Search results for: motor impairment

Authors: Erin Micali, Katerina Tolstikova, Cheryl Maykel, Elizabeth Harwood

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Female ASD is seldomly studied separately from males. Further, females with ASD are disproportionately underrepresented in the research at a rate of 3:1 (male to female). As such, much of the current understanding about female rigid repetitive behaviors (RRBs) stems from research’s understanding of male RRBs. This can be detrimental to understanding female ASD because this understanding of female RRBs largely discounts female camouflaging and the possibility that females present their autistic symptoms differently. Current literature suggests that females with ASD engage in fewer RRBs than males with ASD and when females do engage in RRBs, they are likely to engage in more subtle, less overt obsessions and repetitive behaviors than males. Method: The current study utilized a mixed methods research design to identify the type and frequency of RRBs that females with ASD engaged in by using a cross-sectional design. The researcher recruited only females to be part of the present study with the criteria they be at least age six and not have co-occurring cognitive impairment. Results: The researcher collected previous testing data (Autism Diagnostic Interview-Revised (ADI-R), Child or Adolescent/Adult Sensory Profile-2, Autism/ Empathy Quotient, Yale Brown Obsessive Compulsive Checklist, Rigid Repetitive Behavior Checklist (evaluator created list), and demographic questionnaire) from 25 total participants. The participants ages ranged from six to 52. The participants were 96% Caucasion and 4% Latin American. Qualitative analysis found the current participant pool engaged in six RRB themes including repetitive behaviors, socially restrictive behaviors, repetitive speech, difficulty with transition, obsessive behaviors, and restricted interests. The current dataset engaged in socially restrictive behaviors and restrictive interests most frequently. Within the main themes 40 subthemes were isolated, defined, and analyzed. Further, preliminary quantitative analysis was run to determine if age impacted camouflaging behaviors and overall presentation of RRBs. Within this dataset this was not founded. Further qualitative data will be run to determine if this dataset engaged in more overt or subtle RRBs to confirm or rebuff previous research. The researcher intends to run SPSS analysis to determine if there was statistical difference between each RRB theme and overall presentation. Secondly, each participant will be analyzed for presentation of RRB, age, and previous diagnoses. Conclusion: The present study aimed to assist in diagnostic clarity. This was achieved by collecting data from a female only participant pool across the lifespan. Current data aided in clarity of the type of RRBs engage in. A limited sample size was a barrier in this study.

Keywords: autism spectrum disorder, camouflaging, rigid repetitive behaviors, gender disparity

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Authors: Benito Minjarez, Jesse Haramati, Yury Rodriguez-Yanez, Florencio Recendiz-Hurtado, Juan-Pedro Luna-Arias, Salvador Mena-Munguia

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During the last decades, the world has experienced a rapid industrialization and an expanding economy favoring a demographic boom. As a consequence, countries around the world have focused on developing new strategies related to the production of different farm products in order to meet future demands. Consequently, different strategies have been developed seeking to improve the major food products for both humans and livestock. Corn, after wheat and rice, is the third most important crop globally and is the primary food source for both humans and livestock in many regions around the globe. In addition, maize (Zea mays) is an important source of protein accounting for up to 60% of the daily human protein supply. Generally, many of the cereal grains have proteins with relatively low nutritional value, when they are compared with proteins from meat. In the case of corn, much of the protein is found in the endosperm (75 to 85%) and is deficient in two essential amino acids, lysine, and tryptophan. This deficiency results in an imbalance of amino acids and low protein content; normal maize varieties have less than half of the recommended amino acids for human nutrition. In addition, studies have shown that this deficiency has been associated with symptoms of growth impairment, anemia, hypoproteinemia, and fatty liver. Due to the fact that most of the presently available maize varieties do not contain the quality and quantity of proteins necessary for a balanced diet, different countries have focused on the research of quality protein maize (QPM). Researchers have characterized QPM noting that these varieties may contain between 70 to 100% more residues of the amino acids essential for animal and human nutrition, lysine, and tryptophan, than common corn. Several countries in Africa, Latin America, as well as China, have incorporated QPM in their agricultural development plan. Large parts of these countries have chosen a specific QPM variety based on their local needs and climate. Reviews have described the breeding methods of maize and have revealed the lack of studies on genetic and proteomic diversity of proteins in QPM varieties, and their genetic relationships with normal maize varieties. Therefore, molecular marker identification using tools such as mass spectrometry may accelerate the selection of plants that carry the desired proteins with high lysine and tryptophan concentration. To date, QPM maize lines have played a very important role in alleviating the malnutrition, and better characterization of these lines would provide a valuable nutritional enhancement for use in the resource-poor regions of the world. Thus, the objectives of this study were to identify proteins in QPM maize in comparison with a common maize line as a control.

Keywords: corn, mass spectrometry, QPM, tryptophan

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Authors: Hanieh Mohammadi, Sarah Fraser, Anil Nigam, Frederic Lesage, Louis Bherer

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A chronically higher cerebral pulsatility is thought to damage cerebral microcirculation, leading to cognitive decline in older adults. Although it is widely known that regular physical activity is linked to improvement in some cognitive domains, including executive functions, the mediating role of cerebral pulsatility on this link remains to be elucidated. This study assessed the impact of 6 months of regular physical activity upon changes in an optical index of cerebral pulsatility and the role of physical activity for the improvement of executive functions. 27 older adults (aged 57-79, 66.7% women) with cardiovascular risk factors (CVRF) were enrolled in the study. The participants completed the behavioral Stroop test, which was extracted from the Delis-Kaplan executive functions system battery at baseline (T0) and after 6 months (T6) of physical activity. Near-infrared spectroscopy (NIRS) was applied for an innovative approach to indexing cerebral pulsatility in the brain microcirculation at T0 and T6. The participants were at standing rest while a NIRS device recorded hemodynamics data from frontal and motor cortex subregions at T0 and T6. The cerebral pulsatility index of interest was cerebral pulse amplitude, which was extracted from the pulsatile component of NIRS data. Our data indicated that 6 months of physical activity was associated with a reduction in the response time for the executive functions, including inhibition (T0: 56.33± 18.2 to T6: 53.33± 15.7,p= 0.038)and Switching(T0: 63.05± 5.68 to T6: 57.96 ±7.19,p< 0.001) conditions of the Stroop test. Also, physical activity was associated with a reduction in cerebral pulse amplitude (T0: 0.62± 0.05 to T6: 0.55± 0.08, p < 0.001). Notably, cerebral pulse amplitude was a significant mediator of the link between physical activity and response to the Stroop test for both inhibition (β=0.33 (0.61,0.23),p< 0.05)and switching (β=0.42 (0.69,0.11),p <0.01) conditions. This study suggests that regular physical activity may support cognitive functions through the improvement of cerebral pulsatility in older adults with CVRF.

