Search results for: nearest neighbor search
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2197

Search results for: nearest neighbor search

937 A Machine Learning Approach for Assessment of Tremor: A Neurological Movement Disorder

Authors: Rajesh Ranjan, Marimuthu Palaniswami, A. A. Hashmi

Abstract:

With the changing lifestyle and environment around us, the prevalence of the critical and incurable disease has proliferated. One such condition is the neurological disorder which is rampant among the old age population and is increasing at an unstoppable rate. Most of the neurological disorder patients suffer from some movement disorder affecting the movement of their body parts. Tremor is the most common movement disorder which is prevalent in such patients that infect the upper or lower limbs or both extremities. The tremor symptoms are commonly visible in Parkinson’s disease patient, and it can also be a pure tremor (essential tremor). The patients suffering from tremor face enormous trouble in performing the daily activity, and they always need a caretaker for assistance. In the clinics, the assessment of tremor is done through a manual clinical rating task such as Unified Parkinson’s disease rating scale which is time taking and cumbersome. Neurologists have also affirmed a challenge in differentiating a Parkinsonian tremor with the pure tremor which is essential in providing an accurate diagnosis. Therefore, there is a need to develop a monitoring and assistive tool for the tremor patient that keep on checking their health condition by coordinating them with the clinicians and caretakers for early diagnosis and assistance in performing the daily activity. In our research, we focus on developing a system for automatic classification of tremor which can accurately differentiate the pure tremor from the Parkinsonian tremor using a wearable accelerometer-based device, so that adequate diagnosis can be provided to the correct patient. In this research, a study was conducted in the neuro-clinic to assess the upper wrist movement of the patient suffering from Pure (Essential) tremor and Parkinsonian tremor using a wearable accelerometer-based device. Four tasks were designed in accordance with Unified Parkinson’s disease motor rating scale which is used to assess the rest, postural, intentional and action tremor in such patient. Various features such as time-frequency domain, wavelet-based and fast-Fourier transform based cross-correlation were extracted from the tri-axial signal which was used as input feature vector space for the different supervised and unsupervised learning tools for quantification of severity of tremor. A minimum covariance maximum correlation energy comparison index was also developed which was used as the input feature for various classification tools for distinguishing the PT and ET tremor types. An automatic system for efficient classification of tremor was developed using feature extraction methods, and superior performance was achieved using K-nearest neighbors and Support Vector Machine classifiers respectively.

Keywords: machine learning approach for neurological disorder assessment, automatic classification of tremor types, feature extraction method for tremor classification, neurological movement disorder, parkinsonian tremor, essential tremor

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936 The Effectiveness of Non-surgical Treatment for Androgenetic Alopecia in Men: A Systematic Review and Meta-Analysis

Authors: Monica Trifitriana, Rido Mulawarman

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Introduction: Androgenetic alopecia (AGA) is a genetically predetermined disorder due to an excessive response to dihydrotestosterone (DHT). Currently, non-surgical treatment of androgenetic alopecia is more in demand by the patient. There are many non-surgical treatments, ranging from topical treatments oral medications, and procedure treatments. Objective: We aim to assess the latest evidence of the efficacy of non-surgical treatments of androgenetic alopecia in men in comparison to placebo for improving hair density, thickness, and growth. Method: We performed a comprehensive search on topics that assess non-surgical treatments of androgenetic alopecia in men from inception up until November 2021. Result: There were 24 studies out of a total of 2438 patients divided into five non-surgical treatment groups to assess the effectiveness of hair growth, namely: minoxidil 2% (MD: 8.11 hairs/cm²), minoxidil 5% (MD: 12.02 hairs/cm²), low-level laser light therapy/LLLT (MD: 12.35 hairs/cm²), finasteride 1mg (MD: 20.43 hairs/cm²), and Platelete-Rich Plasma/PRP with microneedling (MD: 26.33 hairs/cm²). All treatments had significant results for increasing hair growth, particularly in cases of androgenetic alopecia in men (P<0.00001). Conclusion: From the results, it was found that the five non-surgical treatment groups proved to be effective and significant for hair growth, particularly in cases of androgenetic alopecia in men. In order of the best non-surgical treatment for hair growth is starting from PRP with microneedling, Finasteride 1mg, LLLT, minoxidil 5%, to minoxidil 2%.

Keywords: androgenetic alopecia, non-surgical, men, meta-analysis, systematic review

Procedia PDF Downloads 143
935 Numerical Analysis of Crack's Effects in a Dissimilar Welded Joint

Authors: Daniel N. L. Alves, Marcelo C. Rodrigues, Jose G. de Almeida

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The search for structural efficiency in mechanical systems has been strongly exerted with aim of economic optimization and structural safety. As soon, to understand the response of materials when submitted to adverse conditions is essential to design a safety project. This work investigates the presence of cracks in dissimilar welded joints (DWJ). Its fracture toughness responses depend upon the heterogeneity present in these joints. Thus, this work aim analyzing the behavior of the crack tip zone located in a buttery dissimilar welded joint (ASTM A-36, Inconel, and AISI 8630 M) used in the union of pipes present in the offshore oil production lines. The crack was placed 1 mm from fusion line (FL) Inconel-AISI 8630 M toward the AISI 8630 M. Finite Element Method (FEM) was used to analyze stress and strain fields generated during the loading imposed on the specimen. It was possible observing critical stress area by the numerical tool as well as a preferential plastic flow was also observed in the sample of dissimilar welded joint, which can be considered a harbinger of the crack growth path. The results obtained through numerical analysis showed a convergent behavior in relation to the plastic flow, qualitatively and quantitatively, in agreement with previous performed.

