Miracle-dz/UniFAR-FTUs huggingface dataset:
The Impact of Chronic Low Back Pain on Leisure Participation: Implications for Occupational Therapy

Aim: Chronic low back pain can reduce engagement and participation in all areas of daily life. Previous research has focused on employment and vocational rehabilitation initiatives, with less attention paid to its impact on leisure. This paper examines the difficulties men with chronic low back pain experienced in the maintenance of their leisure activities. It explores the connection between leisure and social networks and the potential barriers to resuming leisure occupations due to chronic low back pain. Method: This ethnographic study examined the experiences of 11 men involved in a vocational rehabilitation programme in New South Wales, Australia. Data were gathered using participant observation and semi-structured interviews. Findings: Chronic low back pain has a critical impact on leisure occupations. It creates two barriers to a client's engagement in former leisure occupations: physical restrictions and financial barriers. Conclusion: The findings build on knowledge of how leisure impacts on social dimensions of health and wellbeing. Occupational therapists can play an important role in enabling people with chronic low back pain to re-engage in leisure. These interventions may reduce the social isolation experienced by individuals due to the loss of leisure activity.
A voltage-combiners-biased amplifier with enhanced gain and speed using current starving

In this paper, the current starving technique is applied to a voltage-combiners-biased symmetrical CMOS Operational Transconductance Amplifier (OTA). The proposed topology upgrade enhances the gain of the conventional topology, improves the settling time by means of enhancing its gain-bandwidth product and highly improves its energy efficiency. Simulation results of a properly optimized circuit, using AIDA-C, a state-of-the-art multi-objective multi-constraint circuit-level optimization tool, demonstrate that a DC gain above 60 dB can be achieved together with a high energy efficiency (a figure-of-merit of 2200 MHz×pF/mA has been reached). The circuit was designed using a standard 130 nm CMOS technology and drains less than 0.5 mA from a 3.3 V power supply.
Effect of age and aortic valve anatomy on calcification and haemodynamic severity of aortic stenosis

Objective To evaluate the effect of age and aortic valve anatomy (tricuspid (TAV) vs bicuspid (BAV) aortic valve) on the relationship between the aortic valve calcification (AVC) and the haemodynamic parameters of aortic stenosis (AS) severity. Methods Two hundred patients with AS and preserved left ventricular ejection fraction were prospectively recruited in the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study and underwent a comprehensive Doppler echocardiography and multidetector CT (MDCT). Mean transvalvular gradient (MG) measured by Doppler echocardiography was used to assess AS haemodynamic severity and AVC was evaluated by MDCT using the Agatston method and indexed to the left ventricular outflow tract area to obtain AVC density (AVCd). All analyses were adjusted for sex. Results Thirty-nine patients had a BAV and 161 a TAV. Median age was 51 and 72 years for BAV and TAV patients, respectively. There was a modest correlation between MG and AVCd (ρ=0.51, p<0.0001) in the whole cohort. After dichotomisation for valve anatomy, there was a good correlation between AVCd and MG in the TAV group (ρ=0.61, p<0.0001) but weak correlation in the BAV group (ρ=0.32, p=0.046). In the TAV group, the strength of the AVCd–MG correlation was similar in younger (<72 years old; ρ=0.59, p<0.0001) versus older (≥72 years old; ρ=0.61, p<0.0001) patients. In the BAV group, there was no correlation between AVCd and MG in younger patients (<51 years old; ρ=0.12, p=0.65), whereas there was a good correlation in older patients (≥51 years old; ρ=0.55, p=0.009). AVCd (p=0.005) and age (p=0.02) were both independent determinants of MG in BAV patients while AVCd (p<0.0001) was the only independent determinant of MG in TAV patients. Conclusions In patients with TAV as well as in older patients with BAV, AVCd appears to be the main factor significantly associated with the haemodynamic severity of AS and so it may be used to corroborate AS severity in case of uncertain or discordant findings at echocardiography. However, among younger patients with BAV, some may have a haemodynamically significant stenosis with minimal AVCd. The results of MDCT AVCd should thus be interpreted cautiously in this subset of patients. Trial registration number NCT01679431; Pre-results.
Development of the SBIRT checklist for observation in real‐time (SCORe)

