusions, we group the equities into classes and calculate probabilities of price recovery after these rare events for each class. The methodology that we have developed is based on non-parametric statistics and makes no assumption about the distribution of the random variables in the study. Copyright © 2011 Wilmott Magazine Ltd.

Will depleted populations of Pacific salmon recover under persistent reductions in survival and catastrophic mortality events?

Abstract Holt, C. A. 2010. Will depleted populations of Pacific salmon recover under persistent reductions in survival and catastrophic mortality events? – ICES Journal of Marine Science, 67: 2018–2026. Under Canada's Wild Salmon Policy, benchmarks between zones of biological status are required to distinguish populations requiring conservation attention (Red and Amber zones) from those that can be managed for production (Green zone). The recovery of depleted populations (i.e. from Red to Green) will depend in part on the choice of the lower benchmark. At a minimum, that benchmark should be set high enough to allow recovery within an acceptable time-frame in the absence of targeted fishing. Currently, benchmarks are evaluated and selected using simulation models that assess the probability of recovery to spawner abundance associated with the maximum sustainable yield within a specified time-frame. Guided by case examples, the evaluation is extended to include two scenarios of future conditions: persistent reductions in survival rates below the replacement level; and increased frequency of catastrophic mortality (die-off) events. Probabilities of recovery appear to be more sensitive to persistent reductions in survival than to increased probability of die-off events. The current lower benchmarks on spawner abundance and fishing mortality might not be sufficiently precautionary to allow recovery under those conditions.

Demographic Parameters of Rural and Urban Adult Resident Canada Geese in Georgia

ABSTRACT In many urban metropolitan areas, resident Canada goose (Branta canadensis) populations have grown to nuisance levels in spite of increasing harvest opportunity. To document differences in demographic parameters between urban and rural geese, I estimated probabilities of survival, recapture, recovery, and fidelity for adult resident Canada geese between 2001 and 2006 using banding, live recapture, and dead recovery data from 2 distinct banding locations in Georgia, USA. Adult survival rates were higher for urban geese (0.958, SE = 0.020) than for rural geese (0.682, SE = 0.049). Using estimated recovery probabilities of 0.505 (SE = 0.107) for urban and 0.463 (SE = 0.045) for rural geese, along with current estimates of crippling loss and reporting rate, the estimated mean harvest rate for urban geese was 0.029 (SE = 0.006) and for rural geese was 0.202 (SE = 0.020). Fidelity rates were similar between urban (0.730, SE = 0.033) and rural geese (0.713, SE = 0.069). This information suggests that urban segments of the Canada goose population have substantially higher survival than rural geese and are harvested at a very low rate, and that liberalizing hunting regulations may have little impact on Georgia's urban goose population. Wildlife managers may need to consider options other than sport hunting to control nuisance goose populations in urban areas.

Recovery Potential Assessment for Lake Sturgeon in Canadian Designatable Units

AbstractSignificant declines in the abundance of lake sturgeon Acipenser fulvescens across most of its North American range have led to abundances less than 10% of estimated minimum sustainable population sizes and, in some locations, less than 1% of historic abundances. These precipitous declines in abundance have resulted in most lake sturgeon populations being considered a conservation concern and have prompted management actions toward recovery. Here we present modeling in support of a recovery potential assessment, using stage‐structured matrix models and population viability analysis to quantitatively assess allowable harm, recovery efforts, probabilities of recovery, and recovery time frames. From this assessment, we conclude that lake sturgeon populations are most sensitive to harm on adult survival and that some designatable units are highly sensitive to any level of harm. However, the scope for recovering lake sturgeon by improving adult survival is limited; instead, larger proportional increases in population growth rates can be achieved by focusing recovery efforts on age‐0 and juvenile survival. Finally, based on a recovery target of 1,188 spawning females/year for each discrete population and current abundances from 1% to 10% of this target, long‐term projections indicate recovery time frames ranging from 20 to over 100 years, depending on the recovery actions implemented.

