Search results for: early stopping

Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

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Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

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Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.

Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn

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Authors: Neelofar, Khursheed Alam, Jamal Ahmad

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Protein modification in diabetes mellitus may lead to early glycation products (EGPs) or amadori product as well as advanced glycation end products (AGEs). Early glycation involves the reaction of glucose with N-terminal and lysyl side chain amino groups to form Schiff’s base which undergoes rearrangements to form more stable early glycation product known as Amadori product. After Amadori, the reactions become more complicated leading to the formation of advanced glycation end products (AGEs) that interact with various AGE receptors, thereby playing an important role in the long-term complications of diabetes. Millard reaction or nonenzymatic glycation reaction accelerate in diabetes due to hyperglycation and alter serum protein’s structure, their normal functions that lead micro and macro vascular complications in diabetic patients. In this study, Human Serum Albumin (HSA) with a constant concentration was incubated with different concentrations of glucose at 370C for a week. At 4th day, Amadori product was formed that was confirmed by colorimetric method NBT assay and TBA assay which both are authenticate early glycation product. Conformational changes in native as well as all samples of Amadori albumin with different concentrations of glucose were investigated by various biophysical and biochemical techniques. Main biophysical techniques hyperchromacity, quenching of fluorescence intensity, FTIR, CD and SDS-PAGE were used. Further conformational changes were observed by biochemical assays mainly HMF formation, fructoseamine, reduction of fructoseamine with NaBH4, carbonyl content estimation, lysine and arginine residues estimation, ANS binding property and thiol group estimation. This study find structural and biochemical changes in Amadori modified HSA with normal to hyperchronic range of glucose with respect to native HSA. When glucose concentration was increased from normal to chronic range biochemical and structural changes also increased. Highest alteration in secondary and tertiary structure and conformation in glycated HSA was observed at the hyperchronic concentration (75mM) of glucose. Although it has been found that Amadori modified proteins is also involved in secondary complications of diabetes as AGEs but very few studies have been done to analyze the conformational changes in Amadori modified proteins due to early glycation. Most of the studies were found on the structural changes in Amadori protein at a particular glucose concentration but no study was found to compare the biophysical and biochemical changes in HSA due to early glycation with a range of glucose concentration at a constant incubation time. So this study provide the information about the biochemical and biophysical changes occur in Amadori modified albumin at a range of glucose normal to chronic in diabetes. Although many implicates currently in use i.e. glycaemic control, insulin treatment and other chemical therapies that can control many aspects of diabetes. However, even with intensive use of current antidiabetic agents more than 50 % of diabetic patient’s type 2 suffers poor glycaemic control and 18 % develop serious complications within six years of diagnosis. Experimental evidence related to diabetes suggests that preventing the nonenzymatic glycation of relevant proteins or blocking their biological effects might beneficially influence the evolution of vascular complications in diabetic patients or quantization of amadori adduct of HSA by authentic antibodies against HSA-EGPs can be used as marker for early detection of the initiation/progression of secondary complications of diabetes. So this research work may be helpful for the same.

Keywords: diabetes mellitus, glycation, albumin, amadori, biophysical and biochemical techniques

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Authors: Tracey Lion-Cachet

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Eating disorders typically manifest in adolescence and are notoriously difficult to treat. There are two notable reasons for this. Firstly, research consistently demonstrates that early intervention is a critical mediator of prognosis, with early intervention leading to a better prognosis. However, because eating disorders do not originate as full-syndrome diagnoses but rather as prodromal cases, they often go undetected; by the time symptoms meet diagnostic criteria, they have become recalcitrant. Another interrelated issue is motivation to change. Research demonstrates that in the early stages of an eating disorder, adolescents are highly resistant to change, and motivation increases only once symptoms have shifted from egosyntonic to egodystonic in nature. The purpose of this project was to design a prevention model based on the social psychology paradigm of Entertainment-Education, which embeds messages within the genre of film as a means of affecting change. The resulting project was a narrative screenplay targeting teenagers/young adults from diverse backgrounds. The goals of the project were to create a film script that, if ultimately made into a film, could serve to: 1) interrupt symptom progression and improve prognosis through early intervention; 2) incorporate techniques from third-wave cognitive behavioral treatment models, acceptance and commitment therapy (ACT) and rational recovery (RR), with a focus on the effects of mindfulness as a means of informing recovery; 3) target issues to do with motivation to change by shifting the perception of eating disorders from culturally specific psychiatric illnesses to habit-based brain wiring issues. Nine licensed clinicians were asked to evaluate two excerpts taken from the final script. They subsequently provided feedback on a Likert-scale, which assessed whether the script had achieved its goals. Overall, evaluators agreed that the project’s etiological and intervention models have the potential to inspire change and serve as an effective means of prevention and treatment of eating disorders. However, one-third of the evaluators did not find the content developmentally appropriate. This is a notable limitation to the study and will need to be addressed in the larger script before the final project can potentially be targeted to a teenage and young adult audience.

