Miracle-dz/UniFAR-FTUs huggingface dataset:
Analysis of stress level and burnout syndrome among physicians of different medical specialties in primary health care

Introduction. Burnout syndrome is a common problem among healthcare workers. The aim of the study was to investigate the level of stress, components of burnout syndrome and the most common causes of workplace stress among the physicians working in the Primary Health Care Center Banja Luka, after which the obtained results concerning family physicians and the physicians of other specialties were compared. Methods. The observational study was conducted by interviewing physicians during the period March to May 2018. All employed physicians were provided with the following questionnaires: The socio-demographic questionnaire, the questionnaire for self-assessment of the level of stress, the questionnaire about the most frequent causes of stress at work and the Maslach Burnout Inventory. Results. The study included 211 physicians, out of a total of 246 physicians (127 family physicians and 84 physicians of other specialties) working in the Primary Health Care Center Banja Luka. There was a significantly higher level of stress (p = 0.011), emotional exhaustion (p < 0.001) and depersonalization (p < 0.001) among family physicians compared to the physicians of other specialties. There was a significant difference in the presence of all causes of stress among family physicians, except the stress concerning the patients requiring emergency care. The multivariate logistic regression analysis found that stress was significantly associated with emotional exhaustion in both groups and with personal accomplishment in family physicians. In family physicians, there was a significant association between a high level of depersonalization and personal accomplishment. In physicians of other specialties significant association was found between education and emotional exhaustion as well as personal accomplishment, and between female gender and high level of depersonalization. Conclusion. The level of stress and the burnout syndrome were considerably more present in family physicians compared to physicians of other specialties.
Eczema the hidden face of primary immunodeficiency diseases

Primary immunodeficiency diseases (PIDs) are a group of more than 130 disorders caused by genetic defects of the immune system. Most of these disorders are caused by single gene defects, but the variable penetrance of these mutations results in heterogeneous phenotypes which lead to a delay in the diagnosis. In the USA, the prevalence of all PIDs per 100,000 has increased over the last decade from 66.6 in 2003 to 126.8 in 2012 and this could reflect the rise in the disease awareness. The classical clinical presentation of PIDs includes recurrent or unusual infections, however, new presentations are now coming to attention such as autoimmune diseases, malignancy and cutaneous manifestations. Cutaneous manifestation in PIDs affects around 40 % to 70 % of patients and they include various presentation as eczema, cutaneous granulomas, recurrent abscesses, dysplasia of skin, hair, and nails, autoimmune conditions, and others. Dhouib et al found that the incidence of cutaneous manifestation among 200 children with PIDs to be 56%, whereas Al-Herz et al and Moin et al found it to be 48% and 32% respectively. Cutaneous manifestations could be the first presenting symptoms and faulty presenting to dermatologist. In a series of 75 patients with severe dermatitis with no known underlying primary immunodeficiency, Aghamohammadi et al identified 5 patients with hyperimmunoglobulin E syndrome (HIES) and one patient with Wiskott Aldreich syndrome (WAS). This raises the awareness to suspect an underlying PID in patients presenting with severe and nonresolving cutaneous manifestation. Eczema (Atopic dermatitis “AD”) is an inflammatory, chronically relapsing, noncontagious and extremely pruritic skin disease. It is commonly associated with an elevation in total immunoglobulin E, which sometimes correlates with disease severity. The prevalence of childhood AD ranges from 15% to 30%. AD is one of the commonest cutaneous manifestations for some PID diseases and sometime used as one of the disease diagnostic critieria of HIES, WAS, and others (Table). It is characterized by being severe, resistant to treatment and associated by chronic or recurrent viral or bacterial infections. Such condition confirms the importance of eliciting history of recurrent infections in affected patients or history of infection in any of their family members .
Dialogue Systems and Dialogue Management

Abstract : A spoken dialogue system (SDS) is a specialised form of computer system that operates as an interface between users and the application, using spoken natural language as the primary means of communication. The motivation for spoken interaction with such systems is that it allows for a natural and efficient means of communication. It is for this reason that the use of an SDS has been considered as a means for furthering development of DST Groups Consensus project by providing an engaging spoken interface to high-level information fusion software. This document provides a general overview of the key issues surrounding the development of such interfaces.
How much compliance is too much compliance: Is long-term ABA therapy abuse?