Keywords: near-infrared spectroscopy, cerebral pulsatility, physical activity, cardiovascular risk factors, executive functions

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Authors: Nalini Kaul, Barrie Drewitt, Elsie Kohoot

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Hyperpigmentation is the third most common pigmentary disorder where dermatologic treatment is sought. It affects all ages resulting in skin darkening because of melanin accumulation. An uneven skin tone because of either exposure to the sun (solar lentigos/age spots/sun spots or skin disruption following acne, or rashes (post-inflammatory hyperpigmentation -PIH) or hormonal changes (melasma) can lead to significant psychosocial impairment. Dyschromia is a result of various alterations in biochemical processes regulating melanogenesis. Treatments include the daily use of sunscreen with lightening, brightening, and exfoliating products. Depigmentation is achieved by various depigmenting agents: common examples are hydroquinone, arbutin, azelaic acid, aloesin, mulberry, licorice extracts, kojic acid, niacinamide, ellagic acid, arbutin, green tea, turmeric, soy, ascorbic acid, and tranexamic acid. These agents affect pigmentation by interfering with mechanisms before, during, and after melanin synthesis. While immediate correction is much sought after, patience and diligence are key. Our objective was to assess the effects of a facial product with pigmentation treatment and UV protection in 35 healthy F (35-65y), meeting the study criteria. Subjects with mild to moderate hyperpigmentation and fine lines with no use of skin-lightening products in the last six months or any dermatological procedures in the last twelve months before the study started were included. Efficacy parameters included expert clinical grading for hyperpigmentation, radiance, skin tone & smoothness, fine lines, and wrinkles bioinstrumentation (Corneometer®, Colorimeter®), digital photography and imaging (Visia-CR®), and self-assessment questionnaires. Safety included grading for erythema, edema, dryness & peeling and self-assessments for itching, stinging, tingling, and burning. Our results showed statistically significant improvement in clinical grading scores, bioinstrumentation, and digital photos for hyperpigmentation-brown spots, fine lines/wrinkles, skin tone, radiance, pores, skin smoothness, and overall appearance compared to baseline. The product was also well-tolerated and liked by subjects. Conclusion: Facial hyperpigmentation is of great concern, and treatment strategies are increasingly sought. Clinical trials with both subjective and objective assessments, imaging analyses, and self-perception are essential to distinguish evidence-based products. The multifunctional cosmetic product tested in this clinical study showed efficacy, tolerability, and subject satisfaction in reducing hyperpigmentation and global photoaging.

Keywords: hyperpigmentation; photoaging, clinical testing, expert visual evaluations, bio-instruments

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Authors: Michał Gęca, Konrad Pietrykowski, Grzegorz Barański

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The water pump in the compression-ignition internal combustion engine transports a hot coolant along a system of ducts from the engine block to the radiator where coolant temperature is lowered. This part needs to maintain a constant volumetric flow rate. Its power should be regulated to avoid a significant drop in pressure if a coolant flow decreases. The internal combustion engine cooling system uses centrifugal pumps for suction. The paper investigates 4 constructions of engine pumps. The pumps are from diesel engine of a maximum power of 75 kW. Each of them has a different rotor shape, diameter and width. The test stand was created and the geometry inside the all 4 engine blocks was mapped. For a given pump speed on the inverter of the electric engine motor, the valve position was changed and volumetric flow rate, pressure, and power were recorded. Pump speed was regulated from 1200 RPM to 7000 RPM every 300 RPM. The volumetric flow rates and pressure drops for the pump speeds and efficiencies were specified. Accordingly, the operations of each pump were mapped. Our research was to select a pump for the aircraft compression-ignition engine. There was calculated a pressure drop at a given flow on the block and radiator of the designed aircraft engine. The water pump should be lightweight and have a low power demand. This fact shall affect the shape of a rotor and bearings. The pump volumetric flow rate was assumed as 3 kg/s (previous AVL BOOST research model) where the temperature difference was 5°C between the inlet (90°C) and outlet (95°C). Increasing pump speed above the boundary flow power defined by pressure and volumetric flow rate does not increase it but pump efficiency decreases. The maximum total pump efficiency (PCC) is 45-50%. When the pump is driven by low speeds with a 90% closed valve, its overall efficiency drops to 15-20%. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: aircraft engine, diesel engine, flow, water pump

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Authors: Mohammad Ehsani, Elham Karimi, Hashem Koozechian

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Aim: The purpose of current semi-experimental study was a survey on effect of 16 week walking on psychosocial function related quality of life among 60 to 75 years old men. Methodology: For this reason, short from of health – related quality of life questionnaire (SF – 36) and Geriatric Depression Scale (GDS) had been distributed to the subjects at 2 times of pre – test and posttest. Statistical sample of current study was 60 to 75 years old men who placed at Kahrizak house and assessed by considering physically and medical background. Also factors of entrance to the intervention like age range, have satisfaction and have intent to participating in walking program, lack of having diabetic, cardiovascular, Parkinsonism diseases and postural, neurological, musculoskeletal disorders, lack of having clinical background like visual disorders or disordering on equilibrium system, lack of motor limitation, foot print disorders, having surgery and mental health had been determined and assessed. Finally after primary studies, 80 persons selected and categorized accidentally to the 3 experimental group (1, 2, 3 sessions per week, 30 min walking with moderate intension at every sessions) and one control group (without physical activity in period of 16 weeks). Data analysed by employing ANOVA, Pearson coefficient and Scheffe Post – Hoc tests at the significance level of p < 0.05. Results: Results showed that psychosocial function of men with 60 to 75 years old increase by influence of 16 week walking and increase of exercise sessions lead to more effectiveness of walking. Also there was no significant difference between psychosocial function of subjects within 1 session and 3 sessions experimental groups (p > 0.05). Conclusion: On the basis of results, we can say that doing regular walking with efficient and standard dosage for elderly people, can increase their quality of life. Furthermore, designing and action operation regular walking program for elderly men on the basis of special, logical and systematic pattern under the supervision of aware coaches have been recommended on the basis of results.

Keywords: walking, quality of life, psychosocial function, elders

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Authors: Zhenzhen Xu, Chunfu Shao, Shengyou Wang, Chunjiao Dong

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To improve the satisfaction of residents' travel, this paper analyzes the characteristics and influencing factors of urban residents' travel behavior. First, a Multinominal Logit Model (MNL) model is built to analyze the characteristics of residents' travel behavior, reveal the influence of individual attributes, family attributes and travel characteristics on the choice of travel mode, and identify the significant factors. Then put forward suggestions for policy improvement. Finally, Support Vector Machine (SVM) and Multi-Layer Perceptron (MLP) models are introduced to evaluate the policy effect. This paper selects Futian Street in Futian District, Shenzhen City for investigation and research. The results show that gender, age, education, income, number of cars owned, travel purpose, departure time, journey time, travel distance and times all have a significant influence on residents' choice of travel mode. Based on the above results, two policy improvement suggestions are put forward from reducing public transportation and non-motor vehicle travel time, and the policy effect is evaluated. Before the evaluation, the prediction effect of MNL, SVM and MLP models was evaluated. After parameter optimization, it was found that the prediction accuracy of the three models was 72.80%, 71.42%, and 76.42%, respectively. The MLP model with the highest prediction accuracy was selected to evaluate the effect of policy improvement. The results showed that after the implementation of the policy, the proportion of public transportation in plan 1 and plan 2 increased by 14.04% and 9.86%, respectively, while the proportion of private cars decreased by 3.47% and 2.54%, respectively. The proportion of car trips decreased obviously, while the proportion of public transport trips increased. It can be considered that the measures have a positive effect on promoting green trips and improving the satisfaction of urban residents, and can provide a reference for relevant departments to formulate transportation policies.