Keywords: adolescents, eating disorders, pediatrics, entertainment-education, mindfulness-based intervention, prevention

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Authors: Gabriela Estrada, Joaquim Lloveras

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Design for error-proofing assembly is a new DFX approach to prevent assembly issues since early design stages. Assembly issues that can happen during the life phases of a system such as: production, installation, operation, and replacement phases. This prevention is possible by designing the product with poka-yoke or error-proofing characteristics. This approach guide designers to make decisions based on poka-yoke assembly design requirements. As a result of applying these requirements designers are able to create solutions to prevent assembly issues for the product in development stage. This paper integrates the needs to design products in an error proofing way into the systematic approach of design process by Pahl and Beitz. A case study is presented applying this approach.

Keywords: poka-yoke, error-proofing, assembly issues, design process, life phases of a system

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Authors: Gabriela Estrada, Joaquim Lloveras

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Design for error-proofing assembly is a new DFX approach to prevent assembly issues since early design stages. Assembly issues that can happen during the life phases of a system such as: production, installation, operation and replacement phases. This prevention is possible by designing the product with poka-yoke or error-proofing characteristics. This approach guide designers to make decisions based on poka-yoke assembly design requirements. As a result of applying these requirements designers are able to create solutions to prevent assembly issues for the product in development stage. This paper integrates the needs to design products in an error proofing way into the systematic approach of design process by Pahl and Beitz. A case study is presented applying this approach.

Keywords: poka-yoke, error-proofing, assembly issues, design process, life phases of a system

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Authors: Eloise Thomson

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The COVID-19 global pandemic challenged our normative conceptualization of teaching across all age levels, requiring the transition to remote instruction, in some instances, literally overnight. Included in the rapidly changing education environment was the delivery of early childhood education. In Victoria, Australia, the capital city, Melbourne, became known as the most locked down city in the world. This presentation examines the ways educators used social media to collaborate with families before the COVID-19 pandemic and during the lockdown phase through the use of a Third Space conceptual framework and case study methodology. As a first step, the paper examines how social media may offer new opportunities for collaborative practice between educators and families. Second, the data is outlined and discussed with respect to collaborative practice and quality. Finally, a postscript then allows for insight into how educators’ practice of using social media to collaborate with families has been impacted by the COVID-19 global pandemic. Finally, the implications of the ways in which educators are using social media to collaborate with families are discussed. The use of social media in early-childhood education has the potential to provide a valuable platform for educators to connect with families and students. However, the use of social media by educators uncovered a dialogue of ‘quality’ and appeared to be dominated by evidence around compliance and attaining quality in a very specific, and perhaps narrow, way. The findings suggest a culture of compliance that is dominated by outcomes, standards and assessments and that this has changed the dynamics by which educators engage with families. Furthermore, findings highlighted the disparity between educators' and families' understanding of the intent of the collaborations themselves. This research was significant as it exposed the ways in which educators are engaging with social media, resulting in a discussion on the intent of collaborations, the questioning of imposed quality, and the notion that quality is measurable and exists in only one form.

Keywords: collaboration, compliance, early childhood, third space, pedagogy of caring, social media

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Authors: Brian Smith

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This paper seeks to contrast the contemporary anti-immigration rhetoric since the US pullout of Afghanistan with the debate about enemy aliens in the early modern period. In the seventeenth century, Sir Edward Coke declared that “infidels” should be seen as perpetui inimici (perpetual enemies) since their values were inimical to those of Christian states. As such, they could be perpetually excluded and denied legal standing. Even at that time, these anti-“infidel” arguments clashed with the natural law tradition of hospitality, which assumed that states had a moral responsibility to admit and care for strangers. In particular, this paper looks at the conflict between Hugo Grotius, Samuel Pufendorf, and John Locke. Grotius argues that states have a duty to admit foreigners. He goes out of his way to plan for the admittance of Jewish immigrants. In contrast, Pufendorf claimed that sovereigns had a duty exclude foreigners who would alter the constitutional character of the state. Much like Grotius, Locke argued that non-Christian peoples should be treated as friends and admitted without reservation.

Keywords: enemy aliens, perpetual enemies, hospitality, refugees

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Authors: Tasanee Satthapong

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The purpose of the study was to determine the relationship between learning style preferences, teaching style preferences, and learning with happiness of college students who were majors in five different academic areas at the Suansunandha Rajabhat University in Thailand. The selected participants were 729 students 1st year-5th year in Faculty of Education from Thai teaching, early childhood education, math and science teaching, and English teaching majors. The research instruments are the Grasha and Riechmann learning and teaching styles survey and the students’ happiness in learning survey, based on learning with happiness theory initiated by the Office of the National Education Commission. The results of this study: 1) The most students’ learning styles were participant style, followed by collaborative style, and independent style 2) Most students’ happiness in learning in all subjects areas were at the moderate level: Early Childhood Education subject had the highest scores, while Math subject was at the least scores. 3) No different of student’s happiness in learning were found between students who has learning styles that match and not match to teachers’ teaching styles.

