Search results for: early reading
3462 Attention Deficit Hyperactivity Disorder and Criminality: A Psychological Profile of Convicts Serving Prison Sentences
Authors: Agnieszka Nowogrodzka
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Objectives: ADHD is a neurodevelopmental disorder in which symptoms are most prominent throughout childhood. In the longer term, these symptoms, as well as the behaviour of the child, the experiences arising from the response of the community to the child's symptoms, as well as the functioning of the community itself, all contribute to the onset of secondary symptoms and subsequent outcomes of the disorder, such as crime or mental disorders. The purpose of this study is to estimate the prevalence of ADHD among Polish convicts serving a prison sentence. To that end, the study will focus on the relationship between the severity of ADHD and early childhood trauma, family relations, maladaptive cognitive schemas, as well as mental disorders. It is an attempt to assess the interdependence between ADHD, childhood experiences, and secondary outcomes. Methods: The study enrolled two groups of first-time convicts and repeat offenders aged between 21 and 65 –each of the study groups comprised 120 participants; 240 participants in total took part in the study. Participants were recruited in semi-open penal institutions in Poland (Poznań Custody Suite, Wronki Penal Institution, Iława Penal Institution). The control group comprised 110 men without criminal records aged 21 to 65. The DIVA 5.0 questionnaire was employed to identify the severity of ADHD symptoms. Other questionnaires employed in the course of the study included the Childhood Trauma Questionnaire (CTQ), The Family Adaptability and Cohesion Scale IV (FACES-IV), Young Schema Questionnaire (YSQ), and the General Health Questionnaire (GHQ-30). Results: The findings of the study in question are currently still being compiled and will be shared during the conference. The findings of a pilot study involving two cohorts of convicts (each numbering 20 men) and a control group (20 men with no criminal records) indicate a significant correlation between ADHD and the experience of early childhood trauma. The severity of ADHD also shows a correlation with the assessment of the functioning of the family, with the subjects assessing the relationships in their families more negatively than the control group. Furthermore, the severity of ADHD is also correlated with maladaptive emotional schemas manifesting in the participants. The findings also show a correlation between selected dimensions and the severity of offenses.Keywords: ADHD, social impairments, mental disorders, early childhood traumas, criminality
Procedia PDF Downloads 923461 Severity Index Level in Effectively Managing Medium Voltage Underground Power Cable
Authors: Mohd Azraei Pangah Pa'at, Mohd Ruzlin Mohd Mokhtar, Norhidayu Rameli, Tashia Marie Anthony, Huzainie Shafi Abd Halim
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Partial Discharge (PD) diagnostic mapping testing is one of the main diagnostic testing techniques that are widely used in the field or onsite testing for underground power cable in medium voltage level. The existence of PD activities is an early indication of insulation weakness hence early detection of PD activities can be determined and provides an initial prediction on the condition of the cable. To effectively manage the results of PD Mapping test, it is important to have acceptable criteria to facilitate prioritization of mitigation action. Tenaga Nasional Berhad (TNB) through Distribution Network (DN) division have developed PD severity model name Severity Index (SI) for offline PD mapping test since 2007 based on onsite test experience. However, this severity index recommendation action had never been revised since its establishment. At presence, PD measurements data have been extensively increased, hence the severity level indication and the effectiveness of the recommendation actions can be analyzed and verified again. Based on the new revision, the recommended action to be taken will be able to reflect the actual defect condition. Hence, will be accurately prioritizing preventive action plan and minimizing maintenance expenditure.Keywords: partial discharge, severity index, diagnostic testing, medium voltage, power cable
Procedia PDF Downloads 1863460 On the Development of Evidential Contrasts in the Greater Himalayan Region
Authors: Marius Zemp
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Evidentials indicate how the speaker obtained the information conveyed in a statement. Detailed diachronic-functional accounts of evidential contrasts found in the Greater Himalayan Region (GHR) reveal that contrasting evidentials are not only defined against each other but also that most of them once had different aspecto-temporal (TA) values which must have aligned when their contrast was conventionalized. Based on these accounts, the present paper sheds light on hitherto unidentified mechanisms of grammatical change. The main insights of the present study were facilitated by ‘functional reconstruction’, which (i) revolves around morphemes which appear to be used in divergent ways within a language and/or across different related languages, (ii) persistently devises hypotheses as to how these functional divergences may have developed, and (iii) retains those hypotheses which most plausibly and economically account for the data. Based on the dense and detailed grammatical literature on the Tibetic language family, the author of this study is able to reconstruct the initial steps by which its evidentiality systems developed: By the time Proto-Tibetan started to be spread across much of Central Asia in the 7th century CE, verbal concatenations with and without a connective -s had become common. As typical for resultative constructions around the globe, Proto-Tibetan *V-s-’dug ‘was there, having undergone V’ (employing the simple past of ’dug ‘stay, be there’) allowed both for a perfect reading (‘the state resulting from V holds at the moment of speech’) and an inferential reading (‘(I infer from its result that) V has taken place’). In Western Tibetic, *V-s-’dug grammaticalized in its perfect meaning as it became contrasted with perfect *V-s-yod ‘is there, having undergone V’ (employing the existential copula yod); that is, *V-s-’dug came to mean that the speaker directly witnessed the profiled result of V, whereas *V-s-yod came to mean that the speaker does not depend on direct evidence of the result, as s/he simply knows that it holds. In Eastern Tibetic, on the other hand, V-s-’dug grammaticalized in its inferential past meaning as it became contrasted with past *V-thal ‘went past V-ing’ (employing the simple past of thal ‘go past’); that is, *V-s-’dug came to mean that the profiled past event was inferred from its result, while *V-thal came to mean that it was directly witnessed. Hence, depending on whether it became contrasted with a perfect or a past construction, resultative V-s-’dug grammaticalized either its direct evidential perfect or its inferential past function. This means that in both cases, evidential readings of constructions with distinct but overlapping TA-values became contrasted, and in order for their contrasting meanings to grammaticalize, the constructions had to agree on their tertium comparationis, which was their shared TA-value. By showing that other types of evidential contrasts in the GHR are also TA-aligned, while no single markers (or privative contrasts) are found to have grammaticalized evidential functions, the present study suggests that, at least in this region of the world, evidential meanings grammaticalize only in equipollent contrasts, which always end up TA-aligned.Keywords: evidential contrasts, functional-diachronic accounts, grammatical change, himalayan languages, tense/aspect-alignment
