Search results for: early mild cognitive impairment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5908

Search results for: early mild cognitive impairment

5458 Impact of Stress and Protein Malnutrition on the Potential Role of Epigallocatechin-3-Gallate in Providing Protection from Nephrotoxicity and Hepatotoxicity Induced by Aluminum in Rats

Authors: Azza A. Ali, Mona G. Khalil, Hemat A. Elariny, Shereen S. El Shaer

Abstract:

Background: Aluminium (Al) is very abundant metal in the earth’s crust. It is a constituent of cooking utensils, medicines, cosmetics, some foods and food additives. Salts of Al are widely used in the treatment of drinking water for purification purposes. Excessive and prolonged exposure to Al causes oxidative stress and impairment of many physiological functions. Its accumulation in liver and kidney causes hepatotoxicity and nephrotoxicity. Social isolation (SI) or Protein malnutrition (PM) also increases oxidative stress and may enhance the toxicity of Al as well as the degeneration in liver and kidney. Epigallocatechin-3-gallate (EGCG) is the most abundant catechin in green tea and has strong antioxidant as well as anti-inflammatory activities and can protect against oxidative stress-induced degenerations. Objective: To study the influence of stress or PM on Al-induced nephrotoxicity and hepatotoxicity in rats, as well as on the potential role of EGCG in providing protection. Methods: Rats received daily AlCl3 (70 mg/kg, IP) for three weeks (Al-toxicity groups) except one normal control group received saline. Al-toxicity groups were divided into four treated and four untreated groups; treated rats received EGCG (10 mg/kg, IP) together with AlCl3. One group of both treated and untreated rats served as control for each of them, and the others were subjected to either stress (mild using isolation or high using electric shock) or to PM (10% casein diet). Specimens of liver and kidney were used for assessment of levels of inflammatory mediators as TNF-α, IL6β, nuclear factor kappa B (NF-κB), oxidative stress (MDA, SOD, TAC, NO), Caspase-3 and for DNA fragmentation as well as for histopathological examinations. Biochemical changes were also measured in the serum as total lipids, cholesterol, triglycerides, glucose, proteins, bilirubin, creatinine and urea as well as the level of Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and lactate deshydrogenase (LDH). Results: Nephrotoxicity and hepatotoxicity induced by Al were enhanced in rats exposed to stress and to PM. The influence of stress was more pronounced than PM. Al-toxicity was indicated by the increase in liver and kidney MDA, NO, TNF-α, IL-6β, NF-κB, caspase-3, DNA fragmentation and in ALT, AST, ALP, LDH and total lipids, cholesterol, triglycerides, glucose, proteins, bilirubin, creatinine and urea levels, together with the decrease in total proteins, SOD, TAC. EGCG provided protection against hazards of Al as indicated by the decrease in MDA, NO, TNF-α, IL-6β, NF-κB, caspase-3 and DNA fragmentation as well as in levels of ALT, AST, ALP, LDH and total lipids, cholesterol, triglycerides, glucose, proteins, bilirubin, creatinine and urea in liver and kidney, together with the increase in total proteins, SOD, TAC and confirmed by histopathological examinations. It provided more pronounced protection in high stressful conditions than in mild one than in PM. Conclusion: Stress have a bad impact on Al-induced nephrotoxicity and hepatotoxicity more than PM. Thus it can clarify and maximize the role of EGCG in providing protection. Consequently, administration of EGCG is advised with excessive Al-exposure to avoid nephrotoxicity and hepatotoxicity especially in populations more subjected to stress or PM.

Keywords: aluminum, stress, protein malnutrition, nephrotoxicity, hepatotoxicity, epigallocatechin-3-gallate, rats

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5457 Simulation of Kinetic Friction in L-Bending of Sheet Metals

Authors: Maziar Ramezani, Thomas Neitzert, Timotius Pasang

Abstract:

This paper aims at experimental and numerical investigation of springback behavior of sheet metals during L-bending process with emphasis on Stribeck-type friction modeling. The coefficient of friction in Stribeck curve depends on sliding velocity and contact pressure. The springback behavior of mild steel and aluminum alloy 6022-T4 sheets was studied experimentally and using numerical simulations with ABAQUS software with two types of friction model: Coulomb friction and Stribeck friction. The influence of forming speed on springback behavior was studied experimentally and numerically. The results showed that Stribeck-type friction model has better results in predicting springback in sheet metal forming. The FE prediction error for mild steel and 6022-T4 AA is 23.8%, 25.5% respectively, using Coulomb friction model and 11%, 13% respectively, using Stribeck friction model. These results show that Stribeck model is suitable for simulation of sheet metal forming especially at higher forming speed.

Keywords: friction, L-bending, springback, Stribeck curves

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5456 Earnings-Related Information, Cognitive Bias, and the Disposition Effect

Authors: Chih-Hsiang Chang, Pei-Shan Kao

Abstract:

This paper discusses the reaction of investors in the Taiwan stock market to the most probable unknown earnings-related information and the most probable known earnings-related information. As compared with the previous literature regarding the effect of an official announcement of earnings forecast revision, this paper further analyzes investors’ cognitive bias toward the unknown and known earnings-related information, and the role of media during the investors' reactions to the foresaid information shocks. The empirical results show that both the unknown and known earnings-related information provides useful information content for a stock market. In addition, cognitive bias and disposition effect are the behavioral pitfalls that commonly occur in the process of the investors' reactions to the earnings-related information. Finally, media coverage has a remarkable influence upon the investors' trading decisions.