Enumeration of protozoan ciliates in activated sludge: Determination of replicate number using probability

A new approach to the enumeration of ciliate protozoa in activated sludge is described. A 25 μL sub-sample volume is optimal for routine analysis using a standard slide and 24 × 24 mm cover slip requiring between 20 and 40 min per sub-sample for full enumeration and identification of species. However, to achieve high probability (≥95%) of recovering all species large numbers of replicates are required (i.e. 23–47). To achieve high probabilities of recovery using less replicates it is necessary to neglect rare species with low densities (<0.5%); based on the assumption that they do not play a significant role in plant performance. The precise number of replicates required for different probabilities of recovering species is determined by conducting an initial pilot survey analysing a minimum of 8 replicates and using a probability equation to determine the optimum replicate number for that particular plant. Six replicate 25 μL sub-samples provided excellent species recovery (90–95% excluding up to 3 rare species), while analysing just two or three replicates, as commonly used in previous wastewater studies, only gave probabilities of 25 and 50% respectively for the same recovery. Ciliate analysis should be completed within 8 h of collection with significant changes in community structure occurring beyond this period.

Donor-Recipient Matching at the HLA-C Locus and Early Outcomes after Unrelated Umbilical Cord Blood Transplant (UCBT)

Previous studies indicate unrelated donor bone marrow transplantation mismatched at HLA-C locus (antigen-level but not allele-level) result in higher acute graft-versus-host disease (GVHD) and mortality. Hematopoietic recovery is not affected by mismatching at this locus. The current selection of cord blood units is based on antigen-level HLA typing at HLA A and B and allele-level at DRB1. The relative importance of matching at HLA-C has not yet been described for unrelated UCBT. To address this question we analyzed hematopoietic recovery, acute GVHD and mortality in 619 UCBT recipients who received a single cord blood (CB) unit, a myeloablative preparative regimen and a calcinuerin inhibitor for GVHD prophylaxis. Eighty-three percent of patients received UCBT for leukemia or lymphoma and 17% for immunologic, metabolic or histiocytic diseases. Seventy percent of patients were ≤16 years of age at transplantation. HLA typing (using molecular methods) was performed for 96% (n=593) of donor-recipient pairs. Method of typing is not available for the remaining 4% (n=26). For all analysis, donor-recipient HLA matching was evaluated at the antigen-level (first 2 of 4 digits) for HLA-A, B, C and allele-level (4 digits) for DRB1. The median infused cell dose was 4 × 107/kg and median follow-up, 2 years. We first examined the effect of donor-recipient HLA matching and cell dose on hematopoietic recovery and mortality considering the current standard for selection of cord blood units. Fifteen percent (n=94) were matched at HLA A, B and DRB1, with 43% (n=265) mismatched at 1-locus and 42% (n=260) mismatched at 2-loci. As reported previously, compared to matched UCBT, neutrophil recovery at day-42 was lower after UCBT mismatched at 1-locus (RR 0.48, p=0.042) and 2-loci (RR 0.38, p=0.007). After adjusting for infused cell dose, year of transplant and disease status, platelet recovery and 1-year mortality rates were not different after matched and mismatched UCBT. We then examined whether the addition of another mismatch at the C locus impacted outcomes. The Table below shows the probabilities of hematopoietic recovery, acute GVHD and survival considering matching at the C-locus in addition to the standard criteria used for CB unit selection. The comparison groups for each of the categories below are patients who received UCBT matched at the C locus for the respective category. In conclusion, the data shown suggest HLA-C does not affect hematopoietic recovery, acute GVHD and 1-year overall survival after UCBT. However, definitive conclusions can only be achieved in a larger series. In the mean time, cord blood unit selection need not consider matching at the C-locus.OutcomesProbabilityp-valueNeutrophil recovery at day-42Matched at A, B, DRB1 + mismatch at C (n=22) vs. matched at C (n=72)82% vs. 93%0.241-locus mismatch at A, B, DRB1 + mismatch at C (n=162) vs. matched at C (n=103)81% vs. 85%0.342-loci mismatch at A, B, DRB1 + mismatch at C (n=217) vs. matched at C (n=43)77% vs. 77%0.98Platelet recovery at day-100Matched at A, B, DRB1 + mismatch at C (n=22) vs. matched at C (n=72)72% vs. 68%0.681-locus mismatch at A, B, DRB1 + mismatch at C (n=162) vs. matched at C (n=103)61% vs. 66%0.352-loci mismatch at A, B, DRB1 + mismatch at C (n=217) vs. matched at C (n=43)54% vs. 58%0.59Acute grade 2–4 GVHD at day-100Matched at A, B, DRB1 + mismatch at C (n=21) vs. matched at C (n=71)32% vs. 40%0.481-locus mismatch at A, B, DRB1 + mismatch at C (n=162) vs. matched at C (n=101)36% vs. 42%0.392-loci mismatch at A, B, DRB1 + mismatch at C (n=213) vs. matched at C (n=43)35% vs. 40%0.61Overall survival at 1-yearMatched at A, B, DRB1 + mismatch at C (n=22) vs. matched at C (n=72)55% vs. 59%0.741-locus mismatch at A, B, DRB1 + mismatch at C (n=162) vs. matched at C (n=103)57% vs. 59%0.742-loci mismatch at A, B, DRB1 + mismatch at C (n=217) vs. matched at C (n=43)52% vs. 53%0.89

Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study

Objective:The authors sought to observe the long-term clinical course of anxiety disorders over 12 years and to examine the influence of comorbid psychiatric disorders on recovery from or recurrence of panic disorder, generalized anxiety disorder, and social phobia. Method: Data were drawn from the Harvard/Brown Anxiety Disorders Research Program, a prospective, naturalistic, longitudinal, multicenter study of adults with a current or past history of anxiety disorders. Probabilities of recovery and recurrence were calculated by using standard survival analysis methods. Proportional hazards regression analyses with timevarying covariates were conducted to determine risk ratios for possible comorbid psychiatric predictors of recovery and recurrence. Results: Survival analyses revealed an overall chronic course for the majority of the anxiety disorders. Social phobia had the smallest probability of recovery after 12 years of follow-up. Moreover, patients who had prospectively observed recovery from their int...

Temporal Patterns of Recovery Across Eating Disorder Subtypes

To compare patterns of recovery in individuals with index episodes of anorexia nervosa (AN) and bulimia nervosa (BN). Using Kaplan-Meier methods and Cox proportional hazards models, comparisons were conducted that were conditional on duration of eating disorder from onset and included a conservative recovery criterion of 3 asymptomatic years. Data collection was retrospective and from two of the international Price Foundation genetic studies on 901 individuals with eating disorders. Using Kaplan-Meier methods, 11% of those with index AN and 10% of those with index BN met recovery criteria at 10 years. At 15 years, 16% of those with index AN and 25% of those with index BN met recovery criteria. In a Cox proportional hazards model the index BN group had three times the rate of recovery at 10-14 years (p=0.01) than the index AN group. Initially the probability of recovery was greater for those with index AN, but as the duration of the eating disorder lengthened those with BN had higher probabilities of recovery. Replication of these results with prospective data using similarly stringent recovery criteria and methods is required to confirm trends.

Recovery from Eating Disorders

The article by Von Holle et al. in this issue is one of a series of reports emerging from a large and impressive group of investigators assembled to collect information on the genetics of eating disorders [1]. Having rigorously obtained an extensive array of information from a large number of probands and family members, the investigators are appropriately mining the data in numerous ways. In this paper they turn their attention to temporal patterns of recovery among 901 women with anorexia nervosa and bulimia nervosa. The retrospective data were collected from subjects at the time of their assessment and entry into the genetics studies. The investigators report what appears to be, at first blush, a remarkably low rate of improvement: fewer than 20% of participants reported recovery at the time of assessment. However, this observation must be interpreted in light of the study’s definitions and methods. The investigators chose to rate as recovered only those individuals who denied being below normal weight, as well as reporting no behavioural symptoms suggestive of an eating disorder, for a full 3 years. While the investigators’ rationale for this very conservative criterion is solid, it obviously reduced the fraction of subjects who had recovered. For example, because the average time between reported onset of the disorder and the assessment was 12 years, individuals, on average, had to begin their full recovery no more than 9 years after onset. Other studies of recovery from eating disorders have generally utilized less stringent criteria, making comparisons across studies difficult. In addition, as noted by the authors, most reports of recovery are derived from clinical populations, and examine time to recovery from entry into treatment. In the current report, duration is measured from the time of reported onset. Furthermore, individuals were recruited expressly to participate in a genetics study, and were at various stages of illness and recovery at the time of their assessment. Conceivably, individuals with more chronic courses may have been more motivated to participate. In any case, it is very difficult to apply these estimates of time to recovery to patients presenting for treatment. As the authors emphasize, both the conduct of their study and the interpretation of their results are limited by the lack of a consensus in the eating disorders field on precisely what constitutes recovery. Unfortunately, this is not a newly recognized problem, nor is it confined to eating disorders [2]. Because of the multifaceted nature of psychiatric disorders, and the paucity of objective, easily obtained markers of illness, it has proven difficult for consensus to form around definitions of relapse, recovery and remission. In the eating disorders field, the wide range of definitions limits the ability to pool data across studies, much less to have confidence about comparisons between studies. However, within the Von Holle et al. study the interpretation of different temporal patterns of recovery between eating disorders is more straightforward and of interest. In the early years after onset, the odds of recovering from anorexia nervosa were greater than those of recovering from bulimia nervosa but, over time, the probabilities of recovery shifted to favour bulimia nervosa. This pattern is consistent with the results of other types of studies, such as those based on follow up of clinical samples, and echo the anecdotal reports of many clinicians. These varied sources of information suggest that an adolescent B. Timothy Walsh, Professor of Psychiatry, College of Physicians & Surgeons, Columbia University, Director, Division of Clinical Therapeutics, New York State Psychiatric Institute

