Miracle-dz/UniFAR-FTUs huggingface dataset:
Gender issues for people with intellectual disabilities and mental health problems: asking what service users and staff think

Purpose – The current qualitative study aims to investigate service users’, support staff’s and community team members’ views of gender differences in cause and presentation of mental health problems, whether current services respond differently to men and women with mental health problems and areas in which services can become more gender sensitive. Design/methodology/approach – Two focus groups were conducted with service users with intellectual disabilities and mental health problems in addition to two focus groups with a variety of staff. Subsequently, individual interviews were conducted with both male and female staff members employed in residential and community intellectual disability services. The number of participants totalled 54 (16 service users and 38 staff). Thematic analysis was adopted in order to identify dominant themes in the discourse of these stakeholder groups. Findings – The analysis produced a number of themes which include: compliance versus challenge; vulnerability; expression of emotion; gender equality; same sex support; caring qualities; and boundaries. Originality/value – A number of suggestions for improving services are discussed in the context of the current findings.
The Central Nervous System Manifestations of HIV-1 Infection in the Combination Antiretroviral Therapy Era

2 Acknowledgements. 3 Declaration . 3 Abbreviations . 5 Chapter 1: General Introduction . 9 Chapter 2: Materials and Methods . 41 Chapter 3: A UK Cohort Study to Assess the Impact of Antiretroviral Therapy CNS Penetration upon the Incidence of HIV-1 Associated CNS Diseases and Overall Survival . 56 Chapter 4: A Proscpective, Randomised-Controlled Study to Assess Changes to Cerebral Function Parameters in Stable, HIV-1 Infected Subjects Switching Antiretroviral Therapy to Darunavir/Ritonavir alone or Darunavir/Ritonavir with Nucleoside Analogues . 71 Chapter 5: A Prospective Study to Assess the Central Nervous System Effects of a CCR5-Inhibitor in HIV-1 Infected Subjects on Stable Antiretroviral Therapy ; A Pharmacokinetic and Cerebral Metabolite Study . 88 Chapter 6: A Cross-Sectional Study to Compare Cognitive Performance in Subjects with Chronic HIV-1 and Acute HCV Coinfection and Subjects with Chronic HIV-1 Infection . 106 Chapter 7: A Case-Control Study to Compare Cerebral Metabolite Ratios in Subjects with Chronic HIV-1 and Acute HCV Coinfection and Subjects with Chronic HIV-1 infection . 123 Chapter 8: A Case-Control Study using PK-11195 Radio-labelled Cerebral Positron Emission (PET) Scanning To Compare Microglial Cell Activation in Subjects with Chronic HIV-1 and Acute HCV Coinfection and Subjects with Chronic HIV-1 Infection . 133 Chapter 9: Overall Conclusions . 147 List of communications . 153 References . 155
Bed blocking in hospitals : simulation of the transmural care chain

Problem description: This research is done in the general hospital Reinier de Graaf Groep (RdGG). RdGG, just like many hospitals, has to deal with the problem of bed blocking: patients who need no further medical treatment are waiting in the hospital for aftercare. The congestion of departments by bed blocking has a negative impact on both costs and service level of the provided care. Contradicting financial objectives of nursing homes and hospitals make this a continuous problem. Nursing homes aim at maximising bed occupation, while hospitals aim for maximum bed availability at nursing homes. Increased availability of nursing home beds allows patients who do not require further medical care to go to a nursing home, so it becomes possible to admit new patients in the hospital. The impact of every extra day spent in the hospital increases with the trend of decreasing lengths of stay in hospital care. Bed blocking can be caused by lack of transparency and bad communication processes between the hospital and cooperating nursing homes. On the other hand, lack of available nursing home beds causes bed blocking. Fluctuations in demand and patient preferences for specific nursing homes, in turn, hinder balancing occupation. In the literature, little research is available on how to integrate care needs that span over different care providers. We study the dynamics of a smooth and timely flow of patients from a hospital towards nursing homes. Objective: To design a tool that allows analysis of various configurations of transmural networks, in order to minimise bed blocking. The study explores interventions of bed reservation by hospitals and of (temporary) reallocating capacity to other patient categories. The main performance indicators we use are waiting time (bed blocking days), occupation of nursing home departments and throughput of nursing homes.
Celiac Disease: A Scientometric Analysis of World Publication Output, 2005-2014

