Search results for: neurological differences

Authors: Ritika Chaturvedi

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Introduction: Sexual objectification, characterized by the reduction of an individual to a mere object of sexual desire, remains a pervasive societal issue with profound repercussions on individual well-being. Such experiences, often rooted in systemic and cultural norms, have long-lasting implications for mental and emotional health. This study aims to explore the intricate relationship between experiences of sexual objectification and insidious trauma, further investigating the potential moderating effects of overexcitabilities as proposed by Dabrowski's theory of positive disintegration. Methodology: The research involved a comprehensive cohort of 204 women, spanning ages from 18 to 65 years. Participants were tasked with completing self-administered questionnaires designed to capture their experiences with sexual objectification. Additionally, the questionnaire assessed symptoms indicative of insidious trauma and explored overexcitabilities across five distinct domains: emotional, intellectual, psychomotor, sensory, and imaginational. Employing advanced statistical techniques, including multiple regression and moderation analysis, the study sought to decipher the intricate interplay among these variables. Findings: The study's results revealed a compelling positive correlation between experiences of sexual objectification and the onset of symptoms indicative of insidious trauma. This correlation underscores the profound and detrimental effects of sexual objectification on an individual's psychological well-being. Interestingly, the moderation analyses introduced a nuanced understanding, highlighting the differential roles of various overexcitabilities. Specifically, emotional, intellectual, and sensual overexcitabilities were found to exacerbate trauma symptomatology. In contrast, psychomotor overexcitability emerged as a protective factor, demonstrating a mitigating influence on the relationship between sexual objectification and trauma. Implications: The study's findings hold significant implications for a diverse array of stakeholders, encompassing mental health practitioners, educators, policymakers, and advocacy groups. The identified moderating effects of overexcitabilities emphasize the need for tailored interventions that consider individual differences in coping and resilience mechanisms. By recognizing the pivotal role of overexcitabilities in modulating the traumatic consequences of sexual objectification, this research advocates for the development of more nuanced and targeted support frameworks. Moreover, the study underscores the importance of continued research endeavors to unravel the intricate mechanisms and dynamics underpinning these relationships. Such endeavors are crucial for fostering the evolution of informed, evidence-based interventions and strategies aimed at mitigating the adverse effects of sexual objectification and promoting holistic well-being.

Keywords: sexual objectification, insidious trauma, emotional overexcitability, intellectual overexcitability, sensual overexcitability, psychomotor overexcitability, imaginational overexcitability

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Agnieszka Antończyk, MałGorzata Ochota, Wojciech Niżański, ZdzisłAw Kiełbowicz

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The goal of the cesarean section (CS) is the delivery of healthy, vigorous pups with the provision of surgical plane anesthesia, appropriate analgesia, and rapid recovery of the dam. In human medicine, spinal or epidural anesthesia is preferred for a cesarean section as associated with a lower risk of neonatal asphyxia and the need for resuscitation. Nevertheless, the specificity of veterinary patients makes the application of regional anesthesia as a sole technique impractical, thus to obtain patient compliance the general anesthesia is required. This study aimed to compare the influence of balanced (inhalant with epidural) and inhalant anesthesia on neonatal umbilical cord blood gas (UCBG) parameters and vitality (modified Apgar scoring). The bitches (31) undergoing elective CS were enrolled in this study. All females received a single dose of 0.2 mg/kg s.c. Meloxicam. Females were randomly assigned into two groups: Gr I (Isoflurane, n=16) and Gr IE (Isoflurane plus Epidural, n=15). Anesthesia was induced with propofol at 4-6 mg/kg to effect, and maintained with isoflurane in oxygen; in IE group epidural anesthesia was also done using lidocaine (3-4 mg/kg) into the lumbosacral space. CSs were performed using a standard mid-line approach. Directly after the puppy extraction, the umbilical cord was double clamped before the placenta detachment. The vessels were gently stretched between forceps to allow blood sampling. At least 100 mcl of mixed umbilical cord blood was collected into a heparinized syringe for further analysis. The modified Apgar scoring system (AS) was used to objectively score neonatal health and vitality immediately after birth (before first aid or neonatal care was instituted), at 5 and 20 min after birth. The neonates were scored as normal (AS 7-10), weak (AS 4-6), or critical (AS 0-3). During surgery, the IE group required a lower isoflurane concentration compared to the females in group I (MAC 1.05±0.2 and 1.4±0.13, respectively, p<0.01). All investigated UCBG parameters were not statistically different between groups. All pups had mild acidosis (pH 7.21±0.08 and 7.21±0.09 in Gr I and IE, respectively) with moderately elevated pCO2 (Gr I 57.18±11.48, Gr IE 58.74±15.07), HCO3- on the lower border (Gr I 22.58±3.24, Gr IE 22.83±3.6), lowered BE (Gr I -6.1±3.57, Gr IE -5.6±4.19) and mildly elevated level of lactates (Gr I 2.58±1.48, Gr IE2.53±1.03). The glucose levels were above the reference limits in both groups of puppies (74.50±25.32 in Gr I, 79.50±29.73 in Gr IE). The initial Apgar score results were similar in I and IE groups. However, the subsequent measurements of AS revealed significant differences between both groups. Puppies from the IE group received better AS scores at 5 and 20 min compared to the I group (6.86±2.23 and 8.06±2.06 vs 5.11±2.40 and 7.83±2.05, respectively). The obtained results demonstrated that administration of epidural anesthesia reduced the requirement for isoflurane in dams undergoing cesarean section and did not affect the neonatal umbilical blood gas results. Moreover, newborns from the epidural anesthesia group were scored significantly higher in AS at 5 and 20 min, indicating their better vitality and quicker improvement post-surgery.

Keywords: apgar scoring, balanced anesthesia, cesarean section, umbilical blood gas

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Authors: P. Serrano-Pérez, M. C. Rodríguez-Molina, C. Palo, E. Palo, A. Lacasa

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Phytophthora nicotianae is the principal causal agent of root and crown rot disease of red pepper plants in Extremadura (Western Spain). There is a need to develop a biologically-based method of soil disinfestation that facilitates profitable and sustainable production without the use of chemical fumigants. Anaerobic Soil Disinfestation (ASD), as well know as biodisinfestation, has been shown to control a wide range of soil-borne pathogens and nematodes in numerous crop production systems. This method implies soil wetting, incorporation of a easily decomposable carbon-rich organic amendment and covering with plastic film for several weeks. ASD with rapeseed cake (var. Tocatta, a glucosinolates-free variety) used as C-source was assayed in spring 2014, before the pepper crop establishment. The field experiment was conducted at the Agricultural Research Centre Finca La Orden (Southwestern Spain) and the treatments were: rapeseed cake (RCP); rapeseed cake without plastic cover (RC); control non-amendment (CP) and control non-amendment without plastic cover (C). The experimental design was a randomized complete block design with four replicates and a plot size of 5 x 5 m. On 26 March, rapeseed cake (1 kg·m-2) was incorporated into the soil with a rotovator. Biological probes with the inoculum were buried at 15 and 30-cm depth (biological probes were previously prepared with 100 g of disinfected soil inoculated with chlamydospores (chlam) of P. nicotianae P13 isolate [100 chlam·g-1 of soil] and wrapped in agryl cloth). Sprinkler irrigation was run until field capacity and the corresponding plots were covered with transparent plastic (PE 0.05 mm). On 6 May plastics were removed, the biological probes were dug out and a bioassay was established. One pepper seedling at the 2 to 4 true-leaves stage was transplanted in the soil from each biological probe. Plants were grown in a climatic chamber and disease symptoms were recorded every week during 2 months. Fragments of roots and crown of symptomatic plants were analyzed on NARPH media and soil from rizospheres was analyzed using carnation petals as baits. Results of “survival” were expressed as the percentage of soil samples where P. nicotianae was detected and results of “infectivity” were expressed as the percentage of diseased plants. No differences were detected in deep effect. Infectivity of P. nicotianae chlamydospores was successfully reduced in RCP treatment (4.2% of infectivity) compared with the controls (41.7% of infectivity). The pattern of survival was similar to infectivity observed by the bioassay: 21% of survival in RCP; 79% in CP; 83% in C and 87% in RC. Although ASD may be an effective alternative to chemical fumigants to pest management, more research is necessary to show their impact on the microbial community and chemistry of the soil.

