Treatment of Advanced Parkinson's Disease

Patients at late stage Parkinson's disease (PD) develop several motor and nonmotor complications, which dramatically impair their quality of life. These complications include motor fluctuations, dyskinesia, unpredictable or absent response to medications, falls, dysautonomia, dementia, hallucinations, sleep disorders, depression, and psychosis. The therapeutic management should be driven by the attempt to create a balance between benefit and side effects of the pharmacological treatments available. Supportive care, including physical and rehabilitative interventions, speech therapy, occupational therapy, and nursing care, has a key role in the late stage of disease. In this review we discuss the several complications experienced by advance PD patients and their management. The importance of an integrative approach, including both pharmacological and supportive interventions, is emphasized

Compressed Real Numbers for AI: a case-study using a RISC-V CPU

As recently demonstrated, Deep Neural Networks (DNN), usually trained using single precision IEEE 754 floating point numbers (binary32), can also work using lower precision. Therefore, 16-bit and 8-bit compressed format have attracted considerable attention. In this paper, we focused on two families of formats that have already achieved interesting results in compressing binary32 numbers in machine learning applications, without sensible degradation of the accuracy: bfloat and posit. Even if 16-bit and 8-bit bfloat/posit are routinely used for reducing the storage of the weights/biases of trained DNNs, the inference still often happens on the 32-bit FPU of the CPU (especially if GPUs are not available). In this paper we propose a way to decompress a tensor of bfloat/posits just before computations, i.e., after the compressed operands have been loaded within the vector registers of a vector capable CPU, in order to save bandwidth usage and increase cache efficiency. Finally, we show the architectural parameters and considerations under which this solution is advantageous with respect to the uncompressed one

Title: A cross sectional multisite exploration of Italian paediatric nurses' reported burnout and its relationship to perceptions of clinical safety and adverse events using the RN4CAST@IT-Ped

AimTo explore Italian paediatric nurses’ reported burnout and its relationship to their perceptions of safety and adverse events.DesignA cross‐sectional study using the RN4CAST@IT‐Ped database with a web‐based survey design.MethodsThe RN4CAST@IT‐Ped questionnaire was used to collect data in 2017. This comprised three main components: three dimensions (22 items) of the Maslach Burnout Inventory including emotional exhaustion, depersonalization and personal accomplishment. Participants also scored an overall grade of patient safety and estimated the occurrence of adverse clinical events.ResultsNurses (N = 2,243) reported high levels of burnout. Most rated clinical safety as high. The risk of adverse events ranged from 1.3–12.4%. The degree of burnout appeared to influence the perception of safety and adverse events.ConclusionThe association between nurses’ burnout and perceptions of higher rates of adverse events and reduced safety in clinical practice is an important finding. However, it is unclear whether this was influenced by a negative state of mind, and whether reduced safety and increased adverse events negatively influenced nurses’ well‐being, thus leading to burnout. Regardless, the association between nurses’ burnout and these quality concepts needs further exploration to examine the effect, if any, on burnout and safety, and identify supportive mechanisms for nurses.ImpactThe association between reported burnout and perception of safety and risk of adverse events in Italian paediatric nurses has been reported for the first time. Nurses reporting burnout are at greater risk of intensely negative perceptions of clinical safety and adverse events. This is an important finding as perceptions can influence practice and behaviours. Quality measures in children's clinical environments need to go beyond obvious indicators to examine nurses’ well‐being as this also influences quality and safety

Unmet nursing care needs on medical and surgical wards : a scoping review of patients’ perspectives

© 2019 John Wiley & Sons Ltd Aims and objectives: To review and synthesise research studies on surgical and medical inpatients’ perceptions on unmet nursing care needs. Background: Missed nursing care is a growing phenomenon that has been shown to adversely affect care outcomes—mainly in adult medical and surgical care settings. However, to date the aggregated and synthesised evidence of missed care comes from research that measures perceptions on missed care in surgical and medical settings from nurses, but not from the patients. Design: Scoping review. Methods: In September 2018, three databases were searched: MEDLINE/PubMed, CINAHL and SCOPUS and papers were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were as follows: primary studies; published in peer-reviewed journals; in English or Italian; and regarding routine care provided to adult inpatients. Quality appraisal and a thematic analysis were conducted. Results: Of the 1541 abstracts initially identified, 44 papers were included. Five themes emerged: “communication,” “self-management, autonomy and education,” “personal sphere,” “essential physical care” and “emotional and psychological care.” The majority of the unmet needs were related to the “personal sphere” and “emotional and psychological care.” These unmet needs were not identified in previous literature on nurses’ perspectives of missed care. Also, physical care deficits like oral hygiene were identified. Conclusion: It is important to take into account patients’ perspectives. The themes focusing on patients’ personal sphere, and emotional and psychological care, underline how patients need nurses to pay more attention to their cultural background, consider the person as a whole and for nursing care to be holistic and respectful of patients’ dignity. Relevance to Clinical Practice: This study intends to raise awareness amongst nurses and policymakers about the importance of addressing missed nursing care and unmet patients’ needs in adult medical or surgical inpatient settings to ensure high-quality care and patient satisfaction