International license. Cite this article: Bansal M, Gupta R, Bansal J. Celiac Disease: A Scientometric Analysis of World Publication Output, 2005-2014. OGH Reports. 2017;6(1):8-15. ABSTRACT The paper presents an analysis of 14317 world papers in celiac disease, retrieved from Scopus database for the period 2005-14, experiencing an annual average growth rate of 5.20% and citation impact of 12.53. The 15 most productive countries account for 83.89% share in world output, with largest share (21.40%) coming from U.S.A, followed by Italy (12.61%), U.K. (8.23%), Germany (5.41%) etc., during 2005-14. U.S.A achieved the global citation share (35.13%) followed by Italy (17.16%), U.K. (15.74%) etc. Medicine registered the highest publication share (87.93%), followed by biochemistry, genetics and molecular biology (13.56%), immunology and microbiology (6.73%), agricultural and biological sciences, (5.57%), nursing (3.07%), pharmacology, toxicology and pharmaceutics (2.74%), neurosciences (2.26%), etc. Diarrhoea contributed the largest share (8.10%) in publications by symptoms during 2005-14, followed by abdominal pain (7.68%), insulin dependent diabetes mellitus (6.84%), Crohn disease (6.22%), enteritis (5.34%), etc. Gluten free diet contributed the largest share (18.47%) among significant keywords. The 15 most productive organisations, authors and journals accounted for 15.06%, 10.71% and 16.57% share of the world publication output respectively during 2005-14. It is concluded that individual countries must foster global research and development, by way of providing increased investment in R and D and increase their specialized manpower and provide adequate training courses and infrastructural facilities to scientists and researchers to control the challenges faced by the spread of this disease.
Scientific Opinion on the safety evaluation of the substance, titanium nitride, nanoparticles, for use in food contact materials

This scientific opinion of EFSA deals with the safety evaluation of titanium nitride, nanoparticles with the European Commission REF. No 93485 and FCM substance No 807, for use as additive in PET plastics. A request has been submitted for an extension of use in thermoformed PET sheets/films in addition to the use in PET bottles, evaluated by the EFSA in 2008. Under the intended conditions of use, no migration of the substance into food is expected and therefore no exposure of the consumer via food is expected. Based on this, the CEF Panel concluded that there is no safety concern for the consumer if the substance is used up to 20 mg/kg in only PET plastics intended for contact with all types of foodstuffs under conditions of any duration of time and at temperatures up to and including hot-fill.
Supporting Beginning Primary Mathematics Teachers through a 'Fellow Worker' Professional Development Model

A large study tracked four primary teachers during their ftrst year of teaching, with a focus on how a 'fellow worker' professional development support model influenced their pedagogical. practices and beliefs concerning mathematics. The case studies used an interpretive research approach for analysis of data from interviews, observations, reflective journals, and group meetings. The fmdings highlight how the realities and challenges of beginning teachers' classroom experiences prompted adoption of 'traditional', teacher­ centred mathematics pedagogy. Support in the form of a 'fellow worker' helped the beginning teachers survive and then begin to teach in ways consistent with current trends in mathematics education.
A Comparative Study of Clinical Scoring System of Cerebrovascular Accident with CT Scan