Keywords: biodisinfestation, BSD, soil fumigant alternatives, organic amendments

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Authors: Margareth Guimaraes Lima, Marilisa Berti A. Barros, Deborah Carvalho Malta

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The relationship between physical activity (PA) and depression has been investigated, in both, observational and clinical studies: PA can integrate the treatments for depression; the physical inactivity (PI) may contribute to increase depression symptoms; and on the other hand, emotional problems can decrease PA. The main of this study was analyze the association among leisure and transportation PI and time watching television (TV) according to depression (minor and major), evaluated with the Patient Health Questionnaire (PHQ-9). The association was also analyzed by gender. This is a cross-sectional study. Data were obtained from the National Health Survey 2013 (PNS), performed with representative sample of the Brazilian adult population, in 2013. The PNS collected information from 60,202 individuals, aged 18 years or more. The independent variable were: leisure time physical inactivity (LTPI), considering inactive or insufficiently actives (categories were linked for analyzes), those who do not performed a minimum of 150 or 74 minutes of moderate or vigorous LTPA, respectively, by week; transportation physical inactivity (TPI), individuals who did not reached 150 minutes, by week, travelling by bicycle or on foot to work or other activities; daily time watching TV > 5 hours. The principal independent variable was depression, identified by PHQ-9. Individuals were classified with major depression, with > 5 symptoms, more than seven days, but one of the symptoms was “depressive mood” or “lack of interest or pleasure”. The others had minor depression. The variables used to adjustment were gender, age, schooling and chronic disease. The prevalence of LTPI, TPI and TV time were estimated according to depression, and differences were tested with Chi-Square test. Adjusted prevalence ratios were estimated using multiple Poisson regression models. The analyzes also had stratification by gender. Mean age of the studied population was 42.9 years old (CI95%:42.6-43.2) and 52.9% were women. 77.5% and 68.1% were inactive or insufficiently active in leisure and transportation, respectively and 13.3% spent time watching TV 5 > hours. 6% and 4.1% of the Brazilian population were diagnosed with minor or major depression. LTPI prevalence was 5% and 9% higher among individuals with minor and major depression, respectively, comparing with no depression. The prevalence of TPI was 7% higher in those with major depression. Considering larger time watching TV, the prevalence was 45% and 74% higher among those with minor and major depression, respectively. Analyzing by gender, the associations were greater in men than women and TPI was note be associated, in women. The study detected the higher prevalence of leisure time physical inactivity and, especially, time spent watching TV, among individuals with major and minor depression, after to adjust for a number of potential confounding factors. TPI was only associated with major disorders and among men. Considering the cross-sectional design of the research, these associations can point out the importance of the mental problems control of the population to increase PA and decrease the sedentary lifestyle; on the other hand, the study highlight the need of interventions by encouraging people with depression, to practice PA, even to transportation.

Keywords: depression, physical activity, PHQ-9, sedentary lifestyle

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Authors: K. Nazan Turhan, Tuğçe Ersan

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The population of the world is approximately 8 billion, and it increases uncontrollably and irrepressibly, leading to an increase in consumption. This situation causes crucial problems, and food waste is one of these. The Food and Agriculture Organization of the United Nations (FAO) defines food waste as the discarding or alternative utilization of food that is safe and nutritious for the consumption of humans along the entire food supply chain, from primary production to end household consumer level. In addition, according to the estimation of FAO, one-third of all food produced for human consumption is lost or wasted worldwide every year. Wasting food endangers natural resources and causes hunger. For instance, excessive amounts of food waste cause greenhouse gas emissions, contributing to global warming. Therefore, waste management has been gaining significance in the last few decades at both local and global levels due to the expected scarcity of resources for the increasing population of the world. There are several ways to recover food waste. According to the United States Environmental Protection Agency’s Food Recovery Hierarchy, food waste recovery ways are source reduction, feeding hungry people, feeding animals, industrial uses, composting, and landfill/incineration from the most preferred to the least preferred, respectively. Bioethanol, biodiesel, biogas, agricultural fertilizer and animal feed can be obtained from food waste that is generated by different food industries. In this project, feeding animals was selected as a food waste recovery method and food waste of a plant was used to provide ingredient uniformity. Grasshoppers were used as a protein source. In other words, the project was performed to develop a dog food product by recovery of the plant’s food waste after following some steps. The collected food waste and purchased grasshoppers were sterilized, dried and pulverized. Then, they were all mixed with 60 g agar-agar solution (4%w/v). 3 different aromas were added, separately to the samples to enhance flavour quality. Since there are differences in the required amounts of different species of dogs, fulfilling all nutritional needs is one of the problems. In other words, there is a wide range of nutritional needs in terms of carbohydrates, protein, fat, sodium, calcium, and so on. Furthermore, the requirements differ depending on age, gender, weight, height, and species. Therefore, the product that was developed contains average amounts of each substance so as not to cause any deficiency or surplus. On the other hand, it contains more protein than similar products in the market. The product was evaluated in terms of contamination and nutritional content. For contamination risk, detection of E. coli and Salmonella experiments were performed, and the results were negative. For the nutritional value test, protein content analysis was done. The protein contents of different samples vary between 33.68% and 26.07%. In addition, water activity analysis was performed, and the water activity (aw) values of different samples ranged between 0.2456 and 0.4145.

Keywords: food waste, dog food, animal nutrition, food waste recovery

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Authors: M. Kamimukai, M. Bhattarai, B. B. Rana, K. Maeda, H. B. Kc, T. Kawano, M. Murai

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Most of the aged people older than 70 have difficulty in chewing and swallowing more or less. According to magnitude of this difficulty, gruel, “nanhan” (semi-soft rice) and ordinary cooked rice are served in general, particularly in sanatoriums and homes for old people in Japan. Nanhan is the name of a cooked rice used in Japan, having softness intermediate between gruel and ordinary cooked rice, which is boiled with intermediate amount of water between those of the latter two kinds of cooked rice. In the present study, nanhan was made in the rate of 240g of water to 100g of milled rice with an electric rice cooker. Murai developed a high amylose-content and high-yielding elite line ‘Murai 79’. Sensory eating-quality test was performed for nanhan and ordinary cooked rice of Murai 79 and the standard variety ‘Hinohikari’ which is a high eating-quality variety representative in southern Japan. Panelists (6 to 14 persons) scored each cooked rice in six items viz. taste, stickiness, hardness, flavor, external appearance and overall evaluation. Grading (-3 ~ +3) in each trait was performed, regarding the value of the standard variety Hinohikari as 0. Paddy rice produced in a farmer’s field in 2013 and 2014 and in an experimental field of Kochi University in 2015 and 2016 were used for the sensory test. According to results of the sensory eating-quality test for nanhan, Murai 79 is higher in overall evaluation than Hinohikari in the four years. The former was less sticky than the latter in the four years, but the former was statistically significantly harder than the latter throughout the four years. In external appearance, the former was significantly higher than the latter in the four years. In the taste, the former was significantly higher than the latter in 2014, but significant difference was not noticed between them in the other three years. There were no significant differences throughout the four years in flavor. Regarding amylose content, Murai 79 is higher by 3.7 and 5.7% than Hinohikari in 2015 and 2016, respectively. As for protein content, Murai 79 was higher than Hinohikari in 2015, but the former was lower than the latter in 2016. Consequently, the nanhan of Murai 79 was harder and less sticky, keeping the shape of grains as compared with that of Hinohikari, which may be due to its higher amylose content. Hence, the nanhan of Murai 79 may be recognized as grains more easily in a human mouth, which could make easier the continuous performance of mastication and deglutition particularly in aged persons. Regarding ordinary cooked rice, Murai 79 was similar to or higher in both overall evaluation and external appearance as compared with Hinohikari, despite its higher hardness and lower stickiness. Additionally, Murai 79 had brown-rice yield of 1.55 times as compared with Hinohikari, suggesting that it would enable to supply inexpensive rice for making nanhan with high quality particularly for aged people in Japan.

Keywords: high-amylose content, high-yielding rice line, nanhan, nursing care food, sensory eating quality test

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Authors: Henry Venter, Murali Thyloth, Alceu Casseb

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Historically, mental and substance use disorders were not a global health priority. Since the 1993 World Development Report, the importance of the contribution of mental health and substance abuse on the relative global burden associated with disease morbidity has been recognized with 300 million people worldwide suffering from depression alone. This led to an international effort to improve the mental health of populations around the world. Despite these efforts some countries remain at the top of the list of countries with the highest rate of mental illness. Important research questions were asked: Would there be commonalities regarding mental health between these countries; would there be common factors leading to the high prevalence of mental illness; and how prepared are these countries with mental health delivery? Findings from this research can aid organizations and institutions preparing mental health service providers to focus training and preparation to address specific needs revealed by the study. Methods: Researchers decided to compare three distinctly different countries at the top of the list of countries with the highest rate of mental illness, the USA, India and Brazil, situated on three different continents with different economies and lifestyles. Data were collected using archival research methodology, reviewing records and findings of international and national health and mental health studies to subtract and compare data and findings. Results: The findings indicated that India is the most depressed country in the world, followed by the USA (and China) with Brazil in Latin America with the greatest number of depressed individuals. By 2020 roughly 20% of India, acountry of over one billion citizens, will suffer from some form of mental illnees, yet there are less than 4,000 experts available. In the USA 164.8 million people were substance abusers and an estimate of 47.6 million adults, 18 or older, had any mental illness in 2018. That means that about one in five adults in the USA experiences some form of mental illness each year, but only 41% of those affected received mental health care or services in the past year. Brazil has the greatest number of depressed individuals, in Latin America. Adults living in Sao Paulo megacity has prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world with more than one million adults with serious impairment levels. Discussion: The results show that, despite the vast socioeconomic differences between the three countries, there are correlations regarding mental health prevalence and difficulty to provide adequate services including a lack of awareness of how serious mental illness is, stigma for seeking mental illness, with comorbidity a common phenomenon, and a lack of partnership between different levels of service providers, which weakens mental health service delivery. The findings also indicate that mental health training institutions have a monumental task to prepare personnel to address the future mental health needs in each of the countries compared, which will constitute the next phase of the research.

