Miracle-dz/UniFAR-FTUs huggingface dataset:
G49 Resilience, Post-Traumatic Stress, Burnout and Coping in Medical Staff on the Paediatric and Neonatal Intensive Care Unit (P/NICU) – A Survey

Aims Working on intensive care (ICU) can be stressful, Adult-ICU studies demonstrate staff burnout and post-traumatic stress disorder, (PTSD) although resilience is associated with a healthier psychological state in ICU nurses. This study aims to determine whether resilience is related to the prevalence of burnout and PTSD symptoms in PICU/NICU staff, and to establish any differences in coping strategies with varying levels of resilience. Methods Workplace questionnaire: demographic data, questions on coping strategies and extracts: (1) Brief Resilience Scale 6 items scored on a 5-point scale, higher scores indicate greater resilience) (2) Trauma Screening Questionnaire 10 statements answered ‘yes’ or ‘no’. Score of > 6 predicts PTSD (3) abbreviated Maslach Burnout Inventory – 3 separate subscales: Emotional Exhaustion (EE) = reduced energy and job enthusiasm, Depersonalization (DP) = cynicism, treatment of patients as inanimate, Personal Accomplishment (PA) = Sense of efficacy and effectiveness. Results 58 respondents (50 female) 32 nurses, 22 doctors, 4 other HCPs. Years qualified: Range 0–32; P/NICU experience: Range 0–28 years. Mean score for resilience = 3.58 (1.83 –5) 1 = lowest level of resilience and 5 = highest. Mean burnout measure: PA = 12.5, DP = 2.6 and EE = 8.0 (Scale ‘felt this way’ 0 = never to 18 = everyday). All staff admitted to symptoms of emotional exhaustion on some level, 22 experienced some depersonalization. Scores for personal achievement ranged from 2–18. Higher resilience levels were significantly associated with lower PTSD symptoms (r = –0.41, p = 0.001). 10 HCPs met criteria suggestive of PTSD, 38 had lower but concerning scores. Significant negative correlation between resilience and emotional exhaustion (r = –0.36, p = 0.005) and positive correlation between resilience and personal achievement (r = 0.36, p = 0.005). No significant difference in coping strategies across different levels of resilience, only one (‘keep professional boundaries’) distinguished between higher and lower resilience levels. Conclusion Paediatric and Neonatal ICU staff show concerning levels of psychological trauma. Greater resilience is associated with lower levels of PTSD symptomatology and some measures of burnout, indicating a better psychological state. More research is required to investigate the role of different coping strategies, including techniques, which can influence resilience, and how these may be promoted in staff working in this environment to facilitate staff wellbeing and retention.
Depression in chronic back pain patients: prediction of pain intensity and pain disability in cognitive-behavioral treatment.

BACKGROUND Pain patients with comorbid depression have reduced quality of life and more disturbances than patients without such comorbidity. OBJECTIVE The aim of this study was to investigate cross-sectional and longitudinal associations of depression and chronic pain. METHOD The authors followed a sample of patients who took part in a cognitive-behavior treatment protocol for chronic pain. RESULTS Higher depression levels at pretreatment were associated with higher pain intensity and higher pain disability at pretreatment. Depression at pretreatment did not affect treatment outcome. Changes in depression from pretreatment to posttreatment accounted for variance in changes in pain intensity and pain disability. DISCUSSION The authors concluded that reducing pain-related depression could be a central therapeutic mechanism in cognitive-behavioral treatment of chronic back pain.
Insights into open innovation and ICT entrepreneurship in Africa