OBJECTIVE: Stroke is the second most common cause of death and major cause of disability worldwide. Low and middle income countries account for 85.5% of total stroke deaths worldwide and the number of disability-adjusted life years in these countries is seven times that in high income countries. CT scan is a safe and non-invasive procedure for differentiating between cerebral infarction and haemorrhage. However, in India and other developing countries the availability of CT scan facilities in rural and peripheral centres is low but cost of scanning precludes its routine usage by the poorer society. So this study aims at differentiating ischaemic and haemorrhagic strokes at bedside by using clinical scoring systems and to compare the accuracy of clinical scoring with the CT scan findings. METHODS: This was a prospective clinical study on 100 patients who presented to the hospital within 72 hours of onset of symptoms of stroke. Siriraj and Allen stroke score were calculated using various parameters, subsequently all of these patients underwent CT scan of brain and accuracy of clinical scoring system with the CT scan was compared. RESULTS: Most number of affected patients belonged to the age-group 61-70 with a male preponderance. 66% of the stroke cases were ischaemic, most common presenting symptom was hemiplegia followed by altered sensorium. Midline shift in CT scan was seen more in haemorrhagic stroke patients. On comparison of Siriraj score with CT scan findings correct correlation was seen in 82% of cases while Allen score showed correct correlation only in 67% of cases so the diagnosis of stroke subtype was best predicated by Siriraj score as compared to Allen score. CONCLUSION: Present study shows that Siriraj score had good sensitivity and positive predictive value for ischaemic stroke (91.93% and 90.47%) while for haemorrhagic stroke sensitivity and positive predictive value was less (80.6% and 83.33%). Allen's score also showed good sensitivity and positive predictive value (96.2% and 91.22%) for ischaemic stroke however for haemorrhagic stroke it had poor sensitivity and positive predictive value (75% and 88.23%). So overall Siriraj score is a better tool for bedside early clinical diagnosis of stroke and to start anti-ischaemic therapy where immediate CT scan facilities are not available but these scores cannot be used for deciding thrombolysis using recombinant tissue plasminogen activators (r-tPA) which requires exclusion of haemorrhage by CT scan.
Response of TLD badges and cards for measurement of the operational quantity Hp(10) to a 137Cs source

The operational quantity, H p (10), for strongly penetrating radiation was measured by a dosimeter placed on a phantom surface for individual external dose monitoring. Measurement of H p (10) was carried out with a 137 Cs source using CaSO4 :Dy Teflon-based TLD badges and cards placed on the surface of a PMMA as well as water phantom at a depth of 10 mm. The ratio of response of the TLD discs to TLD badges and that of the TLD cards under similar conditions were identical for different experimental conditions. This experiment quantified the impact of the cassette on the dose measurement. Minor changes in the PMMA phantom thickness beyond 15 cm showed an insignificant impact on the dosimeter response.
Emphysematous Pyelonephritis in a Black African Woman Managed with Antibiotics Alone

Introduction: Emphysematous pyelonephritis (EPN) is a severe, life-threatening infection of the renal parenchyma. This condition is characterized by the production of intrarenal and perinephric gas. In the world, the EPN is currently limited to case series reported. No cases have been described in black Africa. Aims: Related a first case of EPN diagnosed and treated in the University Hospital Center Sylvanus Olympio of Lome in Togo. Observation: A 40 years old woman, with antecedent of diabetes presented pyelonephritis emphysematous class 2. She was treated successfully with antibiotic alone without using percutaneous drainage or nephrectomy. Conclusion: As reported in every case series, it was a young diabetic patient with a clinical features of acute pyelonephritis which CT scan had helped lay the EPN class 2 diagnosed. The germ was Klebsiella pneumoniae. She was treated with adapted antibiotic alone.
Outpatient surgery for brain tumours: A changing paradigm