Procedia PDF Downloads 1283459 Encouraging the Development of Scientific Literacy in Early Childhood Institutions: Croatian Experience
Authors: L. Vujičić, Ž. Ivković, Ž. Boneta
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There is a widespread belief in everyday discourse that science subjects (physics, chemistry and biology) are, along with math, the most difficult school subjects in the education of an individual. This assumption is usually justified by the following facts: low GPA in these subjects, the number of pupils who fail these subjects is high in comparison to other subjects, and the number of pupils interested in continuing their studies in the fields with a focus on science subjects is lower compared to non-science-oriented fields. From that perspective, the project: “Could it be different? How do children explore it?” becomes extremely interesting because it is focused on young children and on the introduction of new methods, with aim of arousing interest in scientific literacy development in 10 kindergartens by applying the methodology of an action research, with an ethnographic approach. We define scientific literacy as a process of encouraging and nurturing the research and explorative spirit in children, as well as their natural potential and abilities that represent an object of scientific research: to learn about exploration by conducting exploration. Upon project completion, an evaluation questionnaire was created for the parents of the children who had participated in the project, as well as for those whose children had not been involved in the project. The purpose of the first questionnaire was to examine the level of satisfaction with the project implementation and its outcomes among those parents whose children had been involved in the project (N=142), while the aim of the second questionnaire was to find out how much the parents of the children not involved (N=154) in this activity were interested in this topic.Keywords: documenting, early childhood education, evaluation questionnaire for parents, scientific literacy development
Procedia PDF Downloads 2533458 The Great Mimicker: A Case of Disseminated Tuberculosis
Authors: W. Ling, Mohamed Saufi Bin Awang
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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis
Procedia PDF Downloads 1893457 Electrical Cardiac Remodeling in Elite Athletes: A Comparative Study between Triathletes and Cyclists
Authors: Lingxia Li, Frédéric Schnell, Thibault Lachard, Anne-Charlotte Dupont, Shuzhe Ding, Solène Le Douairon Lahaye
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Background: Repetitive participation in triathlon training results in significant myocardial changes. However, whether the cardiac remodeling in triathletes is related to the specificities of the sport (consisting of three sports) raises questions. Methods: Elite triathletes and cyclists registered on the French ministerial lists of high-level athletes were involved. The basic information and routine electrocardiogram records were obtained. Electrocardiograms were evaluated according to clinical criteria. Results: Of the 105 athletes included in the study, 42 were from the short-distance triathlon (40%), and 63 were from the road cycling (60%). The average age was 22.1±4.2 years. The P wave amplitude was significantly lower in triathletes than in cyclists (p=0.005), and no significant statistical difference was found in heart rate, RR interval, PR or PQ interval, QRS complex, QRS axe, QT interval, and QTc (p>0.05). All the measured parameters were within normal ranges. The most common electrical manifestations were early repolarization (60.95%) and incomplete right bundle branch block (43.81%); there was no statistical difference between the groups (p>0.05). Conclusions: Prolonged intensive endurance exercise training induces physiological cardiac remodeling in both triathletes and cyclists. The most common electrocardiogram manifestations were early repolarization and incomplete right bundle branch block.Keywords: cardiac screening, electrocardiogram, triathlon, cycling, elite athletes
Procedia PDF Downloads 43456 A Framework for Teaching the Intracranial Pressure Measurement through an Experimental Model
Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira
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This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.Keywords: neurology, intracranial pressure, medical education, simulation
Procedia PDF Downloads 1723455 Prevalent Affective-Cognitive Functioning of Intimate Partner Offenders: A study with Inmates
Authors: Alexandra Serra, Nair Torrão, Rui G. Serôdio, José A. Lima
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The present study aimed to evaluate the incidence and the prevalence of domestic violence legitimatory beliefs, emotional regulation difficulties and, early maladaptive schemas regarding intimidate partner violence in a sample of 50 Portuguese inmates. As expected, results show high levels of legitimatory beliefs, significant difficulties of emotional regulation and a set of high levels of early maladaptive schemas that clearly compromise the inmates affective-cognitive functioning. The most prevalent set of maladaptive schemas are associated with depression, anxiety, hostility, reduced ability to empathize and, dependence on the approval of others, which, combined, may trigger aggressive responses towards the intimate’s partner. Being victimized in their childhood and having committing murder are not differentiating factors on the measures we analyzed, but alcohol consumption may be associated with an intensification of domestic violence legitimatory beliefs. In the discussion of our findings, we compare the pattern of the psychosocial measures we used with the equivalent results obtained with convicted individuals that attend a community compulsory program, specifically designed for domestic violence perpetrators. We also highlight the importance of implementing specialized interventions in prison settings focusing on an evidence-based-practice.Keywords: domestic violence, intimate partner offenders, incidence and prevalence of legitimatory beliefs, Portuguese inmates
Procedia PDF Downloads 5313454 Madame Bovary in Transit: from Novel to Graphic Novel
Authors: Hania Pasandi