Keywords: cognitive bias, role of media, disposition effect, earnings-related information, behavioral pitfall

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5455 Pattern Identification in Statistical Process Control Using Artificial Neural Networks

Authors: M. Pramila Devi, N. V. N. Indra Kiran

Abstract:

Control charts, predominantly in the form of X-bar chart, are important tools in statistical process control (SPC). They are useful in determining whether a process is behaving as intended or there are some unnatural causes of variation. A process is out of control if a point falls outside the control limits or a series of point’s exhibit an unnatural pattern. In this paper, a study is carried out on four training algorithms for CCPs recognition. For those algorithms optimal structure is identified and then they are studied for type I and type II errors for generalization without early stopping and with early stopping and the best one is proposed.

Keywords: control chart pattern recognition, neural network, backpropagation, generalization, early stopping

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5454 Traumatic Brain Injury Neurosurgical Care Continuum Delays in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

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5453 A Comparitive Study of the Effect of Stress on the Cognitive Parameters in Women with Increased Body Mass Index before and after Menopause

Authors: Ramesh Bhat, Ammu Somanath, A. K. Nayanatara

Abstract:

Background: The increasing prevalence of overweight and obesity is a critical public health problem for women. The negative effect of stress on memory and cognitive functions has been widely explored for decades in numerous research projects using a wide range of methodology. Deterioration of memory and other brain functions are hallmarks of Alzheimer’s disease. Estrogen fluctuations and withdrawal have myriad direct effects on the central nervous system that have the potential to influence cognitive functions. Aim: The present study aims to compare the effect of stress on the cognitive functions in overweight/obese women before and after menopause. Material and Methods: A total of 142 female subjects constituting women before menopause between the age group of 18–44 years and women after menopause between the age group of 45–60 years were included in the sample. Participants were categorized into overweight/obese groups based on the body mass index. The Perceived Stress Scale (PSS) the major tool was used for measuring the perception of stress. Based on the stress scale measurement each group was classified into with stress and without stress. Addenbrooke’s cognitive Examination-III was used for measuring the cognitive functions. Results: Premenopausal women with stress showed a significant (P<0.05) decrease in the cognitive parameters such as attention and orientation Fluency, language and visuospatial ability. Memory did not show any significant change in this group. Whereas, in the postmenopausal stressed women all the cognitive functions except fluency showed a significant (P<0.05) decrease after menopause stressed group. Conclusion: Stress is a significant factor on the cognitive functions of obese and overweight women before and after menopause. Practice of Yoga, Encouragement in activities like gardening, embroidery, games and relaxation techniques should be recommended to prevent stress. Insights into the neurobiology before and after menopause can be gained from future studies examining the effect on the HPA axis in relation to cognition and stress.

Keywords: cognition, stress, premenopausal, body mass index

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5452 Innovative Ideas through Collaboration with Potential Users

Authors: Martin Hewing, Katharina Hölzle

Abstract:

Organizations increasingly use environmental stimuli and ideas from users within participatory innovation processes in order to tap new sources of knowledge. The research presented in this article focuses on users who shape the distant edges of markets and currently are not using products and services from a domain– so called potential users. Those users at the peripheries are perceived to contribute more novel information, by which they better reflect shifts in needs and behavior than current users in the core market. Their contributions in collaborative and creative problem-solving processes and how they generate ideas for discontinuous innovations are of particular interest. With an experimental design, we compare ideas from potential and current users and analyze the effects of cognitive distance in collaboration and the utilization of explicit and tacit knowledge. We find potential users to generate more original ideas, particularly when they collaborate with someone experienced within the domain. Their ideas are most obviously characterized by an increased level of surprise and unusualness compared to dominant designs, which is rooted in contexts and does not require technological leaps. Collaboration with potential users can therefore result in new ways to leverage technological competences. Furthermore, the cross-fertilization arising from cognitive distance between a potential and a current user is asymmetric due to differences in the nature of their utilized knowledge and personal objectives. This paper discusses implications for innovation research and the management of early innovation processes.

Keywords: user collaboration, co-creation, discontinuous innovation, innovation research

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5451 The Effect of Trans-Cranial Direct Current Stimulation (tDCS) on Cognitive Flexibility and Social Decision-Making in Football Players

Authors: Erfan Izadpanah

Abstract:

The present study was conducted to investigate the effect of the Trans-Cranial Direct Current Stimulation (tDCS) on cognitive flexibility and social decision-making in skilled, semi-skilled and novice football players. The present quasi-experimental pretest-posttest study was conducted on 60 randomly-selected subjects divided into trial and placebo groups (n=30 per group). The trial group received three 20-minute sessions of anodic stimulation at the intensity of 2 mA. The placebo group also received three sessions of sham anodic stimulation. Data were collected using the Wisconsin, Grant and Berg Card-Sorting Test (1948) and the ultimatum game and were then analyzed using the ANCOVA. The results showed significant differences between the skilled, semi-skilled and novice football players in the trial and placebo groups in terms of cognitive flexibility and social decision-making (P<0.01). TDCS appears to be able to improve cognitive flexibility and consequently social decision-making in football players and is recommended to sport psychologists and coaches as a useful intervention to increase cognitive flexibility and improve social decision-making in players.