Patient selection is of utmost importance for successful implementation of outpatient surgery. In addition, patients and attendants need to be educated regarding the procedure, the expected complications and the necessity to readmit the patient in the event of complications. The post-operative complications that one is particularly concerned about in these patients include intracranial haematoma, post-operative brain swelling and seizures. The incidence of surgical haematoma following intracranial surgery requiring surgical evacuation is 2%. [10] Taylor et al. found that intracranial haematoma usually occurs within 6 h of craniotomy or stereotactic biopsy. [11] Keeping this in mind, the DSU protocol includes a post-operative computed tomography scan at 4 h and conversion to inpatient status in the event of significant haematoma or oedema, even if the patient is clinically asymptomatic. [1] Usually, patients are discharged 6 h after surgery once the discharge criteria are met. Post-operative brain oedema, which usually peaks around the 2nd or 3rd post-operative day, has the incidence of 10%. [12] Most neurosurgeons prefer to keep their patients under observation during this period although the value of this is not really known. [13] In a recent 5-year retrospective observational study of same-day discharge for supratentorial tumours, Venkatraghavan et al. found that successful same-day discharge was possible in 88.4% of patient with a readmission rate of 2.9%. [1] Same-day discharge has been found to be feasible after both GA and awake craniotomy. [1,3] The key factors contributing to successful discharge on the day of surgery include careful patient selection on an individualised basis, small craniotomy flaps and an estimated surgical duration of <4 h. The latter would enable 6 h of post-operative monitoring before discharging the patient to home. Sughrue et al. demonstrated the feasibility of early discharge (day 1 or 2) following keyhole craniotomies under image guidance. [13] In their series, 17% were infratentorial lesions. Their philosophy was to discharge The last couple of decades has witnessed an increasing trend in ambulatory surgery and day of admission surgery. Enhanced recovery after surgery (ERAS) is a multimodal perioperative pathway of care model designed to facilitate early discharge of patients from hospital and at the same time achieve improved functional capacity. [1] The advantages to the patient are manifold and include less time spent in the hospital, less time lost at work preoperatively and the ability to remain in a familiar setting preoperatively, all of which lead to better patient satisfaction. Shortened hospital stays and earlier mobilisation also reduce the risk of hospital‐acquired infections and venous thromboembolism and, interestingly, less risk for medical errors. [2-5] Moreover, it is more economical to the hospital as there is more efficient and effective use of resources including decreased average length of stay and increased availability of inpatient surgical beds in the hospital. [6] The latter leads to fewer case cancellations. [3]
Generalized Inverse Optimization with Application to Cancer Therapy

Generalized Inverse Optimization with Application to Cancer Therapy Taewoo Lee Doctor of Philosophy Graduate Department of Mechanical and Industrial Engineering University of Toronto 2015 Inverse optimization has recently received a growing amount of attention as a datadriven approach to determining parameter values for an optimization problem. In this thesis, we study new inverse optimization methodologies that generalize the traditional method of solving inverse optimization problems and accommodate data that makes the standard method ill-posed. We apply the proposed methodologies to prostate cancer therapy data and provide novel insights for radiation therapy treatment planning. In the first part of the thesis, we briefly review recent theoretical development of inverse optimization and discuss how this thesis contributes to the literature. In the second part of the thesis, we describe a motivational example in radiation therapy treatment planning and illustrate the problem settings and clinical data. In the third part of the thesis, we develop generalized inverse linear optimization models. We characterize the relationship between the generalized models and the standard model in the literature. By building on the models in general inverse multiobjective optimization problems, we establish a new connection between inverse optimization and existing multiobjective optimization techniques. We show how our methods can be used for determining objective function weights for radiation therapy treatment planning. Next, we present a clinical application of the results from the previous part of the thesis, by proposing a statistical model that relates the objective function weights to ii a patient’s anatomical characteristics. Using the statistical relationship, we propose a prediction model that infers objective function weights from patient anatomy and provide a proof of concept of automated, knowledge-based weight determination for radiation therapy treatment planning. Finally, we extend the theory of the second part of the thesis by developing generalized inverse convex optimization models. In the multiobjective optimization framework, we propose inverse convex optimization models that preserve the preference ordering among different objectives that is encoded by given data, and compare our models to existing inverse optimization models using prostate cancer therapy data. We present a unifying framework that encompasses many of the inverse optimization models in the literature.
Molecular Basis of G6PD Deficiency in Babylon : Iraq