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Since its publication in 1856, Madame Bovary has established itself as one of the most adapted texts of French literature. Some eighteen film adaptations and twenty-seven rewritings of Madame Bovary in fiction to date shows a great enthusiasm for recreating Flaubert’s masterpiece in a variety of mediums. Posy Simmonds’ 1999 graphic novel, Gemma Bovery stands out among these adaptations as the graphic novel with its visual and narrative structure offers a new reading experience of Madame Bovary, while combining Emma Bovary’s elements with contemporary social, cultural, and artistic discourses. This paper studies the transposition of Flaubert’s Madame Bovary (1857) to late twentieth-century Britain in Posy Simmonds’ 1999 graphic novel, Gemma Bovery by exploring how it borrows the essential flaubertian themes, from its source text to incorporate it with contemporary cultural trends.Keywords: graphic novel, Gemma Bovery, Madame Bovary, transposition
Procedia PDF Downloads 1533453 Expression of Hypoxia-Inducible Transmembrane Carbonic Anhydrases IX, Ca XII and Glut 1 in Ovarian Cancer
Authors: M. Sunitha, B. Nithyavani, Mathew Yohannan, S. Thiruvieni Balajji, M. A. Rathi, C. Arul Raj, P. Ragavendran, V. K. Gopalkrishnan
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Establishment of an early and reliable biomarker for ovarian carcinogenesis whose expression can be monitored through noninvasive techniques will enable early diagnosis of cancer. Carbonic anhydrases (CA) isozymes IX and XII have been suggested to play a role in oncogenic processes. In von Hippel-Lindau (VHL)-defective tumors, the cell surface transmembrane carbonic anhydrase (CA) CA XI and CA XII genes are overexpressed because of the absence of pVHL. These enzymes are involved in causing a hypoxia condition, thereby providing an environment for metastasis. Aberrant expression of the facilitative glucose transporter GLUT I is found in a wide spectrum of epithelial malignancies. Studying the mRNA expression of CA IX, CA XII and Glut I isozymes in ovarian cancer cell lines (OAW-42 and PA-1) revealed the expression of these hypoxia genes. Immunohistochemical staining of carbonic anhydrases was also performed in 40 ovarian cancer tissues. CA IX and CA XII were expressed at 540 bp and 520 bp in OAW42, PA1 in ovarian cancer cell lines. GLUT-1 was expressed at 325bp in OAW 42, PA1 genes in ovarian cancer cell lines. Immunohistochemistry revealed high to moderate levels of expression of these enzymes. The immuostaining was seen predominantly on the cell surface membrane. The study concluded that these genes CA IX, CA XII and Glut I are expressed under hypoxic condition in tumor cells. From the present results expression of CA IX, XII and Glut I may represent potential targets in ovarian cancer therapy.Keywords: ovarian cancer, carbonic anhydrase IX, XII, Glut I, tumor markers
Procedia PDF Downloads 3693452 An Analysis of a Relational Frame Skills Training Intervention to Increase General Intelligence in Early Childhood
Authors: Ian M. Grey, Bryan Roche, Anna Dillon, Justin Thomas, Sarah Cassidy, Dylan Colbert, Ian Stewart
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This paper presents findings from a study conducted in two schools in Abu Dhabi. The hypothesis is that teaching young children to derive various relations between stimuli leads to increases in full-scale IQ scores of typically developing children. In the experimental group, sixteen 6-7-year-old children were exposed over six weeks to an intensive training intervention designed specifically for their age group. This training intervention, presented on a tablet, aimed to improve their understanding of the relations Same, Opposite, Different, contextual control over the concept of Sameness and Difference, and purely arbitrary derived relational responding for Sameness and Difference. In the control group, sixteen 6-7-year-old children interacted with KIBO robotics over six weeks. KIBO purports to improve cognitive skills through engagement with STEAM activities. Increases in full-scale IQ were recorded for most children in the experimental group, while no increases in full-scale IQ were recorded for the control group. These findings support the hypothesis that relational skills underlie many aspects of general cognitive ability.Keywords: early childhood, derived relational responding, intelligence, relational frame theory, relational skills
Procedia PDF Downloads 1843451 Ideological and Poetological Tensions: Wu Mi’s Enterprise of Imitating and Translating George Gordon Byron
Authors: Hanjin Yan
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The English Romantic George Gordon Byron (1788-1824) was widely celebrated by men of letters in early republican China as a Satanic freedom fighter challenging classical poetics and traditional values. However, Wu Mi (1894-1978), the most persistent critic of contemporary iconoclasm, perceived Byron as a paragon of self-righteous poet-exiles who maintained moral integrity and achieved poetic excellence during times of frustration, just like canonized classical Chinese poets. Wu Mi not only composed lengthy imitations of the third canto of Byron’s Childe Harold’s Pilgrimage (1816) but also patronized a rendering of the canto. Taking André Lefevere’s rewriting theory as a framework, this paper explores the interplay of ideology and poetics by examining Wu Mi’s imitations against Byron’s original and its Chinese translation patronized by Wu Mi. Textual analysis shows that Wu Mi’s approach to Byron’s poetry was informed not only by his endeavor to invigorate classical Chinese poetics, but also by his program to preserve China’s cultural traditions and integrate Western new humanism, a theory proposed by his Harvard mentor Irving Babbitt (1865-1933). This study reveals how Byron was appropriated to serve conflicting poetic and ideological purposes in early republican China and suggests that imitation as a type of rewriting merits further attention.Keywords: George Gordon Byron, ideology, imitation, poetics, translation
Procedia PDF Downloads 2303450 Identifying Autism Spectrum Disorder Using Optimization-Based Clustering
Authors: Sharifah Mousli, Sona Taheri, Jiayuan He
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Autism spectrum disorder (ASD) is a complex developmental condition involving persistent difficulties with social communication, restricted interests, and repetitive behavior. The challenges associated with ASD can interfere with an affected individual’s ability to function in social, academic, and employment settings. Although there is no effective medication known to treat ASD, to our best knowledge, early intervention can significantly improve an affected individual’s overall development. Hence, an accurate diagnosis of ASD at an early phase is essential. The use of machine learning approaches improves and speeds up the diagnosis of ASD. In this paper, we focus on the application of unsupervised clustering methods in ASD as a large volume of ASD data generated through hospitals, therapy centers, and mobile applications has no pre-existing labels. We conduct a comparative analysis using seven clustering approaches such as K-means, agglomerative hierarchical, model-based, fuzzy-C-means, affinity propagation, self organizing maps, linear vector quantisation – as well as the recently developed optimization-based clustering (COMSEP-Clust) approach. We evaluate the performances of the clustering methods extensively on real-world ASD datasets encompassing different age groups: toddlers, children, adolescents, and adults. Our experimental results suggest that the COMSEP-Clust approach outperforms the other seven methods in recognizing ASD with well-separated clusters.Keywords: autism spectrum disorder, clustering, optimization, unsupervised machine learning