Keywords: neural network, travel characteristics analysis, transportation choice, travel sharing rate, traffic resource allocation

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Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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Authors: Richa Shri, Varinder Singh, Kundan Singh Bora, Abhishek Bhanot, Rahul Kumar, Amit Kumar, Ravinder Kaur

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The term ‘neuroprotection’ means preserving/salvaging function and structure of neurons. Neuroprotection is an adjunctive treatment option for neurodegenerative disorders. Oxidative stress is considered a major culprit in neurodegenerative disorders; hence, management strategies include use of antioxidants. Our search for a neuroprotective agent began with Allium cepa L. or onions, (family Amaryllidaceae) - a potent antioxidant. We have investigated the neuroprotective potential of onions in experimental models of ischemic stroke, diabetic neuropathy, neuropathic pain, and dementia. In pre and post-ischemic stroke model, the methanol extract of outer scales of onion bulbs (MEOS) prevented memory loss and motor in-coordination; reduced oxidative stress and cerebral infarct size. This also prevented and ameliorated diabetic neuropathy in mice. The MEOS was fractionated to yield a flavonoid rich fraction (FRF) that successfully reversed ischemia-reperfusion induced neuronal damage, thereby demonstrating that the flavonoids are responsible for the activity. The FRF effectively ameliorated chronic constriction induced neuropathic pain in rats. The FRF was subjected to bioactivity-guided fractionated. It was seen that FRF is more effective as compared to the isolated components probably due to synergism among the constituents (i.e., quercetin and quercetin glucosides) in the FRF. The outer scales of onion bulbs have great potential for prevention as well as for treatment of neuronal disorders. Red onions, with higher amounts of flavonoids as compared to the white onions, produced more significant neuroprotection. Thus, the standardized FRF from the waste material of a commonly used vegetable, especially the red variety, may be developed as a valuable neuroprotective agent.

Keywords: Allium cepa, antioxidant activity, flavonoid rich fraction, neuroprotection

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Authors: Henry Venter, Murali Thyloth, Alceu Casseb

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

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

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Authors: Stephanie Ducrot, Marie Vernet, Eve Meiss, Yves Chaix

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Learning to read is a key topic of debate today, both in terms of its implications on school failure and illiteracy and regarding what are the best teaching methods to develop. It is estimated today that four to six percent of school-age children suffer from specific developmental disorders that impair learning. The findings from people with dyslexia and typically developing readers suggest that the problems children experience in learning to read are related to the preliteracy skills that they bring with them from kindergarten. Most tools available to professionals are designed for the evaluation of child language problems. In comparison, there are very few tools for assessing the relations between visual skills and the process of learning to read. Recent literature reports that visual-motor skills and visual-spatial attention in preschoolers are important predictors of reading development — the main goal of this study aimed at improving screening for future reading difficulties in preschool children. We used a prospective, longitudinal approach where oculomotor processes (assessed with the DiagLECT test) were measured in pre-readers, and the impact of these skills on future reading development was explored. The dialect test specifically measures the online time taken to name numbers arranged irregularly in horizontal rows (horizontal time, HT), and the time taken to name numbers arranged in vertical columns (vertical time, VT). A total of 131 preschoolers took part in this study. At Time 0 (kindergarten), the mean VT, HT, errors were recorded. One year later, at Time 1, the reading level of the same children was evaluated. Firstly, this study allowed us to provide normative data for a standardized evaluation of the oculomotor skills in 5- and 6-year-old children. The data also revealed that 25% of our sample of preschoolers showed oculomotor impairments (without any clinical complaints). Finally, the results of this study assessed the validity of the DiagLECT test for predicting reading outcomes; the better a child's oculomotor skills are, the better his/her reading abilities will be.

Keywords: vision, attention, oculomotor processes, reading, preschoolers

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Authors: Anna Slupik, Anna Mosiolek, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Whole-body vibration (WBV) uses high frequency mechanical stimuli generated by a vibration plate and transmitted through bone, muscle and connective tissues to the whole body. Research has shown that long-term vibration-plate training improves neuromuscular facilitation, especially in afferent neural pathways, responsible for the conduction of vibration and proprioceptive stimuli, muscle function, balance and proprioception. Some researchers suggest that the vibration stimulus briefly inhibits the conduction of afferent signals from proprioceptors and can interfere with the maintenance of body balance. The aim of this study was to evaluate the influence of a single set of exercises associated with whole-body vibration on the joint position sense and body balance. Material and methods: The study enrolled 55 people aged 19-24 years. These individuals were randomly divided into a test group (30 persons) and a control group (25 persons). Both groups performed the same set of exercises on a vibration plate. The following vibration parameters: frequency of 20Hz and amplitude of 3mm, were used in the test group. The control group performed exercises on the vibration plate while it was off. All participants were instructed to perform six dynamic exercises lasting 30 seconds each with a 60-second period of rest between them. The exercises involved large muscle groups of the trunk, pelvis and lower limbs. Measurements were carried out before and immediately after exercise. Joint position sense (JPS) was measured in the knee joint for the starting position at 45° in an open kinematic chain. JPS error was measured using a digital inclinometer. Balance was assessed in a standing position with both feet on the ground with the eyes open and closed (each test lasting 30 sec). Balance was assessed using Matscan with FootMat 7.0 SAM software. The surface of the ellipse of confidence and front-back as well as right-left swing were measured to assess balance. Statistical analysis was performed using Statistica 10.0 PL software. Results: There were no significant differences between the groups, both before and after the exercise (p> 0.05). JPS did not change in both the test (10.7° vs. 8.4°) and control groups (9.0° vs. 8.4°). No significant differences were shown in any of the test parameters during balance tests with the eyes open or closed in both the test and control groups (p> 0.05). Conclusions. 1. Deterioration in proprioception or balance was not observed immediately after the vibration stimulus. This suggests that vibration-induced blockage of proprioceptive stimuli conduction can have only a short-lasting effect that occurs only as long as a vibration stimulus is present. 2. Short-term use of vibration in treatment does not impair proprioception and seems to be safe for patients with proprioceptive impairment. 3. These results need to be supplemented with an assessment of proprioception during the application of vibration stimuli. Additionally, the impact of vibration parameters used in the exercises should be evaluated.