Keywords: TDCS, cognitive flexibility, social decision-making, skilled, semi-skilled and novice football players

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5450 NaCl Erosion-Corrosion of Mild Steel under Submerged Impingement Jet

Authors: M. Sadique, S. Ainane, Y. F. Yap, P. Rostron, E. Al Hajri

Abstract:

The presence of sand in production lines in the oil and gas industries causes material degradation due to erosion-corrosion. The material degradation caused by erosion-corrosion in pipelines can result in a high cost of monitoring and maintenance and in major accidents. The process of erosion-corrosion consists of erosion, corrosion, and their interactions. Investigating and understanding how the erosion-corrosion process affects the degradation process in certain materials will allow for a reduction in economic loss and help prevent accidents. In this study, material loss due to erosion-corrosion of mild steel under impingement of sand-laden water at 90˚ impingement angle is investigated using a submerged impingement jet (SIJ) test. In particular, effects of jet velocity and sand loading on TWL due to erosion-corrosion, weight loss due to pure erosion and erosion-corrosion interactions, at a temperature of 29-33 °C in sea water environment (3.5% NaCl), are analyzed. The results show that the velocity and sand loading have a great influence on the removal of materials, and erosion is more dominant under all conditions studied. Changes in the surface characteristics of the specimen after impingement test are also discussed.

Keywords: erosion-corrosion, flow velocity, jet impingement, sand loading

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5449 The Effectiveness of Energy Index Technique in Bearing Condition Monitoring

Authors: Faisal Alshammari, Abdulmajid Addali, Mosab Alrashed, Taihiret Alhashan

Abstract:

The application of acoustic emission techniques is gaining popularity, as it can monitor the condition of gears and bearings and detect early symptoms of a defect in the form of pitting, wear, and flaking of surfaces. Early detection of these defects is essential as it helps to avoid major failures and the associated catastrophic consequences. Signal processing techniques are required for early defect detection – in this article, a time domain technique called the Energy Index (EI) is used. This article presents an investigation into the Energy Index’s effectiveness to detect early-stage defect initiation and deterioration, and compares it with the common r.m.s. index, Kurtosis, and the Kolmogorov-Smirnov statistical test. It is concluded that EI is a more effective technique for monitoring defect initiation and development than other statistical parameters.

Keywords: acoustic emission, signal processing, kurtosis, Kolmogorov-Smirnov test

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5448 Atwood's Canadianisms and Neologisms: A Cognitive Approach to Literature

Authors: Eleonora Sasso

Abstract:

This paper takes as its starting point the notions of cognitive linguistics and lexical blending, and uses both these theoretical concepts to advance a new reading of Margaret Atwood’s latest writings, one which sees them as paramount literary examples of norm and usage in bilingual Canadian lexicography. Atwood’s prose seems to be imbued with Canadianisms and neologisms, lexical blends of zoomorphic forms, a kind of meeting-point between two conceptual structures which follow the principles of lexical economy and asyntactic relation. Atwood’s neologisms also attest to the undeniable impact on language exerted by Canada’s aboriginal peoples. This paper aims to track through these references and with the aid of the Eskimo-English dictionary look at the linguistic issues – attitudes to contaminations and hybridisations, questions of lexical blending in literary examples, etc – which they raise. Atwood’s fiction, whose cognitive linguistic strategy employs ‘the virtues of scissors and matches’, always strives to achieve isomorphism between word form and concept.

Keywords: Atwood, Canadianisms, cognitive science, Eskimo/English dictionary

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5447 Anthropometric Indices of Obesity and Coronary Artery Atherosclerosis: An Autopsy Study in South Indian population

Authors: Francis Nanda Prakash Monteiro, Shyna Quadras, Tanush Shetty

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The association between human physique and morbidity and mortality resulting from coronary artery disease has been studied extensively over several decades. Multiple studies have also been done on the correlation between grade of atherosclerosis, coronary artery diseases and anthropometrical measurements. However, the number of autopsy-based studies drastically reduces this number. It has been suggested that while in living subjects, it would be expensive, difficult, and even harmful to subject them to imaging modalities like CT scans and procedures involving contrast media to study mild atherosclerosis, no such harm is encountered in study of autopsy cases. This autopsy-based study was aimed to correlate the anthropometric measurements and indices of obesity, such as waist circumference (WC), hip circumference (HC), body mass index (BMI) and waist hip ratio (WHR) with the degree of atherosclerosis in the right coronary artery (RCA), main branch of the left coronary artery (LCA) and the left anterior descending artery (LADA) in 95 South Indian origin victims of both the genders between the age of 18 years and 75 years. The grading of atherosclerosis was done according to criteria suggested by the American Heart Association. The study also analysed the correlation of the anthropometric measurements and indices of obesity with the number of coronaries affected with atherosclerosis in an individual. All the anthropometric measurements and the derived indices were found to be significantly correlated to each other in both the genders except for the age, which is found to have a significant correlation only with the WHR. In both the genders severe degree of atherosclerosis was commonly observed in LADA, followed by LCA and RCA. Grade of atherosclerosis in RCA is significantly related to the WHR in males. Grade of atherosclerosis in LCA and LADA is significantly related to the WHR in females. Significant relation was observed between grade of atherosclerosis in RCA and WC, and WHR, and between grade of atherosclerosis in LADA and HC in males. Significant relation was observed between grade of atherosclerosis in RCA and WC, and WHR, and between grade of atherosclerosis in LADA and HC in females. Anthropometric measurements/indices of obesity can be an effective means to identify high risk cases of atherosclerosis at an early stage that can be effective in reducing the associated cardiac morbidity and mortality. A person with anthropometric measurements suggestive of mild atherosclerosis can be advised to modify his lifestyle, along with decreasing his exposure to the other risk factors. Those with measurements suggestive of higher degree of atherosclerosis can be subjected to confirmatory procedures to start effective treatment.