Keywords: mental health epidemiology, mental health disorder, mental health prevalence, mental health treatment

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Authors: Jui Chen Wu, Ming Yi Hsu

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Background and Purpose: Shift work of nursing staff is inevitable in hospital to provide continuing medical care. However, shift work is considered as a health hazard that may cause physical and psychological problems. Serious workplace fatigue of nursing shift work might impact on family, social and work life, moreover, causes serious reduction of quality of medical care, or even malpractice. This study aims to explore relationships among nursing staff’s shift, workplace fatigue and quality of working life. Method: Structured questionnaires were used in this study to explore relationships among shift work, workplace fatigue and quality of working life in nursing staffs. We recruited 590 nursing staffs in different Community Teaching hospitals in Taiwan. Data analysed by descriptive statistics, single sample t-test, single factor analysis, Pearson correlation coefficient and hierarchical regression, etc. Results: The overall workplace fatigue score is 50.59 points. In further analysis, the score of personal burnout, work-related burnout, over-commitment and client-related burnout are 57.86, 53.83, 45.95 and 44.71. The basic attributes of nursing staff are significantly different from those of workplace fatigue with different ages, licenses, sleeping quality, self-conscious health status, number of care patients of chronic diseases and number of care people in the obstetric ward. The shift variables revealed no significant influence on workplace fatigue during the hierarchical regression analysis. About the analysis on nursing staff’s basic attributes and shift on the quality of working life, descriptive results show that the overall quality of working life of nursing staff is 3.23 points. Comparing the average score of the six aspects, the ranked average score are 3.47 (SD= .43) in interrelationship, 3.40 (SD= .46) in self-actualisation, 3.30 (SD= .40) in self-efficacy, 3.15 (SD= .38) in vocational concept, 3.07 (SD= .37) in work aspects, and 3.02 (SD= .56) in organization aspects. The basic attributes of nursing staff are significantly different from quality of working life in different marriage situations, education level, years of nursing work, occupation area, sleep quality, self-conscious health status and number of care in medical ward. There are significant differences between shift mode and shift rate with the quality of working life. The results of the hierarchical regression analysis reveal that one of the shifts variables 'shift mode' which does affect staff’s quality of working life. The workplace fatigue is negatively correlated with the quality of working life, and the over-commitment in the workplace fatigue is positively related to the vocational concept of the quality of working life. According to the regression analysis of nursing staff’s basic attributes, shift mode, workplace fatigue and quality of working life related shift, the results show that the workplace fatigue has a significant impact on nursing staff’s quality of working life. Conclusion: According to our study, shift work is correlated with workplace fatigue in nursing staffs. This results work as important reference for human resources management in hospitals to establishing a more positive and healthy work arrangement policy.

Keywords: nursing staff, shift, workplace fatigue, quality of working life

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Authors: Pui-sze Yeung, Connie Suk-han Ho, David Wai-ock Chan, Kevin Kien-hoa Chung

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Background: Recent findings have shown that transcription skills play a unique and significant role in Chinese word reading and spelling (i.e. word dictation), and written composition development. The interrelationships among component skills of transcription, word reading, word spelling, and written composition in Chinese have rarely been examined in the literature. Is the contribution of component skills of transcription to Chinese written composition mediated by word level skills (i.e., word reading and spelling)? Methods: The participants in the study were 249 Chinese children in Grade 1, Grade 3, and Grade 5 in Hong Kong. They were administered measures of general reasoning ability, orthographic knowledge, stroke sequence knowledge, word spelling, handwriting fluency, word reading, and Chinese narrative writing. Orthographic knowledge- orthographic knowledge was assessed by a task modeled after the lexical decision subtest of the Hong Kong Test of Specific Learning Difficulties in Reading and Writing (HKT-SpLD). Stroke sequence knowledge: The participants’ performance in producing legitimate stroke sequences was measured by a stroke sequence knowledge task. Handwriting fluency- Handwriting fluency was assessed by a task modeled after the Chinese Handwriting Speed Test. Word spelling: The stimuli of the word spelling task consist of fourteen two-character Chinese words. Word reading: The stimuli of the word reading task consist of 120 two-character Chinese words. Written composition: A narrative writing task was used to assess the participants’ text writing skills. Results: Analysis of covariance results showed that there were significant between-grade differences in the performance of word reading, word spelling, handwriting fluency, and written composition. Preliminary hierarchical multiple regression analysis results showed that orthographic knowledge, word spelling, and handwriting fluency were unique predictors of Chinese written composition even after controlling for age, IQ, and word reading. The interaction effects between grade and each of these three skills (orthographic knowledge, word spelling, and handwriting fluency) were not significant. Path analysis results showed that orthographic knowledge contributed to written composition both directly and indirectly through word spelling, while handwriting fluency contributed to written composition directly and indirectly through both word reading and spelling. Stroke sequence knowledge only contributed to written composition indirectly through word spelling. Conclusions: Preliminary hierarchical regression results were consistent with previous findings about the significant role of transcription skills in Chinese word reading, spelling and written composition development. The fact that orthographic knowledge contributed both directly and indirectly to written composition through word reading and spelling may reflect the impact of the script-sound-meaning convergence of Chinese characters on the composing process. The significant contribution of word spelling and handwriting fluency to Chinese written composition across elementary grades highlighted the difficulty in attaining automaticity of transcription skills in Chinese, which limits the working memory resources available for other composing processes.

Keywords: orthographic knowledge, transcription skills, word reading, writing

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Authors: Katarzyna Zięba, Hajnalka Szentgyörgyi, Paweł Miśkowiec, Agnieszka Moos-Matysik

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Bees are effective pollinators of plants using by humans. However, there is a concern about the fate different species due to their recently decline. Pollution of the environment is described in the literature as one of the causes of this phenomenon. Due to human activities, heavy metals and aromatic hydrocarbons can occur in bee organisms in high concentrations. The presented study aims to provide information on how pollution affects bee quality, taking into account, also the biological differences between various groups of bees. Understanding the consequences of environmental pollution on bees can help to create and promote bee friendly habitats and actions. The analyses were carried out using two contamination gradients with 5 sites on each. The first, mainly heavy metal polluted gradient is stretching approx. 30km from the Bukowno Zinc smelter near Olkusz in the Lesser Poland Voivodship, to the north. The second cuts through the agglomeration of Kraków up to the southern borders of the Ojców National Park. The gradient near Olkusz is a well-described pollution gradient contaminated mainly by zinc, lead, and cadmium. The second gradient cut through the agglomeration of Kraków and end below the Ojców National Park. On each gradient, two bee species were installed: red mason bees (Osmia bicornis) and honey bees (Apis mellifera). Red mason bee is a polylectic, solitary bee species, widely distributed in Poland. Honey bees are a highly social species of bees, with clearly defined casts and roles in the colony. Before installing the bees in the field, samples of imagos of red mason bees and samples of pollen and imagos from each honey bee colony were analysed for zinc, lead cadmium, polycyclic and monocyclic hydrocarbons levels. After collecting the bees from the field, samples of bees and pollen samples for each site were prepared for heavy metal, monocyclic hydrocarbon, and polycyclic hydrocarbon analysis. Analyses of aromatic hydrocarbons were performed with gas chromatography coupled with a headspace sampler (HP 7694E) and mass spectrometer (MS) as detector. Monocyclic compounds were injected into column with headspace sampler while polycyclic ones with manual injector (after solid-liquid extraction with hexane). The heavy metal content (zinc, lead and cadmium) was assessed with flame atomic absorption spectroscopy (FAAS AAnalyst 300 Perkin Elmer spectrometer) according to the methods for honey and bee products described in the literature. Pollution levels found in bee bodies and imago body masses in both species, and proportion of sex in case of red mason bees were correlated with pollution levels found in pollen for each site and colony or trap nest. An attempt to pinpoint the most important form of contamination regarding bee health was also be undertaken based on the achieved results.