Keywords: learning style, teaching style, learning with happiness

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Authors: Hitesh Gupta, Surender Dabas

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TORS is increasingly gaining widespread use and has been explored as minimally invasive surgery for the treatment of supraglottic cancer (SGC). Being a central critical role of Supraglottis in deglutition, swallowing outcomes post TORS remain a most important factor. Available published studies show inconsistent swallowing outcomes and are deficient in standardized outcome measures, description of swallowing recovery and rehabilitation. So, the objective of this study is to find out swallowing outcomes in SGC patients after TORS provided with early dysphagia management using standardized measures. Prospectively 16 patients were recruited in the study who underwent TORS for primary tumor of Supraglottis, involving one or more sub-sites or invading to sites other than Supraglottis at the BLK Super Specialty Hospital, New Delhi from March 2019 to June 2020. All patients were evaluated for dysphagia with subsequent swallowing rehabilitation on post operative day 3 in the hospital or at the time of discharge, whichever was earlier. Functional oral intake scale (FOIS) and penetration-aspiration score (PAS) were used as outcome measures to quantify swallowing recovery at one month and six month post operatively. Post TORS, patients achieved functional swallow in less than one month, where resection was limited to Supraglottis, while the recovery was delayed in patients with extended resection to tongue base or hypopharynx. Overall, out of Total 16 cases including all supraglottis sub-catagories, 13 (81%) could remove their NG tube (FOIS ≥5 and PAS=1 ) within 6 months. In which 8 cases(62%) achieved functional swallow in less than one month. Swallowing outcomes post TORS supraglottic laryngectomy are favorable if provided with early dysphagia management (or swallowing rehabilitation).

Keywords: dysphagia, supraglottic cancer, swallowing, TORS

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Authors: Shu-Min Tsao, Chung-Ming Lo, Shao-Chun Chen

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Most diabetes patients tend to suffer from its complication of retina diseases. Therefore, early detection and early treatment are important. In clinical examinations, using color fundus image was the most convenient and available examination method. According to the exudates appeared in the retinal image, the status of retina can be confirmed. However, the routine screening of diabetic retinopathy by color fundus images would bring time-consuming tasks to physicians. This study thus proposed a computer-aided exudate diagnosis for the screening of diabetic retinopathy. After removing vessels and optic disc in the retinal image, six quantitative features including region number, region area, and gray-scale values etc… were extracted from the remaining regions for classification. As results, all six features were evaluated to be statistically significant (p-value < 0.001). The accuracy of classifying the retinal images into normal and diabetic retinopathy achieved 82%. Based on this system, the clinical workload could be reduced. The examination procedure may also be improved to be more efficient.

Keywords: computer-aided diagnosis, diabetic retinopathy, exudate, image processing

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Authors: Mohadese Sukhtesaraii, Mohammad Esmail Esmaili Jelodar, Kosar Sookhtesaraii

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Throughout history, humans have always wanted to have a shelter to live in, and this need and desire became the beginning of building and architecture. It was necessary to build a shelter and a building, dealing with the surrounding nature. The design and construction of architectural spaces are always influenced by nature, climate, and geographical location, and It is believed clearly see this influence even in the use of materials used in the construction of architectural buildings. The historical port of Siraf is located on the northern coast of the Persian Gulf in Bushehr province and 38 km from Kangan port. Geographically and climatically, Siraf is considered one of the hot and humid areas. The Zagros mountains, which continue from the Iranian plateau to the sea, end at Bandar Siraf; As a result, it creates a strip one kilometer wide by the sea. The location of Siraf in the restrictive conditions of the mountains and the sea has made it impossible to expand the city. The main goal of the current research is to investigate the climate of Siraf and the influence of the region's climate on the architecture and design of residential buildings in Siraf, known as noble houses, in the early Islamic centuries. In this research, it is looking for an answer to the question of how the climatic and geographical conditions have affected the architecture of Siraf buildings. The theoretical framework of this research can be expressed based on the influence of climate on the historical architecture of Bandar Seraf and the spatial analysis of archeology. Also, the research method will be analytical-descriptive and using field and library studies. The authors of the article believe that the architectural spaces of the early Islamic centuries of Siraf city were affected by the climate and geographical location, and the architects started building buildings by considering factors such as the sun's radiation, wind direction, and the position of the mountains and the sea. To use the regional and environmental potential for buildings.