Keywords: balance, joint position sense, proprioception, whole body vibration

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Authors: Dalila Lino, Maria Joao Hortas, Carla Rocha, Clarisse Nunes, Natalia Vieira, Marina Fuertes, Kátia Sa

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The value of play is recognized worldwide and is considered a fundamental right of all children, as defined in Article 31 of the United Nations Children’s Rights. It is consensual among the scientific community that play, and toys are of vital importance for children’s learning and development. Play promotes the acquisition of language, enhances creativity and improves social, affective, emotional, cognitive and motor development of young children. Young children ages 0 to 6 who have had many opportunities to get involved in play show greater competence to adapt to new and unexpected situations and more easily overcome the pain and suffering caused by traumatic situations. The PlayTrain Project aims to understand the places/spaces of play in the education of children from 0 to 6 years and promoting the training of preschool teachers to become capable of developing practices that enhance children’s agency, experimentation in the physical and social world and the development of imagination and creativity. This project follows the Design-Based-Research (DBR) and has two dimensions: research and intervention. The participants are 120 students from the Master in Pre-school Education of the Higher School of Education, Polytechnic Institute of Lisbon enrolled in the academic year 2018/2019. The development of workshops focused on the role of play and toys for young children’s learning promotes the participants reflection and the development of skills and knowledge to construct developmentally appropriated practices in early childhood education. Data was collected through an online questionnaire and focal groups. Results show that the PlayTrain Project contribute to the development of a body of knowledge about the role of play for early childhood education. It was possible to identify the needs of preschool teacher education and to enhance the discussion among the scientific and academic community about the importance of deepening the role of play and toys in the study plans of the masters in pre-school education.

Keywords: children's learning, early childhood education, play, teacher education, toys

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

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

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

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Authors: Mamoon Masud, Suleman Mazhar

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Indus river basin’s irrigation system in Pakistan is extremely complex, spanning over 50,000 km. Maintenance and monitoring of this demands enormous resources. This paper describes the development of a streamlined and low-cost autonomous underwater vehicle (AUV) for the monitoring of irrigation canals including water quality monitoring and water theft detection. The vehicle is a hovering-type AUV, designed mainly for monitoring irrigation canals, with fully documented design and open source code. It has a length of 17 inches, and a radius of 3.5 inches with a depth rating of 5m. Multiple sensors are present onboard the AUV for monitoring water quality parameters including pH, turbidity, total dissolved solids (TDS) and dissolved oxygen. A 9-DOF Inertial Measurement Unit (IMU), GY-85, is used, which incorporates an Accelerometer (ADXL345), a Gyroscope (ITG-3200) and a Magnetometer (HMC5883L). The readings from these sensors are fused together using directional cosine matrix (DCM) algorithm, providing the AUV with the heading angle, while a pressure sensor gives the depth of the AUV. 2 sonar-based range sensors are used for obstacle detection, enabling the vehicle to align itself with the irrigation canals edges. 4 thrusters control the vehicle’s surge, heading and heave, providing 3 DOF. The thrusters are controlled using a proportional-integral-derivative (PID) feedback control system, with heading angle and depth being the controller’s input and the thruster motor speed as the output. A flow sensor has been incorporated to monitor canal water level to detect water-theft event in the irrigation system. In addition to water theft detection, the vehicle also provides information on water quality, providing us with the ability to identify the source(s) of water contamination. Detection of such events can provide useful policy inputs for improving irrigation efficiency and reducing water contamination. The AUV being low cost, small sized and suitable for autonomous maneuvering, water level and quality monitoring in the irrigation canals, can be used for irrigation network monitoring at a large scale.

Keywords: the autonomous underwater vehicle, irrigation canal monitoring, water quality monitoring, underwater line tracking

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Authors: Hanan Algarni

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Background: Impairment of walking and balance skills has negative impact on functional independence and community participation after stroke. Gait recovery is considered a primary goal in rehabilitation by both patients and physiotherapists. Treadmill training coupled with virtual reality technology is a new emerging approach that offers patients with feedback, open and random skills practice while walking and interacting with virtual environmental scenes. Objectives: To synthesize the evidence around the effects of the VR treadmill training on gait speed and balance primarily, functional independence and community participation secondarily in stroke patients. Methods: Systematic review was conducted; search strategy included electronic data bases: MEDLINE, AMED, Cochrane, CINAHL, EMBASE, PEDro, Web of Science, and unpublished literature. Inclusion criteria: Participant: adult >18 years, stroke, ambulatory, without severe visual or cognitive impartments. Intervention: VR treadmill training alone or with physiotherapy. Comparator: any other interventions. Outcomes: gait speed, balance, function, community participation. Characteristics of included studies were extracted for analysis. Risk of bias assessment was performed using Cochrane's ROB tool. Narrative synthesis of findings was undertaken and summary of findings in each outcome was reported using GRADEpro. Results: Four studies were included involving 84 stroke participants with chronic hemiparesis. Interventions intensity ranged (6-12 sessions, 20 minutes-1 hour/session). Three studies investigated the effects on gait speed and balance. 2 studies investigated functional outcomes and one study assessed community participation. ROB assessment showed 50% unclear risk of selection bias and 25% of unclear risk of detection bias across the studies. Heterogeneity was identified in the intervention effects at post training and follow up. Outcome measures, training intensity and durations also varied across the studies, grade of evidence was low for balance, moderate for speed and function outcomes, and high for community participation. However, it is important to note that grading was done on few numbers of studies in each outcome. Conclusions: The summary of findings suggests positive and statistically significant effects (p<0.05) of VR treadmill training compared to other interventions on gait speed, dynamic balance skills, function and participation directly after training. However, the effects were not sustained at follow up in two studies (2 weeks-1 month) and other studies did not perform follow up measurements. More RCTs with larger sample sizes and higher methodological quality are required to examine the long term effects of VR treadmill effects on function independence and community participation after stroke, in order to draw conclusions and produce stronger robust evidence.

Keywords: virtual reality, treadmill, stroke, gait rehabilitation

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Authors: Geum Yeon Sim, Tyler Pigott, Julio Vasquez

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A 38-year-old obese female with no apparent past medical history presented with left knee pain. Six months ago, she sustained a left knee dislocation in a motor vehicle accident that was managed with a skin graft over the left lower extremity without any reconstructive surgery. She developed persistent pain and stiffness in her left knee that worsened with walking and stair climbing. Examination revealed healed extensive skin graft over the left lower extremity, including the left knee. Palpation showed moderate tenderness along the superior border of the patella, exquisite tenderness over MCL, and mild tenderness on the tibial tuberosity. There was normal sensation, reflexes, and strength in her lower extremities. There was limited active and passive range of motion of her left knee during flexion. There was instability noted upon the valgus stress test of the left knee. Left knee magnetic resonance imaging showed high-grade (grade 2-3) injury of the proximal superficial fibers of the MCL and diffuse thickening and signal abnormality of the cruciate ligaments, as well as edema-like subchondral marrow signal change in the anterolateral aspect of the lateral femoral condyle weight-bearing surface. There was also notable extensive scarring and edema of the skin, subcutaneous soft tissues, and musculature surrounding the knee. The patient was managed with left knee immobilization for five months, which was complicated by limited knee flexion. Physical therapy consisting of quadriceps, hamstrings, gastrocnemius stretching and strengthening, range of motion exercises, scar/soft tissue mobilization, and gait training was given with marked improvement in pain and range of motion. The patient experienced a further reduction in pain as well as an improvement in function with home exercises consisting of continued strengthening and stretching.