Innovation and ICT entrepreneurship are slowly being recognised as important enablers of socio-economic growth and realising national strategic goals in African Member States. However, the level of practical skills capacity, indigenous entrepreneurial expertise and policy support to take full advantage of this at national level varies considerably. This research study focused on identifying factors impacting on the current level of open innovation and ICT entrepreneurship in Africa. It was informed by a semi-structured, moderated focus group which captured the perspectives of senior public and education and research stakeholders from eight African Member States. The results highlighted six main factors: (a) level of political will reflected by resource prioritisation; (b) alignment with national development plans and associated funding priorities; (c) level of understanding of strategic benefits by ministers and senior civil servants; (d) level of awareness and sensitization of the general public, (e) availability of national innovation and entrepreneurial expertise; and (f) willingness and capacity to cooperate with other stakeholders to achieve common goals. Future research will capture perspectives from the private, societal and international donor sectors, and create and validate potential models/methodologies to address the challenges and opportunities identified in this study.
Impaired sensorimotor integration in focal hand dystonia patients in the absence of symptoms

Background Functional imaging studies of people with focal hand dystonia (FHD) have indicated abnormal activity in sensorimotor brain regions. Few studies however, have examined FHD during movements that do not provoke symptoms of the disorder. It is possible, therefore, that any differences between FHD and controls are confounded by activity due to the occurrence of symptoms. Thus, in order to characterise impairments in patients with FHD during movements that do not induce dystonic symptoms, we investigated the neural correlates of externally paced finger tapping movements. Methods Functional MRI (fMRI) was used to compare patients with FHD to controls with respect to activation in networks modulated by task complexity and hand used to perform simple and complex tapping movements. Results In the ‘complexity network,’ patients with FHD showed significantly less activity relative to controls in posterior parietal cortex, medial supplementary motor area (SMA), anterior putamen and cerebellum. In the ‘hand network,’ patients with FHD showed less activation than controls in primary motor (M1) and somatosensory (S1) cortices, SMA and cerebellum. Conjunction analysis revealed that patients with FHD demonstrated reduced activation in the majority of combined network regions (M1, S1 and cerebellum). Conclusion Dysfunction in FHD is widespread in both complexity and hand networks, and impairments are demonstrated even when performing tasks that do not evoke dystonic symptoms. These results suggest that such impairments are inherent to, rather than symptomatic of, the disorder.
Zinc-induced copper deficiency in Wilson disease

Zinc intoxication has been reported in cases of dietary supplementation, therapeutic overdose, coin ingestion and chronic use of denture cream. Zinc in excess upregulates copper-binding metallothionein in the gut mucosa, leading to increased elimination of copper and negative copper balance. Copper deficiency may also occur in the absence of zinc intoxication, during long-lasting parenteral nutrition and in malabsorption. It is characterised by haematological abnormalities, including sideroblastic anaemia, neutropenia and myelodysplastic syndrome, possibly related to a decreased activity of reductase enzymes of the mitochondria. Neurological manifestations of copper deficiency typically involve a myelopathy resembling subacute combined degeneration, yet optic and peripheral neuropathies, lower motoneuron degeneration, myopathy and central nervous system demyelination have also been reported.1–5 No case of renal manifestation has been published yet. Because of its core feature of chronic copper overload, Wilson disease (WD) may be considered a low risk for such complications to occur. We report here an original case of copper deficiency in WD related to chronic therapeutic overdose of zinc. In 1992, a 25-year-old patient was diagnosed as having WD. He had mild cognitive deficit, resting tremor, dystonia, dysarthria, gait impairment and liver cirrhosis. Penicillamine therapy was discontinued after 6 months due to further neurological deterioration. Zinc sulfate in monotherapy was introduced …
The profile of motor unit number estimation (MUNE) in spinal and bulbar muscular atrophy

Objective Spinal and bulbar muscular atrophy (SBMA) is a lower motor neuron disease caused by the expansion of a trinucleotide CAG repeat in the androgen receptor (AR) gene. The fundamental histopathological finding of this disease is an extensive loss of lower motor neurons in the spinal cord and brainstem. It is, however, difficult to evaluate clinically the degree of motor neuron degeneration, which stresses the need for biomarkers to detect the remaining neuronal function. Methods The authors performed motor unit number estimation (MUNE) in 52 patients with SBMA, to investigate whether this method could be a potential biomarker of SBMA, and re-evaluated MUNE 1 year later in a subgroup of the patients. Results The number of functioning motor units was remarkably reduced in patients with SBMA compared with controls, and was correlated with both ipsilateral grip power and disease duration. A longitudinal analysis demonstrated a further reduction in motor units within 1 year. Conclusions The results suggest that MUNE is an electrophysiological parameter that reflects the severity and progression of motor neuron degeneration in patients with SBMA.
Clustering of 3D Spatial Points Using Maximum Likelihood Estimator over Voronoi Tessellations: Study of the Galaxy Distribution in Redshift Space