Keywords: hose N, noble hose, islamic era, siraf, climate

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Authors: Naoum Abderrahmane, Boumehed Meriem, Alshaqaqi Belal

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Background subtraction algorithm is a larger used technique for detecting moving objects in video surveillance to extract the foreground objects from a reference background image. There are many challenges to test a good background subtraction algorithm, like changes in illumination, dynamic background such as swinging leaves, rain, snow, and the changes in the background, for example, moving and stopping of vehicles. In this paper, we propose an efficient and accurate background subtraction method for moving object detection in video surveillance. The main idea is to use a developed fast-independent component analysis (ICA) algorithm to separate background, noise, and foreground masks from an image sequence in practical environments. The fast-ICA algorithm is adapted and adjusted with a matrix calculation and searching for an optimum non-quadratic function to be faster and more robust. Moreover, in order to estimate the de-mixing matrix and the denoising de-mixing matrix parameters, we propose to convert all images to YCrCb color space, where the luma component Y (brightness of the color) gives suitable results. The proposed technique has been verified on the publicly available datasets CD net 2012 and CD net 2014, and experimental results show that our algorithm can detect competently and accurately moving objects in challenging conditions compared to other methods in the literature in terms of quantitative and qualitative evaluations with real-time frame rate.

Keywords: background subtraction, moving object detection, fast-ICA, de-mixing matrix

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Authors: Ehsan Eshtehardian, Saeed Khodaverdi

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This paper surveys the studies on construction change and reveals some of the potential future works. A full-scale investigation of change literature, including change definitions, types, causes and effects, and change management systems, is accomplished to explore some of the coming change trends. It is tried to pick up the critical works in each section to deduct a true timeline of construction changes. The findings show that leaping from best practice guides in late 1990s and generic process models in the early 2000s to very advanced modeling environments in the mid-2000s and the early 2010s have made gaps along with opportunities for change researchers in order to develop some more easy and applicable models. Another finding is that there is a compelling similarity between the change and risk prediction models. Therefore, integrating these two concepts, specifically from proactive management point of view, may lead to a synergy and help project teams avoid rework. Also, the findings show that exploitation of cause-effect relationship models, in order to facilitate the dispute resolutions, seems to be an interesting field for future works.

Keywords: construction change, change management systems, dispute resolutions, change literature

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Authors: P. N. Salini, B. Anish Kini, R. Ashalatha

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At signalized intersections with heterogeneous traffic, the percentage share of different vehicle categories have a bearing on the inter-vehicle space utilization, which eventually impacts the saturation flow. This paper analyzed the impact of the percentage share of various vehicle categories in the traffic stream on the saturation flow at signalized intersections by video graphing major intersections with varying geometry in Kerala, India. It was found that as the percentage share of two-wheelers increases, the saturation flow at signalized intersections increases and vice-versa for the percentage share of cars. The effect of bus blockage and parking maneuvers on the saturation flow were also studied. As the distance of bus blockage increases from the stop line, the effect on the saturation flow decreases, while with more buses stopping at the same bus stop, the saturation flow reduces further. The study revealed that with higher kerbside parking maneuvers on the upstream, the saturation flow reduces, and with an increase in the distance of the parking maneuver from the stop line, the effect on the saturation flow decreases. The adjustment factors for bus blockage due to bus stops within 75m downstream and parking maneuvers within 75m upstream of the intersection have been established for mixed traffic conditions. These adjustment factors could empower the urban planners, enforcement personnel and decision-makers to estimate the reduction in the capacity of signalized intersections for suggesting improvements in the form of parking restrictions/ bus stop relocation for existing intersections or make design changes for planned intersections.

Keywords: signalized intersection, saturation flow, adjustment factors, capacity

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Authors: A. Kourou, A. Ioakeimidou, A. Gakou

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Greece due to its location in the Eastern Mediterranean region is characterized by a high degree of seismicity and occurrence of severe earthquakes. It is generally accepted that preventive planning is vital in mitigating impacts, protecting those who are the most vulnerable namely children and increasing the degree of resilience of local communities. Worldwide, States have highlighted the need to ensure the safety of early childhood environments in case of disaster. A great number of children are enrolled in daycare facilities, so building and improving the preparedness of pre-primary schools to prevent injuries and fatalities in case of an earthquake becomes an important policy issue. It is more than evident that preparedness in early preschool level will be increased through awareness and education of the people who work to pre-primary classes and provide early childhood care. The aim of the present study is to assess the level of awareness and preparedness of the Greek pre-primary schools staff concerning earthquake protection issues, as well as their risk mitigation behaviors and earthquake management in case of a strong event. In this framework, specific questionnaire was developed and filled by the abovementioned target group at 30 different municipalities of Greece (2014-2016). Also in the framework of this study it is presented the Pre-Primary Schools’ Earthquake Safety Initiative that has been undertaken by Earthquake Planning and Protection Organization (EPPO) the last years. This initiative aims to develop disaster-resilient day care centers through awareness, self-help, cooperation and education. Recognizing the necessity of integration of the disaster safety concept at pre-primary environments, EPPO published practical guidelines that focused on earthquake planning of these workspaces. Furthermore, dozens of seminars are implemented in municipality or prefecture-level every year by EPPO, in order the early childhood schools’ staff to be appropriately educated and adequately trained to face the earthquake risk. Great progress has been made towards building awareness and increasing preschool preparedness in Greece but significant gaps still remain. Anyway, it is extremely important that the implementation of effective programs and practices and the broad collaboration of all involved parties have been recognized as essential in order to develop a comprehensive disaster management system at preschool environment.