Keywords: crack, dissimilar welded joint, numerical analysis, strain field, the stress field

Procedia PDF Downloads 157
934 Does One Size Fit All: Immigrant Youths, Bullying and Peer-Aggression

Authors: Shila Khayambashi

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For the past few decades, Western researchers studied different youth issues, such as bullying, peer-aggression, depression, self-harm, and suicide, in a formulated and standardized manner. These researchers have grounded their studies upon a series of introduced characteristics and traits, which pragmatically defined the action of the individuals involved in these activities (Olweus, 1994). The phenomena of bullying and peer-aggression have touched the lives of many immigrant youths, as well. However, in the case of these immigrant young adults, the Police investigated, and later dismissed, the victims’ involvement in drugs and gangs’ activities, instead of questioning the possibility of the peer-aggression. This paper argues that neither government officials nor school personnel has ever investigated any cyber-documentation which would clarify these youth’s untimely deaths or search for any indication of peer-aggression at school. Through my ongoing research, I will problematize the Eurocentric definition of bullying and its limitations. I question the assumed universality of these definitions’ characteristics and their lack of minority representation. This research questions explicitly the positionality of the displaced youth within the promised multiculturality of Canada. I will ask: Does one size fit all, considering the bio-psycho-socio-economic differences between the Eastern and the Western worlds? More importantly, how does the epidemy of the communicative devices, like smartphones, and communicative apps, like Twitter and Snapchats, facilitate or hinder peer-aggression for the displaced youths?

Keywords: Bullying , Immigrant youths, Peer aggression, Minority population

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933 The Display of Age-Period/Age-Cohort Mortality Trends Using 1-Year Intervals Reveals Period and Cohort Effects Coincident with Major Influenza A Events

Authors: Maria Ines Azambuja

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Graphic displays of Age-Period-Cohort (APC) mortality trends generally uses data aggregated within 5 or 10-year intervals. Technology allows one to increase the amount of processed data. Displaying occurrences by 1-year intervals is a logic first step in the direction of attaining higher quality landscapes of variations in temporal occurrences. Method: 1) Comparison of UK mortality trends plotted by 10-, 5- and 1-year intervals; 2) Comparison of UK and US mortality trends (period X age and cohort X age) displayed by 1-year intervals. Source: Mortality data (period, 1x1, males, 1933-1912) uploaded from the Human Mortality Database to Excel files, where Period X Age and Cohort X Age graphics were produced. The choice of transforming age-specific trends from calendar to birth-cohort years (cohort = period – age) (instead of using cohort 1x1 data available at the HMD resource) was taken to facilitate the comparison of age-specific trends when looking across calendar-years and birth-cohorts. Yearly live births, males, 1933 to 1912 (UK) were uploaded from the HFD. Influenza references are from the literature. Results: 1) The use of 1-year intervals unveiled previously unsuspected period, cohort and interacting period x cohort effects upon all-causes mortality. 2) The UK and US figures showed variations associated with particular calendar years (1936, 1940, 1951, 1957-68, 72) and, most surprisingly, with particular birth-cohorts (1889-90 in the US, and 1900, 1918-19, 1940-41 and 1946-47, in both countries. Also, the figures showed ups and downs in age-specific trends initiated at particular birth-cohorts (1900, 1918-19 and 1947-48) or a particular calendar-year (1968, 1972, 1977-78 in the US), variations at times restricted to just a range of ages (cohort x period interacting effects). Importantly, most of the identified “scars” (period and cohort) correlates with the record of occurrences of Influenza A epidemics since the late 19th Century. Conclusions: The use of 1-year intervals to describe APC mortality trends both increases the amount of information available, thus enhancing the opportunities for patterns’ recognition, and increases our capability of interpreting those patterns by describing trends across smaller intervals of time (period or birth-cohort). The US and the UK mortality landscapes share many but not all 'scars' and distortions suggested here to be associated with influenza epidemics. Different size-effects of wars are evident, both in mortality and in fertility. But it would also be realistic to suppose that the preponderant influenza A viruses circulating in UK and US at the beginning of the 20th Century might be different and the difference to have intergenerational long-term consequences. Compared with the live births trend (UK data), birth-cohort scars clearly depend on birth-cohort sizes relatives to neighbor ones, which, if causally associated with influenza, would result from influenza-related fetal outcomes/selection. Fetal selection could introduce continuing modifications on population patterns of immune-inflammatory phenotypes that might give rise to 'epidemic constitutions' favoring the occurrence of particular diseases. Comparative analysis of mortality landscapes may help us to straight our record of past circulation of Influenza viruses and document associations between influenza recycling and fertility changes.