This paper describes an algorithm based on the 2D approach of Allard & Fraley that uses Voronoi tessellation and a non-parametric maximum likelihood estimator. We have designed a 3D version of this algorithm which detects multiple clusters of points immersed in background noise; its application to the detection of galaxy clusters in red-shift space, using the astronomical database of the 2-degree Field Galaxy Redshift Survey, is presented and discussed. Adopting as a benchmark a particular set of catalogued clusters of galaxies, we find that the proposed algorithm recognizes the location of ~67% of the clusters. Three variants of the algorithm were assessed to deal with the elongation of the clusters in the radial direction of observation introduced by the astronomical distance indicator; their merits and limitations are discussed. We address separately the detection of the galaxy cluster location and the detection of galaxy cluster members, both of them having an anisotropic space as their search domain. In the case of detection of galaxy cluster members, a second stage of detection was incorporated in order to improve the results.
Development and validation of a short version of the Stroke Specific Quality of Life Scale

Background and purpose The Stroke Specific Quality of Life Scale (SS-QoL) is a well validated measure of health related quality of life in patients with stroke, but with 49 items its length is a disadvantage. A short version of the SS-QoL was developed and tested here. Methods Secondary analyses of three different studies. The short version was developed using data from 141 patients with aneurysmal subarachnoid haemorrhage (SAH) and tested on data from independent samples of 97 patients with SAH and 105 patients with ischaemic stroke or intracerebral haemorrhage. The item with the highest item domain correlation from each of the SS-QoL domains was selected to obtain a 12 item SS-QoL (SS-QoL-12) with a total score and physical and psychosocial subscores. Criterion validity of the SS-QoL-12 scores was tested in each sample with the original SS-QoL as reference. Results All three scores of the SS-QoL-12 showed good internal consistency (Cronbach's alpha 0.77–0.89). The SS-Qol-12 scores predicted 88–95% of the variance of the original SS-QoL. Mean differences between the SS-QoL-12 and SS-QoL and their 95% CI were generally within 0.1 points on a 1–5 scale. The limits of agreement were generally within 0.4 points. Conclusion The SS-QoL-12 has good criterion validity for all subsets of stroke. Because it consists of only 12 questions, this short form will be easy to use in research and clinical settings.
Determinants for undetected dementia and late-life depression.

BACKGROUND Determinants for undetected dementia and late-life depression have been not well studied. AIMS To investigate risk factors for undetected dementia and depression in older communities. METHOD Using the method of the 10/66 algorithm, we interviewed a random sample of 7072 participants aged ≥60 years in six provinces of China during 2007-2011. We documented doctor-diagnosed dementia and depression in the interview. Using the validated 10/66 algorithm we diagnosed dementia (n = 359) and depression (n = 328). RESULTS We found that 93.1% of dementia and 92.5% of depression was undetected. Both undetected dementia and depression were significantly associated with low levels of education and occupation, and living in a rural area. The risk of undetected dementia was also associated with 'help available when needed', and inversely, with a family history of mental illness and having functional impairment. Undetected depression was significantly related to female gender, low income, having more children and inversely with having heart disease. CONCLUSIONS Older adults in China have high levels of undetected dementia and depression. General socioeconomic improvement, associated with mental health education, targeting high-risk populations are likely to increase detection of dementia and depression in older adults, providing a backdrop for culturally acceptable service development.
Test–retest Reliability of Biomechanical Output and Subjective Ratings of Exertion in Isometric and Isokinetic Shoulder Forward Flexion in Healthy Subjects