Keywords: awareness, earthquake, education, emergency plans, preparedness, pre-primary schools

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Authors: Ahmet Parlak, Celalettin Bilgen

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In order to create an effective early warning system, Identification of the risks, preparation and carrying out risk modeling of risk scenarios, taking into account the shortcomings of the old disaster scenarios should be used to improve the system. In the light of this, the importance of risk modeling in creating an effective early warning system is understood. In the scope of TAFRISK project risk modeling trend analysis report on risk modeling developed and a demonstration was conducted for Risk Modeling for flood and mass movements. For risk modeling R&D, studies have been conducted to determine the information, and source of the information, to be gathered, to develop algorithms and to adapt the current algorithms to Turkey’s conditions for determining the risk score in the high disaster risk areas. For each type of the disaster; Disaster Deficit Index (DDI), Local Disaster Index (LDI), Prevalent Vulnerability Index (PVI), Risk Management Index (RMI) have been developed as disaster indices taking danger, sensitivity, fragility, and vulnerability, the physical and economic damage into account in the appropriate scale of the respective type.

Keywords: disaster, hazard, risk modeling, sensor

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Authors: Rosa S. Wong, Keith T.S. Tung, Winnie W. Y. Tso, King-Wa Fu, Nirmala Rao, Patrick Ip

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Electronic devices have become an essential part of our lives. Various reports have highlighted the alarming usage of electronic devices at early ages and its long-term developmental consequences. More sedentary screen time was associated with increased adiposity, worse cognitive and motor development, and psychosocial health. Apart from the problems caused by children’s own screen time, parents today are often paying less attention to their children due to hand-held device. Some anecdotes suggest that distracted parenting has negative impact on parent-child relationship. This study examined whether distracted parenting detrimentally affected parent-child activities which may, in turn, impair children’s psychosocial health. In 2018/19, we recruited a cohort of preschoolers from 32 local kindergartens in Tin Shui Wai and Sham Shui Po for a 5-year programme aiming to build stronger foundations for children from disadvantaged backgrounds through an integrated support model involving medical, education and social service sectors. A comprehensive set of questionnaires were used to survey parents on their frequency of being distracted while parenting and their frequency of learning and recreational activities with children. Furthermore, they were asked to report children’s screen time amount and their psychosocial problems. Mediation analyses were performed to test the direct and indirect effects of electronic device-distracted parenting on children’s psychosocial problems. This study recruited 873 children (448 females and 425 males, average age: 3.42±0.35). Longer screen time was associated with more psychosocial difficulties (Adjusted B=0.37, 95%CI: 0.12 to 0.62, p=0.004). Children’s screen time positively correlated with electronic device-distracted parenting (r=0.369, p < 01). We also found that electronic device-distracted parenting was associated with more hyperactive/inattentive problems (Adjusted B=0.66, p < 0.01), fewer prosocial behavior (Adjusted B=-0.74, p < 0.01), and more emotional symptoms (Adjusted B=0.61, p < 0.001) in children. Further analyses showed that electronic device-distracted parenting exerted influences both directly and indirectly through parent-child interactions but to different extent depending upon the outcome under investigation (38.8% for hyperactivity/inattention, 31.3% for prosocial behavior, and 15.6% for emotional symptoms). We found that parents’ use of devices and children’s own screen time both have negative effects on children’s psychosocial health. It is important for parents to set “device-free times” each day so as to ensure enough relaxed downtime for connecting with children and responding to their needs.

Keywords: early childhood, electronic device, psychosocial wellbeing, parenting

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Authors: Huang Ying

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The present study was to investigate factors affecting children's improvement through the first two years of elementary school on a population-based sample of children with autism in Taiwan. All the children were diagnosed with autism spectrum disorder (ASD) by clinical psychologists according to DSM-IV. Children's development was assessed by the Vineland Adaptive Behavior Scales-Chinese version (VABS-C) on the first and the third grade. Children's improvement was measured by the difference between the standardized total score of the third and the first year. In Taiwan, school-age children with special-education needs will be arranged into different classes, including normal classes (NC), resource classes (RC), and special classes (SC) by the government. Therefore, type of class was one of the independent variables. Moreover, as early intervention is considered to be crucial, the earliest age when intervention begins was collected from parents. Attention was also included in the analysis. Teachers were asked to evaluate children's attention with a 3-item Likert Scale. The frequency of paying attention to the class or the task was recorded and scores were summed up. Additionally, standardized scores of the VABS-C in the first grade were used as pretest scores representing children's developmental level at the beginning of elementary school. Multiple regression was conducted with improvement as the dependent variable. Results showed that children in special classes had smaller improvement compared to those in normal or resource classes. Attention positively predicted improvement yet the effect of earliest intervention age was not significant. Furthermore, scores in the first grade negatively predicted improvement, which indicated that children with higher developmental levels would make less progress in the following years. Results were to some degree consistent with previous findings through meta-analysis that the effectiveness of conventional intervention methods lacked sufficient evidence to support.