Keywords: heavy metals, aromatic hydrocarbons, bees, pollution

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Authors: Chandanee Wasana Kalansooriya

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Dietary behaviour is a crucial factor affecting diabetes control. With increasing rates of diabetes prevalence in Asian countries, examining their dietary patterns, which are largely based on rice, is timely required. It has been identified that higher consumption of some rice varieties is associated with increased risk of type 2 diabetes. Although diabetes patients are advised to consume healthier rice varieties, which contains low glycemic, several conditions, one of which food insecurity, make them difficult to preserve those healthy dietary guidelines. Hence this study tries to investigate how food security affects on making right decisions of rice consumption within diabetes affected households using a sample from Sri Lanka, a country which rice considered as the staple food and records the highest diabetes prevalence rate in South Asia. The study uses data from the Household Income and Expenditure Survey 2016, a nationally representative sample conducted by the Department of Census and Statistics, Sri Lanka. The survey used a two-stage stratified sampling method to cover different sectors and districts of the country and collected micro-data on demographics, health, income and expenditures of different categories. The study uses data from 2547 households which consist of one or more diabetes patients, based on the self-recorded health status. The Household Dietary Diversity Score (HDDS), which constructed based on twelve food groups, is used to measure the level of food security. Rice is categorized into three groups according to their Glycemic Index (GI), high GI, medium GI and low GI, and the likelihood and impact made by food security on each rice consumption categories are estimated using a Two-part Model. The shares of each rice categories out of total rice consumption is considered as the dependent variable to exclude the endogeneity issue between rice consumption and the HDDS. The results indicate that the consumption of medium GI rice is likely to increase with the increasing household food security, but low GI varieties are not. Households in rural and estate sectors are less likely and Tamil ethnic group is more likely to consume low GI rice varieties. Further, an increase in food security significantly decreases the consumption share of low GI rice, while it increases the share of medium GI varieties. The consumption share of low GI rice is largely affected by the ethnic variability. The effects of food security on the likelihood of consuming high GI rice varieties and changing its shares are statistically insignificant. Accordingly, the study concludes that a higher level of food security does not ensure diabetes patients are consuming healthy rice varieties or reducing consumption of unhealthy varieties. Hence policy attention must be directed towards educating people for making healthy dietary choices. Further, the study provides a room for further studies as it reveals considerable ethnic and sectorial differences in making healthy dietary decisions.

Keywords: diabetes, food security, glycemic index, rice consumption

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Authors: Eva Filová, Jana Daňková, Věra Sovková, Matej Daniel

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Titanium alloys are biocompatible metals that are widely used in clinical practice as load bearing implants. The chemical modification may influence cell adhesion, proliferation, and differentiation as well as stiffness of the material. The aim of the study was to evaluate the adhesion, growth and differentiation of pig mesenchymal stem cells on the novel beta titanium alloy Ti36Nb6Ta compared to standard medical titanium alloy Ti6Al4V. Discs of Ti36Nb6Ta and Ti6Al4V alloy were sterilized by ethanol, put in 48-well plates, and seeded by pig mesenchymal stem cells at the density of 60×103/cm2 and cultured in Minimum essential medium (Sigma) supplemented with 10% fetal bovine serum and penicillin/streptomycin. Cell viability was evaluated using MTS assay (CellTiter 96® AQueous One Solution Cell Proliferation Assay;Promega), cell proliferation using Quant-iT™ ds DNA Assay Kit (Life Technologies). Cells were stained immunohistochemically using monoclonal antibody beta-actin, and secondary antibody conjugated with AlexaFluor®488 and subsequently the spread area of cells was measured. Cell differentiation was evaluated by alkaline phosphatase assay using p-nitrophenyl phosphate (pNPP) as a substrate; the reaction was stopped by NaOH, and the absorbance was measured at 405 nm. Osteocalcin, specific bone marker was stained immunohistochemically and subsequently visualized using confocal microscopy; the fluorescence intensity was analyzed and quantified. Moreover, gene expression of osteogenic markers osteocalcin and type I collagen was evaluated by real-time reverse transcription-PCR (qRT-PCR). For statistical evaluation, One-way ANOVA followed by Student-Newman-Keuls Method was used. For qRT-PCR, the nonparametric Kruskal-Wallis Test and Dunn's Multiple Comparison Test were used. The absorbance in MTS assay was significantly higher on titanium alloy Ti6Al4V compared to beta titanium alloy Ti36Nb6Ta on days 7 and 14. Mesenchymal stem cells were well spread on both alloys, but no difference in spread area was found. No differences in alkaline phosphatase assay, fluorescence intensity of osteocalcin as well as the expression of type I collagen, and osteocalcin genes were observed. Higher expression of type I collagen compared to osteocalcin was observed for cells on both alloys. Both beta titanium alloy Ti36Nb6Ta and titanium alloy Ti6Al4V Ti36Nb6Ta supported mesenchymal stem cellsˈ adhesion, proliferation and osteogenic differentiation. Novel beta titanium alloys Ti36Nb6Ta is a promising material for bone implantation. The project was supported by the Czech Science Foundation: grant No. 16-14758S, the Grant Agency of the Charles University, grant No. 1246314 and by the Ministry of Education, Youth and Sports NPU I: LO1309.

Keywords: beta titanium, cell growth, mesenchymal stem cells, titanium alloy, implant

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Authors: Ivelise M. Strozberg, Lucas O. Vale, Maria V. V. Morais

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Expansive soils are characterized by their significant volumetric variations, tending to suffer an increase of this volume when added water in their voids and a decrease of volume when this water is removed. The parameters of resistance (especially the angle of friction, cohesion and specific weight) of expansive or non-expansive soils of the same field present differences, as found in laboratory tests. What is expected is that, through this research, demonstrate that this variation directly affects the results of the calculation of factors of safety for slope stability. The expansibility due to specific clay minerals such as montmorillonites and vermiculites is the most common form of expansion of soils or rocks, causing expansion pressures. These pressures can become an aggravating problem in regions across the globe that, when not previously studied, may present high risks to the enterprise, such as cracks, fissures, movements in structures, breaking of retaining walls, drilling of wells, among others. The study provides results based on analyzes carried out in the Slide 2018 software belonging to the Rocsience group, where the software is a two-dimensional equilibrium slope stability program that calculates the factor of safety or probability of failure of certain surfaces composed of soils or rocks (or both, depending on the situation), - through the methods of: Bishop simplified, Fellenius and Janbu corrected. This research compares the factors of safety of a homogeneous earthfill dam geometry, analysed for operation and end-of-construction situations, having a height of approximately 35 meters, with a slope of 1.5: 1 in the slope downstream and 2: 1 on the upstream slope. As the water level is 32.73m high and the water table is drawn automatically by the Slide program using the finite element method for the operating situation, considering two hypotheses for the use of materials - the first with soils with characteristics of expansion and the second with soils without expansibility. For this purpose, soil samples were collected from the region of São Bento do Una - Pernambuco, Brazil and taken to the soil mechanics laboratory to characterize and determine the percentage of expansibility. There were found 2 types of soils in that area: 1 site of expansive soils (8%) and another with non- expansive ones. Based on the results found, the analysis of the values of factors of safety indicated, both upstream and downstream slopes, the highest values were obtained in the case where there is no presence of materials with expansibility resulting, for one of the situations, values of 1.353 (Fellenius), 1,295 (Janbu corrected) and 1,409 (Bishop simplified). There is a considerable drop in safety factors in cases where soils are potentially expansive, resulting in values for the same situation of 0.859 (Fellenius), 0.809 (Janbu corrected) and 0.842 (Bishop simplified), in the case of higher expansibility (8 %). This shows that the expansibility is a determinant factor in the fall of resistance of soil, determined by the factors of cohesion and angle of friction.

Keywords: dam. slope. software. swelling soil

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Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: Hyuk-Jin Lee

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Even though 23 years have passed in the 21st century, nation-state and nationality-centered cultural identities are still the sentiments and ideologies that dominate the world. Nevertheless, as seen in many cases in Europe, a new perspective is needed to recognize mutual exchanges and influences and to view them as natural cultural exchanges between countries. The situation in East Asia is completely different from Europe. This is presumed to be from the long tradition of having an ethnocentric state concept for at least hundreds of years, quite different from Europe, where the concept of a nation-state was established relatively recently. In other words, unlike Europe, where active exchanges took place, the problem stems from the unique characteristics of East Asia, which has a strong tradition of finding its identity in 'difference'. Thus, it would not be hard to find cultural studies or news of the three East Asian countries emphasizing differences among one another. This applies to all cultural areas, including traditional architecture. For example, in the Korean traditional architecture field, buildings with effects from neighboring countries tend to be ignored, even if they are traditional Korean architecture. In addition to this, in the case of Korea, there seems to be one more cultural harmful aftereffect caused by the 36 years of Japanese colonial rule in the early 20th century; the obsessive filtering concept of 'it must be different from Japan'. In other words, the implicit ideological coercion that the definition of 'Korean cultural heritage' should not be influenced by exchanges with Japan may be found throughout Korean studies. The architectural and cultural aspects of the vast period of time, from the Three Kingdoms era to the beginning of Joseon, which was a period in which cultural influence exchanges with neighboring countries were relatively strong compared to the late Joseon Dynasty, also reflect the 'distorted filtering' caused by finding a repulsive identity against the Japanese colonial period. It is important to look the cultural heritage and traditions as they are inductively, not deductively. If not, we may often ignore or limit our own precious cultural heritage. Conversely, If Baekje, the ancient Korean Kingdom, helped Japan in construction and craftsmen played a big role in building the ancient temple, it would be a healthier perspective to view it as a cultural exchange rather than proudly seeing it as a cultural owner's perspective because this point of view is a proper reconstruction of our ancient and medieval Asian culture (strictly speaking, the color common to East Asia at the time). In particular, this study will examine this topic by giving specific examples from each field of Korean cultural studies. In the search for cultural identity, it would be more helpful for healthy relations between countries and collaborative research in the sensitive part of the interpretation of historical facts as well as cultural circles to minimize excessive meanings on originality and difference.