The purpose of this study was to investigate the test–retest reliability of biomechanical output and subjective ratings of exertion in isometric and isokinetic shoulder forward flexion in healthy subjects. Twenty-seven healthy middle-aged subjects, 13 men and 14 women, took part in the study. The shoulder flexion performance in the right shoulder was investigated using an isokinetic dynamometer (Kin-Com®). The investigation consisted of static contractions in two different positions, 30° and 90°, single dynamic contractions at two different angular velocities, 30°/s and 90°/s, and 100 repeated dynamic contractions. There was a fair to excellent test–retest agreement (intra-class correlation coefficient, ICC=0.45–0.95) for all the biomechanical tests. In general, the men exhibited higher relative reliability compared to the women, and when all subjects were analysed together the relative reliability was even better. Relative agreement of perceived exertion during the 100 contractions was highest during the second part of the test for the women separately (κ=0.55–1.00) and for all subjects (κ=0.50–0.77). The agreement of perceived exertion in men was generally low (κ=0.22–0.68) throughout the test. From results of the SEM% values, a change of 15% of biomechanical output or more is necessary if it should be interpreted as a change due to an intervention when testing shoulder flexion in healthy subjects using an isokinetic dynamometer.
Consultation with users, carers and staff in order to improve local palliative care services – how to do it and views on current services

Abstract Objective: To learn about the quality of local services and develop an appropriate methodology for future consultation. Methods: Tape recordings were made of patient and carer consultations using semi-structured interviews and staff focus groups using semistructured questioning. These were then transcribed and analysed. Results: The majority of feedback was positive. Continuity of care is very important and complex when a large range of agencies are involved in an individual package of care. Many staff expressed concern that expectations of patients are beyond what they are able to deliver. Participants wanted to have choice in the way that they were consulted. It is difficult to enable staff to support the consultation process whilst meeting constraints imposed by ethical considerations. The consultation work must demonstrate a difference in order to encourage enthusiasm from staff or patients/carers for projects in the future. Conclusions: Users of palliative care services are a particularly hard group to access and consult with; we must demonstrate that their contribution is likely to lead to change.
On the Farthest-Neighbor Voronoi Diagram of Segments in Three Dimensions

We consider the farthest-neighbor Voronoi diagram of a set of line segments in three dimensions. To understand the structure of the diagram, we define the “farthest hull” of the segments and investigate it by its representation in a Gaussian map. We then provide lower and upper bounds on the worst-case complexities of the farthest hull and of the Voronoi diagram.
Heterogeneity of small vessel disease: a systematic review of MRI and histopathology correlations

Background White matter hyperintensities (WMH), lacunes and microbleeds are regarded as typical MRI expressions of cerebral small vessel disease (SVD) and they are highly prevalent in the elderly. However, clinical expression of MRI defined SVD is generally moderate and heterogeneous. By reviewing studies that directly correlated postmortem MRI and histopathology, this paper aimed to characterise the pathological substrates of SVD in order to create more understanding as to its heterogeneous clinical manifestation. Summary Postmortem studies showed that WMH are also heterogeneous in terms of histopathology. Damage to the tissue ranges from slight disentanglement of the matrix to varying degrees of myelin and axonal loss. Glial cell responses include astrocytic reactions—for example, astrogliosis and clasmatodendrosis—as well as loss of oligodendrocytes and distinct microglial responses. Lipohyalinosis, arteriosclerosis, vessel wall leakage and collagen deposition in venular walls are recognised microvascular changes. Suggested pathogenetic mechanisms are ischaemia/hypoxia, hypoperfusion due to altered cerebrovascular autoregulation, blood–brain barrier leakage, inflammation, degeneration and amyloid angiopathy. Only a few postmortem MRI studies have addressed lacunes and microbleeds to date. Cortical microinfarcts and changes in the normal appearing white matter are ‘invisible’ on conventional MRI but are nevertheless expected to contribute substantially to clinical symptoms. Conclusion Pathological substrates of WMH are heterogeneous in nature and severity, which may partly explain the weak clinicoradiological associations found in SVD. Lacunes and microbleeds have been relatively understudied and need to be further investigated. Future studies should also take into account ‘MRI invisible’ SVD features and consider the use of, for example, quantitative MRI techniques, to increase the sensitivity of MRI for these abnormalities and study their effects on clinical functioning.
Nitric Oxide in Liver Diseases