Keywords: atherosclerosis, coronary artery disease, indices, obesity

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5446 The Impact of Upward Social Media Comparisons on Body Image and the Role of Physical Appearance Perfectionism and Cognitive Coping

Authors: Lauren Currell, Gemma Hurst

Abstract:

Introduction: The present study experimentally investigated the impact of attractive Instagram images on female’s body image. It also examined whether physical appearance perfectionism and cognitive coping predicted body image following upward comparisons to idealised bodies on Instagram. Methods: One-hundred and fifty-eight females (mean age 24.35 years) were randomly assigned to an experimental (where they compared their bodies to those of Instagram models) or control condition (where they critiqued landscape painting). All participants completed measures on physical appearance perfectionism, cognitive coping, and pre- and post-measures of body image. Results: Comparing one’s body to idealised bodies on Instagram resulted in increased appearance and weight dissatisfaction and decreased confidence, compared to the control condition. Physical appearance perfectionism and cognitive coping both predicted body image outcomes for the experimental condition. Discussion: Clinical implications, such as the prevention and treatment of body dissatisfaction, are discussed. Strengths and limitations of the current study are also noted, and suggestions for future research are provided.

Keywords: perfectionism, cognitive coping, body image, social media

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5445 Development and Validation of Family Outcome Survey – Revised Taiwan Version

Authors: Shih-Heng Sun, Hsiu-Yu Chang

Abstract:

“Family centered service model” becomes mainstream in early intervention. Family outcome should be evaluated in addition child improvement in terms of outcome evaluation in early intervention. The purpose of this study is to develop a surveys to evaluate family outcomes in early intervention. Method: “Family Outcomes Survey- Revised Taiwan Version” (FOS-RT) was developed through translation, back-translation, and review by the original author. Expert meeting was held to determine the content validity. Two hundred and eighty six parent-child dyads recruited from 10 local Early Intervention Resource Centers (EIRC) participated in the study after they signed inform consent. The results showed both parts of FOS-RT exhibits good internal consistency and test-retest reliability. The result of confirmatory factor analysis indicated moderate fit of 5 factor structure of part A and 3 factor structure of part B of FOS-RT. The correlation between different sessions reached moderate to high level reveals some sessions measure similar latent trait of family outcomes. Correlation between FOS-RT and Parents‘ Perceived Parenting Skills Questionnaire was calculated to determine the convergence validity. The moderate correlation indicates the two assessments measure different parts of early intervention outcome although both assessments have similar sub-scales. The results of this study support FOS-RT is a valid and reliable tool to evaluate family outcome after the family and children with developmental disability receive early intervention services.

Keywords: early intervention, family service, outcome evaluation, parenting skills, family centered

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5444 Management Tools for Assessment of Adverse Reactions Caused by Contrast Media at the Hospital

Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

Abstract:

Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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5443 Spectrum Allocation Using Cognitive Radio in Wireless Mesh Networks

Authors: Ayoub Alsarhan, Ahmed Otoom, Yousef Kilani, Abdel-Rahman al-GHuwairi

Abstract:

Wireless mesh networks (WMNs) have emerged recently to improve internet access and other networking services. WMNs provide network access to the clients and other networking functions such as routing, and packet forwarding. Spectrum scarcity is the main challenge that limits the performance of WMNs. Cognitive radio is proposed to solve spectrum scarcity problem. In this paper, we consider a cognitive wireless mesh network where unlicensed users (secondary users, SUs) can access free spectrum that is allocated to spectrum owners (primary users, PUs). Although considerable research has been conducted on spectrum allocation, spectrum assignment is still considered an important challenging problem. This problem can be solved using cognitive radio technology that allows SUs to intelligently locate free bands and access them without interfering with PUs. Our scheme considers several heuristics for spectrum allocation. These heuristics include: channel error rate, PUs activities, channel capacity and channel switching time. Performance evaluation of the proposed scheme shows that the scheme is able to allocate the unused spectrum for SUs efficiently.

Keywords: cognitive radio, dynamic spectrum access, spectrum management, spectrum sharing, wireless mesh networks

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5442 Evaluation of Humoral Immune Response Against Somatic and Excretory- Secretory Antigens of Dicrocoelium Dendriticum in Infected Sheep by Western Blot

Authors: Arash Jafari, Somaye Bahrami, Mohammad Hossein Razi Jalali

Abstract:

The aim of this study was the isolation and identification of excretory-secretory and somatic antigens from D. dendriticum by SDS-PAGE and evaluation of humeral immune response against these antigens. The sera of infected sheep with different infection degrees were collected. Somatic and ES proteins were isolated with SDS PAGE. Immunogenicity properties of the resulting proteins were determined using western blot analysis. The total extract of somatic antigens analysed by SDS-PAGE revealed 21 proteins. In mild infection, bands of 130 KDa were immune dominant. In moderate infections 48, 80 and 130 KDa and in heavy infections 48, 60, 80, 130 KDa were detected as immune dominant bands. In ES antigens, mild infection 130 KDa, in moderate infection 100, 120 and 130 KDa and in heavy infection 45, 80, 85, 100, 120 and 130 KDa were immune dominant bands. The most immunogenic protein band during different degrees of infection was 130KDa.