Keywords: attention, early intervention, elementary school, special education in Taiwan

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Authors: Judit Nagy

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Many scientific studies claim that financial education should start as early as possible. Children are much more capable of and willing to absorb new concepts than adults. If we introduce children to financial knowledge early, their behaviour and attitudes to this subject will change, increasing later success in this area of life. However, poor financial decisions may entail severe consequences, not only to individuals but even to the wider society. Good financial decisions and economic attitudes may contribute to economic growth and well-being. Whilst in several countries, education about financial awareness and fundamentals is available, the understanding and acquisition of complex economic knowledge and the development of children’s independent problem-solving skills are still lacking. The results suggest that teaching economic and financial knowledge through accounting and making lectures interactive by using special tools of positive education is critical to stimulating children’s interest. Eighty percent of the students in the study liked the combined and interactive lecture. Introducing this kind of knowledge to individuals is a relevant objective, even at the societal level.

Keywords: positive psychology, education innovation, primary school, gender, economics, accounting, finance, personal finance, mathematics, economic growth, well-being, sustainability

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Authors: Matthew McArthur, Margaret Friend

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The COVID-19 pandemic disrupted the stability of the home environment for families across the world. Potential disruptions include parent work modality (in-person vs. remote), levels of health anxiety, family routines, and caregiving. These disruptions may have interfered with the processes of early vocabulary acquisition, carrying lasting effects over the life course. Our justification for this research is as follows: First, early, stable, caregiver-child reciprocal interactions, which may have been disrupted during the pandemic, contribute to the development of the brain architecture that supports language, cognitive, and social-emotional development. Second, early vocabulary predicts several cognitive outcomes, such as numeracy, literacy, and executive function. Further, disruption in the home is associated with adverse cognitive, academic, socio-emotional, behavioral, and communication outcomes in young children. We are interested in how disruptions related to the COVID-19 pandemic are associated with vocabulary acquisition in children born during the first two waves of the pandemic. We are conducting a moderated online experiment to assess this question. Participants are 16 children (10F) ranging in age from 19 to 39 months (M=25.27) and their caregivers. All child participants were screened for language background, health history, and history of language disorders, and were typically developing. Parents completed a modified version of the COVID-19 Family Stressor Scale (CoFaSS), a published measure of COVID-19-related family stressors. Thirteen items from the original scale were replaced to better capture change in family organization and stability specifically related to disruptions in income, anxiety, family relations, and childcare. Following completion of the modified CoFaSS, children completed a Web-Based version of the Computerized Comprehension Task and the Receptive One Word Picture Vocabulary if 24 months or older or the MacArthur-Bates Communicative Development Inventory if younger than 24 months. We report our preliminary data as a partial correlation analysis controlling for age. Raw vocabulary scores on the CCT, ROWPVT-4, and MCDI were all negatively associated with pandemic-related disruptions related to anxiety (r12=-.321; r1=-.332; r9=-.509), family relations (r12=-.590*; r1=-.155; r9=-.468), and childcare (r12=-.294; r1=-.468; r9=-.177). Although the small sample size for these preliminary data limits our power to detect significance, this trend is in the predicted direction, suggesting that increased pandemic-related disruption across multiple domains is associated with lower vocabulary scores. We anticipate presenting data on a full sample of 50 monolingual English participants. A sample of 50 participants would provide sufficient statistical power to detect a moderate effect size, adhering to a nominal alpha of 0.05 and ensuring a power level of 0.80.

Keywords: COVID-19, early vocabulary, home environment, language acquisition, multiple measures

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Authors: Jiahui Song

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There have been decades of research into the action potential block in nerves. To our best knowledge electrical voltages can reversibly block the conduction of action potentials across whole animal nerves. Blocking biological electrical signaling pathways can have a variety of applications in muscular and sensory incapacitation and clinical research, including urethral pressure reduction and relieving chronic pain relief from a peripheral nerve injury. The cessation ability has been used in muscle activation and fatigue reduction. Ultrashort, high-intensity electric pulses modulate the membrane conductivity to block nerve conduction through the electroporation process. Nanopore formation on the membrane surface would increase the local membrane conductivity and effectively "short-out" the trans-membrane potential of a nerve that inhibits action potential propagation. This block would be similar in concept to stopping the propagation of an air-pressure wave down a "leaky" pipe. This research focuses on a distributed electrical model with an additional time-dependent membrane conductance to calculate the poration induced by the ultrashort, high-intensity electric pulses. The changes in membrane conductivity are used to predict changes in action potential transmission. A "strength-duration (SD)" curve is generated for action potential blockage and would be used as a design guide for benchmarking safety thresholds or setting the pulse voltage and/or durations necessary for neuro-muscular incapacitation.