Risk Factors for Graft Failure and Mortality after HLA-Matched Sibling Donor Transplant for Severe Aplastic Anemia in Brazil.

Higher rates of graft failure observed after conventional cyclophosphamide (Cy) at 200mg/kg and HLA-matched sibling bone marrow transplant (BMT) for severe aplastic anemia (SAA) in South America prompted the use of a different conditioning regimen: busulfan (Bu) at 12 mg/kg plus Cy at 120 mg/kg. This change was instituted to provide greater immunosuppression for heavily transfused patients (>15 blood transfusion units pre-BMT). We report transplant outcomes in 269 SAA patients who received their HLA-matched BMT at a single center in Brazil between 1990 and 2003. Median age at transplant was 19 years (range 2 – 45). Median time from diagnosis to transplant was 3 months; 78% were transplanted ≤ 6 months from diagnosis, 11%, 7–24 months and 11% > 24 months. 128 patients received Cy alone, 2, Cy plus anti-thymocyte globulin and 139, Bu plus Cy. Eighty-one patients (62%) who received Cy conditioning also received ≤15 blood transfusion units and 49 (38%) received >15 blood transfusion units pre- BMT; all patients who received Bu plus Cy conditioning received >15 blood transfusion units. All patients received T-cell replete bone marrow grafts and almost all patients received cyclosporine and short course methotrexate for graft-versus-host disease prophylaxis. Median follow-up of surviving patients after Cy is 9 years and after Bu plus Cy, 6 years. This reflects the change in practice after 1994, when Bu plus Cy was favored for patients who received >15 blood transfusion units pre-BMT. Most patients achieved neutrophil recovery; the day-60 probabilities of recovery were 95% and 86% after Cy conditioning (≤15 and >15 blood transfusion units, respectively) and 92% after Bu plus Cy. Corresponding day-100 probabilities of platelet recovery were 95%, 86% and 87%. Thirty-nine patients subsequently lost their graft; failure rates were similar after Bu plus Cy and Cy conditioning in patients who received ≤15 blood transfusion units (13% vs. 17%; RR 0.97, p=0.924). Though failure rates were higher (10 of 42, 24%) after Cy conditioning in patients who received >15 blood transfusion units this did not attain statistical significance when compared to those who received Bu plus Cy (16 of 128, 13%, p=0.077). This may be explained by limited numbers of patients in the heavily transfused Cy group. Younger age (≤10 years) was the only factor that was associated with higher rates of secondary graft failure (RR 2.91, p=0.001). As expected, the 8-year probability of overall survival was highest (87%) after Cy conditioning in patients who received ≤15 blood transfusion units. Mortality rates were higher after Bu plus Cy conditioning (RR 3.18, p<0.001) and Cy conditioning in patients who received > 15 blood transfusion units (RR 4.66, p<0.001). The corresponding 8-year probabilities of overall survival were 67% and 51% (p=0.059). The data suggest secondary graft failure rates are similar after Bu plus Cy conditioning in patients who received >15 blood transfusion units compared to those who received Cy conditioning and fewer transfusions. Though survival rates are generally lower in patients who receive >15 blood transfusion units, the use of Bu plus Cy appears to confer a survival advantage. Patients with SAA should be referred for transplantation as soon as the diagnosis is confirmed to avoid excess blood transfusion pre-BMT.

Risk Factors and Outcome after Second HLA-Matched Sibling Donor Transplantation for Graft Failure after a First HLA-Matched Sibling Transplant in Severe Aplastic Anemia.