Keywords: Dicrocoelium dendriticum excretory-secretory antigens, somatic antigens, western blot

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5441 Challenging Weak Central Coherence: An Exploration of Neurological Evidence from Visual Processing and Linguistic Studies in Autism Spectrum Disorder

Authors: Jessica Scher Lisa, Eric Shyman

Abstract:

Autism spectrum disorder (ASD) is a neuro-developmental disorder that is characterized by persistent deficits in social communication and social interaction (i.e. deficits in social-emotional reciprocity, nonverbal communicative behaviors, and establishing/maintaining social relationships), as well as by the presence of repetitive behaviors and perseverative areas of interest (i.e. stereotyped or receptive motor movements, use of objects, or speech, rigidity, restricted interests, and hypo or hyperactivity to sensory input or unusual interest in sensory aspects of the environment). Additionally, diagnoses of ASD require the presentation of symptoms in the early developmental period, marked impairments in adaptive functioning, and a lack of explanation by general intellectual impairment or global developmental delay (although these conditions may be co-occurring). Over the past several decades, many theories have been developed in an effort to explain the root cause of ASD in terms of atypical central cognitive processes. The field of neuroscience is increasingly finding structural and functional differences between autistic and neurotypical individuals using neuro-imaging technology. One main area this research has focused upon is in visuospatial processing, with specific attention to the notion of ‘weak central coherence’ (WCC). This paper offers an analysis of findings from selected studies in order to explore research that challenges the ‘deficit’ characterization of a weak central coherence theory as opposed to a ‘superiority’ characterization of strong local coherence. The weak central coherence theory has long been both supported and refuted in the ASD literature and has most recently been increasingly challenged by advances in neuroscience. The selected studies lend evidence to the notion of amplified localized perception rather than deficient global perception. In other words, WCC may represent superiority in ‘local processing’ rather than a deficit in global processing. Additionally, the right hemisphere and the specific area of the extrastriate appear to be key in both the visual and lexicosemantic process. Overactivity in the striate region seems to suggest inaccuracy in semantic language, which lends itself to support for the link between the striate region and the atypical organization of the lexicosemantic system in ASD.

Keywords: autism spectrum disorder, neurology, visual processing, weak coherence

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5440 A Collaborative Action Research by Using the Children’s School Success Plus Curriculum Framework to Support Early Childhood Education/Early Childhood Special Education Teachers to Build a Professional Learning Community

Authors: Chiou-Shiue Ko, Pei-Fang Wu, Shu-hsien Tseng

Abstract:

The researchers adopted two-year action research to investigate the professional collaborative process and development in learning communities for both early childhood and early childhood special education teachers on implementing the children’s school success curriculum framework. The participating teachers were recruited from three preschool sites for this current study. Research data were collected from multiple methods in order to ensure the data quality and validity. The results showed that participating educators had achieved professional growth, and they became more aware of teaching intentions and the preparation for the curriculum. Teachers in this research become more child-focused in teaching and create opportunities for children to participate in classroom activities and routines. The researcher also finds teachers’ participation levels were driven by each individual personality; during professional growth, some teachers are more proactive and reflective, and some are not. According to the research findings, suggestions for future studies and practices are provided.

Keywords: children’s school success curriculum framework, early childhood special education, preschool education, professional learning community

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5439 Early Versus Delayed Antiretroviral Therapy in HIV‐positive People with Tuberculosis

Authors: Mohhamed El Habib Labdouni

Abstract:

Introduction: Co-infection with VIH and tuberculosis poses one of the major ongoing challenges for global TB and AIDS prevention and control. The objective of this study is to raise the issue of the resurgence of TB, in People living with VIH supported in a referent center in western Algeria. Its epidemiological, clinical, biological and radiological new trends, and to compare the mortality rate between early and delayed ART. Methods: It was a prospective study, during 36 months from the 01st/01/2012 to 31st/12/2014, by identifying and analyzing cases of TB-VIH co-infection. Our population was devised in two groups/ early ART and delayed ART. The primary and secondary endpoints were analyzed with Kaplan-Meier curves and log-rank test the period of follow up, which was fixed at 300 weeks. Results: Sixty cases of co-infection TB -VIH were enrolled in our study: 78.3% had pulmonary tuberculosis associated with extra-pulmonary, 13.3% had only pulmonary tuberculosis and 08.3% presented strictly extra-pulmonary TB. The clinical particularity of this co-infection is the frequency of serious localization such us: pleural 23.3%, peritoneal 31.7%, and meningeal suffusion 13.3%.y-.biologicaly we notice the predominance both of pancytopenia and leucoanemia, hyponatremia in 38,6% and hypokalemia in 19,3%. By analyzing Kaplan-Meier survival curves, we notice that early ART initiation is associated with a significant reduction of all-cause mortality (p = 0,000), and we have identified several prognostic factors such as hypokalemia hyponatremia, leukocytosis thrombopenemia leucothrombopenia (p = 0,005). Conclusion: Our study confirms most of the results reported in the literature. Early ART initiation reduces the rate of all-cause mortality, despite the probability of the occurrence of TB-IRIS.