Abstract This article discusses the prevalence of ASD with specific regard to the most ubiquitous current treatment, Applied Behavior Analysis (ABA). A discussion of some of the issues with the underlying theory of ABA in its current application is conducted, especially with regard to “lower functioning” and nonverbal autistic individuals; namely, the curtailing of soothing “stimming” behaviors, operant conditioning, behaviorist principles that research has continued to prove it is not apt for usage with autistic individuals, as well as the unintended but damaging consequences, such as prompt dependency, psychological abuse and compliance that tend to pose high costs on former ABA students as they move into adulthood. Serious issues with the application of ABA to autistic students, specifically “lower functioning” and nonverbal ones, are discussed, especially with regard to lack of current and longitudinal scientific testing and research with respect to these individuals. These effects and the trauma that occurs resultantly are categorized as abuse. Finally, drivers of the expanded usage of ABA within the autistic community despite a lack of efficacy are also discussed, such as a potential current market size as large as $17 billion annually and the deficiency of variety in techniques used by the psychologists and behavior technicians who utilize ABA with ASD students, as well as a lack of introspection about the true effectiveness of the technique amongst the whole population on the part of these professionals.
[Burdens and resources of nurses working in the specialist palliative care: an explorative cross-sectional study].

Burdens and resources of nurses working in the specialist palliative care: an explorative cross-sectional study Abstract. Background: For Germany, there are no studies so far which compare the burdens and the resources of nurses working in the specialized palliative care settings. AIM The aim of this study was to analyse and compare burdens and resources of nurses working in palliative care wards, inpatient hospices and in specialized outpatient palliative care services. METHOD In 2015, nurses from the referred settings in Rhineland-Palatinate were invited to complete a self-developed questionnaire on burdens and resources. Contingency tables, Kruskal-Wallis tests and regressions were calculated. RESULTS 149 nurses (response rate: 34.5 %) participated in the survey. Nurses working in palliative care wards indicated higher values in all types of burdens than nurses working in hospices and specialized outpatient palliative care. Nurses in palliative care wards and hospices reported emotional burdens as the most stressful factor, while nurses working in specialized outpatient care services expressed the highest levels of burdens in patient-related areas. An association between the experienced amount of burdens and having acquired an additional qualification in palliative care was determined (adjusted Odds Ratio (aOR) for burden due to organizational conditions: 2.56, CI: 1.06 - 6.19; aOR for burden due to support for family members: 2.99, CI: 1.06 - 8.46). The three settings in our study differ in terms of the availability of the resources family, group supervision and additional qualifications. CONCLUSIONS This study provides an insight into the burdens and the resources of nurses working in palliative care wards, hospices and specialized outpatient palliative care services in Rhineland-Palatinate, Germany. Future preventative measures should be tailored to the respective settings.
Role of Aspergillus Galactomannan Antigen Test for the Screening of Invasive Aspergillosis in Patients with Hematological Malignancies

Background: Invasive aspergillosis (IA) is a leading cause of death among immunocompromised patients, particularly those with hematological malignancies. The use of galactomannan (GM) antigen as a biological marker for screening of IA in high-risk patients is attractive and non-invasive tool that detect evidence of IA prior to the appearance of clinical manifestations. Objectives: The aim of this study was to compare the diagnostic value of the conventional blood culture technique to the serological detection of GM antigen using ELISA for screening of IA in neutropenic patients with hematological malignancies. Methods: Forty patients with haematological malignancies from those admitted to the Clinical Oncology Department of Menoufia University Hospitals (MUH) were enrolled and classified to have either proven (5/40; 12.5%), probable (10/40; 25%) or possible (25/40; 62.5%) invasive aspergillosis based on the clinical criteria provided by the European Organization for research and treatment of Cancer (EORTC) and Mycoses Study Group (MSG). Blood samples were collected from all participants and subjected to conventional blood culture for isolation and identification of Aspergillus spp. ELISA technique was applied for serological detection of GM antigen in the patients’ serum samples. Results: The sensitivity, specificity, PPV(positive predictive value) and NPV (negative predictive value of GM antigen ELISA testing were 100%, 74%, 36% and 100% respectively for both proven and probable cases. On applying the principle of test in series (the patient is positive if positive in both culture and the GM test), the results were improved to 100% sensitivity, 100% specificity, 100% PPV, 100% NPV and 100% accuracy. Galactomannan antigen testing proved excellent sensitivity (80%) compared to other clinical features and radiological criteria for diagnosis of probable aspergillosis and proved to be a good negative test. Conclusion: With conjunction of clinical and radiological signs, Aspergillus GM test can assist physicians in the of diagnosis of IA in patients with hematological malignancies to allow initiation of effective antifungal therapy which is ultimately important in high-risk populations.
Intensity of Health Behaviors in People Who Practice Combat Sports and Martial Arts