Modelling the Dynamics of an Aedes albopictus Population

We present a methodology for modelling population dynamics with formal means of computer science. This allows unambiguous description of systems and application of analysis tools such as simulators and model checkers. In particular, the dynamics of a population of Aedes albopictus (a species of mosquito) and its modelling with the Stochastic Calculus of Looping Sequences (Stochastic CLS) are considered. The use of Stochastic CLS to model population dynamics requires an extension which allows environmental events (such as changes in the temperature and rainfalls) to be taken into account. A simulator for the constructed model is developed via translation into the specification language Maude, and used to compare the dynamics obtained from the model with real data.Comment: In Proceedings AMCA-POP 2010, arXiv:1008.314

Cuspons, peakons and regular gap solitons between three dispersion curves

A general wave model with the cubic nonlinearity is introduced to describe a situation when the linear dispersion relation has three branches, which would intersect in the absence of linear couplings between the three waves. Actually, the system contains two waves with a strong linear coupling between them, to which a third wave is then coupled. This model has two gaps in its linear spectrum. Realizations of this model can be made in terms of temporal or spatial evolution of optical fields in, respectively, a planar waveguide or a bulk-layered medium resembling a photonic-crystal fiber. Another physical system described by the same model is a set of three internal wave modes in a density-stratified fluid. A nonlinear analysis is performed for solitons which have zero velocity in the reference frame in which the group velocity of the third wave vanishes. Disregarding the self-phase modulation (SPM) term in the equation for the third wave, we find two coexisting families of solitons: regular ones, which may be regarded as a smooth deformation of the usual gap solitons in a two-wave system, and cuspons with a singularity in the first derivative at their center. Even in the limit when the linear coupling of the third wave to the first two vanishes, the soliton family remains drastically different from that in the linearly uncoupled system; in this limit, regular solitons whose amplitude exceeds a certain critical value are replaced by peakons. While the regular solitons, cuspons, and peakons are found in an exact analytical form, their stability is tested numerically, which shows that they all may be stable. If the SPM terms are retained, we find that there again coexist two different families of generic stable soliton solutions, namely, regular ones and peakons.Comment: a latex file with the text and 10 pdf files with figures. Physical Review E, in pres

External memory BWT and LCP computation for sequence collections with applications

Sequencing technologies produce larger and larger collections of biosequences that have to be stored in compressed indices supporting fast search operations. Many compressed indices are based on the Burrows-Wheeler Transform (BWT) and the longest common prefix (LCP) array. Because of the sheer size of the input it is important to build these data structures in external memory and time using in the best possible way the available RAM.ResultsWe propose a space-efficient algorithm to compute the BWT and LCP array for a collection of sequences in the external or semi-external memory setting. Our algorithm splits the input collection into subcollections sufficiently small that it can compute their BWT in RAM using an optimal linear time algorithm. Next, it merges the partial BWTs in external or semi-external memory and in the process it also computes the LCP values. Our algorithm can be modified to output two additional arrays that, combined with the BWT and LCP array, provide simple, scan-based, external memory algorithms for three well known problems in bioinformatics: the computation of maximal repeats, the all pairs suffix-prefix overlaps, and the construction of succinct de Bruijn graphs.ConclusionsWe prove that our algorithm performs O(nmaxlcp) sequential I/Os, where n is the total length of the collection and maxlcp is the maximum LCP value. The experimental results show that our algorithm is only slightly slower than the state of the art for short sequences but it is up to 40 times faster for longer sequences or when the available RAM is at least equal to the size of the input.14CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESUniversity of Eastern Piedmont project Behavioural Types for Dependability Analysis with Bayesian Networks; Sao Paulo Research Foundation (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2017/09105-0, 2018/21509-2]; PRIN grant [201534HNXC]; INdAM-GNCS Project 2019 Innovative methods for the solution of medical and biological big data; Brazilian agency Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)National Council for Scientific and Technological Development (CNPq); Brazilian agency Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)CAPE

LHC Luminosity and energy upgrade: A Feasibility Study

We discuss a possible staged upgrade of the LHC and of its injectors, with a view to increasing the luminosity from the nominal 10**34 cm**-2s**-1 to 10**35 cm**-2s**-1 in each of the two high-luminosity experiments. We also consider possible scenarios for an upgrade to a proton beam energy of about 14 TeV. Starting from beam dynamics considerations and fundamental limitations of the hardware subsystems, we derive realistic requirements for the major components, such as superconducting magnets, cryogenic and RF systems, beam dump and vacuum. We also discuss a novel approach to the optimization of the collider performance, compatible with the beam-beam limit for high intensity proton bunches or long "super-bunches", and sketch a new design of the interaction regions, including an alternative beam crossing scheme. Finally we identify further studies required for an LHC performance upgrade and propose an R&D programm