Keywords: age-period-cohort trends, epidemic constitution, fertility, influenza, mortality

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932 Optimization of Pregelatinized Taro Boloso-I Starch as a Direct Compression Tablet Excipient

Authors: Tamrat Balcha Balla

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Background: Tablets are still the most preferred means of drug delivery. The search for new and improved direct compression tablet excipients is an area of research focus. Taro Boloso-I is a variety of Colocasia esculenta (L. Schott) yielding 67% more than the other varieties (Godare) in Ethiopia. This study aimed to enhance the flowability while keeping the compressibility and compactibility of the pregelatinized Taro Boloso-I starch. Methods: Central composite design was used for the optimization of two factors which were the temperature and duration of pregelatinization against 5 responses. The responses were angle of repose, Hausner ratio, Kawakita compressibility index, mean yield pressure and tablet breaking force. Results and Discussions: An increase in both temperature and time resulted in decrease in the angle of repose. The increase in temperature was shown to decrease the Hausner ratio and to decrease the Kawakita compressibility index. The mean yield pressure was observed to increase with increasing levels of both temperature and time. The pregelatinized (optimized) Taro Boloso-I starch could show desired flow property and compressibility. Conclusions: Pregelatinized Taro Boloso - I starch could be regarded as a potential direct compression excipient in terms of flowability, compressibility and compactibility.

Keywords: starch, compression, pregelatinization, Taro Boloso-I

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931 Second Order Optimality Conditions in Nonsmooth Analysis on Riemannian Manifolds

Authors: Seyedehsomayeh Hosseini

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Much attention has been paid over centuries to understanding and solving the problem of minimization of functions. Compared to linear programming and nonlinear unconstrained optimization problems, nonlinear constrained optimization problems are much more difficult. Since the procedure of finding an optimizer is a search based on the local information of the constraints and the objective function, it is very important to develop techniques using geometric properties of the constraints and the objective function. In fact, differential geometry provides a powerful tool to characterize and analyze these geometric properties. Thus, there is clearly a link between the techniques of optimization on manifolds and standard constrained optimization approaches. Furthermore, there are manifolds that are not defined as constrained sets in R^n an important example is the Grassmann manifolds. Hence, to solve optimization problems on these spaces, intrinsic methods are used. In a nondifferentiable problem, the gradient information of the objective function generally cannot be used to determine the direction in which the function is decreasing. Therefore, techniques of nonsmooth analysis are needed to deal with such a problem. As a manifold, in general, does not have a linear structure, the usual techniques, which are often used in nonsmooth analysis on linear spaces, cannot be applied and new techniques need to be developed. This paper presents necessary and sufficient conditions for a strict local minimum of extended real-valued, nonsmooth functions defined on Riemannian manifolds.

Keywords: Riemannian manifolds, nonsmooth optimization, lower semicontinuous functions, subdifferential

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930 Multi-Criteria Test Case Selection Using Ant Colony Optimization

Authors: Niranjana Devi N.

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Test case selection is to select the subset of only the fit test cases and remove the unfit, ambiguous, redundant, unnecessary test cases which in turn improve the quality and reduce the cost of software testing. Test cases optimization is the problem of finding the best subset of test cases from a pool of the test cases to be audited. It will meet all the objectives of testing concurrently. But most of the research have evaluated the fitness of test cases only on single parameter fault detecting capability and optimize the test cases using a single objective. In the proposed approach, nine parameters are considered for test case selection and the best subset of parameters for test case selection is obtained using Interval Type-2 Fuzzy Rough Set. Test case selection is done in two stages. The first stage is the fuzzy entropy-based filtration technique, used for estimating and reducing the ambiguity in test case fitness evaluation and selection. The second stage is the ant colony optimization-based wrapper technique with a forward search strategy, employed to select test cases from the reduced test suite of the first stage. The results are evaluated using the Coverage parameters, Precision, Recall, F-Measure, APSC, APDC, and SSR. The experimental evaluation demonstrates that by this approach considerable computational effort can be avoided.

Keywords: ant colony optimization, fuzzy entropy, interval type-2 fuzzy rough set, test case selection

Procedia PDF Downloads 649
929 Extraction and Antibacterial Studies of Oil from Three Mango Kernel Obtained from Makurdi, Nigeria

Authors: K. Asemave, D. O. Abakpa, T. T. Ligom

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The ability of bacteria to develop resistance to many antibiotics cannot be undermined, given the multifaceted health challenges in the present times. For this reason, a lot of attention is on botanicals and their products in search of new antibacterial agents. On the other hand, mango kernel oils (MKO) can be heavily valorized by taking advantage of the myriads bioactive phytochemicals it contains. Herein, we validated the use of MKO as bioactive agent against bacteria. The MKOs for the study were extracted by soxhlet means with ethanol and hexane for 4 h from 3 different mango kernels, namely; 'local' (sample A), 'julie' (sample B), and 'john' (sample C). Prior to the extraction, ground fine particles of the kernels were obtained from the seed kernels dried in oven at 100 °C for 8 h. Hexane gave higher yield of the oils than ethanol. It was also qualitatively confirmed that the mango kernel oils contain some phytochemicals such as phenol, quinone, saponin, and terpenoid. The results of the antibacterial activities of the MKO against both gram positive (Staphylococcus aureus) and gram negative (Pseudomonas aeruginosa) at different concentrations showed that the oils extracted with ethanol gave better antibacterial properties than those of the hexane. More so, the bioactivities were best with the local mango kernel oil. Indeed this work has completely validated the previous claim that MKOs are effective antibacterial agents. Thus, these oils (especially the ethanol-derived ones) can be used as bacteriostatic and antibacterial agents in say food, cosmetics, and allied industries.