BACKGROUND AND AIMS Screening, Brief Intervention and Referral to Treatment (SBIRT) programs have been implemented widely in medical settings, with little attention focused on how well providers adhere to evidence-based service delivery in everyday practice. The purposes of this paper were to: (1) introduce a flexible, relatively simple methodology, the SBIRT Checklist for Observation in Real-time (SCORe), to assess adherence to evidence-based practice and provide preliminary evidence supporting its criterion validity; and (2) illustrate the feasibility and potential utility of the SCORe by analyzing observations of providers within four large-scale SBIRT programs in the United States. METHODS Eighteen potential adherence judges were trained to recognize SBIRT service elements presented in realistic taped portrayals constructed to serve as criterion coding standards. Across the four SBIRT programs, 76 providers were observed performing 388 services in three types of medical settings; emergency departments (n = 10), hospital out-patient/ambulatory clinics (n = 16) and hospital in-patient settings (n = 5). RESULTS Across two exercises, trainees identified 81% of screening and 75% of brief intervention (BI) elements correctly; for the six FRAMES components (Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy), agreement ranged from 69% to 91%. Across programs, 56% of screening, 54% of brief intervention (BI) (81% of FRAMES) and 53% of referral to treatment elements were observed. Programs differed significantly in adherence [screening, P = 0.024; BI, P < 0.001; FRAMES, P < 0.001; referral to treatment (RT), P < 0.001]; medical setting differences were minimal. CONCLUSIONS The Screening, Brief Intervention and Referral to Treatment Checklist for Observation in Real-time provides a flexible method for assessing adherence to evidence-based Screening, Brief Intervention and Referral to Treatment service protocols. Preliminary evidence supports the criterion validity, feasibility and potential utility of the Screening, Brief Intervention and Referral to Treatment Checklist for Observation in Real-time protocol.
An interactive computer‐based revision aid

A computer‐based revision system has been developed, based on the multiple‐choice question technique. Five questions are supplied to the user on the subject specified. The user can enter an answer and this will be checked against the examiner's answer, or he can have a list of questions to take away and enter the answers later. A record is kept of his performance, and a log is maintained on the use of the system. Students from three of the University of London medical schools have been using the system since it was available in April 1975. Their reports on their experiences in using this revision technique have been most favourable, and particularly useful in the continuing development of the system.
Cost‐effectiveness of extended release naltrexone to prevent relapse among criminal justice‐involved individuals with a history of opioid use disorder

BACKGROUND AND AIMS Criminal justice-involved individuals are highly susceptible to opioid relapse and overdose-related deaths. In a recent randomized trial, we demonstrated the effectiveness of extended-release naltrexone (XR-NTX; Vivitrol® ) in preventing opioid relapse among criminal justice-involved US adults with a history of opioid use disorder. The cost of XR-NTX may be a significant barrier to adoption. Thus, it is important to account for improved quality of life and downstream cost-offsets. Our aims were to (1) estimate the incremental cost per quality-adjusted life-year (QALY) gained for XR-NTX versus treatment as usual (TAU) and evaluate it relative to generally accepted value thresholds; and (2) estimate the incremental cost per additional year of opioid abstinence. DESIGN Economic evaluation of the aforementioned trial from the taxpayer perspective. Participants were randomized to 25 weeks of XR-NTX injections or TAU; follow-up occurred at 52 and 78 weeks. SETTING Five study sites in the US Northeast corridor. PARTICIPANTS A total of 308 participants were randomized to XR-NTX (n = 153) or TAU (n = 155). MEASUREMENTS Incremental costs relative to incremental economic and clinical effectiveness measures, QALYs and abstinent years, respectively. FINDINGS The 25-week cost per QALY and abstinent-year figures were $162 150 and $46 329, respectively. The 78-week figures were $76 400/QALY and $16 371/abstinent year. At 25 weeks, we can be 10% certain that XR-NTX is cost-effective at a value threshold of $100 000/QALY and 62% certain at $200 000/QALY. At 78 weeks, the cost-effectiveness probabilities are 59% at $100 000/QALY and 76% at $200 000/QALY. We can be 95% confident that the intervention would be considered 'good value' at $90 000/abstinent year at 25 weeks and $500/abstinent year at 78 weeks. CONCLUSIONS While extended-release naltrexone appears to be effective in increasing both quality-adjusted life-years (QALYs) and abstinence, it does not appear to be cost-effective using generally accepted value thresholds for QALYs, due to the high price of the injection.
Quantitative evaluation of reliability and performance for STT-MRAM