Keywords: cultural heritage identity, cultural ideology, East Asia, Korea

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Authors: Regis Pochon, Nicolas Stefaniak, Veronique Baltazart, Pamela Gobin

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Anxiety is known to have an impact on working memory. In reasoning or memory tasks, individuals with anxiety tend to show longer response times and poorer performance. Furthermore, there is a memory bias for negative information in anxiety. Given the crucial role of working memory in lexical learning, anxious students may encounter more difficulties in learning to read and spell. Anxiety could even affect an earlier learning, that is the activation of phonological representations, which are decisive for the learning of reading and writing. The aim of this study is to compare the access to phonological representations of beginning readers and writers according to their level of anxiety, using an auditory lexical decision task. Eighty students of 6- to 9-years-old completed the French version of the Revised Children's Manifest Anxiety Scale and were then divided into four anxiety groups according to their total score (Low, Median-Low, Median-High and High). Two set of eighty-one stimuli (words and non-words) have been auditory presented to these students by means of a laptop computer. Stimuli words were selected according to their emotional valence (positive, negative, neutral). Students had to decide as quickly and accurately as possible whether the presented stimulus was a real word or not (lexical decision). Response times and accuracy were recorded automatically on each trial. It was anticipated a) longer response times for the Median-High and High anxiety groups in comparison with the two others groups, b) faster response times for negative-valence words in comparison with positive and neutral-valence words only for the Median-High and High anxiety groups, c) lower response accuracy for Median-High and High anxiety groups in comparison with the two others groups, d) better response accuracy for negative-valence words in comparison with positive and neutral-valence words only for the Median-High and High anxiety groups. Concerning the response times, our results showed no difference between the four groups. Furthermore, inside each group, the average response times was very close regardless the emotional valence. Otherwise, group differences appear when considering the error rates. Median-High and High anxiety groups made significantly more errors in lexical decision than Median-Low and Low groups. Better response accuracy, however, is not found for negative-valence words in comparison with positive and neutral-valence words in the Median-High and High anxiety groups. Thus, these results showed a lower response accuracy for above-median anxiety groups than below-median groups but without specificity for the negative-valence words. This study suggests that anxiety can negatively impact the lexical processing in young students. Although the lexical processing speed seems preserved, the accuracy of this processing may be altered in students with moderate or high level of anxiety. This finding has important implication for the prevention of reading and spelling difficulties. Indeed, during these learnings, if anxiety affects the access to phonological representations, anxious students could be disturbed when they have to match phonological representations with new orthographic representations, because of less efficient lexical representations. This study should be continued in order to precise the impact of anxiety on basic school learning.

Keywords: anxiety, emotional valence, childhood, lexical access

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Authors: Mai Sirhan, Arieh Sidess

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Asphaltic mixture is a heterogeneous material composed of three main components: aggregates; bitumen and air voids. The professional experience and scientific literature categorize asphaltic mixture as a viscoelastic material, whose behavior is determined by temperature and loading rate. Properties characterization of the asphaltic mixture used under the service conditions is done by compacting and testing cylindric asphalt samples in the laboratory. These samples must resemble in a high degree internal structure of the mixture achieved in service, and the mechanical characteristics of the compacted asphalt layer in the pavement. The laboratory samples are usually compacted in temperatures between 140 and 160 degrees Celsius. In this temperature range, the asphalt has a low degree of strength. The laboratory samples are compacted using the dynamic or vibrational compaction methods. In the compaction process, the aggregates tend to align themselves in certain directions that lead to anisotropic behavior of the asphaltic mixture. This issue has been studied in the Strategic Highway Research Program (SHRP) research, that recommended using the gyratory compactor based on the assumption that this method is the best in mimicking the compaction in the service. In Israel, the Netivei Israel company is considering adopting the Gyratory Method as a replacement for the Marshall method used today. Therefore, the compatibility of the Gyratory Method for the use with Israeli asphaltic mixtures should be investigated. In this research, we aimed to examine the impact of the compaction method used on the mechanical characteristics of the asphaltic mixtures and to evaluate the degree of anisotropy in relation to the compaction method. In order to carry out this research, samples have been compacted in the vibratory and gyratory compactors. These samples were cylindrically cored both vertically (compaction wise) and horizontally (perpendicular to compaction direction). These models were tested under dynamic modulus and permanent deformation tests. The comparable results of the tests proved that: (1) specimens compacted by the vibratory compactor had higher dynamic modulus values than the specimens compacted by the gyratory compactor (2) both vibratory and gyratory compacted specimens had anisotropic behavior, especially in high temperatures. Also, the degree of anisotropy is higher in specimens compacted by the gyratory method. (3) Specimens compacted by the vibratory method that were cored vertically had the highest resistance to rutting. On the other hand, specimens compacted by the vibratory method that were cored horizontally had the lowest resistance to rutting. Additionally (4) these differences between the different types of specimens rise mainly due to the different internal arrangement of aggregates resulting from the compaction method. (5) Based on the initial prediction of the performance of the flexible pavement containing an asphalt layer having characteristics based on the results achieved in this research. It can be concluded that there is a significant impact of the compaction method and the degree of anisotropy on the strains that develop in the pavement, and the resistance of the pavement to fatigue and rutting defects.

Keywords: anisotropy, asphalt compaction, dynamic modulus, gyratory compactor, mechanical properties, permanent deformation, vibratory compactor

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Authors: Stacey Herzog, Mitchell McCleary, Istvan Kovacs

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Purpose: Maximal strength and maximal power are key athletic abilities in many sports disciplines. In recent years, velocity-based training (VBT) with a relatively high 75-85% 1RM resistance has been popularized in preparation for powerlifting and various other sports. The purpose of this study was to discover differences between beginner/intermediate and advanced lifters’ push/press performances after a heavy resistance-based BP training program. Methods: A six-week, three-workouts per week program was administered to 52 young, physically active adults (age: 22.4±5.1; 12 female). The majority of the participants (84.6%) had prior experience in bench pressing. Typical workouts began with BP using 75-95% 1RM in the 1-5 repetition range. The sets in the lower part of the range (75-80% 1RM) were performed with velocity-focus as well. The BP sets were followed by seated dumbbell presses and six additional upper-body assistance exercises. Pre- and post-tests were conducted on five test exercises: one-repetition maximum BP (1RM), calculated relative strength index: BP/BW (RSI), four-repetition maximal-effort dynamic BP for peak concentric velocity with 80% 1RM (4RV), 4-repetition ballistic pushups (BPU) for height (4PU), and seated medicine ball toss for distance (MBT). For analytic purposes, the participant group was divided into two subgroups: self-indicated beginner or intermediate initial resistance training status (BITS) [n=21, age: 21.9±3.6; 10 female] and advanced initial resistance training status (ATS) [n=31, age: 22.7±5.9; 2 female]. Pre- and post-test results were compared within subgroups. Results: Paired-sample t-tests indicated significant within-group improvements in all five test exercises in both groups (p < 0.05). BITS improved 18.1 lbs. (13.0%) in 1RM, 0.099 (12.8%) in RSI, 0.133 m/s (23.3%) in 4RV, 1.55 in. (27.1%) in BPU, and 1.00 ft. (5.8%) in MBT, while the ATS group improved 13.2 lbs. (5.7%) in 1RM, 0.071 (5.8%) in RSI, 0.051 m/s (9.1%) in 4RV, 1.20 in. (13.7%) in BPU, and 1.15 ft. (5.5%) in MBT. Conclusion: While the two training groups had different initial resistance training backgrounds, both showed significant improvements in all test exercises. As expected, the beginner/intermediate group displayed better relative improvements in four of the five test exercises. However, the medicine ball toss, which had the lightest resistance among the tests, showed similar relative improvements between the two groups. These findings relate to two important training principles: specificity and transfer. The ATS group had more specific experiences with heavy-resistance BP. Therefore, fewer improvements were detected in their test performances with heavy resistances. On the other hand, while the heavy resistance-based training transferred to increased power outcomes in light-resistance power exercises, the difference in the rate of improvement between the two groups disappeared. Practical applications: Based on initial training status, S&C coaches should expect different performance gains in maximal strength training-specific test exercises. However, the transfer from maximal strength to a non-training-specific performance category along the F-v curve continuum (i.e., light resistance and high velocity) might not depend on initial training status.