Procedia PDF Downloads 1153449 Persistent Ribosomal In-Frame Mis-Translation of Stop Codons as Amino Acids in Multiple Open Reading Frames of a Human Long Non-Coding RNA
Authors: Leonard Lipovich, Pattaraporn Thepsuwan, Anton-Scott Goustin, Juan Cai, Donghong Ju, James B. Brown
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Two-thirds of human genes do not encode any known proteins. Aside from long non-coding RNA (lncRNA) genes with recently-discovered functions, the ~40,000 non-protein-coding human genes remain poorly understood, and a role for their transcripts as de-facto unconventional messenger RNAs has not been formally excluded. Ribosome profiling (Riboseq) predicts translational potential, but without independent evidence of proteins from lncRNA open reading frames (ORFs), ribosome binding of lncRNAs does not prove translation. Previously, we mass-spectrometrically documented translation of specific lncRNAs in human K562 and GM12878 cells. We now examined lncRNA translation in human MCF7 cells, integrating strand-specific Illumina RNAseq, Riboseq, and deep mass spectrometry in biological quadruplicates performed at two core facilities (BGI, China; City of Hope, USA). We excluded known-protein matches. UCSC Genome Browser-assisted manual annotation of imperfect (tryptic-digest-peptides)-to-(lncRNA-three-frame-translations) alignments revealed three peptides hypothetically explicable by 'stop-to-nonstop' in-frame replacement of stop codons by amino acids in two ORFs of the lncRNA MMP24-AS1. To search for this phenomenon genomewide, we designed and implemented a novel pipeline, matching tryptic-digest spectra to wildcard-instead-of-stop versions of repeat-masked, six-frame, whole-genome translations. Along with singleton putative stop-to-nonstop events affecting four other lncRNAs, we identified 24 additional peptides with stop-to-nonstop in-frame substitutions from multiple positive-strand MMP24-AS1 ORFs. Only UAG and UGA, never UAA, stop codons were impacted. All MMP24-AS1-matching spectra met the same significance thresholds as high-confidence known-protein signatures. Targeted resequencing of MMP24-AS1 genomic DNA and cDNA from the same samples did not reveal any mutations, polymorphisms, or sequencing-detectable RNA editing. This unprecedented apparent gene-specific violation of the genetic code highlights the importance of matching peptides to whole-genome, not known-genes-only, ORFs in mass-spectrometry workflows, and suggests a new mechanism enhancing the combinatorial complexity of the proteome. Funding: NIH Director’s New Innovator Award 1DP2-CA196375 to LL.Keywords: genetic code, lncRNA, long non-coding RNA, mass spectrometry, proteogenomics, ribo-seq, ribosome, RNAseq
Procedia PDF Downloads 2353448 A Comparative Study on Vowel Articulation in Malayalam Speaking Children Using Cochlear Implant
Authors: Deepthy Ann Joy, N. Sreedevi
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Hearing impairment (HI) at an early age, identified before the onset of language development can reduce the negative effect on speech and language development of children. Early rehabilitation is very important in the improvement of speech production in children with HI. Other than conventional hearing aids, Cochlear Implants are being used in the rehabilitation of children with HI. However, delay in acquisition of speech and language milestones persist in children with Cochlear Implant (CI). Delay in speech milestones are reflected through speech sound errors. These errors reflect the temporal and spectral characteristics of speech. Hence, acoustical analysis of the speech sounds will provide a better representation of speech production skills in children with CI. The present study aimed at investigating the acoustic characteristics of vowels in Malayalam speaking children with a cochlear implant. The participants of the study consisted of 20 Malayalam speaking children in the age range of four and seven years. The experimental group consisted of 10 children with CI, and the control group consisted of 10 typically developing children. Acoustic analysis was carried out for 5 short (/a/, /i/, /u/, /e/, /o/) and 5 long vowels (/a:/, /i:/, /u:/, /e:/, /o:/) in word-initial position. The responses were recorded and analyzed for acoustic parameters such as Vowel duration, Ratio of the duration of a short and long vowel, Formant frequencies (F₁ and F₂) and Formant Centralization Ratio (FCR) computed using the formula (F₂u+F₂a+F₁i+F₁u)/(F₂i+F₁a). Findings of the present study indicated that the values for vowel duration were higher in experimental group compared to the control group for all the vowels except for /u/. Ratio of duration of short and long vowel was also found to be higher in experimental group compared to control group except for /i/. Further F₁ for all vowels was found to be higher in experimental group with variability noticed in F₂ values. FCR was found be higher in experimental group, indicating vowel centralization. Further, the results of independent t-test revealed no significant difference across the parameters in both the groups. It was found that the spectral and temporal measures in children with CI moved towards normal range. The result emphasizes the significance of early rehabilitation in children with hearing impairment. The role of rehabilitation related aspects are also discussed in detail which can be clinically incorporated for the betterment of speech therapeutic services in children with CI.Keywords: acoustics, cochlear implant, Malayalam, vowels
Procedia PDF Downloads 1443447 Petroleum Generative Potential of Eocene-Paleocene Sequences of Potwar Basin, Pakistan
Authors: Syed Bilawal Ali Shah
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The investigation of the hydrocarbon source rock potential of Eocene-Paleocene formations of Potwar Basin, part of Upper Indus Basin Pakistan, was done using geochemical and petrological techniques. Analysis was performed on forty-five core-cutting samples from two wells. The sequences analysed are Sakesar, Lockhart and Patala formations of Potwar Basin. Patala Formation is one of Potwar Basin's major petroleum-bearing source rocks. The Lockhart Formation samples VR (%Ro) and Tmax data indicate that the formation is early mature to immature for petroleum generation for hydrocarbon generation; samples from the Patala and Sakesar formations, however, have a peak oil generation window and an early maturity (oil window). With 3.37 weight percent mean TOC and HI levels up to 498 mg HC/g TOC, the source rock characteristics of the Sakesar and Patala formations generally exhibit good to very strong petroleum generative potential. The majority of sediments representing Lockhart Formation have 1.5 wt.% mean TOC having fair to good potential with HI values ranging between 203-498 mg HC/g TOC. 1. The analysed sediments of all formations possess primarily mixed Type II/III and Type III kerogen. Analysed sediments indicate that both the Sakesar and Patala formations can possess good oil-generation potential and may act as an oil source rock in the Potwar Basin.Keywords: Potwar Basin, Patala Shale, Rock-Eval pyrolysis, Indus Basin, VR %Ro