Keywords: action potential, ultrashort, high-intensity, nerve, strength-duration

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Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

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Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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Authors: Preecha Yupapin And Somnath

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From the emptiness, the vibration induces the fractal, and the strings are formed. From which the first elementary particle groups, known as quarks, were established. The neutrino and electron are created by them. More elementary particles and life are formed by organic and inorganic substances. The universe is constructed, from which the multi-universe has formed in the same way. universe assumes that the intense energy has escaped from the singularity cone from the multi-universes. Initially, the single mass energy is confined, from which it is disturbed by the space-time distortion. It splits into the entangled pair, where the circular motion is established. It will consider one side of the entangled pair, where the fusion energy of the strong coupling force has formed. The growth of the fusion energy has the quantum physic phenomena, where the moving of the particle along the circumference with a speed faster than light. It introduces the wave-particle duality aspect, which will be saturated at the stopping point. It will be re-run again and again without limitation, which can say that the universe has been created and expanded. The Bose-Einstein condensate (BEC) is released through the singularity by the wormhole, which will be condensed to become a mass associated with the Sun's size. It will circulate(orbit) along the Sun. the consideration of the uncertainty principle is applied, from which the breath control is followed by the uncertainty condition ∆p∆x=∆E∆t~ℏ. The flowing in-out air into a body via a nose has applied momentum and energy control respecting the movement and time, in which the target is that the distortion of space-time will have vanished. Finally, the body is clean which can go to the next procedure, where the mind can escape from the body by the speed of light. However, the borderline between contemplation to being an Arahant is a vacuum, which will be explained.

Keywords: space-time, relativity, enlightenment, emptiness

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Authors: Helen L. Hein, Joachim Schwarte

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As a pillar of sustainable development, ecology has become an important milestone in research community, especially due to global challenges like climate change. The ecological performance of products can be scientifically conducted with life cycle assessments. In the construction sector, significant amounts of CO₂ emissions are assigned to the energy used for building heating purposes. Therefore, sustainable construction materials for insulating purposes are substantial, whereby aerogels have been explored intensively in the last years due to their low thermal conductivity. Therefore, the WALL-ACE project aims to develop an aerogel-based thermal insulating plaster that would achieve minor thermal conductivities. But as in the early stage of development phases, a lot of information is still missing or not yet accessible, the ecological performance of innovative products bases increasingly on uncertain data that can lead to significant deviations in the results. To be able to predict realistically how meaningful the results are and how viable the developed products may be with regard to their corresponding respective market, these deviations however have to be considered. Therefore, a classification method is presented in this study, which may allow comparing the ecological performance of modern products with already established and competitive materials. In order to achieve this, an alternative calculation method was used that allows computing with lower and upper bounds to consider all possible values without precise data. The life cycle analysis of the considered products was conducted with an interval arithmetic based calculation method. The results lead to the conclusion that the interval solutions describing the possible environmental impacts are so wide that the result usability is limited. Nevertheless, a further optimization in reducing environmental impacts of aerogels seems to be needed to become more competitive in the future.

Keywords: aerogel-based, insulating material, early development phase, interval arithmetic

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Authors: Hafsa Raheel

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Objectives: Secondary school girls, ages 15–19 years old were surveyed to find out the coping strategies they used when stressed. Adolescents, who are affected with stress and depression early in life, suffer from depression throughout their lives, especially if they are utilizing improper ways to cope with it. Methods: A cross-sectional school-based survey among 1028 adolescent girls was conducted among the secondary schools in Riyadh city, Kingdom of Saudi Arabia. Results: About 25% stated that they cry, 19% listen to music, 15% start eating a lot, 12% sit alone/isolate themselves, 11% pray/read the Quran, 10% get into a verbal argument or a fight. Only a few, 3% exercise, and 2% stated that they find someone to discuss and talk to. Conclusion: The majority of the adolescent girls in our survey rely on emotion-related coping mechanisms rather than problem-solving mechanisms. This can cause long-term implications in these adolescents as there is an increased probability to develop depression later on in life. Policy makers need to implement strategies for early identification of stress and depression. Talking to friends and family can serve as an effective way to cope with stress.