Keywords: ligamentous injury, trauma, rehabilitation, knee pain

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Authors: Kougioumtzis Konstantin, Rylander Pär, Karlsteen Magnus

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Ball skills as a subset of fundamental motor skills are predictors for performance in sports. Currently, most tools evaluate ball skills utilizing subjective ratings. The aim of this study was to examine the psychometric properties of a newly developed instrument to objectively measure ball handling skills (BHS-test) utilizing digital instrument. Participants were a convenience sample of 213 adolescents (age M = 17.1 years, SD =3.6; 55% females, 45% males) recruited from upper secondary schools and invited to a sports hall for the assessment. The 8-item instrument incorporated both accuracy-based ball skill tests and repetitive-performance tests with a ball. Testers counted performance manually in the four tests (one throwing and three juggling tasks). Furthermore, assessment was technologically enhanced in the other four tests utilizing a ball machine, a Kinect camera and balls with motion sensors (one balancing and three rolling tasks). 3D printing technology was used to construct equipment, while all results were administered digitally with smart phones/tablets, computers and a specially constructed application to send data to a server. The instrument was deemed reliable (α = .77) and principal component analysis was used in a random subset (53 of the participants). Furthermore, latent variable modeling was employed to confirm the structure with the remaining subset (160 of the participants). The analysis showed good factorial-related validity with one factor explaining 57.90 % of the total variance. Four loadings were larger than .80, two more exceeded .76 and the other two were .65 and .49. The one factor solution was confirmed by a first order model with one general factor and an excellent fit between model and data (χ² = 16.12, DF = 20; RMSEA = .00, CI90 .00–.05; CFI = 1.00; SRMR = .02). The loadings on the general factor ranged between .65 and .83. Our findings indicate good reliability and construct validity for the BHS-test. To develop the instrument further, more studies are needed with various age-groups, e.g. children. We suggest using the BHS-test for diagnostic or assessment purpose for talent development and sports participation interventions that focus on ball games.

Keywords: ball-handling skills, ball-handling ability, technologically-enhanced measurements, assessment

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Authors: Ladda Thiamwong, Renata Komalasari

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Falls are the leading cause of disability and hospitalization in low-income older adults. Fear of falling is present in 20% to 85 % of older adults and has been identified as an independent risk factor of fall risk, activity restriction, and loss of independence. About 12% of American older adults have subjective cognitive decline. Cognitive impairment is also an established factor of fall risk. However, it is unclear whether measures of fear of falling and subjective cognitive decline have the greatest association with fall risk in low-income older adults. The aim of this study was to evaluate the association between fear of falling, subjective cognitive decline-functional performance (SCD-FP), and fall risk using simple screening tools. In this cross-section study, we collected data from community-dwelling older adults 60 years or older in low-income settings in Central Florida, and 86 participants were included in the data analysis. Fear of falling was assessed by the Short Fall Efficacy Scale- International (Short FES-I) with seven items. Subjective cognitive decline-functional performance (SCD-FP) was assessed by a self-reported experience of worsening or more frequent confusion or memory loss in the past 12 months and its functional implications. Fall risk was evaluated by the Centers for Disease Control and Prevention (CDC)'s Stay Independent checklist with 12 items. The majority of participants were female, and more than half of the participants were African American. More than half of the participants had a higher school degree or higher, and less than 20% had no financial problems. Less than 30% of the participants perceived their general health as very good- excellent. More than half of the participants lived alone, and less than 15% lived with a partner or spouse. About 60% of the participants had hypertension, 40% had diabetes, 16% had cancer, and 50% had arthritis. About 30% of the participants had difficulty walking up ten steps without resting, more than 40% felt unsteady when walking, and 30% had been advised to use a cane or walker to get around safely. Regression analysis showed that fall risk was associated with fear of falling ( = .524, p <.001) and subjective cognitive decline-functional performance ( = .465, p =.027). The structure coefficient showed that fear of falling (rs2 = .922) was a stronger predictor of fall risk than subjective cognitive decline-functional performance (rs2= .200). Fear of falling and subjective cognitive decline-functional performance are growing public health issues, and addressing those issues is a public priority. Proactive screening for fear of falling and subjective cognitive decline-functional performance is critical in fall prevention. A combination of all three self-reported tools (Short FES-I, SCD-FP, and CDC's Stay Independent checklist) takes less than 5 minutes to complete. Primary care providers or public health professionals should consider including these tools to screen fear of falling and subjective cognitive decline-functional performance as part of fall risk assessment, especially in low-income settings. Thus, encouraging older adults and healthcare professionals to discuss fear of falling, subjective cognitive decline, and fall risk during routine medical office visits.

Keywords: falls, fall risk, fear of falling, cognition, subjective cognitive decline, low-income, older adults, community, screening, nursing, primary care

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Authors: Afifa Aslam, Muhammad Ibrahim, Abid Mahmood, Muhammad Usman Alvi, Fariha Jabeen, Umara Tabassum

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Many factors cause air pollution in Pakistan, which poses a significant threat to human health. Diesel fuel and gasoline motor vehicles, as well as industrial companies, pollute the air in Pakistan's cities. The study's goal is to determine the level of air pollution in a Pakistani industrial city and to establish risk levels for the health of the population. We measured the intensity of air pollution by chemical characterization and examination of air samples collected at stationary remark sites. The PM10 levels observed at all sampling sites, including residential, commercial, high-traffic, and industrial areas were well above the limits imposed by Pakistan EPA, the United States EPA, and WHO. We assessed the health risk via chemical factors using a methodology approved for risk assessment. All Igeo index values greater than one were considered moderately contaminated or moderately to severely contaminated. Heavy metals have a substantial risk of acute adverse effects. In Faisalabad, Pakistan, there was an enormously high risk of chronic effects produced by a heavy metal acquaintance. Concerning specified toxic metals, intolerable levels of carcinogenic risks have been determined for the entire population. As a result, in most of the investigated areas of Faisalabad, the indices and hazard quotients for chronic and acute exposure exceeded the permissible level of 1.0. In the current study, re-suspended roadside mineral dust, anthropogenic exhaust emissions from traffic and industry, and industrial dust were identified as major emission sources of elemental particulate contents. Because of the unacceptable levels of risk in the research area, it is strongly suggested that a comprehensive study of the population's health status as a result of air pollution should be conducted for policies to be developed against these risks.

Keywords: elemental composition, particulate pollution, Igeo index, health risk assessment, hazard quotient

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Authors: V. Argyropoulos, M. Nikolaraizi, K. Tanou

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There is little available information concerning the cognitive and communicative abilities of the people who are deaf-blind. This mainly stems from the general inadequacy of existing assessment instruments employed with deafblind individuals. Although considerable variability exists with regard to cognitive capacities of the deaf-blind, careful examination of the literature reveals that the majority of these persons suffer from significant deficits in cognitive and adaptive functioning. The few reports available primarily are case studies, narrative program descriptions, or position papers by workers in the field. Without the objective verification afforded by controlled research, specialists in psychology, education, and other rehabilitation services must rely on personal speculations or biases to guide their decisions in the planning, implementation, and evaluation of services to deaf-blind children and adults. This paper highlights the framework and discusses the results of an action research network. The aim of this study was twofold: a) to describe and analyse the different ways in which a student with deafblindness approached a number of developmental issues such as novel tasks, exploration and manipulation of objects, reactions to social stimuli, motor coordination, and quality of play and b) to map the appropriate functional approach for the specific student that could be used to develop strategies for classroom participation and socialization. The persons involved in this collaborative action research scheme were general teachers, a school counsellor, academic staff and student teachers. Rating scales and checklists were used to gather information in natural activities and settings, and additional data were also obtained through interviews with the educators of the student. The findings of this case study indicated that there is a great need to focus on the development of effective intervention strategies. The results showed that the identification of positive reinforcers for this population might represent an important and challenging aspect of behaviour programmes. Finally, the findings suggest that additional empirical work is needed to increase attention to methodological and social validity issues.