Graft failure rates after HLA matched sibling bone marrow (BM) transplants for severe aplastic anemia (SAA) are about 10%. We analyzed factors that may affect rates of hematopoietic recovery, graft-versus-host (GVHD) and overall survival after a second HLA-matched sibling donor transplant in 166 patients with SAA with graft failure after a first HLA-matched sibling donor transplant. Transplantations occurred between 1986 and 2004; median follow up of surviving patients is 8 years. One hundred and forty patients (84%) received their second transplant for secondary graft failure and 26 (16%), for primary graft failure. The median age at second transplantation was 17 years; 90% of patients were younger than 30 years. Sixty-seven percent had performance scores <90%. All patients received T-replete BM grafts for their first transplant; 16% received peripheral blood progenitor cells and 84% BM for their second transplant. Most (88%) second transplants used the original donor. Median time between first and second transplants was 7 months (range 1 – 114). Seventy-four percent received cyclophosphamide (CY) with or without anti-thymocyte globulin (ATG) conditioning for their first transplant. Forty-nine percent received this regimen for second transplant, 19% received CY and limited field irradiation, 10%, busulfan and CY, 11% melphalan and ATG, 4% other combinations of CY and 7% did not receive a second conditioning regimen. For both transplants, most patients (>95%) received GVHD prophylaxis regimen that included a calcineurin-inhibitor. Probabilities of neutrophil recovery at day 28 and platelet recovery at day 60 after second transplantation were 63% and, 62%. Rates of acute grades 2–4 GVHD at day 100 and chronic GVHD at 5 years were 9% and 16%, respectively. Early mortality rates were high, 30% at day-100. Risks of early mortality were lower when pre-transplant performance scores were 90–100% (relative risk [RR] 0.17, 95% CI 0.06–0.47, p=0.001) and when second transplant occurred >3 months from first transplant (RR 0.32, 95% CI 0.15–0.68, p=0.003). Similarly, risks of overall mortality were lower in patients with performance scores 90 – 100% (RR 0.53, 95% CI 0.30–0.95, p=0.033) and when second transplant occurred >3 months from first transplant (RR 0.47, 95% CI 0.29–0.76, p=0.002). Of the 47 patients who received their second transplant ≤ 3 months after their first transplant, 22 had primary graft failure after their first transplant and 25, early secondary graft failure. Fifteen of these 47 patients failed to achieve neutrophil recovery after their second transplant; 12 of 15 had primary graft failure after first transplant. Other factors such as use of a different donor, conditioning regimen, graft type and growth factor administration did not affect outcome after second transplantation. The 5-year probabilities of overall survival in patients with performance scores 90–100% whose second transplants occurred ≤ 3 months and >3 months after their first transplant were 56% and 76%, respectively. Corresponding rates for patients with performance scores <90 were 33% and 61%. We conclude that salvage with second transplantation after primary or early secondary graft failure is suboptimal. Better therapies are required to ensure sustained hematopoietic recovery in these patients.

Rapid Transport and Infusion of Hematopoietic Stem Cells Can Improve Outcome after Unrelated Donor Transplant.