Keywords: bacteria, mango, kernel, oil, phytochemicals

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928 Pedagogical Content Knowledge for Nature of Science: In Search for a Meaning for the Construct

Authors: Elaosi Vhurumuku

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During the past twenty years, there has been an increased interest by science educators in researching and developing teachers’ pedagogical content knowledge for teaching the nature of science (PCKNOS). While there has been this surge in interest in the idea of PCKNOS, there has not been a common understanding among NOS researchers as to how exactly the PCKNOS concept should be construed. In this paper, we analyse and evaluate published accredited journal articles on PCKNOS research. We also draw from our teaching experiences. The major points of foci are the researchers’ presentations of SMKNOS and their centres of attention regarding the elements of PCKNOS. Our content, cluster analysis, and evaluation of the studies on PCKNOS reveal that most researchers have presented SMKNOS in the form of a heuristic or a set of heuristics (targeted NOS ideas) to be mastered by teachers or learners. Furthermore, we found that most of the researchers’ attention has been on developing and recommending teacher pedagogical practices for teaching NOS. From this, we synthesize and propose a subject knowledge content structure and a pedagogical approach that we believe is relevant and appropriate for secondary school and science teacher education if the goal of science education for scientific literacy is to be achieved. The justification of our arguments is rooted in tracing and unpacking the origins and meaning of pedagogical content knowledge (PCK). From our analysis, synthesis, and evaluation, as well as teaching experiences, we distil and construct a meaning for the PCKNOS construct.

Keywords: pedagogical content knowledge, teaching, nature of science, construct, subject matter knowledge

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927 Chaos Fuzzy Genetic Algorithm

Authors: Mohammad Jalali Varnamkhasti

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The genetic algorithms have been very successful in handling difficult optimization problems. The fundamental problem in genetic algorithms is premature convergence. This paper, present a new fuzzy genetic algorithm based on chaotic values instead of the random values in genetic algorithm processes. In this algorithm, for initial population is used chaotic sequences and then a new sexual selection proposed for selection mechanism. In this technique, the population is divided such that the male and female would be selected in an alternate way. The layout of the male and female chromosomes in each generation is different. A female chromosome is selected by tournament selection size from the female group. Then, the male chromosome is selected, in order of preference based on the maximum Hamming distance between the male chromosome and the female chromosome or The highest fitness value of male chromosome (if more than one male chromosome is having the maximum Hamming distance existed), or Random selection. The selections of crossover and mutation operators are achieved by running the fuzzy logic controllers, the crossover and mutation probabilities are varied on the basis of the phenotype and genotype characteristics of the chromosome population. Computational experiments are conducted on the proposed techniques and the results are compared with some other operators, heuristic and local search algorithms commonly used for solving p-median problems published in the literature.

Keywords: genetic algorithm, fuzzy system, chaos, sexual selection

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926 Surgical Applied Anatomy: Alive and Kicking

Authors: Jake Hindmarch, Edward Farley, Norman Eizenberg, Mark Midwinter

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There is a need to bring the anatomical knowledge of medical students up to the standards required by surgical specialties. Contention exists amongst anatomists, clinicians, and surgeons about the standard of anatomical knowledge medical students need. The aim of this study was to explore the standards which the Royal Australasian College of Surgeons are applying knowledge of anatomy. Furthermore, to align medical school teaching to what the surgical profession requires from graduates.: The 2018 volume of the ANZ Journal of Surgery was narrowed down to 254 articles by applying the search term “Anatomy”. The main topic was then extracted from each paper. The content of the paper was assessed for ‘novel description’ or ‘application’ of anatomical knowledge’ and classified accordingly. The majority of papers with an anatomical focus was from the general surgery specialty, which focused on surgical techniques, outcomes and management. Vascular surgery had the highest percentage of papers with a novel description and application of anatomy. Cardiothoracic and paediatric surgery had no papers with a novel description of anatomy. Finally, a novel application of anatomy was the main focus of each speciality. Firstly, a high proportion of novel applications and descriptions of anatomy are in general surgery. Secondly, vascular surgery had the largest proportion of novel application and description of anatomy, namely due to the rise of therapeutic imaging and endovascular techniques. Finally, all disciplines demonstrated a trend towards having a higher proportion of novel application of anatomical knowledge

Keywords: anatomical knowledge, anatomy, surgery, novel anatomy

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925 One Species into Five: Nucleo-Mito Barcoding Reveals Cryptic Species in 'Frankliniella Schultzei Complex': Vector for Tospoviruses