Due to its non-volatility, high access speed, ultra low power consumption and unlimited writing/reading cycles, STT-MRAM (Spin Transfer Torque Magnetic Random Access Memory) has emerged as the most promising candidate for the next generation universal memory. However, the process of commercialization of STT-MRAM is hampered by its poor reliability. Generally, these reliability issues are caused by the PVT (Process Variations, Voltage, and Temperature) of both MTJ (Magnetic Tunneling Junction) and transistor. Mitigation and alleviating the impacts of the intrinsic properties and PVT on STT-MRAM is a challenging work. This paper discusses the errors occurring in STT-MRAM resulting from its poor reliability, and analyzes the causes of such errors. To obtain a quantitative assessment of PVT impact on STT-MRAM reliability, we investigate three aspects: writing/reading operation error rate, power consumption and access delay of a single cell. This study is carried out on Cadence platform for 45 nm technology node and the PMA (Perpendicular Magnetic Anisotropy) MTJ model used in the investigation comes from SP INLIB. These quantitative information would be helpful for designing reliability enhancing strategies of STT-MRAM.
To take or not to take: the association between perceived addiction risk, expected analgesic response and likelihood of trying novel pain relievers in self‐identified chronic pain patients

BACKGROUND AND AIMS Probability discounting refers to the effect of outcome uncertainty on decision making. Using probability discounting, we examined the degree to which self-identified chronic pain patients (CPP) were likely to try a novel analgesic medication given increasing addiction risk. We postulated that propensity for opioid misuse, trait impulsivity and previous opioid experience would be associated positively with likelihood of risky medication use. DESIGN This cross-sectional on-line study determined state/trait associations with addiction-related medication decisions in CPP. SETTING US-based CPP participated via Amazon Mechanical Turk; data were collected and analyzed in Baltimore, Maryland. PARTICIPANTS A total of 263 CPP (70.6% female) participated in the study from 12-13 December 2014. MEASUREMENTS CPP responded to the Benefit versus Addiction Risk Questionnaire (BARQ) assessing likelihood of taking a hypothetical once-daily oral analgesic medication as a function of two factors: risk of addiction (0-50%) and duration of expected complete pain relief (3, 30 or 365 days). The primary outcome was the BARQ, quantified as area under the curve (AUC). Grouping of CPP at high or low risk for opioid misuse was based on the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R). Predictors included previous experience with opioids, as well as various measures of chronic pain and mental health. FINDINGS Across hypothetical addiction risk assessed in the BARQ, the likelihood of taking a novel analgesic medication was elevated significantly in patients with high (≥18; n = 137) versus low (<18; n = 126) SOAPP-R scores [P < 0.001; 3-day: Cohen's d = 0.66, 95% confidence interval (CI) = 0.63, 0.69; 30-day: d = 0.74, 95% CI = 0.71, 0.78; 365-day: d = 0.75, 95% CI = 0.72, 0.79]. CONCLUSIONS In the United States, self-identified chronic pain patients (CPP) at higher risk for opioid misuse were more likely to report willingness to try a novel analgesic despite increasing addiction risk than CPP with low risk of opioid misuse.
A Practical Approach to Neurophysiologic Intraoperative Monitoring