Keywords: exercise, power, resistance training, strength

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Authors: Lana Whiskeyjack, Kyle Napier

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The Spirit of the language embodies the motivation for indigenous people to connect with the indigenous language of their lineage. While the concept of the spirit of the language is often woven into the discussion by indigenous language revitalizationists, particularly those who are indigenous, there are few tangible terms in academic research conceptually actualizing the term. Through collaborative work with indigenous language speakers, elders, and learners, this research sets out to identify the spirit of the language, the catalysts of disconnection from the spirit of the language, and the sources of reconnection to the spirit of the language. This work fundamentally addresses the terms of engagement around collaboration with indigenous communities, itself inviting a decolonial approach to community outreach and individual relationships. As indigenous researchers, this means beginning, maintain, and closing this work in the ceremony while being transparent with community members in this work and related publishing throughout the project’s duration. Decolonizing this approach also requires maintaining explicit ongoing consent by the elders, knowledge keepers, and community members when handling their ancestral and indigenous knowledge. The handling of this knowledge is regarded in this work as stewardship, both in the handling of digital materials and the handling of ancestral Indigenous knowledge. This work observes recorded conversations in both nêhiyawêwin and English, resulting from 10 semi-structured interviews with fluent nêhiyawêwin speakers as well as three structured dialogue circles with fluent and emerging speakers. The words were transcribed by a speaker fluent in both nêhiyawêwin and English. The results of those interviews were categorized thematically to conceptually actualize the spirit of the language, catalysts of disconnection to thespirit of the language, and community voices methods of reconnection to the spirit of the language. Results of these interviews vastly determine that the spirit of the language is drawn from the land. Although nêhiyawêwin is the focus of this work, Indigenous languages are by nature inherently related to the land. This is further reaffirmed by the Indigenous language learners and speakers who expressed having ancestries and lineages from multiple Indigenous communities. Several other key differences embody this spirit of the language, which include ceremony and spirituality, as well as the semantic worldviews tied to polysynthetic verb-oriented morphophonemics most often found in indigenous languages — and of focus, nêhiyawêwin. The catalysts of disconnection to the spirit of the language are those whose histories have severed connections between Indigenous Peoples and the spirit of their languages or those that have affected relationships with the land, ceremony, and ways of thinking. Results of this research and its literature review have determined the three most ubiquitously damaging interdependent factors, which are catalysts of disconnection from the spirit of the language as colonization, capitalism, and Christianity. As voiced by the Indigenous language learners, this work necessitates addressing means to reconnect to the spirit of the language. Interviewees mentioned that the process of reconnection involves a whole relationship with the land, the practice of reciprocal-relational methodologies for language learning, and indigenous-protected and -governed learning. This work concludes in support of those reconnection methodologies.

Keywords: indigenous language acquisition, indigenous language reclamation, indigenous language revitalization, nêhiyawêwin, spirit of the language

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Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

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Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

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Authors: G. Singer, M. Golan

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Providing students with learning disabilities (LD) with extra time to grant them equal access to the exam is a necessary but insufficient condition to compensate for their LD; there should also be a clear indication that the additional time was actually used. For example, if students with LD use more time than students without LD and yet receive lower grades, this may indicate that a different accommodation is required. If they achieve higher grades but use the same amount of time, then the effectiveness of the accommodation has not been demonstrated. The main goal of this study is to evaluate the effect of including parameters related to LD and extended exam time, along with other commonly-used characteristics (e.g., student background and ability measures such as high-school grades), on the ability of ordinal decision-tree algorithms to predict exam performance. We use naturally-occurring data collected from hundreds of undergraduate engineering students. The sub-goals are i) to examine the improvement in prediction accuracy when the indicator of exam performance includes 'actual time used' in addition to the conventional indicator (exam grade) employed in most research; ii) to explore the effectiveness of extended exam time on exam performance for different courses and for LD students with different profiles (i.e., sets of characteristics). This is achieved by using the patterns (i.e., subgroups) generated by the algorithms to identify pairs of subgroups that differ in just one characteristic (e.g., course or type of LD) but have different outcomes in terms of exam performance (grade and time used). Since grade and time used to exhibit an ordering form, we propose a method based on ordinal decision-trees, which applies a weighted information-gain ratio (WIGR) measure for selecting the classifying attributes. Unlike other known ordinal algorithms, our method does not assume monotonicity in the data. The proposed WIGR is an extension of an information-theoretic measure, in the sense that it adjusts to the case of an ordinal target and takes into account the error severity between two different target classes. Specifically, we use ordinal C4.5, random-forest, and AdaBoost algorithms, as well as an ensemble technique composed of ordinal and non-ordinal classifiers. Firstly, we find that the inclusion of LD and extended exam-time parameters improves prediction of exam performance (compared to specifications of the algorithms that do not include these variables). Secondly, when the indicator of exam performance includes 'actual time used' together with grade (as opposed to grade only), the prediction accuracy improves. Thirdly, our subgroup analyses show clear differences in the effect of extended exam time on exam performance among different courses and different student profiles. From a methodological perspective, we find that the ordinal decision-tree based algorithms outperform their conventional, non-ordinal counterparts. Further, we demonstrate that the ensemble-based approach leverages the strengths of each type of classifier (ordinal and non-ordinal) and yields better performance than each classifier individually.

Keywords: actual exam time usage, ensemble learning, learning disabilities, ordinal classification, time extension

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Authors: Alinka Molnár-Tóth, Tímea Tánczos, Regina Barna, Katalin Jakab, Péter Klivényi

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Supported by neuroscientific findings, the so-called Hub-and-Spoke model of the human semantic system is based on two subcomponents of semantic cognition, namely the semantic control process and semantic representation. Our semantic knowledge is multimodal in nature, as the knowledge system stored in relation to a conception is extensive and broad, while different aspects of the conception may be relevant depending on the purpose. The motivation of our research is to develop a new diagnostic measurement procedure based on the preservation of semantic representation, which is appropriate to the specificities of the Hungarian language and which can be used to compare the non-verbal semantic knowledge of healthy and aphasic persons. The development of the test will broaden the Hungarian clinical diagnostic toolkit, which will allow for more specific therapy planning. The sample of healthy persons (n=480) was determined by the last census data for the representativeness of the sample. Based on the concept of the Pyramids and Palm Tree Test, and according to the characteristics of the Hungarian language, we have elaborated a test based on different types of semantic information, in which the subjects are presented with three pictures: they have to choose the one that best fits the target word above from the two lower options, based on the semantic relation defined. We have measured 5 types of semantic knowledge representations: associative relations, taxonomy, motional representations, concrete as well as abstract verbs. As the first step in our data analysis, we examined the normal distribution of our results, and since it was not normally distributed (p < 0.05), we used nonparametric statistics further into the analysis. Using descriptive statistics, we could determine the frequency of the correct and incorrect responses, and with this knowledge, we could later adjust and remove the items of questionable reliability. The reliability was tested using Cronbach’s α, and it can be safely said that all the results were in an acceptable range of reliability (α = 0.6-0.8). We then tested for the potential gender differences using the Mann Whitney-U test, however, we found no difference between the two (p < 0.05). Likewise, we didn’t see that the age had any effect on the results using one-way ANOVA (p < 0.05), however, the level of education did influence the results (p > 0.05). The relationships between the subtests were observed by the nonparametric Spearman’s rho correlation matrix, showing statistically significant correlation between the subtests (p > 0.05), signifying a linear relationship between the measured semantic functions. A margin of error of 5% was used in all cases. The research will contribute to the expansion of the clinical diagnostic toolkit and will be relevant for the individualised therapeutic design of treatment procedures. The use of a non-verbal test procedure will allow an early assessment of the most severe language conditions, which is a priority in the differential diagnosis. The measurement of reaction time is expected to advance prodrome research, as the tests can be easily conducted in the subclinical phase.