Keywords: TB-HIV co-infection, early ART, hyponatremia, extrapulmonary tuberculosis

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5438 A Literature Review of How Cognitive Disability Is Represented in Higher Education Research in the African Academy

Authors: Fadzayi M.Maruza

Abstract:

The conversation about diversity in the African academy focuses on the need for an international and ethnically diverse population of scholars and students. Operationalising the concept of cognitive diversity offers us an opportunity to broaden our conception of who can know and who can proclaim knowledge by availing new understandings of what knowledge is and how it is made. Limited attention is paid to the value of diversity generated by cognitive disabilities in the African academy. The inclusion of persons with minds labelled disabled in African academia requires an epistemology of disability to reform the still dominant notion of the expert and scholar as an able-bodied and hyper-rational in African academia. This review wants to explore how cognitive disabilities have been represented in higher education research in Africa or has the African academy reinforced ignorance by promoting an able-bodied academia. The review aims to tackle its exploratory objective by using Malcom Tights framework. The main questions this paper would focus on are: (I)What are the major disability themes and concerns discussed in the disability-related articles? (II)What are the major methods or methodologies used to address the topic in the papers? (III)What are the levels of analysis the papers focus on? (IV)How do higher education researchers define and represent cognitive disabilities in higher education research in Africa? To answer the exploratory questions that are aimed at mapping the disability-related higher education research landscape, Malcolm Tights’ framework is seen as most appropriate. In addition to a thematic categorization, that shall be made after reviewing of published empirical studies on disability in African higher education from the period 2010 – 2017. A synthesis of the findings and implications of African disability studies relating to students with cognitive disabilities in the African Academy will be provided using the categories suggested by Tight as a benchmark. Data for the proposed work shall be taken from well-reputed higher education journals between 2010 and 2017.Using the keyword ‘Disability’ in the titles, abstracts and keywords section of journal articles, a selection of disability-focused higher education articles shall be compiled for analysis regarding cognitive disability. It has to be noted as a limitation that the word Disability might not be sufficient to investigate the topic for there can be many more specific disabilities concerns the researchers would discuss. Therefore, the paper is only intended to give a bird’s eye view of cognitive disability in higher education research and therefore is not comprehensive. The paper is expected to shed some light for me, as a beginning researcher, and other researchers like myself as to what has been the focus of higher education researchers about cognitive disability in the African academy. Keywords: Cognitive diversity, cognitive disability, disability, higher education.

Keywords: cognitive disability, cognitive diversity, disability, higher education

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5437 Amyloid Angiopathy and Golf: Two Opposite but Close Worlds

Authors: Andrea Bertocchi, Alessio Barnaba Di Fonzo, Davide Talarico, Simone Rivaroli, Jeff Konin

Abstract:

The patient is a 89 years old male (180cm/85kg) retired notary former golfer with no past medical history. He describes a progressive ideomotor slowdown for 14 months. The disorder is characterized by short-term memory deficits and, for some months, also by unstable walking with a broad base with skidding and risk of falling at directional changes and urinary urgency. There were also episodes of aggression towards his wife and staff. At the time, the patient takes no prescribed medications. He has difficulty eating, dressing, and some problems with personal hygiene. In the initial visit, the patient was alert, cooperating, and performed simple tasks; however, he has a hearing impairment, slowed spontaneous speech, and amnestic deficit to the short story. Ideomotor apraxia is not present. He scored 20 points in the MMSE. From a motor function, he has deficits using Medical Research Council (MRC) 3-/5 in bilateral lower limbs and requires maximum assistance from sit to stand with existing premature fatigue. He’s unable to walk for about 1 month. Tremors and hypertonia are absent. BERG was unable to be administered, and BARTHEL was obtained 45/100. An Amyloid Angiopathy is suspected and then confirmed at the neurological examination. Therehabilitation objectives were the recovery of mobility and reinforcement of the UE/LE, especially legs, for recovery of standing and walking. The cognitive aspect was also an essential factor for the patient's recovery. The literature doesn’t demonstrate any particular studies regarding motor and cognitive rehabilitation on this pathology. Failing to manage his attention on exercise and tending to be disinterested and falling asleep constantly, we used golf-specific gestures to stimulate his mind to work and get results because the patient has memory recall of golf related movement. We worked for 4 months with a frequency of 3 sessions per week. Every session lasted for 45 minutes. After 4 months of work, the patient walked independently with the use of a stick for about 120 meters without stopping. MRC 4/5 AI bilaterally andpostural steps performed independently with supervision. BERG 36/56. BARTHEL 65/100. 6 Minutes Walking Test (6MWT), at the beginning, it wasn’t measurable, now, he performs 151,5m with Numeric Rating Scale 4 at the beginning and 7 at the end. Cognitively, he no longer has episodes of aggression, although the short-term memory and concentration deficit remains. Amyloid Angiopathy is a mix of motor and cognitive disorder. It is worth the thought that cerebral amyloid angiopathy manifests with functional deficits due to strokes and bleedings and, as such, has an important rehabilitation indication, as classical stroke is not associated with amyloidosis. Exploring the motor patterns learned at a young age and remained in the implicit and explicit memory of the patient allowed us to set up effective work and to obtain significant results in the short-middle term. Surely many studies will still be done regarding this pathology and its rehabilitation, but the importance of the cognitive sphere applied to the motor sphere could represent an important starting point.