Procedia PDF Downloads 873446 Reduce the Impact of Wildfires by Identifying Them Early from Space and Sending Location Directly to Closest First Responders
Authors: Gregory Sullivan
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The evolution of global warming has escalated the number and complexity of forest fires around the world. As an example, the United States and Brazil combined generated more than 30,000 forest fires last year. The impact to our environment, structures and individuals is incalculable. The world has learned to try to take this in stride, trying multiple ways to contain fires. Some countries are trying to use cameras in limited areas. There are discussions of using hundreds of low earth orbit satellites and linking them together, and, interfacing them through ground networks. These are all truly noble attempts to defeat the forest fire phenomenon. But there is a better, simpler answer. A bigger piece of the solutions puzzle is to see the fires while they are small, soon after initiation. The approach is to see the fires while they are very small and report their location (latitude and longitude) to local first responders. This is done by placing a sensor at geostationary orbit (GEO: 26,000 miles above the earth). By placing this small satellite in GEO, we can “stare” at the earth, and sense temperature changes. We do not “see” fires, but “measure” temperature changes. This has already been demonstrated on an experimental scale. Fires were seen at close to initiation, and info forwarded to first responders. it were the first to identify the fires 7 out of 8 times. The goal is to have a small independent satellite at GEO orbit focused only on forest fire initiation. Thus, with one small satellite, focused only on forest fire initiation, we hope to greatly decrease the impact to persons, property and the environment.Keywords: space detection, wildfire early warning, demonstration wildfire detection and action from space, space detection to first responders
Procedia PDF Downloads 703445 Automated Digital Mammogram Segmentation Using Dispersed Region Growing and Pectoral Muscle Sliding Window Algorithm
Authors: Ayush Shrivastava, Arpit Chaudhary, Devang Kulshreshtha, Vibhav Prakash Singh, Rajeev Srivastava
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Early diagnosis of breast cancer can improve the survival rate by detecting cancer at an early stage. Breast region segmentation is an essential step in the analysis of digital mammograms. Accurate image segmentation leads to better detection of cancer. It aims at separating out Region of Interest (ROI) from rest of the image. The procedure begins with removal of labels, annotations and tags from the mammographic image using morphological opening method. Pectoral Muscle Sliding Window Algorithm (PMSWA) is used for removal of pectoral muscle from mammograms which is necessary as the intensity values of pectoral muscles are similar to that of ROI which makes it difficult to separate out. After removing the pectoral muscle, Dispersed Region Growing Algorithm (DRGA) is used for segmentation of mammogram which disperses seeds in different regions instead of a single bright region. To demonstrate the validity of our segmentation method, 322 mammographic images from Mammographic Image Analysis Society (MIAS) database are used. The dataset contains medio-lateral oblique (MLO) view of mammograms. Experimental results on MIAS dataset show the effectiveness of our proposed method.Keywords: CAD, dispersed region growing algorithm (DRGA), image segmentation, mammography, pectoral muscle sliding window algorithm (PMSWA)
Procedia PDF Downloads 3123444 Effect of Total Body Irradiation for Metastatic Lymph Node and Lung Metastasis in Early Stage
Authors: Shouta Sora, Shizuki Kuriu, Radhika Mishra, Ariunbuyan Sukhbaatar, Maya Sakamoto, Shiro Mori, Tetsuya Kodama
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Lymph node (LN) metastasis accounts for 20 - 30 % of all deaths in patients with head and neck cancer. Therefore, the control of metastatic lymph nodes (MLNs) is necessary to improve the life prognosis of patients with cancer. In a classical metastatic theory, tumor cells are thought to metastasize hematogenously through a bead-like network of lymph nodes. Recently, a lymph node-mediated hematogenous metastasis theory has been proposed, in which sentinel LNs are regarded as a source of distant metastasis. Therefore, the treatment of MLNs at the early stage is essential to prevent distant metastasis. Radiation therapy is one of the primary therapeutic modalities in cancer treatment. In addition, total body irradiation (TBI) has been reported to act as activation of natural killer cells and increase of infiltration of CD4+ T-cells to tumor tissues. However, the treatment effect of TBI for MLNs remains unclear. This study evaluated the possibilities of low-dose total body irradiation (L-TBI) and middle-dose total body irradiation (M-TBI) for the treatment of MLNs. Mouse breast cancer FM3A-Luc cells were injected into subiliac lymph node (SiLN) of MXH10/Mo/LPR mice to induce the metastasis to the proper axillary lymph node (PALN) and lung. Mice were irradiated for the whole body on 4 days after tumor injection. The L-TBI and M-TBI were defined as irradiations to the whole body at 0.2 Gy and 1.0 Gy, respectively. Tumor growth was evaluated by in vivo bioluminescence imaging system. In the non-irradiated group, tumor activities on SiLN and PALN significantly increased over time, and the metastasis to the lung from LNs was confirmed 28 days after tumor injection. The L-TBI led to a tumor growth delay in PALN but did not control tumor growth in SiLN and metastasis to the lung. In contrast, it was found that the M-TBI significantly delayed the tumor growth of both SiLN and PALN and controlled the distant metastasis to the lung compared with non-irradiated and L-TBI groups. These results suggest that the M-TBI is an effective treatment method for MLNs in the early stage and distant metastasis from lymph nodes via blood vessels connected with LNs.Keywords: metastatic lymph node, lung metastasis, radiation therapy, total body irradiation, lymphatic system
Procedia PDF Downloads 1813443 Kant on Lying to God: The Intention to Deceive
Authors: James E. Mahon
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This paper addresses the important question in the philosophy of lies and deception of whether all lying requires an intention to deceive. It does by examining a recent attempt by two philosophers to argue that Immanuel Kant abandoned the view that all lying requires an intention to deceive, in order to be able to claim that lying to God was possible. Ian Proops and Roy Sorensen have recently argued that although Kant always held that it was impossible for anyone to intend to deceive God, late in his life he came to believe that it was possible to lie to God. Kant came to believe that this was possible, they argue, because Kant came to believe that lying is not always deceptive, and that it was possible to tell non-deceptive lies, including non-deceptive lies to God. In this paper their arguments will be broken down and analyzed. Based on a close textual reading of the published works and the Kant’s lectures on ethics, it will be argued that Proops and Sorensen are wrong about what Kant believed about lying in general and lying to God in particular. This paper concludes that Kant never did abandon the Deceptionist position that all lying requires an intention to deceive.Keywords: Kant, lie, deception, intention, God, ethics, belief, assertion