The book is divided into two convenient sections: Section One, Basic Principles, covers the modalities used in monitoring as well as the rarely discussed topics of remote monitoring, billing, ethical issues, and a buyer's guide for setting up a laboratory. Section Two reviews anatomy, physiology, and surgery of the various procedures, followed by details of the monitoring modalities and their interpretive criteria.
Anti-oxidative Activity of Nepalese Traditional Anti-diabetic Medicines

Chronic overproduction of free radicals in human body has a role in numerous disease states including diabetes. Proper use of antioxidants may help in the prevention and/or treatment of diabetes. For the management of diabetes, a combination of herbal drugs is being practiced traditionally in Nepal. These herbal medicines might have a good correlation to anti-oxidative properties. Anti-oxidative property was evaluated with the methanolic extracts of nineteen common traditional anti-diabetic medicines by 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging method. Among the evaluated herbal medicines, Phyllanthus emblica , Punica granatum, Syzygium cumini, Terminalia bellirica and Terminalia chebula showed potent radical scavenging activity. The activities of P. emblica, T. bellirica and T. chebula were more potent than that of ascorbic acid. Some of the reported popular hypoglycemic herbal drugs did not show strong activity. Therefore strong anti-oxidative herbal drugs in combination with hypoglycemic drugs might have better results in the management of diabetes. DOI: http://dx.doi. org/10.3126/njst.v14i2. 10429 Nepal Journal of Science and Technology Vol. 14, No. 2 (2013) 151-154
Design of a reliable RRAM-based PUF for compact hardware security primitives

Physical Unclonable Functions (PUF) have to be highly reliable especially when it is being used along with cryptographic hash modules for key generation. To achieve ultrahigh reliability, the conventional approach employs error correction codes (ECC) based on helper data input. Such an approach not only increases the hardware overhead of the PUF but also reduces the entropy of the system, resulting in both hardware and software security issues. In this paper we design a compact and highly reliable PUF architecture based on resistive random access memory (RRAM). We propose a new design where the sum of the read-out currents of multiple RRAM cells is used for generating one response bit. This method statistically minimizes any early-lifetime failure due to RRAM retention degradation at high temperature or under voltage stress. We employ a device model that is calibrated with IMEC HfOx RRAM experimental data and show that with 8 cells per bit, we can ensure <10-6 Intra-Hamming distance (or >99.9999% reliability) for a lifetime >10 years at 125°C. We embed the RRAM PUF into SHA-256 and show that the hardware overhead of the proposed RRAM PUF based architecture is significantly lower than one that uses a traditional RRAM PUF with ECC.
Assessing causal relationships using genetic proxies for exposures: an introduction to Mendelian randomization

Abstract Background and aims Studying the consequences of addictive behaviours is challenging, with understanding causal relationships from observational data being particularly difficult. For example, people who smoke or drink excessively are often systematically different from those who do not, are less likely to participate in research and may misreport their behaviours when they do. Furthermore, the direction of causation between an addictive behaviour and outcome may be unclear. Mendelian randomization (MR) offers potential solutions to these problems. Methods We describe MR's principles and the criteria under which it is valid. We identify challenges and potential solutions in its application (illustrated using two applied examples) and describe methodological extensions in its application. Results MR is subject to certain assumptions, and requires the availability of appropriate genetic data, large sample sizes and careful design and conduct. However, it has already been applied successfully to the addiction literature. The relationship between alcohol consumption (proxied by a variant in the ADH1B gene) and cardiovascular risk has been investigated, finding that alcohol consumption increases risk, with no evidence of a cardioprotective effect at moderate consumption levels. In addition, heaviness of smoking (proxied by a variant in the CHRNA5‐A3‐B4 gene cluster) and risk of depression and schizophrenia have been investigated, with no evidence of a causal effect of smoking on depression but some evidence of a causal effect on schizophrenia. Conclusions Mendelian randomization analyses are already producing robust evidence for addiction‐related practice and policy. As genetic variants associated with addictive behaviours are identified, the potential for Mendelian randomization analyses will grow. Methodological developments are also increasing its applicability.
A comparison of service users placed out of their local area and local rehabilitation service users