Objective: The objective of this study was to investigate the molecular basis of glucose-6-phosphate dehydrogenase (G6PD) genes in hyperbilirubinemic neonates in Babylon province of Iraq by using molecular methods (genomic DNA extraction, PCR and RFLP analysis) and then to investigate the type of G6PD variant predominantly present. Methods: The study included a total of 236 full-term male neonates, 183 of them were associated with severe hyperbilirubinemia which were admitted in Teaching Hospital of Pediatric and Maternity / Babylon during 1 st , Oct., 2007 to 14 th , July, 2008 with age ranged between 1 - 28 days, their TSB levels ≥ 15 mg/dl , while another 53 neonates were used as control group. The blood sample taken from each neonate was divided into two aliquots: the first aliquot was used for hemoglobin (Hb), total and conjugated bilirubin (TSB and SCB), G6PD activity. The second aliquot was used for molecular analysis including genomic DNA extraction and then application of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) protocols. Results and Discussion: Severe hyperbilirubinemic neonates were screened for erythrocyte G6PD enzyme activity measurements, severe G6PD deficiency was detected in 22 of the total 183 hyperbilirubinemic neonates included and their activity levels was significantly decreased (P < 0.05) to 0.34 ± 0.17 U/g Hb as compared with control value 10.02 ± 1.17 U/g Hb. The incidence of severe G6PD deficiency in neonatal hyperbilirubinemic neonates identified was 12.02 %. TSB levels were markedly elevated to (23.01 ± 5.0 mg/dl), whereas the control value was 0.75 ± 0.23 mg/dl. The mean ± SD values of each of SCB and Hb were significantly lower than that found in controls (P < 0.05) and reached to 0.063 ± 0.036 mg/dl ; 13.32 ± 0.94 g/dl as compared with that found in control neonates 0.19 ± 0.11 mg/dl ; 15.91 ± 1.62 g/dl respectively. Conjugated bilirubin was undetectable in sera of 10 of 22 neonates (45.5%) with severe G6PD deficiency which imply a partial defect of bilirubin conjugation.
Development of In Vivo Lung Perfusion Strategy for the Treatment of Lung Metastases

In Vivo Lung Perfusion (IVLP) can potentially enhance the treatment of lung metastases by allowing the delivery of elevated doses of chemotherapy to the lungs without systemic exposure. Previously, experimental and clinical studies reported questionable efficacy and frequent lung toxicity, hindering the broad application of this technique. We have developed a modified IVLP strategy that avoids acute lung injury using a protective mode of ventilation/perfusion. Our IVLP strategy enabled an extended perfusion time using chemotherapy doses usually given intravenously to patients. Additionally, we successfully administered higher chemotherapy levels in a safe manner and found higher lung tissue levels of chemotherapeutic drugs compared to previous studies. Importantly, these findings were possible without acute lung injury, demonstrating a likely protective effect of our IVLP strategy. This is a significant step towards a safer and more effective IVLP technique to help patients with pulmonary metastases, minimizing the adverse effects of chemotherapy to the lungs.
Rural Minority Students’ Perceptions of Ms. An, The Robot Teaching Assistant, as a Social Teaching Tool

We present a socially interactive robotic teaching assistant to engage 5th grade rural minority students in practicing multiplication. In this research we use a NAO humanoid robot as a robotic teaching assistant, Ms. An ( M eeting S tudent’s A cademic N eeds). We have programmed this robot to ask a student multiplication questions based on the Common Core State Standards. We measured, via questionnaires, the students’ perceptions of the robot’s sociability and explored the students’ preference for using the robot as a study tool. We discovered that students perceived the robot as a sociable agent, for 8 of the 10 social ability questionnaire items. Furthermore, perceptions of social ability significantly increased between pre- and post-interaction. Students also indicated, via questionnaire, that they preferred their interaction with the robot assistant over other kinds of study support: peers, computer programs, teachers, other adults. Results from this study provide insight toward the design of a social robot teaching aid.