Procedia PDF Downloads 413442 Development of a BriMAIN System for Health Monitoring of Railway Bridges
Authors: Prakher Mishra, Dikshant Bodana, Saloni Desai, Sudhanshu Dixit, Sopan Agarwal, Shriraj Patel
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Railways are sometimes lifeline of nations as they consist of huge network of rail lines and bridges. Reportedly many of the bridges are aging, weak, distressed and accident prone. It becomes a really challenging task for Engineers and workers to keep up a regular maintenance schedule for proper functioning which itself is quite a hard hitting job. In this paper we have come up with an innvovative wireless system of maintenance called BriMAIN. In this system we have installed two types of sensors, first one is called a force sensor which will continously analyse the readings of pressure at joints of the bridges and secondly an MPU-6050 triaxial gyroscope+accelerometer which will analyse the deflection of the deck of the bridge. Apart from this a separate database is also being made at the server room so that the data can be visualized by the engineers and a warning can be issued in case reading of the sensors goes above threshold.Keywords: Accelerometer, B-MAIN, Gyroscope, MPU-6050
Procedia PDF Downloads 3833441 Multiracial Society and Oral Tradition: A Study through Secondary Data
Authors: Jesvin Puay-Hwa Yeo, Laavanya Kathiravelu, Sa’Eda Binte Buang
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In the early days, myths and taboos were used by our ancestors to give explanations to the existence of nature and man, as well as to propitiate fortunes and to avoid unluckiness and harm. Myths and taboos are deeply rooted in our cultures and environment, and they form certain characteristics of any society, even in modern societies. With decades of the three main ethnic communities in Singapore – Malay, Indian and Chinese – living together, there has been intermingling and intermixing of traditions and practices. This may mean that what we think is a ‘Malay’ practice is actually one that is a hybrid of the Chinese and Malay. A good example would be the practice of covering all mirrors in a house of mourning. Therefore, the proposed seeks to explore and understand the underlying social influences of Singapore’s oral tradition. As part of a bigger cultural research project: Designing Cultures, the proposed paper focused on using secondary data to contribute to the overall cultural understanding of the integral connections between oral traditions, people and landscapes. The proposed paper will discuss in details the initials findings of the research project, including the two manners that contributed to the intermixing of myths and taboos. The first is the presence of social institutions such as religions, and the second is the presence of cross-cultural minorities such as the Straits Chinese. As well as other observations included the use and influence of Chinese oral traditions such as folklore among the early Chinese immigrants through social institutions.Keywords: cultural belief, multiracial society, myths, oral tradition
Procedia PDF Downloads 2633440 Remembering and Forgetting in Shakespeare Sonnets
Authors: Nasreddin Bushra Ahmed
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Humans use language to externalize their mental perceptions and conceptions and thereby set up an interdependent consciousness about the concrete and abstract spheres of their existence. Language also represents a recording device whereby they capture the transient moment in their lives. Literature with it its various manifestations help keep the individual and collective memories alive. Works of the English literature’s prototypical figure, William Shakespeare provides the best illustration of this fact. Shakespeare’s sonnets abound in prescient insights about the intricacies of human relations. Though they have been the concern of scholars’ investigations for centuries, many of their thematic potentialities are yet to be tapped. The present study aspires to highlight the theme of remembering and forgetting in some of these sonnets as reverse faces of the same coin. Using close reading it is intended to demonstrate how Shakespeare, through imagery and literary tropes, plays with the issues of mortality and immortality, and how he has reaffirmed that literature can provide a locus for perennial presence despite the temporariness of individuals’ existence.Keywords: forgetting, immortality, literature, remembering, Shakespeare, sonnet
Procedia PDF Downloads 3623439 Utility of Thromboelastography Derived Maximum Amplitude and R-Time (MA-R) Ratio as a Predictor of Mortality in Trauma Patients
Authors: Arulselvi Subramanian, Albert Venencia, Sanjeev Bhoi
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Coagulopathy of trauma is an early endogenous coagulation abnormality that occurs shortly resulting in high mortality. In emergency trauma situations, viscoelastic tests may be better in identifying the various phenotypes of coagulopathy and demonstrate the contribution of platelet function to coagulation. We aimed to determine thrombin generation and clot strength, by estimating a ratio of Maximum amplitude and R-time (MA-R ratio) for identifying trauma coagulopathy and predicting subsequent mortality. Methods: We conducted a prospective cohort analysis of acutely injured trauma patients of the adult age groups (18- 50 years), admitted within 24hrs of injury, for one year at a Level I trauma center and followed up on 3rd day and 5th day of injury. Patients with h/o coagulation abnormalities, liver disease, renal impairment, with h/o intake of drugs were excluded. Thromboelastography was done and a ratio was calculated by dividing the MA by the R-time (MA-R). Patients were further stratified into sub groups based on the calculated MA-R quartiles. First sampling was done within 24 hours of injury; follow up on 3rd and 5thday of injury. Mortality was the primary outcome. Results: 100 acutely injured patients [average, 36.6±14.3 years; 94% male; injury severity score 12.2(9-32)] were included in the study. Median (min-max) on admission MA-R ratio was 15.01(0.4-88.4) which declined 11.7(2.2-61.8) on day three and slightly rose on day 5 13.1(0.06-68). There were no significant differences between sub groups in regard to age, or gender. In the lowest MA-R ratios subgroup; MA-R1 (<8.90; n = 27), injury severity score was significantly elevated. MA-R2 (8.91-15.0; n = 23), MA-R3 (15.01-19.30; n = 24) and MA-R4 (>19.3; n = 26) had no difference between their admission laboratory investigations, however slight decline was observed in hemoglobin, red blood cell count and platelet counts compared to the other subgroups. Also significantly prolonged R time, shortened alpha angle and MA were seen in MA-R1. Elevated incidence of mortality also significantly correlated with on admission low MA-R ratios (p 0.003). Temporal changes in the MA-R ratio did not correlated with mortality. Conclusion: The MA-R ratio provides a snapshot of early clot function, focusing specifically on thrombin burst and clot strength. In our observation, patients with the lowest MA-R time ratio (MA-R1) had significantly increased mortality compared with all other groups (45.5% MA-R1 compared with <25% in MA-R2 to MA-R3, and 9.1% in MA-R4; p < 0.003). Maximum amplitude and R-time may prove highly useful to predict at-risk patients early, when other physiologic indicators are absent.Keywords: coagulopathy, trauma, thromboelastography, mortality