Background: Under provision of highly supported mental health accommodation in the UK has led to service users being placed away from their local area. These out of area treatments (OATs) are expensive and exacerbate service users' social dislocation. Aims: (i) To assess service users in OATs for suitability for relocation to local rehabilitation and supported accommodation. (ii) To compare characteristics of OATs with local rehabilitation service users in order to identify gaps in local provision. Method: Over the first 30 months, 51 OATs were identified and 40 reviewed. Standardized assessment data were compared with local rehabilitation service users' data. Results: Individuals placed in OATs had a greater range of diagnoses and more had alcohol dependency than local service users. Ratings of social function were similar. Though severity of challenging behaviours was greater for OATs clients, few were “hard to place” in community settings. Of 25 (63%) OATs assessed as suitable to move, 13 (33%) relocated, all to more independent accommodation. Associated financial flows were reinvested into new local highly supported flats. Conclusion: A significant proportion of individuals placed in OATs can successfully relocate to more independent local facilities. Declaration of interest: None.
Susceptibility of Clostridium perfringens of animal origin to fifteen antimicrobial agents

The minimal inhibitory concentrations of fifteen antibacterial agents were determined by agar-dilution method against 121 strains of Clostridium perfringens isolated from pigs, cattle and poultry. All strains, regardless of host of origin, were susceptible to avoparcin, furazolidone, monensin, nitrovin, penicillin G, ronidazole and tiamulin and resistant to flavomycin. Poultry strains were also susceptible to carbadox, chloramphenicol, erythromycin and virginiamycin. Bacitracin-resistant poultry strains were susceptible to all tested antibacterial agents except tetracycline, but the bacitracin-resistant cattle strains were polyresistant. Porcine strains were susceptible to bacitracin and bovine strains to carbadox. Carbadox-resistant porcine strains were resistant to erythromycin, lincomycin and tetracycline and susceptible to chloramphenicol. Resistance to erythromycin was associated with resistance to lincomycin. High level erythromycin-lincomycin-resistant strains were susceptible to virginiamycin, but the intermediate level erythromycin-lincomycin-resistant cattle strains were resistant to virginiamycin. Resistance to chloramphenicol or erythromycin-lincomycin was always associated with resistance to tetracycline but the reverse was not always true.
Burst level congestion control in ATM networks

We present the architecture for burst level congestion control (BLCC) in ATM networks which is well suited for bursty self-similar traffic. The architecture is based upon pre-planned virtual path (PVP) set and preassigned maximal permitted route rates (MPR). The PVP set and MPR are engineered to meet QoS requirements of multi-service demand. The suggested burst level control maintains the maximal rate of cell admission on any PVP below its MPR. This is done at each PVP's source node by regulating bursts admission and by reserving the burst peak rate for each admitted burst. The reservation can be performed very fast since it is done at PVP's source node without any communication with other nodes. The MPR and PVP set are adjusted in a relatively slow, for instance hourly, timeframe adapting to the changes in the demand. The paper also presents an efficient technique for multiclass QoS engineering of burst admission that can be applied to engineer networks with large number of nodes and service classes.
Streaming support in an advanced multimedia infrastructure for the WWW

We present an architecture for managing multiple media streams included in temporal HTML documents. The architecture provides generic services for negotiating media streams on servers, controlling their delivery, adapting their characteristics to varying network and host conditions, and synchronizing multiple remote streams. Integration of the streaming support within a synchronization architecture leads to the concept of QoP (quality of presentation) that characterizes global quality of document playback from remote servers.