Authors: Vikas Kumar, Kailash Chandra, Kaomud Tyagi

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The insect order Thysanoptera includes small insects commonly called thrips. As insect vectors, only thrips are capable of Tospoviruses transmission (genus Tospovirus, family Bunyaviridae) affecting various crops. Currently, fifteen species of subfamily Thripinae (Thripidae) have been reported as vectors for tospoviruses. Frankliniella schultzei, which is reported as act as a vector for at least five tospovirses, have been suspected to be a species complex with more than one species. It is one of the historical unresolved issues where, two species namely, F. schultzei Trybom and F. sulphurea Schmutz were erected from South Africa and Srilanaka respectively. These two species were considered to be valid until 1968 when sulphurea was treated as colour morph (pale form) and synonymised under schultzei (dark form) However, these two have been considered as valid species by some of the thrips workers. Parallel studies have indicated that brown form of schultzei is a vector for tospoviruses while yellow form is a non-vector. However, recent studies have shown that yellow populations have also been documented as vectors. In view of all these facts, it is highly important to have a clear understanding whether these colour forms represent true species or merely different populations with different vector carrying capacities and whether there is some hidden diversity in 'Frankliniella schultzei species complex'. In this study, we aim to study the 'Frankliniella schultzei species complex' with molecular spectacles with DNA data from India and Australia and Africa. A total of fifty-five specimens was collected from diverse locations in India and Australia. We generated molecular data using partial fragments of mitochondrial cytochrome c oxidase I gene (mtCOI) and 28S rRNA gene. For COI dataset, there were seventy-four sequences, out of which data on fifty-five was generated in the current study and others were retrieved from NCBI. All the four different tree construction methods: neighbor-joining, maximum parsimony, maximum likelihood and Bayesian analysis, yielded the same tree topology and produced five cryptic species with high genetic divergence. For, rDNA, there were forty-five sequences, out of which data on thirty-nine was generated in the current study and others were retrieved from NCBI. The four tree building methods yielded four cryptic species with high bootstrap support value/posterior probability. Here we could not retrieve one cryptic species from South Africa as we could not generate data on rDNA from South Africa and sequence for rDNA from African region were not available in the database. The results of multiple species delimitation methods (barcode index numbers, automatic barcode gap discovery, general mixed Yule-coalescent, and Poisson-tree-processes) also supported the phylogenetic data and produced 5 and 4 Molecular Operational Taxonomic Units (MOTUs) for mtCOI and 28S dataset respectively. These results of our study indicate the likelihood that F. sulphurea may be a valid species, however, more morphological and molecular data is required on specimens from type localities of these two species and comparison with type specimens.

Keywords: DNA barcoding, species complex, thrips, species delimitation

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924 Association Between Friendship Quality and Subjective Wellbeing Among Adolescents: A Systematic Review

Authors: Abdullah Alsarrani, Leandro Garcia, Ruth Hunter, Laura Dunne

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Social integration with friends has an important role in shaping adolescents’ behavior and determining their well-being. Friendship features such as companionship, trust, closeness, intimacy, and conflicts all form the concept of friendship quality. The quality of friendship relationships can either enhance or impede mental development during adolescence. Therefore, this systematic review was conducted to understand the association between friendship quality and adolescents’ mental wellbeing. The evidence was synthesized from a search of five databases (Medline, Embase, ProQuest, Scopus, and PsycINFO). Thirty-two articles out of 18801 records were included in the review. The relationship between friendship quality and depression has been investigated extensively in the literature and negative (beneficial) associations were found in twelve studies out of sixteen. Poor peer relationship was linked to loneliness in eight studies out of nine. All five studies on life satisfaction and quality of peer connection found a positive association. In five studies, optimal peer relationship was found to be associated with happiness. A positive association between friendship quality and self-esteem in four out of five applicable studies. Friendship quality was found to be correlated with subjective well-being in all of three included studies focused on this area. The review demonstrates the paramount value of promoting healthy friendship to adolescents’ subjective well-being constructs. Interventions that aim to promote subjective wellbeing among adolescents should consider the development and maintenance of healthy friendships.

Keywords: adolescents, friendship quality, peer, wellbeing

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923 Isolation and Identification of Sarcocystis suihominis in a Slaughtered Domestic Pig (Sus scrofa) in Benue State, Nigeria

Authors: H. I. Obadiah, S. N. Wieser, E. A. Omudu, B. O. Atu, O. Byanet, L. Schnittger, M. Florin-Christensen

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Sarcocystis sp. are Apicomplexan protozoan parasites with a life cycle that involves a predator and a prey as final and intermediate hosts, respectively. In tissues of the intermediate hosts, the parasites produce sarcocysts that vary in size and morphology according to the species. When a suitable predator ingests sarcocyst-containing meat, the parasites are released in the intestine and undergo sexual reproduction producing infective sporocysts, which are excreted with the feces into the environment. The cycle is closed when a prey ingests sporocyst-contaminated water or pasture; the parasites gain access to the circulation, and eventually invade tissues and reproduce asexually yielding sarcocysts. Pig farming is a common practice in Nigeria as well as in many countries around the world. In addition to its importance as protein source, pork is also a source of several pathogens relevant to humans. In the case of Sarcocystis, three species have been described both in domestic and wild pigs, namely, S. miescheriana, S. porcifelis and S. suihominis. Humans can act both as final and aberrant intermediate hosts of S. suihominis, after ingesting undercooked sarcocyst-infested pork. Infections are usually asymptomatic but can be associated with inappetence, nausea, vomiting and diarrhea, or with muscle pain, fever, eosinophilia and bronchospasm, in humans acting as final or intermediate hosts, respectively. Moreover, excretion of infective forms with human feces leads to further dissemination of the infection. In this study, macroscopic sarcocysts of white color, oval shape and a size range of approximately 3-5 mm were observed in the skeletal muscle of a slaughtered pig in an abattoir in Makurdi, Benue State, Nigeria, destined to human consumption. Sarcocysts were excised and washed in distilled water, and genomic DNA was extracted using a commercial kit. The near-complete length of the 18S rRNA gene was analyzed after PCR amplification of two overlapping fragments, each of which were submitted to direct sequencing. In addition, the mitochondrial cytochrome oxidase (cox-1) gene was PCR-amplified and directly sequenced. Two phylogenetic trees containing the obtained sequences along with available relevant 18S rRNA and cox-1 sequences were constructed by neighbor joining after alignment, using the corresponding sequences of Toxoplasma gondii as outgroup. The results showed in both cases that the analyzed sequences grouped with S. suihominis with high bootstrap value, confirming the identity of this macroscopic sarcocyst-forming parasite as S. suihominis. To the best of our knowledge, these results represent the first demonstration of this parasite in pigs of Nigeria and the largest sarcocysts described so far for S. suihominis. The close proximity between pigs and humans in pig farms, and the frequent poor sanitary conditions in human dwellings strongly suggest that the parasite undergoes the sexual stages of its life cycle in humans as final hosts. These findings provide an important reference for the examination and control of Sarcocystis species in pigs of Nigeria.