Keywords: communication disorders, diagnostic toolkit, neurorehabilitation, semantic knowlegde

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Authors: Ch. Sridevi, A. Chalapathi Rao, P. Srinivasulu

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The location accuracy of data products is a critical parameter in assessing the geometric performance of satellite sensors. This study focuses on reliability analysis of onboard sensors to evaluate their performance in terms of location accuracy performance over time. The analysis utilizes field failure data and employs the weibull distribution to determine the reliability and in turn to understand the improvements or degradations over a period of time. The analysis begins by scrutinizing the location accuracy error which is the root mean square (RMS) error of differences between ground control point coordinates observed on the product and the map and identifying the failure data with reference to time. A significant challenge in this study is to thoroughly analyze the possibility of an infant mortality phase in the data. To address this, the Weibull distribution is utilized to determine if the data exhibits an infant stage or if it has transitioned into the operational phase. The shape parameter beta plays a crucial role in identifying this stage. Additionally, determining the exact start of the operational phase and the end of the infant stage poses another challenge as it is crucial to eliminate residual infant mortality or wear-out from the model, as it can significantly increase the total failure rate. To address this, an approach utilizing the well-established statistical Laplace test is applied to infer the behavior of sensors and to accurately ascertain the duration of different phases in the lifetime and the time required for stabilization. This approach also helps in understanding if the bathtub curve model, which accounts for the different phases in the lifetime of a product, is appropriate for the data and whether the thresholds for the infant period and wear-out phase are accurately estimated by validating the data in individual phases with Weibull distribution curve fitting analysis. Once the operational phase is determined, reliability is assessed using Weibull analysis. This analysis not only provides insights into the reliability of individual sensors with regards to location accuracy over the required period of time, but also establishes a model that can be applied to automate similar analyses for various sensors and parameters using field failure data. Furthermore, the identification of the best-performing sensor through this analysis serves as a benchmark for future missions and designs, ensuring continuous improvement in sensor performance and reliability. Overall, this study provides a methodology to accurately determine the duration of different phases in the life data of individual sensors. It enables an assessment of the time required for stabilization and provides insights into the reliability during the operational phase and the commencement of the wear-out phase. By employing this methodology, designers can make informed decisions regarding sensor performance with regards to location accuracy, contributing to enhanced accuracy in satellite-based applications.

Keywords: bathtub curve, geometric performance, Laplace test, location accuracy, reliability analysis, Weibull analysis

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Authors: Sara T. K. Li, Belinda H. J. Chung, Jeffery C. N. Yip, Janet H. Hsiao

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Music notation and text reading both involve statistical learning of music or linguistic structures. However, it remains unclear how music reading expertise influences text reading behavior. The present study examined this issue through an eye-tracking study. Chinese-English bilingual musicians and non-musicians read English sentences, Chinese sentences, musical phrases, and sentences in Tibetan, a language novel to the participants, with their eye movement recorded. Each set of stimuli consisted of two conditions in terms of structural regularity: syntactically correct and syntactically incorrect musical phrases/sentences. They then completed a sentence comprehension (for syntactically correct sentences) or a musical segment/word recognition task afterwards to test their comprehension/recognition abilities. The results showed that in reading musical phrases, as compared with non-musicians, musicians had a higher accuracy in the recognition task, and had shorter reading time, fewer fixations, and shorter fixation duration when reading syntactically correct (i.e., in diatonic key) than incorrect (i.e., in non-diatonic key/atonal) musical phrases. This result reflects their expertise in music reading. Interestingly, in reading Tibetan sentences, which was novel to both participant groups, while non-musicians did not show any behavior differences between reading syntactically correct or incorrect Tibetan sentences, musicians showed a shorter reading time and had marginally fewer fixations when reading syntactically correct sentences than syntactically incorrect ones. However, none of the musicians reported discovering any structural regularities in the Tibetan stimuli after the experiment when being asked explicitly, suggesting that they may have implicitly acquired the structural regularities in Tibetan sentences. This group difference was not observed when they read English or Chinese sentences. This result suggests that music reading expertise facilities reading texts in a novel language (i.e., Tibetan), but not in languages that the readers are already familiar with (i.e., English and Chinese). This phenomenon may be due to the similarities between reading music notations and reading texts in a novel language, as in both cases the stimuli follow particular statistical structures but do not involve semantic or lexical processing. Thus, musicians may transfer their statistical learning skills stemmed from music notation reading experience to implicitly discover structures of sentences in a novel language. This speculation is consistent with a recent finding showing that music reading expertise modulates the processing of English nonwords (i.e., words that do not follow morphological or orthographic rules) but not pseudo- or real words. These results suggest that the modulation of music reading expertise on language processing depends on the similarities in the cognitive processes involved. It also has important implications for the benefits of music education on language and cognitive development.

Keywords: eye movement behavior, eye-tracking, music reading expertise, sentence reading, structural regularity, visual processing

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Authors: Federico Herrera, Valle Gomez García de Soria, Itxaso Portero Sainz, Carlos Fernández Arandojo, Mercedes Royg, Ana Marcos Jimenez, Anna Kreutzman, Cecilia MuñozCalleja

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Introduction: Graft-versus-host disease (GVHD) still remains the major complication associated with allogeneic stem cell transplantation (SCT). The pathogenesis involves migration of donor naïve T-cells into recipient secondary lymphoid organs. Two molecules are important in this process: CD62L and CCR7, which are characteristically expressed in naïve/central memory T-cells. With this background, we aimed to study the influence of CCR7 and CD62L on donor lymphocytes in the development and severity of GVHD. Material and methods: This single center study included 98 donor-recipient pairs. Samples were collected prospectively from the apheresis product and phenotyped by flow cytometry. CCR7 and CD62L expression in CD4+ and CD8+ T-cells were compared between patients who developed acute (n=40) or chronic GVHD (n=33) and those who did not (n=38). Results: The patients who developed acute GVHD were transplanted with a higher percentage of CCR7+CD4+ T-cells (p = 0.05) compared to the no GVHD group. These results were confirmed when these patients were divided in degrees according to the severity of the disease; the more severe disease, the higher percentage of CCR7+CD4+ T-cells. Conversely, chronic GVHD patients received a higher percentage of CCR7+CD8+ T-cells (p=0.02) in comparison to those who did not develop the complication. These data were also confirmed when patients were subdivided in degrees of the disease severity. A multivariable analysis confirmed that percentage of CCR7+CD4+ T-cells is a predictive factor of acute GVHD whereas the percentage of CCR7+CD8+ T-cells is a predictive factor of chronic GVHD. In vitro functional assays (migration and activation assays) supported the idea of CCR7+ T-cells were involved in the development of GVHD. As low levels of CD62L expression were detected in all apheresis products, we tested the hypothesis that CD62L was shed during apheresis procedure. Comparing CD62L surface levels in T-cells from the same donor immediately before collecting the apheresis product, and the final apheresis product we found that this process down-regulated CD62L in both CD4+ and CD8+ T cells (p=0.008). Interestingly, when CD62L levels were analysed in days 30 or 60 after engraftment, they recovered to baseline (p=0.008). However, to investigate the relation between CD62L expression and the development of GVHD in the recipient samples after the engraftment, no differences were observed comparing patients with GVHD to those who did not develop the disease. Discussion: Our prospective study indicates that the CCR7+ T-cells from the donor, which include naïve and central memory T-cells, contain the alloreactive cells with a high ability to mediate GVHD (in the case of both migration and activation). Therefore we suggest that the proportion and functional properties of CCR7+CD4+ and CCR7+CD8+ T-cells in the apheresis could act as a predictive biomarker to both acute and chronic GVHD respectively. Importantly, our study precludes that CD62L is lost in the apheresis and therefore it is not a reliable biomarker for the development of GVHD.

Keywords: CCR7, CD62L, GVHD, SCT

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Authors: Ruslin, R. E. Kartasasmita, M. S. Wibowo, S. Ibrahim

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An aphrodisiac is a substance contained in food or drug that can arouse sexual instinct and increase pleasure while working, these substances derived from plants, animals, and minerals. When consuming substances that have aphrodisiac activity and duration can improve the sexual instinct. The natural aphrodisiac effect can be obtained through plants, animals, and minerals. Leonurine compound has aphrodisiac activity, these compounds can be isolated from plants of Leonurus Sp, Sundanese people is known as deundereman, this plant is empirical has aphrodisiac activity and based on the isolation of active compounds from plants known to contain compounds leonurine, so that the compound is expected to have activity aphrodisiac. Leonurine compound can be isolated from plants or synthesized chemically with material dasa siringat acid. Leonurine compound can be obtained commercial and derivatives of these compounds can be synthesized in an effort to increase its activity. This study aims to obtain derivatives leonurine better aphrodisiac activity compared with the parent compound, modified the structure of the compounds in the form leonurin guanidino butyl ester group with butyl amin and bromoetanol. ArgusLab program version 4.0.1 is used to determine the binding energy, hydrogen bonds and amino acids involved in the interaction of the compound PDE5 receptor. The in vivo test leonurine compounds and derivatives as an aphrodisiac ingredients and hormone testosterone levels using 27 male rats Wistar strain and 9 female mice of the same species, ages ranged from 12 weeks rats weighing + 200 g / tail. The test animal is divided into 9 groups according to the type of compounds and the dose given. Each treatment group was orally administered 2 ml per day for 5 days. On the sixth day was observed male rat sexual behavior and taking blood from the heart to measure testosterone levels using ELISA technique. Statistical analysis was performed in this study is the ANOVA test Least Square Differences (LSD) using the program Statistical Product and Service Solutions (SPSS). Aphrodisiac efficacy of the leonurine compound and its derivatives have proven in silico and in vivo test, the in silico testing leonurine derivatives have smaller binding energy derivatives leonurine so that activity better than leonurine compounds. Testing in vivo using rats of wistar strain that better leonurine derivative of this compound shows leonurine that in silico studies in parallel with in vivo tests. Modification of the structure in the form of guanidine butyl ester group with butyl amin and bromoethanol increase compared leonurine compound for aphrodisiac activity, testosterone derivatives of compounds leonurine experienced a significant improvement especial is 1RD compounds especially at doses of 100 and 150 mg/bb. The results showed that the compound leonurine and its compounds contain aphrodisiac activity and increase the amount of testosterone in the blood. The compound test used in this study acts as a steroid precursor resulting in increased testosterone.