Procedia PDF Downloads 1743438 Role of Apolipoprotein E Polymorphism on the Onset of Inflammatory Bowel Disease in Saudi Patients
Authors: Ebtissam Saleh Al-Meghaiseeb, Abdulaziz Al Masood, Abdulrahman Al-Robayan, Reem Al-Amro, Misbahul Arfin, Abdulrahman Al Asmari
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Objective: The objective of this study was to evaluate the role of apolipoprotein E (APOE) polymorphism on the onset of inflammatory bowel disease (IBD) in Saudi patients. Methods: APOE gene was genotyped to evaluate the frequencies of the alleles and genotypes in Saudi subjects, including IBD patients (n=200) and matched controls (n=200), using APOE StripAssayTM kit (ViennaLab Labordiagnostika GmbH, Vienna, Austria). Results: The frequencies of alleles and genotypes of APOE differed in patients and controls. The APOE allele ε2 and ε4, genotype ε2/ε3 and ε2/ε4 were significantly higher in the IBD patients than the healthy controls. The frequencies of ε3 allele and ε3/ε3 genotype were higher in the control group as compared to patients. The higher prevalence of allele ε2 and ε4 allele in patients compared to that in controls suggested that ε2 and ε4 alleles may increase the risk of IBD. Results also indicated that APOE ε4 allele was associated with early age at onset of IBD. On the other hand, the decreased frequencies of ε3 allele and ε3/ε3 genotype in patients as compared to those in the controls suggested a protective effect of APOE ε3 for IBD susceptibility. In this study, the frequency distribution of APOE alleles and genotypes was not affected by the gender or type of IBD (familial or sporadic). Conclusion: This study indicates that APOE polymorphism plays a significant role in developing IBD and early age of onset in Saudi patients. However, further studies with large-size sample are warranted to confirm this relationship.Keywords: APOE, polymorphism, IBD, saudis
Procedia PDF Downloads 1123437 Evaluation of Random Forest and Support Vector Machine Classification Performance for the Prediction of Early Multiple Sclerosis from Resting State FMRI Connectivity Data
Authors: V. Saccà, A. Sarica, F. Novellino, S. Barone, T. Tallarico, E. Filippelli, A. Granata, P. Valentino, A. Quattrone
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The work aim was to evaluate how well Random Forest (RF) and Support Vector Machine (SVM) algorithms could support the early diagnosis of Multiple Sclerosis (MS) from resting-state functional connectivity data. In particular, we wanted to explore the ability in distinguishing between controls and patients of mean signals extracted from ICA components corresponding to 15 well-known networks. Eighteen patients with early-MS (mean-age 37.42±8.11, 9 females) were recruited according to McDonald and Polman, and matched for demographic variables with 19 healthy controls (mean-age 37.55±14.76, 10 females). MRI was acquired by a 3T scanner with 8-channel head coil: (a)whole-brain T1-weighted; (b)conventional T2-weighted; (c)resting-state functional MRI (rsFMRI), 200 volumes. Estimated total lesion load (ml) and number of lesions were calculated using LST-toolbox from the corrected T1 and FLAIR. All rsFMRIs were pre-processed using tools from the FMRIB's Software Library as follows: (1) discarding of the first 5 volumes to remove T1 equilibrium effects, (2) skull-stripping of images, (3) motion and slice-time correction, (4) denoising with high-pass temporal filter (128s), (5) spatial smoothing with a Gaussian kernel of FWHM 8mm. No statistical significant differences (t-test, p < 0.05) were found between the two groups in the mean Euclidian distance and the mean Euler angle. WM and CSF signal together with 6 motion parameters were regressed out from the time series. We applied an independent component analysis (ICA) with the GIFT-toolbox using the Infomax approach with number of components=21. Fifteen mean components were visually identified by two experts. The resulting z-score maps were thresholded and binarized to extract the mean signal of the 15 networks for each subject. Statistical and machine learning analysis were then conducted on this dataset composed of 37 rows (subjects) and 15 features (mean signal in the network) with R language. The dataset was randomly splitted into training (75%) and test sets and two different classifiers were trained: RF and RBF-SVM. We used the intrinsic feature selection of RF, based on the Gini index, and recursive feature elimination (rfe) for the SVM, to obtain a rank of the most predictive variables. Thus, we built two new classifiers only on the most important features and we evaluated the accuracies (with and without feature selection) on test-set. The classifiers, trained on all the features, showed very poor accuracies on training (RF:58.62%, SVM:65.52%) and test sets (RF:62.5%, SVM:50%). Interestingly, when feature selection by RF and rfe-SVM were performed, the most important variable was the sensori-motor network I in both cases. Indeed, with only this network, RF and SVM classifiers reached an accuracy of 87.5% on test-set. More interestingly, the only misclassified patient resulted to have the lowest value of lesion volume. We showed that, with two different classification algorithms and feature selection approaches, the best discriminant network between controls and early MS, was the sensori-motor I. Similar importance values were obtained for the sensori-motor II, cerebellum and working memory networks. These findings, in according to the early manifestation of motor/sensorial deficits in MS, could represent an encouraging step toward the translation to the clinical diagnosis and prognosis.Keywords: feature selection, machine learning, multiple sclerosis, random forest, support vector machine
Procedia PDF Downloads 2403436 The Influence of Applying Mechanical Chest Compression Systems on the Effectiveness of Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest
Authors: Slawomir Pilip, Michal Wasilewski, Daniel Celinski, Leszek Szpakowski, Grzegorz Michalak