Keywords: nigeria, pork, sarcocystis suihominis, zoonotic parasite

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922 Clinical Course and Prognosis of Cutaneous Manifestations of COVID-19: A Systematic Review of Reported Cases

Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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921 Identification of Potential Predictive Biomarkers for Early Diagnosis of Preeclampsia Growth Factors to microRNAs

Authors: Sadia Munir

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Preeclampsia is the contributor to the worldwide maternal mortality of approximately 100,000 deaths a year. It complicates about 10% of all pregnancies and is the first cause of maternal admission to intensive care units. Predicting preeclampsia is a major challenge in obstetrics. More importantly, no major progress has been achieved in the treatment of preeclampsia. As placenta is the main cause of the disease, the only way to treat the disease is to extract placental and deliver the baby. In developed countries, the cost of an average case of preeclampsia is estimated at £9000. Interestingly, preeclampsia may have an impact on the health of mother or infant, beyond the pregnancy. We performed a systematic search of PubMed including the combination of terms such as preeclampsia, biomarkers, treatment, hypoxia, inflammation, oxidative stress, vascular endothelial growth factor A, activin A, inhibin A, placental growth factor, transforming growth factor β-1, Nodal, placenta, trophoblast cells, microRNAs. In this review, we have summarized current knowledge on the identification of potential biomarkers for the diagnosis of preeclampsia. Although these studies show promising data in early diagnosis of preeclampsia, the current value of these factors as biomarkers, for the precise prediction of preeclampsia, has its limitation. Therefore, future studies need to be done to support some of the very promising and interesting data to develop affordable and widely available tests for early detection and treatment of preeclampsia.

Keywords: activin, biomarkers, growth factors, miroRNA

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920 A Systematic Review Emotion Regulation through Music in Children, Adults, and Elderly

Authors: Fabiana Ribeiro, Ana Moreno, Antonio Oliveira, Patricia Oliveira-Silva

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Music is present in our daily lives, and to our knowledge music is often used to change the emotions in the listeners. For this reason, the objective of this study was to explore and synthesize results examining the use and effects of music on emotion regulation in children, adults, and elderly, and clarify if the music is effective across ages to promote emotion regulation. A literature search was conducted using ISI Web of Knowledge, Pubmed, PsycINFO, and Scopus, inclusion criteria comprised children, adolescents, young, and old adults, including health population. Articles applying musical intervention, specifically musical listening, and assessing the emotion regulation directly through reports or neurophysiological measures were included in this review. Results showed age differences in the function of musical listening; initially, adolescents revealed age increments in emotional listening compared to children, and young adults in comparison to older adults, in which the first use music aiming to emotion regulation and social connection, while older adults also utilize music as emotion regulation searching for personal growth. Moreover, some of the studies showed that personal characteristics also would determine the efficiency of the emotion regulation strategy. In conclusion, it was observed that music could beneficiate all ages investigated, however, this review detected a necessity to develop adequate paradigms to explore the use of music for emotion regulation.

Keywords: music, emotion, regulation, musical listening

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919 The Use of YouTube and Its Relation to Changing the Kuwaiti Children’s Social Values from Parents’ Perspectives: Field Study

Authors: Laila Alkhayat

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In this study, the researcher explored the positive and negative effects of children watching YouTube on changing social values from the perspective of parents in Kuwait. This study also explored whether any correlation exists between changed values from watching YouTube and the following variables: relationship with a child, social situation, school level, gender, and age. The researcher collected data from 286 questionnaires distributed randomly to parents in Kuwait. The results of the study show that parents face many disadvantages when dealing with children watching YouTube, such as children spending too much time in front of screens, inability to organize bedtime, and children’s social isolation. However, the researcher found some positives come from watching YouTube, such as learning new information, enabling children to search for new information, and introducing children to the culture of their society and other cultures around them. Moreover, this study found that boys are more likely to have negative viewing habits than girls. Given the results, this study shows that the biggest impact on social values from children watching YouTube is that they are preoccupied with watching YouTube and they waste time, which makes them feel disturbed, and this affects the value of time management and delays children’s sleeping times. This study concludes that watching YouTube simultaneously has negative and positive effects on changing social values, but it plays a negative role in changing social values of children from the parents’ perspective.