The site of collection of bone marrow (BM) or peripheral blood (PB) grafts for unrelated donor (URD) transplantation depend on the geographic location of the donor and is therefore subject to variations in transport time to transplant centers (TC). We evaluated the impact of transport and other graft characteristics that might influence outcome after transplantation. Transport factors examined include: number of collections, time from end of collection to receipt at TC, manipulation of the graft at TC and time from receipt at TC to infusion. All patients received T-replete grafts, myeloablative conditioning regimens and calcinuerin-inhibitor graft-versus-host disease prophylaxis. Collections were facilitated by the NMDP in 2000–2004 for patients with acute and chronic leukemia in 1st or 2nd remission and myelodysplastic syndrome (refractory anemia); approximately 60% of patients were in 1st remission. Median ages at transplant were 27 years for BM and 35 years for PB recipients. 115 centers collected 938 BM grafts and 80 centers, 507 PB grafts; >90% of collections occurred in the U.S. All BM grafts involved a single collection; 58% of PB grafts involved two collections. 93% of BM grafts were transported at room temperature; 98% of PB grafts were transported in a refrigerated gel-pack. Median time from collection of BM grafts to receipt at TC was 9.3 (range 0.5–46.7) hours and from receipt at TC to infusion was 3.2 (0.1–45.2) hours. Corresponding times for PB grafts were 10.4 (0.5–45.3) and 2.8 (0.1–39.1) hours. Sixty percent of BM and 19% of PB grafts were manipulated (for ABO incompatibility, plasma removal or volume reduction) at TC prior to infusion. Most patients achieved neutrophil recovery by day-28 after BM (93%) and PB (96%) transplants. No transport factors were associated with likelihood of day-28 neutrophil recovery. However, neutrophil recovery by day-28 was more likely when total nucleated cell dose of BM graft at shipping was >5 × 108/kg (odds ratio [OR] 2.74, p=0.013). A cell dose effect was not seen with PB but only 17% of PB grafts contained ≤5 × 108/kg mononuclear cells. Platelet recovery after transplantation of BM and PB grafts appeared to be influenced by time from receipt of graft at TC to infusion; infusion >6 hours after receipt was associated with a lower probability of platelet recovery (OR 0.67, p=0.021 and OR=0.58, p=0.029, respectively). The 60-day probabilities of platelet recovery when BM and PB grafts were infused ≤6 hours were 76% and 84%, respectively. Corresponding probabilities when infusion occurred >6 hours were 67% and 76%. Twenty four percent of BM and 27% of PB grafts were infused >6 hours after receipt at TC. Manipulation of the graft accounted for the delay in infusion for 167 of 228 (73%) of BM and 35 of 135 (26%) of PB transplants. Secondary graft failure rates were 9% after BM and 7% after PB transplants; a third of failures were associated with recurrent leukemia. After adjusting for other significant factors, overall mortality rates were higher when PB grafts involved 2 collections (relative risk [RR] 1.35, p=0.014) and for BM grafts, when interval from end of collection to receipt at TC was >20 hours (RR, 1.47, p=0.023). Therefore, outcomes after URD transplants for hematologic malignancies may be improved by shortening transport time for BM grafts and minimizing lag time between receipt at TC and infusion, regardless of graft type.

Twelve-Month Outcome of Adolescents With Bipolar Disorder Following First Hospitalization for a Manic or Mixed Episode

Objective: Although adolescent-onset bipolar disorder is associated with significant morbidity, there have been few prospective outcome studies of this population. The aim of this study was to examine the 12-month outcome of bipolar adolescents following an initial hospitalization for a manic or mixed episode. Method: Bipolar adolescents (N=71) were recruited during their first hospitalization for a manic or mixed episode and were evaluated using diagnostic, symptomatic, and functional assessments. Patients were also evaluated at 1, 4, 8, and 12 months after hospitalization to assess syndromic, symptomatic, and functional outcomes. Predictors of each type of outcome were identified. Results: Kaplan-Meier estimates of the cumulative probabilities of syndromal, symptomatic, and functional recovery and syndromic recurrence during the first 12 months following initial hospitalization were 0.86, 0.43, 0.41, and 0.54, respectively. Only 35% of bipolar adolescents reported full medication adherence. Individual predictors of poor syndromic recovery included co-occurring attention deficit hyperactivity disorder (ADHD), anxiety disorders, and disruptive behavior disorders as well as nonadherence to psychotropic medication and lower socioeconomic levels. Co-occurring alcohol use disorders, treatment with antidepressants, and the absence of psychotherapeutic intervention predicted syndromic recurrence. Boys were more than twice as likely as girls to experience symptomatic recovery. Conclusions: Most bipolar adolescents experienced syndromic recovery following their first hospitalization. However, rates of symptomatic and functional recoveries were much lower. Future studies examining effective pharmacological and nonpharmacological treatment strategies for bipolar youth with co-occurring disorders and investigating factors that contribute to the development of substance use disorders and treatment adherence in bipolar youth are necessary to improve outcome.

Twelve-Month Outcome of Adolescents With Bipolar Disorder Following First Hospitalization for a Manic or Mixed Episode