Keywords: amyloid angiopathy, cognitive rehabilitation, golf, motor disorder

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5436 Social Norms around Adolescent Girls’ Marriage Practices in Ethiopia: A Qualitative Exploration

Authors: Dagmawit Tewahido

Abstract:

Purpose: This qualitative study was conducted to explore social norms around adolescent girls’ marriage practices in West Hararghe, Ethiopia, where early marriage is prohibited by law. Methods: Twenty Focus Group Discussions were conducted with Married and Unmarried adolescent girls, adolescent boys and parents of girls using locally developed vignettes. A total of 32 in-depth interviews were conducted with married and unmarried adolescent girls, husbands of adolescent girls and mothers-in-law. Key informant interviews were conducted with 36 district officials. Data analysis was assisted by Open Code computer software. The Social Norms Analysis Plot (SNAP) framework developed by CARE guided the development and analysis of vignettes. A thematic data analysis approach was utilized to summarize the data. Results: Early marriage is seen as a positive phenomenon in our study context, and girls who are not married by the perceived ideal age of 15 are socially sanctioned. They are particularly influenced by their peers to marry. Marrying early is considered a chance given by God and a symbol of good luck. The two common types of marriage are decided: 1) by adolescent girl and boy themselves without seeking parental permission (’Jalaa-deemaa’- meaning ‘to go along’), and 2) by just informing girl’s parents (‘Cabsaa’- meaning ‘to break the culture’). Relatives and marriage brokers also arrange early marriages. Girls usually accept the first marriage proposal regardless of their age. Parents generally tend not to oppose marriage arrangements chosen by their daughters. Conclusions: In the study context social norms encourage early marriage despite the existence of a law prohibiting marriage before the age of eighteen years. Early marriage commonly happens through consensual arrangements between adolescent girls and boys. Interventions to reduce early marriage need to consider the influence of Reference Groups on the decision makers for marriages, especially girls’ own peers.

Keywords: adolescent girls, social norms, early marriage, Ethiopia

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5435 Unsupervised Text Mining Approach to Early Warning System

Authors: Ichihan Tai, Bill Olson, Paul Blessner

Abstract:

Traditional early warning systems that alarm against crisis are generally based on structured or numerical data; therefore, a system that can make predictions based on unstructured textual data, an uncorrelated data source, is a great complement to the traditional early warning systems. The Chicago Board Options Exchange (CBOE) Volatility Index (VIX), commonly referred to as the fear index, measures the cost of insurance against market crash, and spikes in the event of crisis. In this study, news data is consumed for prediction of whether there will be a market-wide crisis by predicting the movement of the fear index, and the historical references to similar events are presented in an unsupervised manner. Topic modeling-based prediction and representation are made based on daily news data between 1990 and 2015 from The Wall Street Journal against VIX index data from CBOE.

Keywords: early warning system, knowledge management, market prediction, topic modeling.

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5434 A Real-World Evidence Analysis of Associations between Costs, Quality of Life and Disease-Severity Indicators of Alzheimer’s Disease in Thailand

Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

Abstract:

Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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5433 Modern Spectrum Sensing Techniques for Cognitive Radio Networks: Practical Implementation and Performance Evaluation

Authors: Antoni Ivanov, Nikolay Dandanov, Nicole Christoff, Vladimir Poulkov

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Spectrum underutilization has made cognitive radio a promising technology both for current and future telecommunications. This is due to the ability to exploit the unused spectrum in the bands dedicated to other wireless communication systems, and thus, increase their occupancy. The essential function, which allows the cognitive radio device to perceive the occupancy of the spectrum, is spectrum sensing. In this paper, the performance of modern adaptations of the four most widely used spectrum sensing techniques namely, energy detection (ED), cyclostationary feature detection (CSFD), matched filter (MF) and eigenvalues-based detection (EBD) is compared. The implementation has been accomplished through the PlutoSDR hardware platform and the GNU Radio software package in very low Signal-to-Noise Ratio (SNR) conditions. The optimal detection performance of the examined methods in a realistic implementation-oriented model is found for the common relevant parameters (number of observed samples, sensing time and required probability of false alarm).

Keywords: cognitive radio, dynamic spectrum access, GNU Radio, spectrum sensing

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5432 The Level of Stress and Coping Stress Strategies of Young People with Profound Hearing Impairment

Authors: Anna Czyż

Abstract:

This article is focused on the issues of stress and coping with the stress of young people with profound hearing loss. Perceptional disorders, especially visual or hearing defects, are the reason of homeostasis dysfunction. Biopsychological development can become poor. A substitute reality is formed as a result of compensatory activities of other senses. The hearing disorder itself is a stress-inducing factor, affecting the quality of human functioning. In addition, the limitations of perceptual capabilities in the context of the functioning environment can contribute to increasing the amount of stressors, as well as the specific sensitivity to the stressors, and the use of specific strategies to overcome the difficulties. The appropriate study was conducted on a sample of 92 students, aged 16 -19 years old, 43 females, 49 males. For diagnostic purposes, the standardized psychological' research tools were used. The level of the stress and the strategies of coping with the stress were evaluated. The results of the research indicate that level of the stress is indifferent. The most frequently chosen strategies for coping with the stress in the sample are concentrated on 1) acceptation, 2) 'doing something different', 3) searching of emotional supporting, 4) searching of instrumental supporting, and the factors (grouped items) of coping with the stress are concentrated on 1) searching of support, 2) acceptance. The relationships in both male and female research groups were specified. Also the relationships between the highlighted variables were determined.