Keywords: adolescents, stress, Saudi Arabia, mental health

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Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team

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Authors: Adrienn Novák

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The field research was carried out at the Látókép AGTC KIT research area of the University of Debrecen in Eastern-Hungary, on the area of the aeolain loess of the Hajdúság. We examined the effects of the sowing time on the phytopathogenic characteristics and yield production by applying various fertilizer treatments on two different sunflower genotypes (NK Ferti, PR64H42) in 2012 and 2013. We applied three different sowing times (early, optimal, late) and two different treatment levels of fungicides (control = no fungicides applied, double fungicide protection). During our investigations, the studied cropyears were of different sowing time optimum in terms of yield amount (2012: early, 2013: average). By Pearson’s correlation analysis, we have found that delaying the sowing time pronouncedly decreased the extent of infection in both crop years (Diaporthe: r=0.663**, r=0.681**, Sclerotinia: r=0.465**, r=0.622**). The fungicide treatment not only decreased the extent of infection, but had yield increasing effect too (2012: r=0.498**, 2013: r=0.603**). In 2012, delaying of the sowing time increased (r=0.600**), but in 2013, it decreased (r= 0.356*) the yield amount.

Keywords: fungicide treatment, genotypes, sowing time, yield, sunflower

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Authors: Esther N. Maina, Anna Skowronska, Sridhar Chaganti, Malcolm A. Taylor, Paul G. Murray, Tatjana Stankovic

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Epstein-Barr virus (EBV) has been implicated in the pathogenesis of human tumours of B-cell origin. The demonstration that a proportion of Hodgkin lymphomas and all Burkitt’s lymphomas harbour EBV suggests that the virus contributes to the development of these malignancies. However, the mechanisms of lymphomagenesis remain largely unknown. To determine whether EBV causes DNA damage and alters DNA damage response in cells of EBV-driven lymphoma origin, Germinal Centre (GC) B cells were infected with EBV and DNA damage responses to gamma ionising radiation (IR) assessed at early time points (12hr – 72hr) after infection and prior to establishment of lymphoblastoid (LCL) cell lines. In the presence of EBV, we observed induction of spontaneous DNA DSBs and downregulation of ATM-dependent phosphorylation in response to IR. This downregulation coincided with reduced ability of infected cells to repair IR-induced DNA double-strand breaks, as measured by the kinetics of gamma H2AX, a marker of double-strand breaks, and by the tail moment of the comet assay. Furthermore, we found that alteration of DNA damage responses coincided with the expression of LMP-1 protein. The presence of the EBV virus did not affect the localization of the ATM-dependent DNA repair proteins to sites of damage but instead lead to an increased expression of PP5, a phosphatase that regulates ATM function. The impact of the virus on DNA repair was most prominent 24h after infection, suggesting that this time point is crucial for the viral establishment in B cells. Our results suggest that during an early infection EBV virus dampens crucial cellular responses to DNA double-strand breaks which facilitate successful viral infection, but at the same time might provide the mechanism for tumor development.

Keywords: EBV, ATM, DNA damage, germinal center cells

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Authors: Hugo T. Jorge, Richard T. Simanke

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Lacan’s work addresses overarching issues concerning the scientific intelligibility of the subject in its philosophical sense. Even though his reflection is not, strictly speaking, philosophy of science, it contains many traits that are typical of this branch of philosophy. However, the relation between Lacan’s early thought and the philosophy of science of the time is often disregarded or only incompletely accounted for in Lacanian scholarship. French philosopher of science Emile Meyerson was often implicitly or explicitly referred to in Lacan’s works, yet few publications can be found on their relationship. The objective of this paper is to contribute to the analysis of this relationship, indicating some of its possible implications. For this, the convergence between Meyerson’s doctrine of science and Lacan’s works between 1936 and 1953 is discussed, as well as the conditions under which Lacan’s reception of Meyerson’s ideas take place. In conclusion, it is argued that this convergence allows for the clarification of important issues in Lacan’s early work, such as the concept of imago, his views on the nature of truth, and his thesis of the anthropomorphism of natural sciences. Meyerson’s argument for the permanence of common sense within science makes Lacan’s claims on the anthropomorphism of natural sciences more understandable. Similarly, Meyerson’s views on the epistemological shortfall of the Principle of Identity sheds some light on Lacan’s 1936 critique of associationistic concepts of engram and truth and may be at the origins of his antirealist and anti-idealist stances. Meyerson’s Principle of Identity is also related to some aspects of Lacan’s concept of imago. The imago understood as the unconscious condition for the identity in time of family figures in childhood, would be an excellent expression of the Principle of Identity. In this sense, the Principle of Identity may be linked to the concept of imaginary as developed by Lacan in the 1950s. However, Lacan considerably distorts Meyerson’s views in his 1936 critique of Freud’s concept of libido. Finally, a possible relationship between Lacan’s late concept of the real and Meyerson’s concept of the irrational is suggested.

Keywords: imaginary, Lacan, Meyerson, philosophy of science, real

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