Although adolescent-onset bipolar disorder is associated with significant morbidity, there have been few prospective outcome studies of this population. The aim of this study was to examine the 12-month outcome of bipolar adolescents following an initial hospitalization for a manic or mixed episode. Bipolar adolescents (N=71) were recruited during their first hospitalization for a manic or mixed episode and were evaluated using diagnostic, symptomatic, and functional assessments. Patients were also evaluated at 1, 4, 8, and 12 months after hospitalization to assess syndromic, symptomatic, and functional outcomes. Predictors of each type of outcome were identified. Kaplan-Meier estimates of the cumulative probabilities of syndromal, symptomatic, and functional recovery and syndromic recurrence during the first 12 months following initial hospitalization were 0.86, 0.43, 0.41, and 0.54, respectively. Only 35% of bipolar adolescents reported full medication adherence. Individual predictors of poor syndromic recovery included co-occurring attention deficit hyperactivity disorder (ADHD), anxiety disorders, and disruptive behavior disorders as well as nonadherence to psychotropic medication and lower socioeconomic levels. Co-occurring alcohol use disorders, treatment with antidepressants, and the absence of psychotherapeutic intervention predicted syndromic recurrence. Boys were more than twice as likely as girls to experience symptomatic recovery. Most bipolar adolescents experienced syndromic recovery following their first hospitalization. However, rates of symptomatic and functional recoveries were much lower. Future studies examining effective pharmacological and nonpharmacological treatment strategies for bipolar youth with co-occurring disorders and investigating factors that contribute to the development of substance use disorders and treatment adherence in bipolar youth are necessary to improve outcome.

Loss‐given‐default on farm real estate loans: probability of full recovery

The non‐depreciability characteristic of farmland value implies that farm delinquencies and default may not necessarily lead to loan loss. Considering this, a model under the framework of Value‐at‐Risk is developed to estimate probabilities of debt coverage by farmland that is mortgaged to secure a loan. Loss‐given‐default (LGD) under collateral risk is conceptualized and empirical estimation of land values considering time pattern and uncertainty is proposed. Given different economic situations, the probabilities of full recovery of loan balances under both loan‐level and portfolio specifications are estimated using USDA data from selected states and regions. Results indicate that farmland pledged as collateral is expected to cover the loan balance with relatively high probability.

Improving Patient Selection for Clinical Acute Stroke Trials

Objective: To optimize patient inclusion criteria for clinical acute stroke trials. Methods: We stratified probabilities of death and complete recovery based on two validated prognostic models using age and the National Institutes of Health Stroke Scale (NIH-SS) at admission. In an independent data set of 1,725 consecutively admitted patients with acute ischemic stroke, computer simulation with various inclusion thresholds was used to calculate the number and percentage of potential treatment responders, i.e. who had not died or spontaneously recovered. Results: Using defined thresholds for recovery and mortality, inclusion and exclusion criteria could be designed to considerably decrease both trial time and study size compared to a fixed inclusion criterion based on the NIH-SS alone. Other thresholds may allow optimization of either trial time or study size. Conclusions: The resulting models provide a validated approach for an efficient study inclusion of potential treatment responders based on the Barthel Index 100 days after ischemic stroke. These techniques provide the opportunity for improved stroke trials in terms of enrollment speed, treatment effect size or both.

Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study

The authors sought to observe the long-term clinical course of anxiety disorders over 12 years and to examine the influence of comorbid psychiatric disorders on recovery from or recurrence of panic disorder, generalized anxiety disorder, and social phobia. Data were drawn from the Harvard/Brown Anxiety Disorders Research Program, a prospective, naturalistic, longitudinal, multicenter study of adults with a current or past history of anxiety disorders. Probabilities of recovery and recurrence were calculated by using standard survival analysis methods. Proportional hazards regression analyses with time-varying covariates were conducted to determine risk ratios for possible comorbid psychiatric predictors of recovery and recurrence. Survival analyses revealed an overall chronic course for the majority of the anxiety disorders. Social phobia had the smallest probability of recovery after 12 years of follow-up. Moreover, patients who had prospectively observed recovery from their intake anxiety disorder had a high probability of recurrence over the follow-up period. The overall clinical course was worsened by several comorbid psychiatric conditions, including major depression and alcohol and other substance use disorders, and by comorbidity of generalized anxiety disorder and panic disorder with agoraphobia. These data depict the anxiety disorders as insidious, with a chronic clinical course, low rates of recovery, and relatively high probabilities of recurrence. The presence of particular comorbid psychiatric disorders significantly lowered the likelihood of recovery from anxiety disorders and increased the likelihood of their recurrence. The findings add to the understanding of the nosology and treatment of these disorders.