Background: Health behaviors are associated with a healthy lifestyle, in which relative possibilities of choice play an important part. Athletes are a group of people who should particularly endeavor to have a health-oriented lifestyle. It is believed that combat sports (CS) and martial arts (MA) have an especially significant educational potential, connected with several desirable values which provide positive patterns of health behaviors. The aim of the work was to assess the intensity of health behaviors in athletes who practiced CS and MA in relation to the length of their training history, their age, sex, place of residence, education level, and financial situation. Methods: The research involved 441 men and women who practiced boxing (B), Brazilian ju-jitsu (BJJ), karate (K), mixed martial arts (MMA) and Muay Thai (MT). The average age of the subjects was 24.68 ± 8.24 years. The standardized Health Behavior Inventory (HBI) questionnaire and another questionnaire for a lifestyle survey were applied. Individual behaviors covered four areas: Correct eating habits (CEH), preventive behaviors (PB), positive mental attitude (PMA), and health practices (HP). The one-way analysis of variance (F-test) for independent groups was used (ANOVA). The effect size was calculated with Hedge’s g for Student’s t-test, and with Cramér’s V for the χ2 test. The value of p ≤ 0.05 was assumed to be statistically significant. Results: CS and MA athletes presented a moderate level of health behaviors. The greater intensity of health behaviors (HBI and its categories) was found among B, K and MMA athletes, and the smaller among those who practiced MT. Correct eating habits (CEH) were characteristic of subjects who practiced every day and whose length of training history was 4–8 years. Greater intensity of preventive behaviors (PB) was observed among individuals aged under-19 years, who still studied. Greater intensity of health practices (HP) was found among those who exercised every day. Influence of financial situation was observed in relations to PMA. Conclusions: It seems that the existing educational potential of CS and MA was not fully realized in the studied population. Determining the place of health in the system of values of CS and MA athletes may be the basis for predicting health behaviors and developing health education programs.
Livelihood Implications of Redd+ and Costs-Benefits of Agricultural Intensification in Redd+ Pilot Area of Kilosa, Tanzania

Agriculture is the primary driver of deforestation and degradation. This makes addressing deforesting and degrading agricultural practices highly pertinent in the REDD+ planning and implementation. REDD+ interventions target to mitigate deforestation and degradation by addressing underlying drivers such agricultural expansion into forestland. In tropical Africa, encroachment of forests in search of fertile virgin land has been a common practice. Inevitably, the REDD+ processes will impact on the local livelihoods in different ways – positive and negative. The local-level land use plans promoted under REDD+ are likely to alter how much land a farmer would access and where. Different groups of the poor will be affected differently. Land use alterations will impact on the local food security and food systems at large. In view of such impacts, compensations are made integral of REDD+ programming and delivery. REDD+ projects promote agricultural intensification practices such as conservation agriculture in order to attain higher food production per unit land while mitigating deforestation and degradation. As REDD+ concept is being piloted in the country, we have limited understanding of the livelihood implications of REDD+ interventions. Furthermore, local-scale economic viability of measures used to address drivers of deforestation and degradation such as agricultural expansion is empirically not well understood. This paper is a modest attempt to illuminate the livelihood implications of REDD+ interventions and estimate the economic viability of agricultural intensification practices in the REDD+ pilot area in Kilosa district, Tanzania.
Doppler evaluation of renal blood flow as a predictive index of acute renal failure in perinatal asphyxia

Background: Renal involvement is a common occurrence in perinatal asphyxia. Till date, only a handful of studies from across the globe have evaluated the use of renal Doppler as a predictive modality for acute kidney injury (AKI) in birth asphyxia. Aims: To evaluate the role of Doppler study of renal blood flow in predicting acute renal failure in perinatal asphyxia. Settings and design: This was a prospective cohort study. Materials and methods: 30 preterm and term neonates with perinatal asphyxia defined as an Apgar score of 0-3 at 1 minute and cord pH of ≤ 7.00 or base deficit of > 16 mmol/L and 30 healthy neonates matched for gestational and postnatal age were enrolled. Renal blood flow parameters were studied on the 1st day and the 3rd day. Serum creatinine was taken as the gold standard for defining AKI. Statistical analysis used: Receiver operating characteristics (ROC) was used to evaluate the diagnostic performance of renal Doppler. SPSS® version 17.0 was used. Results: The ROC curves obtained for all the renal blood flow parameters on day 1 and day 3 to see the utility of the renal Doppler ultrasonography in predicting acute renal failure in severe birth asphyxia revealed that the area under the curve (AUC) was not significant for any of the parameters. Conclusions: Contrary to the results seen in the previous studies, this study indicates that renal blood flow parameters may not be a useful modality to predict the occurrence of AKI in perinatal asphyxia.
Deep variational autoencoders for breast cancer tissue modeling and synthesis in SFDI

Extracting pathology information embedded within surface optical properties in Spatial Frequency Domain Imaging (SFDI) datasets is still a rather cumbersome nonlinear translation problem, mainly constrained by intrasample and interpatient variability, as well as dataset size. The β-variational autoencoder (β-VAE) is a rather novel dimensionality reduction technique where a tractable set of latent low-dimensional embeddings can be obtained from a given dataset. These embeddings can then be sampled to synthesize new data, providing further insight into pathology variability as well as differentiability in terms of optical properties. Its applications for data classification and breast margin delineation are also discussed.
Comparison of spatial reconstruction software packages using DSLR images