Keywords: action research, cognitive and communicative abilities, deafblindness, effective strategies

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Authors: Nurten Çelik

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Under the new developments in science, medicine, sociology, psychology and literary theories, body studies has gained huge importance and the body has become a debatable issue. There has emerged, among sociologists and literary theorists, an overwhelming consensus that body is socially, politically and culturally perceived and constructed and thus, the position of an individual in the society is determined in accordance with his/her body image. In this regard, the most complicated point is the theoretical views propounded upon disability studies, where the disabled body is considered to be a site upon which social and political restrictions as well as repressions are inscribed. There has been the widely-accepted view that no matter what kind of disability it is, those with physical, mental or learning impairments face varied social, political and environmental obstacles that prevent them from being an active citizen, worker, lover and even a family member. In parallel with these approaches, the matter of the sufferings of disabled individuals attains its place in cinema and literature as well as in theatre studies under the category of disability theatre. One of the prominent plays that deal with physical disability came from the contemporary British playwright Nina Raine. In her awarded play Tribes, which premiered at the Royal Court Theatre in 2010, Raine develops the social strata where her deaf protagonist, Billy, caught up between two tribes – namely his family and his lover Slyvia, a member of the deaf community– experiences personal and social hardships due to his hearing impairment. In the play, intransigent and self-opinionated family members foster no sense of empathy towards Billy, there are noisy talking and shouting, but no communication, love, compassion or mutual understanding, and language becomes just a tool for the expression of rage and oppression. In the disordered atmosphere of the family life, Billy experiences isolation and loneliness. Billy’s hopes for success and love are destroyed when Slyvia, troubled between hearing and deafness, rejects him because she does not utterly grasp what Billy is experiencing. Drawing upon the hardships, Billy undergoes in his relationships with his family and his girlfriend, Tribes problematizes the concept of deafness and explores to what extent a deaf person can find a place in the hearing world. Setting ‘the disabled’ bodies against ‘the abled’ bodies in a family, a microcosm of the society where bodies are socially shaped and constructed, Tribes dramatizes how the disabled bodies are disenfranchised, stigmatised, marginalized and othered on the grounds that they are socially misfit. Tribes, with a specific focus on the dysfunctional family, shows that the lack of communication and empathy numbs the characters to the feelings of each other and thereby, they become more disabled than Billy. In conclusion, this paper, with the reference to the embodiment of disability and social theories, aims to explore how disabled bodies are socially marked and segregated from family and society.

Keywords: body, deafness, disability, disability theatre, Nina Raine, tribes

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Authors: Mami Miyasaka, Kaichi Yanaoka

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Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity; symptoms often manifest during childhood. In children with ADHD, the development of inhibitory processes is impaired. Inhibitory control allows people to avoid processing unnecessary stimuli and to behave appropriately in various situations; thus, people with ADHD require interventions to improve inhibitory control. Positive or negative reinforcements (i.e., reward or punishment) help improve the performance of children with such difficulties. However, in order to optimize impact, reward and punishment must be presented immediately following the relevant behavior. In regular elementary school classrooms, such supports are uncommon; hence, an alternative practical intervention method is required. One potential intervention involves setting goals to keep children motivated to perform tasks. This study examined whether goal setting improved inhibitory performances, especially for children with severe ADHD-related symptoms. We also focused on giving feedback on children's task performances. We expected that giving children feedback would help them set reasonable goals and monitor their performance. Feedback can be especially effective for children with severe ADHD-related symptoms because they have difficulty monitoring their own performance, perceiving their errors, and correcting their behavior. Our prediction was that goal setting by itself would be effective for children with mild ADHD-related symptoms, and goal setting based on feedback would be effective for children with severe ADHD-related symptoms. Japanese elementary school children and their parents were the sample for this study. Children performed two kinds of go/no-go tasks, and parents completed a checklist about their children's ADHD symptoms, the ADHD Rating Scale-IV, and the Conners 3rd edition. The go/no-go task is a cognitive task to measure inhibitory performance. Children were asked to press a key on the keyboard when a particular symbol appeared on the screen (go stimulus) and to refrain from doing so when another symbol was displayed (no-go stimulus). Errors obtained in response to a no-go stimulus indicated inhibitory impairment. To examine the effect of goal-setting on inhibitory control, 37 children (Mage = 9.49 ± 0.51) were required to set a performance goal, and 34 children (Mage = 9.44 ± 0.50) were not. Further, to manipulate the presence of feedback, in one go/no-go task, no information about children’s scores was provided; however, scores were revealed for the other type of go/no-go tasks. The results revealed a significant interaction between goal setting and feedback. However, three-way interaction between ADHD-related inattention, feedback, and goal setting was not significant. These results indicated that goal setting was effective for improving the performance of the go/no-go task only with feedback, regardless of ADHD severity. Furthermore, we found an interaction between ADHD-related inattention and feedback, indicating that informing inattentive children of their scores made them unexpectedly more impulsive. Taken together, giving feedback was, unexpectedly, too demanding for children with severe ADHD-related symptoms, but the combination of goal setting with feedback was effective for improving their inhibitory control. We discuss effective interventions for children with ADHD from the perspective of goal setting and feedback. This work was supported by the 14th Hakuho Research Grant for Child Education of the Hakuho Foundation.

Keywords: attention deficit disorder with hyperactivity, feedback, goal-setting, go/no-go task, inhibitory control

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Authors: Preetham Shankapal, Jill King, Kori Murray, Corby Martin, Paula Giselman, Jason Hicks, Owen Carmicheal

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Activation of reward and satiety networks in the brain while processing palatable food cues, as well as functional connectivity during rest has been studied using functional Magnetic Resonance Imaging of the brain in various obesity phenotypes. However, functional connectivity within the reward and satiety network during food cue processing is understudied. 14 obese individuals underwent two fMRI scans during viewing of Macronutrient Picture System images. Each scan included two blocks of images of High Sugar/High Fat (HSHF), High Carbohydrate/High Fat (HCHF), Low Sugar/Low Fat (LSLF) and also non-food images. Seed voxels within seven food reward relevant ROIs: Insula, putamen and cingulate, precentral, parahippocampal, medial frontal and superior temporal gyri were isolated based on a prior meta-analysis. Beta series correlation for task-related functional connectivity between these seed voxels and the rest of the brain was computed. Voxel-level differences in functional connectivity were calculated between: first and the second scan; individuals who saw novel (N=7) vs. Repeated (N=7) images in the second scan; and between the HC/HF, HSHF blocks vs LSLF and non-food blocks. Computations and analysis showed that during food image viewing, reward network ROIs showed significant functional connectivity with each other and with other regions responsible for attentional and motor control, including inferior parietal lobe and precentral gyrus. These functional connectivity values were heightened among individuals who viewed novel HS/HF images in the second scan. In the second scan session, functional connectivity was reduced within the reward network but increased within attention, memory and recognition regions, suggesting habituation to reward properties and increased recollection of previously viewed images. In conclusion it can be inferred that Functional Connectivity within reward network and between reward and other brain regions, varies by important experimental conditions during food photography viewing, including habituation to shown foods.