More Phoenix Than Vulture: The Case For Distressed Investor Presence in the Bankruptcy Reorginization Process

Firms in Chapter 11 bankruptcy are presumed to have going-concern value, with operational efficiencies, even though they are usually technically insolvent. A primary objective of Chapter 11 bankruptcy proceedings, therefore, is to protect such going-concern value from the potentially inefficient and destructive behavior of competing and self-motivated creditors. Commentators have often described the challenges of Chapter 11 proceedings as the “residual actor problem.” When the firm is solvent, shareholders, as the residual owners, know that their wealth, often reflected by a publicly traded stock value, is closely tied to firm value, and hence to the success of managerial decision-making. Consequently, it is in shareholders’ interests to champion strategies for long-run profit maximization. By contrast, when the firm is insolvent and in Chapter 11, shareholders’ claims are, by definition, negligible, and creditors cannot be relied upon to maximize an insolvent firm’s value. Senior creditor classes, whose debt may be fully secured or “above water,” will presumably favor risk-averse strategies that maximize the probability of recovering the full value of their loans. Junior creditors, who face low probabilities of appreciable recovery, will prefer high-risk strategies because there is little to lose and potentially something to gain by “swinging for the fences.” The unfortunate result in many bankruptcies is discord between two groups of potential decision makers: overly risk-averse creditors holding claims that are close to or are “above water,” and overly risk-tolerant creditors with claims that are far “below water.” The dynamic is “a basic form of the prisoner’s dilemma: the aggregation of individualistic, albeit rational, decisions leading to an inferior collective result.” An appropriate goal for Chapter 11 proceedings, therefore, is the effective provision of a collective forum for the re-creation of an efficient residual claimant class by creating a new “above-water” equity actor whose self-interest is aligned with the long-run value maximization of the firm. This study examines how the increased presence of distressed-debt investors in bankruptcy proceedings has greatly affected the residual actor problem. The thesis of this paper is that distressed-debt investors generally have a salutary impact on the residual actor problem of bankruptcy by expediting business reorganizations and protecting going-concern enterprise values.

Influence of Body Size and Condition on Harvest and Survival of Juvenile Canada Geese

Direct recoveries for Canada goose (Branta canadensis interior) goslings from the portion of the Southern James Bay Population (SJBP) on Akimiski Island, Nunavut, Canada, have declined markedly since 1987. We suspected that poor gosling nutrition, due to limited food resources on brood-rearing areas, was causing low survival. Consequently, we measured body size and condition of 2,893 unfledged goslings during late July and early August, 1994-1996. Based on 128 recoveries of dead birds during hunting seasons and 69 recaptures during summer on Akimiski Island, we estimated the separate influences of gosling size and condition on subsequent probabilities of recovery by hunters and survival. Estimated survival probabilities were 0.025, 0.051, and 0.147, and reporting probabilities were 0.0026, 0.0051, and 0.0142 for 1994-1996, respectively. Annual variation in both probabilities was related to size and condition of goslings, which were largest and in the best condition in 1996, followed by 1995, and then 1994. Estimates of slopes suggested that relatively small increases in both body size and condition resulted in increased survival and reporting probabilities. Unlike previous waterfowl research, our results showed that the largest goslings, and those in the best condition, were the most likely to be shot. We suggest that goslings in poor condition died on Akimiski Island before they fledged. We conclude that food availability was limiting recruitment, and predict that harvest restrictions on SJBP Canada geese will not result in an increase in the segment of the population that nests on Akimiski Island.

Band Recovery and Recapture Rates of American Black Ducks and Mallards

Data from band recoveries and recapture rates are essential for testing influences on key demographic parameters of avian populations. I used recaptures and recoveries of leg-banded birds to test the influence of condition on the probability of survival and to compare site fidelity of American black ducks (Anal rubripes) and mallards (A. platyrhynchos) to the wetlands of southwestern Lake Erie. I live-trapped and banded 996 black ducks and 1,168 mallards from October through January during 3 annual staging periods (1990-1993) on Ottawa National Wildlife Refuge (NWR) in Ohio, USA. Ducks were aged, sexed, and weighed; total body length, wing chord, culmen, and tarsus also were measured to compute condition indices. I used multiple-logistic regression models to test influences of condition, date of initial capture, and species on the probabilities of recapture and band recovery for each age-sex class, Black ducks were more likely to be recaptured than mallards in all age-sex classes within a season and during subsequent seasons. Body condition had a positive influence on recaptures during subsequent field seasons for adults. Analyses of within-season band recovery for adult males of both species indicated that birds with lower condition were more likely to be harvested. The opposite relationships between condition and the probability of recapture and direct recovery support the contention that poor body condition increased vulnerability to hunting for adult males.