Abstract: Research on the free radical gas, nitric oxide (NO), during the past twenty years is one of the most rapid growing areas in biology. NO seems to play a part in almost every organ and tissue. However, there is considerable controversy and confusion in understanding its role. The liver is one organ that is clearly influenced by NO. Acute versus chronic exposure to NO has been associated with distinct patterns of liver disease. In this paper we review and discuss the involvement of NO in various liver diseases collated from observations by various researchers. Overall, the important factors in determining the beneficial versus harmful effects of NO are the amount, duration, and site of NO production. A low dose of NO serves to maximize blood perfusion, prevent platelet aggregation and thrombosis, and neutralize toxic oxygen radicals in the liver during acute sepsis and reperfusion events. NO also demonstrates antimicrobial and antiapoptosis properties during acute hepatitis infection and other inflammatory processes. However, in the setting of chronic liver inflammation, when a large sustained amount of NO is present, NO might become genotoxic and lead to the development of liver cancer. Additionally, during prolonged ischemia, high levels of NO may have cytotoxic effects leading to severe liver injury. In view of the various possible roles that NO plays, the pharmacologic modulation of NO synthesis is promising in the future treatment of liver diseases, especially with the emergence of selective NO synthase inhibitors and cell‐specific NO donors.
Trends in the epidemiology of multiple sclerosis in Greater Hobart, Tasmania: 1951 to 2009

Background Hobart, Tasmania has been the site of two major studies of multiple sclerosis (MS) frequency, in 1951–1961 and 1971–1981. Since then, there have been no studies of MS frequency in Hobart. Methods Using a prevalent cohort of 226 cases in 2001 and 265 in 2009, the authors undertook a two-stage survey of MS frequency in Hobart. Combined with the published data from the two preceding studies, the authors conducted a time-trend analysis of MS epidemiology over 1951–2009. Results The age-standardised prevalence in 2001 was 96.6/100 000, and 99.6/100 000 in 2009, a significant increase from the 1961 prevalence of 32.5/100 000 (p<0.001). Female prevalence increased over each time point; male prevalence increased between 1961 and 2001 but was unchanged thereafter. Incidence over 2001–2009 was 3.7/100 000, significantly increased from the 1951–1961 incidence of 2.2/100 000 (p=0.004), though the majority of this was between 1951–1961 and 1971–1981. Mortality fell by half from 2.4/100 000 in 1951–1959 to 1.0/100 000 in 2001–2009—this decreased mortality and an older cohort contribute to the increase in prevalence. Neither prevalence (p=0.48) nor incidence (p=0.18) sex ratios changed significantly between 1951 and 2009. Conclusions Between 1951 and 2009, the age-standardised prevalence of MS in Hobart increased threefold, and the incidence nearly doubled. Part of the increase in prevalence was due to an increased longevity, decreased mortality and increased incidence. Differences in patterns by birthplace may be explained by the Australian assisted-migration programme of 1945–1981. These data do not demonstrate the strong and significant changes in sex ratio observed elsewhere.
Subthreshold 1-Bit Full Adder Cells in sub-100 nm Technologies

In this paper, subthreshold 1-bit full adder cells in sub-100 nm technologies are investigated. The analysis is performed using fourteen different full adder cells operating in subthreshold region by decomposing them into smaller blocks. Both individual blocks and the complete full adder cells are simulated. The study, which is carried out for 65nm and 90nm standard CMOS technologies, includes power, delay, and power delay product as functions of supply voltage, frequency, size, and technology. In addition, for both technologies, the minimum required supply voltage for different circuits, are determined