Keywords: aphrodisiac dysfunction erectile leonurine 1-RD 2-RD, dysfunction, erectile leonurine, 1-RD 2-RD

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Authors: Sezer Kefeli, Sertaç Arslan

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Supercavitation is a pressure dependent process which gives opportunity to eliminate the wetted surface effects on the underwater vehicle due to the differences of viscosity and velocity effects between liquid (freestream) and gas phase. Cavitation process occurs depending on rapid pressure drop or temperature rising in liquid phase. In this paper, pressure based cavitation is investigated due to the fact that is encountered in the underwater world, generally. Basically, this vapor-filled pressure based cavities are unstable and harmful for any underwater vehicle because these cavities (bubbles or voids) lead to intense shock waves while collapsing. On the other hand, supercavitation is a desired and stabilized phenomena than general pressure based cavitation. Supercavitation phenomena offers the idea of minimizing form drag, and thus supercavitating vehicles are revived. When proper circumstances are set up, which are either increasing the operating speed of the underwater vehicle or decreasing the pressure difference between free stream and artificial pressure, the continuity of the supercavitation is obtainable. There are 2 types of supercavitation to obtain stable and continuous supercavitation, and these are called as natural and artificial supercavitation. In order to generate natural supercavitation, various mechanical structures are discovered, which are called as cavitators. In literature, a lot of cavitator types are studied either experimentally or numerically on a CFD platforms with intent to observe natural supercavitation since the 1900s. In this paper, firstly, experimental results are obtained, and trend lines are generated based on supercavitation parameters in terms of cavitation number (), form drag coefficientC_D, dimensionless cavity diameter (d_m/d_c), and length (L_c/d_c). After that, natural cavitation verification studies are carried out for disk and cone shape cavitators. In addition, supercavitation parameters are numerically analyzed at different operating conditions, and CFD results are fitted into trend lines of experimental results. The aims of this paper are to generate one generally accepted drag coefficient equation for disk and cone cavitators at different cavitator half angle and investigation of the supercavitation parameters with respect to cavitation number. Moreover, 165 CFD analysis are performed at different cavitation numbers on FLUENT version 21R2. Five different cavitator types are modeled on SCDM with respect tocavitator’s half angles. After that, CFD database is generated depending on numerical results, and new trend lines are generated based on supercavitation parameters. These trend lines are compared with experimental results. Finally, the generally accepted drag coefficient equation and equations of supercavitation parameters are generated.

Keywords: cavity envelope, CFD, high speed underwater vehicles, supercavitation, supercavitating flows, supercavitation parameters, drag reduction, viscous force elimination, natural cavitation verification

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Authors: F. Pal-Fam, R. Hoffmann, S. Keszthelyi

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Granary weevil, Sitophilus granarius (L.) (Col.: Curculionidae) is a typical cosmopolitan pest. It can cause significant damage to stored grains, and can drastically decrease yields. Damaged grain has reduced nutritional and market value, weaker germination, and reduced weight. The commonly used protectants against stored-product pests in Europe are residual insecticides, applied directly to the product. Unfortunately, these pesticides can be toxic to mammals, the residues can accumulate in the treated products, and many pest species could become resistant to the protectants. During recent years, alternative solutions of grain protection have received increased attention. These solutions are considered as the most promising alternatives to residual insecticides. The aims of our comparative study were to obtain information about the efficacies of the 1. diatomaceous earth, 2. sterile insect technology and 3. herbal oils against the S. granarius on grain (foremost maize), and to evaluate the influence of the dose rate on weevil mortality and progeny. The main results of our laboratory experiments are the followings: 1. Diatomaceous earth was especially efficacious against S. granarius, but its insecticidal properties depend on exposure time and applied dose. The efficacy on barley was better than on maize. Mortality value of the highest dose was 85% on the 21st day in the case of barley. It can be ascertained that complete elimination of progeny was evidenced on both gain types. To summarize, a satisfactory efficacy level was obtained only on barley at a rate of 4g/kg. Alteration of efficacy between grain types can be explained with differences in grain surface. 2. The mortality consequences of Roentgen irradiation on the S. granarius was highly influenced by the exposure time, and the dose applied. At doses of 50 and 70Gy, the efficacy accepted in plant protection (mortality: 95%) was recorded only on the 21st day. During the application of 100 and 200Gy doses, high mortality values (83.5% and 97.5%) were observed on the 14th day. Our results confirmed the complete sterilizing effect of the doses of 70Gy and above. The autocide effect of 50 and 70Gy doses were demonstrated when irradiated specimens were mixed into groups of fertile specimens. Consequently, these doses might be successfully applied to put sterile insect technique (SIT) into practice. 3. The results revealed that both studied essential oils (Callendula officinalis, Hippophae rhamnoides) exerted strong toxic effect on S. granarius, but C. officinalis triggered higher mortality. The efficacy (94.62 ± 2.63%) was reached after a 48 hours exposure to H. rhamnoides oil at 2ml/kg while the application of 2ml/kg of C. officinalis oil for 24 hours produced 98.94 ± 1.00% mortality rate. Mortality was 100% at 5 ml/kg of H. rhamnoides after 24 hours duration of its application, while with C. officinalis the same value could be reached after a 12 hour-exposure to the oil. Both essential oils applied were eliminated the progeny.

Keywords: Sitophilus granarius, stored product, protection, alternative solutions

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Authors: Pamela Ventola, Laurel Bales, Sara Florczyk

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Background: Fully remote or hybrid administration of clinical outcome measures in rare neurodevelopmental disorders trials is increasing due to the ongoing pandemic and recognition that remote assessments reduce the burden on families. Many assessments in rare neurodevelopmental disorders trials are complex; however, remote/hybrid trials readily allow for the use of centralized raters to administer and score the scales. The use of centralized raters has many benefits, including reducing site burden; however, a specific impact on data quality has not yet been determined. Purpose: The current study has two aims: a) evaluate differences in data quality between administration of a standardized clinical interview completed by centralized raters compared to those completed by site raters and b) evaluate improvement in accuracy of scoring standardized developmental assessments when scored centrally compared to when scored by site raters. Methods: For aim 1, the Vineland-3, a widely used measure of adaptive functioning, was administered by site raters (n= 52) participating in one of four rare disease trials. The measure was also administered as part of two additional trials that utilized central raters (n=7). Each rater completed a comprehensive training program on the assessment. Following completion of the training, each clinician completed a Vineland-3 with a mock caregiver. Administrations were recorded and reviewed by a neuropsychologist for administration and scoring accuracy. Raters were able to certify for the trials after demonstrating an accurate administration of the scale. For site raters, 25% of each rater’s in-study administrations were reviewed by a neuropsychologist for accuracy of administration and scoring. For central raters, the first two administrations and every 10th administration were reviewed. Aim 2 evaluated the added benefit of centralized scoring on the accuracy of scoring of the Bayley-3, a comprehensive developmental assessment widely used in rare neurodevelopmental disorders trials. Bayley-3 administrations across four rare disease trials were centrally scored. For all administrations, the site rater who administered the Bayley-3 scored the scale, and a centralized rater reviewed the video recordings of the administrations and also scored the scales to confirm accuracy. Results: For aim 1, site raters completed 138 Vineland-3 administrations. Of the138 administrations, 53 administrations were reviewed by a neuropsychologist. Four of the administrations had errors that compromised the validity of the assessment. The central raters completed 180 Vineland-3 administrations, 38 administrations were reviewed, and none had significant errors. For aim 2, 68 administrations of the Bayley-3 were reviewed and scored by both a site rater and a centralized rater. Of these administrations, 25 had errors in scoring that were corrected by the central rater. Conclusion: In rare neurodevelopmental disorders trials, sample sizes are often small, so data quality is critical. The use of central raters inherently decreases site burden, but it also decreases rater variance, as illustrated by the small team of central raters (n=7) needed to conduct all of the assessments (n=180) in these trials compared to the number of site raters (n=53) required for even fewer assessments (n=138). In addition, the use of central raters dramatically improves the quality of scoring the assessments.

Keywords: neurodevelopmental disorders, clinical trials, rare disease, central raters, remote trials, decentralized trials

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