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The aim of the study was to evaluate the effectiveness of cardiopulmonary resuscitation taken by Medical Emergency Teams (MET) at the place of an accident including the usage of mechanical chest compression systems. In the period of January-May 2017, there were 137 cases of a sudden cardiac arrest in a chosen region of Eastern Poland with 360.000 inhabitants. Medical records and questionnaires filled by METs were analysed to prove the effectiveness of cardiopulmonary resuscitations that were considered to be effective when an early indication of spontaneous circulation was provided and the patient was taken to hospital. A chest compression system used by METs was applied in 60 cases (Lucas3 - 34 patients; Auto Pulse - 24 patients). The effectiveness of cardiopulmonary resuscitation among patients who were employed a chest compression system was much higher (43,3%) than the manual cardiac massage (36,4%). Thus, the usage of Lucas3 chest compression system resulted in 47% while Auto Pulse was 33,3%. The average ambulance arrival time could have had a significant impact on the subsequent effectiveness of cardiopulmonary resuscitation in these cases. Ambulances equipped with Lucas3 reached the destination within 8 minutes, and those with Auto Pulse needed 12,1 minutes. Moreover, taking effective basic life support (BLS) by bystanders before the ambulance arrival was much more frequent for ambulances with Lucas3 than Auto Pulse. Therefore, the percentage of BLS among the group of patients who were employed Lucas3 by METs was 26,5%, and 20,8% for Auto Pulse. The total percentage of taking BLS by bystanders before the ambulance arrival resulted in 25% of patients who were later applied a chest compression system by METs. Not only was shockable cardiac rhythm obtained in 47% of these cases, but an early indication of spontaneous circulation was also provided in all these patients. Both Lucas3 and Auto Pulse were evaluated to be significantly useful in improving the effectiveness of cardiopulmonary resuscitation by 97% of Medical Emergency Teams. Therefore, implementation of chest compression systems essentially makes the cardiopulmonary resuscitation even more effective. The ambulance arrival time, taking successful BLS by bystanders before the ambulance arrival and the presence of shockable cardiac rhythm determine an early indication of spontaneous circulation among patients after a sudden cardiac arrest.Keywords: cardiac arrest, effectiveness, mechanical chest compression systems, resuscitation
Procedia PDF Downloads 2483435 Characterization of Crustin from Litopenaeus vannamei
Authors: Suchao Donpudsa, Anchalee Tassanakajon, Vichien Rimphanitchayakit
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A crustin gene, LV-SWD1, previously found in the hemocyte cDNA library of Litopenaeus vannamei, contains the open reading frames of 288 bp encoding a putative protein of 96 amino acid residues. The putative signal peptides of the LV-SWD1 were identified using the online SignalP 3.0 with predicted cleavage sites between Ala24-Val25, resulting in 72 residue mature protein with calculated molecular mass of 7.4 kDa and predicted pI of 8.5. This crustin contains a Arg-Pro rich region at the amino-terminus and a single whey acidic protein (WAP) domain at the carboxyl-terminus. In order to characterize their properties and biological activities, the recombinant crustin protein was produced in the Escherichia coli expression system. Antimicrobial assays showed that the growth of Bacillus subtilis was inhibited by this recombinant crustin with MIC of about 25-50 µM.Keywords: crustin, single whey acidic protein, Litopenaeus vannamei, antimicrobial activity
Procedia PDF Downloads 2443434 Rewritten Oedipus Complex: Huo Datong’s Complex of Generation
Authors: Xinyu Chen
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This article reviews Chinese psychoanalytic theorist, Dr. Huo Datong’s notion, the complex of generation, around which Huo conceptualizes a localized set to recapitulate the unconscious structure of Chinese people. Psychoanalysis underwent constant localization influenced by the socio-cultural milieu and endeavored by scholars receiving training backgrounds from different psychoanalytic schools. Dr. Huo Datong is one of the representatives with a Sino-French background of psychoanalytic training, whose enterprise has demonstrated psychoanalysis's cultural and ideological accommodability. Insufficient academic attention has been paid to this concept as the core of Huo’s re-framework. This notion is put forward by sharing a western psychoanalytic reading of Chinese mythologies to contour Chinese unconsciousness. Regarding Huo’s interpretation of the Chinese kinship network as the basis to propose an omnipotent symbolic mother rather than an Oedipal father, this article intends to review this notion in terms of its mythological root to evaluate the theoretical practicality.Keywords: psychoanalysis, China, Huo Datong, mythology
Procedia PDF Downloads 2513433 Efficacy of Opicapone and Levodopa with Different Levodopa Daily Doses in Parkinson’s Disease Patients with Early Motor Fluctuations: Findings from the Korean ADOPTION Study
Authors: Jee-Young Lee, Joaquim J. Ferreira, Hyeo-il Ma, José-Francisco Rocha, Beomseok Jeon
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The effective management of wearing-off is a key driver of medication changes for patients with Parkinson’s disease (PD) treated with levodopa (L-DOPA). While L-DOPA is well tolerated and efficacious, its clinical utility over time is often limited by the development of complications such as dyskinesia. Still, common first-line option includes adjusting the daily L-DOPA dose followed by adjunctive therapies usually counting for the L-DOPA equivalent daily dose (LEDD). The LEDD conversion formulae are a tool used to compare the equivalence of anti-PD medications. The aim of this work is to compare the effects of opicapone (OPC) 50 mg, a catechol-O-methyltransferase (COMT) inhibitor, and an additional 100 mg dose of L-DOPA in reducing the off time in PD patients with early motor fluctuations receiving different daily L-DOPA doses. OPC was found to be well tolerated and efficacious in advanced PD population. This work utilized patients' home diary data from a 4-week Phase 2 pharmacokinetics clinical study. The Korean ADOPTION study randomized (1:1) patients with PD and early motor fluctuations treated with up to 600 mg of L-DOPA given 3–4 times daily. The main endpoint was change from baseline in off time in the subgroup of patients receiving 300–400 mg/day L-DOPA at baseline plus OPC 50 mg and in the subgroup receiving >300 mg/day L-DOPA at baseline plus an additional dose of L-DOPA 100 mg. Of the 86 patients included in this subgroup analysis, 39 received OPC 50 mg and 47 L-DOPA 100 mg. At baseline, both L-DOPA total daily dose and LEDD were lower in the L-DOPA 300–400 mg/day plus OPC 50 mg group than in the L-DOPA >300 mg/day plus L-DOPA 100 mg. However, at Week 4, LEDD was similar between the two groups. The mean (±standard error) reduction in off time was approximately three-fold greater for the OPC 50 mg than for the L-DOPA 100 mg group, being -63.0 (14.6) minutes for patients treated with L-DOPA 300–400 mg/day plus OPC 50 mg, and -22.1 (9.3) minutes for those receiving L-DOPA >300 mg/day plus L-DOPA 100 mg. In conclusion, despite similar LEDD, OPC demonstrated a significantly greater reduction in off time when compared to an additional 100 mg L-DOPA dose. The effect of OPC appears to be LEDD independent, suggesting that caution should be exercised when employing LEDD to guide treatment decisions as this does not take into account the timing of each dose, onset, duration of therapeutic effect and individual responsiveness. Additionally, OPC could be used for keeping the L-DOPA dose as low as possible for as long as possible to avoid the development of motor complications which are a significant source of disability.Keywords: opicapone, levodopa, pharmacokinetics, off-time
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