Keywords: YouTube, children, social value, social media effects

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918 A Framework for Automating Software Testing: A Practical Approach

Authors: Ana Paula Cavalcanti Furtado, Silvio Meira

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Context: The quality of a software product can be directly influenced by the quality of its development process. Therefore, immature or ad-hoc test processes are means that are unsuited for introducing systematic test automation, and should not be used to support improving the quality of software. Objective: In order to conduct this research, the benefits and limitations of and gaps in automating software testing had to be assessed in order to identify the best practices and to propose a strategy for systematically introducing test automation into software development processes. Method: To conduct this research, an exploratory bibliographical survey was undertaken so as to underpin the search by theory and the recent literature. After defining the proposal, two case studies were conducted so as to analyze the proposal in a real-world environment. In addition, the proposal was also assessed through a focus group with specialists in the field. Results: The proposal of a Framework for Automating Software Testing (FAST), which is a theoretical framework consisting of a hierarchical structure to introduce test automation. Conclusion: The findings of this research showed that the absence of systematic processes is one of the factors that hinder the introduction of test automation. Based on the results of the case studies, FAST can be considered as a satisfactory alternative that lies within the scope of introducing and maintaining test automation in software development.

Keywords: software process improvement, software quality, software testing, test automation

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917 A Scoping Review to Explore the Policies and Procedures Addressing the Implementation of Inclusive Education in BRICS Countries

Authors: Bronwyn S. Mthimunye, Athena S. Pedro, Nicolette V. Roman

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Inclusive education is a global concern, in the context of Brazil, Russia, India, China, and South Africa. These countries are all striving for inclusive education, as there are many children excluded from formal schooling. The need for inclusive education is imperative, given the increase in special needs diagnoses. Many children confronted with special needs are still not able to exercise their basic right to education. The aim of conducting this scoping review was to explore the policies and procedures addressing the implementation of inclusive education in Brazil, Russia, India, China, and South Africa. The studies included were published between 2006-2016 and located in Academic Search Complete, ERIC, Medline, PsycARTICLES, JSTOR, and SAGE Journals. Seven articles were included in which all of the articles reported on inclusive education and the status of implementation. The findings identified many challenges faced by Brazil, Russia, India, China, and South Africa that affect the implementation of policies and programmes. Challenges such as poor planning, resource-constrained communities, lack of professionals in schools, and the need for adequate teacher training were identified. Brazil, Russia, India, China, and South Africa are faced with many social and economic challenges, which serves as a barrier to the implementation of inclusive education.

Keywords: special needs, inclusion, education, scoping review

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916 Automatic Detection of Defects in Ornamental Limestone Using Wavelets

Authors: Maria C. Proença, Marco Aniceto, Pedro N. Santos, José C. Freitas

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A methodology based on wavelets is proposed for the automatic location and delimitation of defects in limestone plates. Natural defects include dark colored spots, crystal zones trapped in the stone, areas of abnormal contrast colors, cracks or fracture lines, and fossil patterns. Although some of these may or may not be considered as defects according to the intended use of the plate, the goal is to pair each stone with a map of defects that can be overlaid on a computer display. These layers of defects constitute a database that will allow the preliminary selection of matching tiles of a particular variety, with specific dimensions, for a requirement of N square meters, to be done on a desktop computer rather than by a two-hour search in the storage park, with human operators manipulating stone plates as large as 3 m x 2 m, weighing about one ton. Accident risks and work times are reduced, with a consequent increase in productivity. The base for the algorithm is wavelet decomposition executed in two instances of the original image, to detect both hypotheses – dark and clear defects. The existence and/or size of these defects are the gauge to classify the quality grade of the stone products. The tuning of parameters that are possible in the framework of the wavelets corresponds to different levels of accuracy in the drawing of the contours and selection of the defects size, which allows for the use of the map of defects to cut a selected stone into tiles with minimum waste, according the dimension of defects allowed.

Keywords: automatic detection, defects, fracture lines, wavelets

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915 The Effect of Physical Therapy on Triceps Surae Myofascial Trigger Point

Authors: M. Simon, O. Peillon, R. Seijas, P. Alvarez, A. Pérez-Bellmunt

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Introduction: Myofascial trigger points (MTrPs) are defined as hyperirritable areas within taut bands of skeletal muscle and classified as either active or latent. Although they could be present in any muscle, the triceps surae is one of the most affected of the lower limb. The aim of this study was described which treatments are more used and their principal results. Study design: We performed a systematic literature search using strategies for the concepts of “Trigger Points and Gastrocnemius and Soleus not Trapezius” in Medline. Articles were screened by authors and included if they contained a rehabilitation intervention of MTrPs in healthy subjects or patients. Results: The treatments used were mostly invasive interventions and only a small part of the studies used non-invasive treatments. The methodology (time o type of intervention, characteristics of treatment, etc.) used in these treatments were frequently undefined. Overall, examination variables varied significantly among the included studies, but they were improving their parameters when the MTrPs were treated. Conclusions: There are a high variety of physical therapy treatments to improve the symptomatology of MTrPs when affect triceps surae muscle. Even so, not a single study analyzing the skeletal muscle contractile parameters (as maximal displacement or delay time) change with MTrPS therapy has been found. The treatments have to better specificity the methodology used in the futures investigation.

