Bibliographic record
Abstract
Introduction. The main objectives of this thesis were to investigate sleepiness and fatigue in shift workers and depressed patients and to observe the therapeutic effects of sedating antidepressants. I hypothesized that shift work might be related to fatigue and that a sedating antidepressant might release symptoms of sleepiness and fatigue, and improve mood, sleep and driving safety in depressed patients. Methods. This research includes several sub-studies. In a survey, the Epworth Sleepiness Scale was used to measure sleepiness and the Fatigue Severity Scale was used to measure fatigue. In treatment studies, depressive subjects took either mirtazapine or nefazodone (both are sedating antidepressants). Sleepiness, fatigue, alertness, mood, sleep and driving safety were measured using multiple instruments. In conducting these studies, I became aware of the limitation of comparing two separately developed scales. Therefore, I developed and validated a scale entitled the "Toronto Sleepiness and Fatigue Scale" (TSFS) to measure these two energy states concurrently. Results. The survey study found that fatigue severity significantly correlated with shift schedule. After taking mirtazapine for 58 days, depressed patients showed an improvement in sleepiness and fatigue. Mood improvement was indicated by decreased scores on the Hamilton Rating Scale for Depression (HRSD-17) and Beck Depression Inventory. Objective sleep improvement was identified by increased slow wave sleep and decreased wakefulness. Furthermore, mirtazapine improved road position and decreased the number of crashes. In seasonal affective disorder patients, treatment with nefazodone decreased patients mean scores of the HRSD-17 and Hamilton Rating Scale for Anxiety. As well, nefazodone improved sleep quality. The TSFS correlated well with well recognized scales measuring sleepiness and fatigue; it has good internal consistency and test-retest reliability. Conclusions. Shift work frequency impacts on fatigue, but not sleepiness. This supports the notion that fatigue and sleepiness are distinct and independent phenomena. The severity of sleepiness and fatigue is higher in depressed patients than in normal population. Treatment of depressed patients with a sedating antidepressant may paradoxically decrease their daytime sleepiness and fatigue, and may aid in improving mood, sleep, and driving safety. The TSFS is a valid and reliable tool to measure sleepiness and fatigue simultaneously.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".