Point cloud based modeling has become widely used in recent years in the engineering practice. This paper presents several point clouds produced by different software packages using pixel based multi view spatial reconstruction. The purpose of the investigation is to give statistical quality measures beyond the apparent differences between the point clouds. Reference measurements have been carried out by terrestrial laser scanning. There are proprietary and free software solutions among the tested programs.
Statistical analysis of breast cancer: The effects of missing values on survival data

Worldwide, breast cancer is the most common cancer in women. In Scotland, there are currently over 3,000 women diagnosed with the disease each year and the incidence continues to rise. Despite some major advances in the treatment of breast cancer, with the discovery of tamoxifen and the on-going development of cytotoxic drugs, only 60% of women are still alive after five years, many of whom have a relapse at some later stage. Against that background, the main aims of this thesis are to interpret the findings of a survival analysis of cases of breast cancer in Scotland; to investigate whether the method of including extra categories for unknown values in factors in that analysis is appropriate; and to check whether the assumption of proportional hazards is valid. Chapter 1 provides a general introduction, whilst Chapter 2 examines the burden that breast cancer places on the National Health Service in Scotland and throughout the world. The risk factors for getting the disease and the different strategies available for treatment of the cancer are also presented. To identify how women with breast cancer in Scotland were managed. Chapter 3 outlines some background to a national retrospective audit of all cases of invasive breast cancer in the years 1987 and 1993. Analyses of a subgroup of the 1987 cohort constitute the majority of this thesis. Chapter 4 examines the associations among the variables included in the survival analysis. The patterns among the missing values in four of the prognostic factors are also investigated, using log-linear- modelling. The method employed in analysing this cohort of women was to create extra categories to represent unknown values in each of the factors. Other techniques available for handling missing values in models are discussed, along with a summary of the methods used in other relevant studies of breast cancer survival. Chapter 5 presents a survival analysis of the cohort, including a discussion of the findings in relation to other relevant studies. Model checking is performed on the best fit model to assess the adequacy of the fit of it and to validate the assumption of proportional hazards. The remainder of the chapter focuses on a comparison of the results from fitting Cox models using the additional categories and the complete cases methods. This investigates whether different interpretations would be concluded from these models. In Chapter 6, simulated datasets are generated using exponential distributions to investigate whether the proportional hazards assumption is valid when additional categories are used to extend two factors at two levels to three levels in an exponential regression model. The extent of any biases for the parameter estimates is examined. Chapter 7 provides a summary of the key conclusions and highlights areas of future research.
Default Mode Network Connectivity Predicts Emotion Recognition and Social Integration After Traumatic Brain Injury

Moderate-severe traumatic brain injury (TBI) may result in difficulty with emotion recognition, which has negative implications for social functioning. As aspects of social cognition have been linked to resting-state functional connectivity (RSFC) in the default mode network (DMN), we sought to determine whether DMN connectivity strength predicts emotion recognition and level of social integration in TBI. To this end, we examined emotion recognition ability of 21 individuals with TBI and 27 healthy controls in relation to RSFC between DMN regions. Across all participants, decreased emotion recognition ability was related to increased connectivity between dorsomedial prefrontal cortex (dmPFC) and temporal regions (temporal pole and parahippocampal gyrus). Furthermore, within the TBI group, connectivity between dmPFC and parahippocampal gyrus predicted level of social integration on the Community Integration Questionnaire, an important index of post-injury social functioning in TBI. This finding was not explained by emotion recognition ability, indicating that DMN connectivity predicts social functioning independent of emotion recognition. These results advance our understanding of the neural underpinnings of emotional and social processes in both healthy and injured brains, and suggest that RSFC may be an important marker of social outcomes in individuals with TBI.
Renal Replacement Therapy in the Critical Care Setting

Renal replacement therapy (RRT) is frequently required to manage critically ill patients with acute kidney injury (AKI). There is limited evidence to support the current practice of RRT in intensive care units (ICUs). Recently published randomized control trials (RCTs) have further questioned our understanding of RRT in critical care. The optimal timing and dosing continues to be debatable; however, current evidence suggests delayed strategy with less intensive dosing when utilising RRT. Various modes of RRT are complementary to each other with no definite benefits to mortality or renal function preservation. Choice of anticoagulation remains regional citrate anticoagulation in continuous renal replacement therapy (CRRT) with lower bleeding risk when compared with heparin. RRT can be used to support resistant cardiac failure, but evolving therapies such as haemoperfusion are currently not recommended in sepsis.