Keywords: fMRI, functional connectivity, task-based, beta series correlation

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Authors: Mostafa Sarabzadeh, Masoumeh Helalizadeh, Seyyed Mahmoud Hejazi

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Multiple Sclerosis is considered as diseases related to central nerve system, the chronic and progressive disease impress on sensory and motor function of people. Due to equilibrium problems in this patients that related to disorder of nerve conduction transmission from central nerve system to organs and the nature of elastic bands that can make changes in neuromuscular junctions and momentary actions, the aim of this research is evaluate elastic training effect by reactionary ropes on nerve conduction velocity (in lower and upper limb) and functional balance in female patients with Multiple Sclerosis. The study was a semi-experimental study that was performed based on pre and post-test method, The statistical community consisted of 16 women with MS in the age mean 25-40yrs, at low and intermediate levels of disease EDSS 1-4 (Expanded Disability Status Scale) that were divided randomly into elastic and control groups, so the training program of experimental group lasted six weeks, 3 sessions per week of elastic exercises with reactionary ropes. Electroneurography parameters (nerve conduction velocity- latency) of Upper and lower nerves (Median, Tibial, Sural, Peroneal) along with balance were investigated respectively by the Electroneurography system (ENG) and Timed up and go (TUG) functional test two times in before and after the training period. After that, To analyze the data were used of Dependent and Independent T-test (with sig level p<0.05). The results showed significant increase in nerve conduction velocity of Sural (p=0.001), Peroneal (p=0.01), Median (p=0.03) except Tibial and also development Latency Time of Tibial (p= 0), Peroneal (p=0), Median (p=0) except Sural. The TUG test showed significant decreases in execution time too (p=0.001). Generally, based on what the obtained data can indicate, modern training with elastic bands can contribute to enhanced nerve conduction velocity and balance in neurosis patients (MS) so lead to reduce problems, promotion of mobility and finally more life expectancy in these patients.

Keywords: balance, elastic bands, multiple sclerosis, nerve conduction, velocity

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Authors: Fen-Ling Kuo, Hsin-Chieh Lee, Han-Yun Hsiao, Jui-Chi Lin

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Background: Children with cerebral palsy (CP) usually suffered from mild to maximum upper limb dysfunction such as having difficulty in reaching and picking up objects, which profoundly affects their participation in activities of daily living (ADLs). Robot-assisted rehabilitation provides intensive physical training in improving sensorimotor function of the hand. Many researchers have extensively studied the effects of robot-assisted therapy (RT) for the paretic upper limb in patients with stroke in recent years. However, few studies have examined the effect of RT on hand function in children with CP. The purpose of this study is to investigate the effectiveness of Gloreha Sinfonia, a robotic device with a dynamic arm support system mainly focus on distal upper-limb training, on improvements of hand function and ADLs in children with CP. Methods: Seven children with moderate CP were recruited in this case series study. RT using Gloreha Sinfonia was performed 2 sessions per week, 60 min per session for 6 consecutive weeks, with 12 times in total. Outcome measures included the Fugl-Meyer Assessment-upper extremity (FMA-UE), the Box and Block Test, the electromyography activity of the extensor digitorum communis muscle (EDC) and brachioradialis (BR), a grip dynamometer for motor evaluation, and the ABILHAND-Kids for measuring manual ability to manage daily activities, were performed at baseline, after 12 sessions (end of treatment) and at the 1-month follow-up. Results: After 6 weeks of robot-assisted treatment of hand function, there were significant increases in FMA-UE shoulder/elbow scores (p=0.002), FMA-UE wrist/hand scores (p=0.002), and FMA-UE total scores (p=0.002). There were also significant improvements in the BR mean value (p = 0.015) and electrical agonist-antagonist muscle ratio (p=0.041) in grasping a 1-inch cube task. These gains were maintained for a month after the end of the intervention. Conclusion: RT using Gloreha Sinfonia for hand function training may contribute toward the improvement of upper extremity function and efficacy in recruiting BR muscle in children with CP. The results were maintained at one month after intervention.

Keywords: activities of daily living, cerebral palsy, hand function, robotic rehabilitation

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Authors: Heba Kamal Mohamed

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Introduction: Tramadol is a weak -opioid receptor agonist with an analgesic effect because of the inhibition of uptake of norepinephrine and serotonin. Nowadays, tramadol hydrochloride is frequently used as a pain reliever. Tramadol is recommended for the management of acute and chronic pain of moderate to severe intensity associated with a variety of diseases or problems, including osteoarthritis, diabetic neuropathy, neuropathic pain, and even perioperative pain in human patients. In obstetrics and gynecology, tramadol is used extensively to treat postoperative pain. Aim of the study: This study was undertaken to investigate the histological (light and electron microscopic) and immunohistochemical effects of long term tramadol treatment on the ovary of adult rats and the possible recovery after tramadol withdrawal. Design: Experimental study. Materials and methods: Thirty adult female albino rats were used in this study. They were classified into three main groups (10 rats each). Group I served as the control group. Group II, rats were subcutaneously injected with tramadol 40 mg/kg three times per week for 8 weeks. Group III, rats were subcutaneously injected with tramadol 40 mg/kg three times per week for 8 weeks then were kept for another 8 weeks without treatment for recovery. At the end of the experiment rats were sacrificed and bilateral oophorectomy was carried out; the ovaries were processed for histological study (light and electron microscopic) and immunohistochemical reaction for caspase-3 (apoptotic protein). Results: Examination of the ovary of tramadol-treated rats (group II) revealed many atretic ovarian follicles, some follicles showed detachment of the oocyte from surrounding granulosa cells and others showed loss of the oocyte. Many follicles revealed degenerated vacuolated oocytes and vacuolated theca folliculi cells. Granulosa cells appeared shrunken, disrupted and loosely attached with vacuolated cytoplasm and pyknotic nuclei. Some follicles showed separation of granulosa cells from the theca folliculi layer. The ultrastructural study revealed the presence of granulosa cells with electron dense indented nuclei, damaged mitochondria and granular vacuolated cytoplasm. Other cells showed accumulation of large amount of lipid droplets in their cytoplasm. Some follicles revealed rarifaction of the cytoplasm of oocytes and absent zona pellucida. Moreover, apoptotic changes were detected by immunohistochemical staining in the form of increased staining intensity to caspase-3 (apoptotic protein). With Masson's Trichrome stain, there was an increased collagen fibre deposition in the ovarian cortical stroma. The wall of blood vessels appeared thickened. In the withdrawal group (group III), there was a little improvement in the histological and immunohistochemical changes. Conclusion: Tramadol had serious deleterious effects on ovarian structure. Thus, it should be used with caution, especially when a long term treatment is indicated. Withdrawal of tramadol led to a little improvement in the structural impairment of the ovary.