Keywords: cooping stress, deaf, hearing impairment, quality of life, stress, stress

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5431 Social-Cognitive Aspects of Interpretation: Didactic Approaches in Language Processing and English as a Second Language Difficulties in Dyslexia

Authors: Schnell Zsuzsanna

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Background: The interpretation of written texts, language processing in the visual domain, in other words, atypical reading abilities, also known as dyslexia, is an ever-growing phenomenon in today’s societies and educational communities. The much-researched problem affects cognitive abilities and, coupled with normal intelligence normally manifests difficulties in the differentiation of sounds and orthography and in the holistic processing of written words. The factors of susceptibility are varied: social, cognitive psychological, and linguistic factors interact with each other. Methods: The research will explain the psycholinguistics of dyslexia on the basis of several empirical experiments and demonstrate how domain-general abilities of inhibition, retrieval from the mental lexicon, priming, phonological processing, and visual modality transfer affect successful language processing and interpretation. Interpretation of visual stimuli is hindered, and the problem seems to be embedded in a sociocultural, psycholinguistic, and cognitive background. This makes the picture even more complex, suggesting that the understanding and resolving of the issues of dyslexia has to be interdisciplinary, aided by several disciplines in the field of humanities and social sciences, and should be researched from an empirical approach, where the practical, educational corollaries can be analyzed on an applied basis. Aim and applicability: The lecture sheds light on the applied, cognitive aspects of interpretation, social cognitive traits of language processing, the mental underpinnings of cognitive interpretation strategies in different languages (namely, Hungarian and English), offering solutions with a few applied techniques for success in foreign language learning that can be useful advice for the developers of testing methodologies and measures across ESL teaching and testing platforms.

Keywords: dyslexia, social cognition, transparency, modalities

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5430 Cross-sectional Developmental Trajectories of Executive Function and Relations to Theory of Mind in Autism Spectrum Disorder

Authors: Evangelia-Chrysanthi Kouklari, Evdokia Tagkouli, Vassiliki Ntre, Artemios Pehlivanidis, Stella Tsermentseli, Gerasimos Kolaitis, Katerina Papanikolaou

Abstract:

Executive Function (EF) is a set of goal-directed cognitive skills essentially needed in problem-solving and social behavior. Developmental EF research has indicated that EF emerges early in life and marks dramatic changes before the age of 5. Research evidence has suggested that it may continue to develop up to adolescence as well, following the development of the prefrontal cortex. Over the last decade, research evidence has suggested distinguished domains of cool and hot EF, but traditionally the development of EF in Autism Spectrum Disorder (ASD) has been examined mainly with tasks that address the “cool” cognitive aspects of EF. Thus, very little is known about the development of “hot” affective EF processes and whether the cross-sectional developmental pathways of cool and hot EF present similarities in ASD. Cool EF has also been proven to have a strong correlation with Theory of Mind (ToM) in young and middle childhood in typical development and in ASD, but information about the relationship of hot EF to ToM skills is minimal. The present study’s objective was to explore the age-related changes of cool and hot EF in ASD participants from middle childhood to adolescence, as well as their relationship to ToM. This study employed an approach of cross-sectional developmental trajectories to investigate patterns of cool and hot EF relative to chronological age within ASD. Eighty-two participants between 7 and 16 years of age were recruited to undertake measures that assessed cool EF (working memory, cognitive flexibility, planning & inhibition), hot EF (affective decision making & delay discounting) and ToM (false belief and mental state/emotion recognition). Results demonstrated that trajectories of all cool EF presented age-related changes in ASD (improvements with age). With regards to hot EF, affective decision-making presented age-related changes, but for delay discounting, there were no statistically significant changes found across younger and older ASD participants. ToM was correlated only to cool EF. Theoretical implications are discussed as the investigation of the cross-sectional developmental trajectories of the broader EF (cool and hot domains) may contribute to better defining cognitive phenotypes in ASD. These findings highlight the need to examine developmental trajectories of both hot and cool EF in research and clinical practice as they may aid in enhancing diagnosis or better-informed intervention programs.

Keywords: autism spectrum disorder, developmental trajectories, executive function, theory of mind

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5429 Effect of Omega-3 Supplementation on Stunted Egyptian Children at Risk of Environmental Enteric Dysfunction: An Interventional Study

Authors: Ghada M. El-Kassas, Maged A. El Wakeel, Salwa R. El-Zayat

Abstract:

Background: Environmental enteric dysfunction (EED) is asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. Evidence has suggested that supplementary omega-3 might ameliorate this damage by reducing gastrointestinal inflammation and may also benefit cognitive development. Objective: We tested whether omega-3 supplementation improves intestinal integrity, growth, and cognitive function in stunted children predicted to have EED. Methodology: 100 Egyptian stunted children aged 1-5 years and 100 age and gender-matched normal children as controls. At the primary phase of the study, we assessed anthropometric measures and fecal markers such as myeloperoxidase (MPO), neopterin (NEO), and alpha-1-anti-trypsin (AAT) (as predictors of EED). Cognitive development was assessed (Bayley or Wechsler scores). Oral n-3 (omega-3) LC-PUFA at a dosage of 500 mg/d was supplemented to all cases and followed up for 6 months after which the 2ry phase of the study included the previous clinical, laboratory and cognitive assessment. Results: Fecal inflammatory markers were significantly higher in cases compared to controls. (MPO), (NEO) and (AAT) showed a significant decline in cases at the end of the 2ry phase (P < 0.001 for all). Omega-3 supplementation resulted also in a significant increase in mid-upper arm circumference (MUAC) (P < 0.01), weight for age z-score, and skinfold thicknesses (P< 0.05 for both). Cases showed significant improvement of cognitive function at phase 2 of the study. Conclusions: Omega-3 supplementation successfully improved intestinal inflammatory state related to EED. Also, some improvement of anthropometric and cognitive parameters showed obvious improvement with omega-3 supplementation.

Keywords: cognitive functions, EED, omega-3, stunting

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