These findings suggest that increasing social support may be particularly important in the management of depression and anxiety in rheumatoid arthritis.

From its early days the Internet of Things (IoT) has evolved into a decentralized system of cooperating smart objects with the requirement, among others, of achieving distributed consensus. Yet, current IoT platform solutions are centralized cloud based computing infrastructures, manifesting a number of significant disadvantages, such as, among others, high cloud server maintenance costs, weakness for supporting time-critical IoT applications, security and trust issues. Enabling blockchain technology into IoT can help to achieve a proper distributed consensus based IoT system that overcomes those disadvantages. While this is an ideal match, it is still a challenging endeavor. In this paper we take a first step towards that goal by designing Hybrid-IoT, a hybrid blockchain architecture for IoT. In Hybrid-IoT, subgroups of IoT devices form PoW blockchains, referred to as PoW sub-blockchains. Then, the connection among the PoW subblockchains employs a BFT inter-connector framework, such as Polkadot or Cosmos. In this paper, we focus on the PoW sub-blockchains formation, guided by a set of guidelines based on a set of dimensions, metrics and bounds. In order to prove the validity of the approach we carry on a performance and security evaluation.

SUMMARYDespite a high prevalence of alcohol-related disabilities and the availability of cost-effective interventions, alcohol abuse and dependence commonly go undetected in hospital inpatients. In a university teaching hospital we compared three well validated screening methods for sensitivity and speci®cityÐthe Alcohol Use Disorders Identi®cation Test (AUDIT, with various cut-off scores), CAGE (a four-question screening tool), and a 10-question version of the Michigan Alcoholism Screening Test (BMAST). A subset of patients also completed the DSM IV structured clinical interview for diagnosis. 1133 adult patients were randomly selected from all hospital admissions, with exclusion of day cases and patients too ill to be interviewed. Two-thirds of the patients were interviewed, most of the remainder being unavailable at the time. 30% of the men and 8% of the women met the DSM IV criteria for alcohol abuse or dependence. Sensitivities and speci®cities of the screening tools were as follows: AUDIT (with cut-off score48) 89% and 91%; CAGE 77% and 99%; BMAST 37% and 100%. 255 case records of patients scoring above the cut-off on one or more questionnaires were subsequently reviewed. The admitting team recognized an alcohol problem in only 46, of whom 17 were referred for appropriate follow up.As in previous hospital surveys, alcohol abuse and dependence was not receiving proper attention. The most ef®cient screening tool was the CAGE questionnaire.

SUMMARYDespite a high prevalence of alcohol-related disabilities and the availability of cost-effective interventions, alcohol abuse and dependence commonly go undetected in hospital inpatients. In a university teaching hospital we compared three well validated screening methods for sensitivity and speci®cityÐthe Alcohol Use Disorders Identi®cation Test (AUDIT, with various cut-off scores), CAGE (a four-question screening tool), and a 10-question version of the Michigan Alcoholism Screening Test (BMAST). A subset of patients also completed the DSM IV structured clinical interview for diagnosis. 1133 adult patients were randomly selected from all hospital admissions, with exclusion of day cases and patients too ill to be interviewed. Two-thirds of the patients were interviewed, most of the remainder being unavailable at the time. 30% of the men and 8% of the women met the DSM IV criteria for alcohol abuse or dependence. Sensitivities and speci®cities of the screening tools were as follows: AUDIT (with cut-off score48) 89% and 91%; CAGE 77% and 99%; BMAST 37% and 100%. 255 case records of patients scoring above the cut-off on one or more questionnaires were subsequently reviewed. The admitting team recognized an alcohol problem in only 46, of whom 17 were referred for appropriate follow up.As in previous hospital surveys, alcohol abuse and dependence was not receiving proper attention. The most ef®cient screening tool was the CAGE questionnaire.