Keywords: tramadol, ovary, withdrawal, rats

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Authors: Mariam A. Abu-Alim

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The purpose of this study was to validate muscle activation amplitudes of two field base dynamic balance tests that are used as strengthen and motor control exercises too in the activation of selected hip and knee stabilizer muscles. Methods: Eighteen college-age females students (21±2 years; 65.6± 8.7 kg; 169.7±8.1 cm) who participated at least for 30 minutes in physical activity most days of the week volunteered. The wireless BIOPAC (MP150, BIOPAC System. Inc, California, USA) surface electromyography system was used to validate the activation of the Gluteus Medius and the Adductor Magnus of hip stabilizer muscles; and the Hamstrings, Quadriceps, and the Gastrocnemius of the knee stabilizer muscles. Surface electrodes (EL 503, BIOPAC, System. Inc) connected to dual wireless EMG BioNormadix Transmitters were place on selected muscles of participants dominate side. Manual muscle testing was performed to obtain the maximal voluntary isometric contraction (MVIC) in which all collected muscle activity data during the three reaching direction: anterior, posteromedial, posterolateral of the Star Excursion Balance Test (SEBT) and the Y-balance Test (YBT) data could be normalized. All participants performed three trials for each reaching direction of the SEBT and the YBT. The domanial leg trial for each participant was selected for analysis which was also the standing leg. Results: the selected hip stabilizer muscles (Gluteus Medius, Adductor Magnus) were both greater than 100%MVIC during the performance of the SEBT and in all three directions. Whereas, selected knee stabilizer muscles had greater activation 0f 100% MVIC and were significantly more activated during the performance of the YBT test in all three reaching directions. The results showed that the posterolateral and the postmedial reaching directions for both dynamic balance tests had greater activation levels and greater than 200%MVIC for all tested muscles expect of the hamstrings. Conclusion: the results of this study showed that the SEBT and the YBT had validated high levels of muscular activity for the hip and the knee stabilizer muscles; which can be used to represent the improvement, strength, control and the decreasing in the injury levels. Since these selected hip and knee stabilizer muscles, represent 35% of all athletic injuries depending on the type of sport.

Keywords: dynamic balance tests, electromyography, hip stabilizer muscles, nee stabilizer muscles

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Authors: Paris Binos

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The present work investigates developmental aspects of the duration of isolated vowels in infants with normal hearing compared to those who received cochlear implants (CIs) before two years of age. Infants with normal hearing produced shorter vowel duration since this find related with more mature production abilities. First isolated vowels are transparent during the protophonic stage as evidence of an increased motor and linguistic control. Vowel duration is a crucial factor for the transition of prelexical speech to normal adult speech. Despite current knowledge of data for infants with normal hearing more research is needed to unravel productions skills in early implanted children. Thus, isolated vowel productions by two congenitally hearing-impaired Greek infants (implantation ages 1:4-1:11; post-implant ages 0:6-1:3) were recorded and sampled for six months after implantation with a Nucleus-24. The results compared with the productions of three normal hearing infants (chronological ages 0:8-1:1). Vegetative data and vocalizations masked by external noise or sounds were excluded. Participants had no other disabilities and had unknown deafness etiology. Prior to implantation the infants had an average unaided hearing loss of 95-110 dB HL while the post-implantation PTA decreased to 10-38 dB HL. The current research offers a methodology for the processing of the prelinguistic productions based on a combination of acoustical and auditory analyses. Based on the current methodological framework, duration measured through spectrograms based on wideband analysis, from the voicing onset to the end of the vowel. The end marked by two co-occurring events: 1) The onset of aperiodicity with a rapid change in amplitude in the waveform and 2) a loss in formant’s energy. Cut-off levels of significance were set at 0.05 for all tests. Bonferroni post hoc tests indicated that difference was significant between the mean duration of vowels of infants wearing CIs and their normal hearing peers. Thus, the mean vowel duration of CIs measured longer compared to the normal hearing peers (0.000). The current longitudinal findings contribute to the existing data for the performance of children wearing CIs at a very young age and enrich also the data of the Greek language. The above described weakness for CI’s performance is a challenge for future work in speech processing and CI’s processing strategies.

Keywords: cochlear implant, duration, spectrogram, vowel

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Authors: Stephen Bahooshy

Abstract:

Co-producing services with the people that access them is considered best practice in the United Kingdom, with the Care Act 2014 arguing that people who access services and their carers should be involved in the design, commissioning and delivery of services. Co-production is a way of working with the community, breaking down barriers of access and providing meaningful opportunity for people to engage. Unfortunately, owing to a number of reported factors such as time constraints, practitioner experience and departmental budget restraints, this process is not always followed. In 2019, in a south London borough, d/Deaf people who access services were engaged in the design, commissioning and delivery of an information and advice service that would support their community to access local government services. To do this, sensory impairment social workers and commissioners collaborated to host a series of engagement events with the d/Deaf community. Interpreters were used to enable communication between the commissioners and d/Deaf participants. Initially, the community’s opinions, ideas and requirements were noted. This was then summarized and fed back to the community to ensure accuracy. Subsequently, a service specification was developed which included performance metrics, inclusive of qualitative and quantitative indicators, such as ‘I statements’, whereby participants respond on an adapted Likert scale how much they agree or disagree with a particular statement in relation to their experience of the service. The service specification was reviewed by a smaller group of d/Deaf residents and social workers, to ensure that it met the community’s requirements. The service was then tendered using the local authority’s e-tender process. Bids were evaluated and scored in two parts; part one was by commissioners and social workers and part two was a presentation by prospective providers to an evaluation panel formed of four d/Deaf residents. The internal evaluation panel formed 75% of the overall score, whilst the d/Deaf resident evaluation panel formed 25% of the overall tender score. Co-producing the evaluation panel with social workers and the d/Deaf community meant that commissioners were able to meet the requirements of this community by developing evaluation questions and tools that were easily understood and use by this community. For example, the wording of questions were reviewed and the scoring mechanism consisted of three faces to reflect the d/Deaf residents’ scores instead of traditional numbering. These faces were a happy face, a neutral face and a sad face. By making simple changes to the commissioning and tender evaluation process, d/Deaf people were able to have meaningful involvement in the design and commissioning process for a service that would benefit their community. Co-produced performance metrics means that it is incumbent on the successful provider to continue to engage with people accessing the service and ensure that the feedback is utilized. d/Deaf residents were grateful to have been involved in this process as this was not an opportunity that they had previously been afforded. In recognition of their time, each d/Deaf resident evaluator received a £40 gift voucher, bringing the total cost of this co-production to £160.

Keywords: co-production, community engagement, deaf and hearing impaired, service design

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