Keywords: fascia, myofascial trigger points, physical therapy, triceps surae

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914 The Sensitization Profile of Children Allergic to IgE-mediated Cow's Milk Proteins

Authors: Gadiri Sabiha

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Introduction : IgE-dependent cow's milk protein allergy (APLV) is one of the most common allergies in children and is one of the three most common allergies observed in children under 6 years of age. Its natural evolution is most often towards healing. The objective is to determine the sensitization profile of patients allergic to cow's milk (VL). Material and method :A retrospective study carried out on a pediatric population (age < 12 years) over a period of four years (2018-2021) in the context of a suspected food allergy to cow's milk proteins carried out on 121 children aged between 8 months -12 years The search for specific IgE was carried out by immunodot (EUROLINE Pediatric; EUROIMMUN) test which allows a semi-quantitative determination of specific IgE. Results 36 patients (29.7%) had a cow's milk protein allergy (ALPV) with a slight female predominance (58.33% girls vs 41.66% boys) The main clinical signs were: acute diarrhoea; vomiting; Intense abdominal pain, and cutaneous signs (pruritus/urticaria) with respective frequencies of 72%; 58%; 44% and 19%. The 3 major and specific VL allergens identified were beta-lactoglobulin 59% caseins 51% and alpha-lactalbumin 29.7%, The profile of sensitization to LV varies according to age, in infants before 1 year of anti-casein, IgE are predominant 83.3%, followed by beta-lactoglobulin 66.66% and alpha-lactolbumin 50% Conclusion CMPA is a frequent pathology which ranks among the three most common food allergies in children. This is the first to appear, most often starting in infants under 6 months old.

Keywords: specific Ige, food allergy, cow 's milk, child

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913 Simultaneous Targeting of MYD88 and Nur77 as an Effective Approach for the Treatment of Inflammatory Diseases

Authors: Uzma Saqib, Mirza S. Baig

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Myeloid differentiation primary response protein 88 (MYD88) has long been considered a central player in the inflammatory pathway. Recent studies clearly suggest that it is an important therapeutic target in inflammation. On the other hand, a recent study on the interaction between the orphan nuclear receptor (Nur77) and p38α, leading to increased lipopolysaccharide-induced hyperinflammatory response, suggests this binary complex as a therapeutic target. In this study, we have designed inhibitors that can inhibit both MYD88 and Nur77 at the same time. Since both MYD88 and Nur77 are an integral part of the pathways involving lipopolysaccharide-induced activation of NF-κB-mediated inflammation, we tried to target both proteins with the same library in order to retrieve compounds having dual inhibitory properties. To perform this, we developed a homodimeric model of MYD88 and, along with the crystal structure of Nur77, screened a virtual library of compounds from the traditional Chinese medicine database containing ~61,000 compounds. We analyzed the resulting hits for their efficacy for dual binding and probed them for developing a common pharmacophore model that could be used as a prototype to screen compound libraries as well as to guide combinatorial library design to search for ideal dual-target inhibitors. Thus, our study explores the identification of novel leads having dual inhibiting effects due to binding to both MYD88 and Nur77 targets.

Keywords: drug design, Nur77, MYD88, inflammation

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912 Multi-Source Data Fusion for Urban Comprehensive Management

Authors: Bolin Hua

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In city governance, various data are involved, including city component data, demographic data, housing data and all kinds of business data. These data reflects different aspects of people, events and activities. Data generated from various systems are different in form and data source are different because they may come from different sectors. In order to reflect one or several facets of an event or rule, data from multiple sources need fusion together. Data from different sources using different ways of collection raised several issues which need to be resolved. Problem of data fusion include data update and synchronization, data exchange and sharing, file parsing and entry, duplicate data and its comparison, resource catalogue construction. Governments adopt statistical analysis, time series analysis, extrapolation, monitoring analysis, value mining, scenario prediction in order to achieve pattern discovery, law verification, root cause analysis and public opinion monitoring. The result of Multi-source data fusion is to form a uniform central database, which includes people data, location data, object data, and institution data, business data and space data. We need to use meta data to be referred to and read when application needs to access, manipulate and display the data. A uniform meta data management ensures effectiveness and consistency of data in the process of data exchange, data modeling, data cleansing, data loading, data storing, data analysis, data search and data delivery.

Keywords: multi-source data fusion, urban comprehensive management, information fusion, government data

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911 Chemical and Biomolecular Detection at a Polarizable Electrical Interface

Authors: Nicholas Mavrogiannis, Francesca Crivellari, Zachary Gagnon

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Development of low-cost, rapid, sensitive and portable biosensing systems are important for the detection and prevention of disease in developing countries, biowarfare/antiterrorism applications, environmental monitoring, point-of-care diagnostic testing and for basic biological research. Currently, the most established commercially available and widespread assays for portable point of care detection and disease testing are paper-based dipstick and lateral flow test strips. These paper-based devices are often small, cheap and simple to operate. The last three decades in particular have seen an emergence in these assays in diagnostic settings for detection of pregnancy, HIV/AIDS, blood glucose, Influenza, urinary protein, cardiovascular disease, respiratory infections and blood chemistries. Such assays are widely available largely because they are inexpensive, lightweight, and portable, are simple to operate, and a few platforms are capable of multiplexed detection for a small number of sample targets. However, there is a critical need for sensitive, quantitative and multiplexed detection capabilities for point-of-care diagnostics and for the detection and prevention of disease in the developing world that cannot be satisfied by current state-of-the-art paper-based assays. For example, applications including the detection of cardiac and cancer biomarkers and biothreat applications require sensitive multiplexed detection of analytes in the nM and pM range, and cannot currently be satisfied with current inexpensive portable platforms due to their lack of sensitivity, quantitative capabilities and often unreliable performance. In this talk, inexpensive label-free biomolecular detection at liquid interfaces using a newly discovered electrokinetic phenomenon known as fluidic dielectrophoresis (fDEP) is demonstrated. The electrokinetic approach involves exploiting the electrical mismatches between two aqueous liquid streams forced to flow side-by-side in a microfluidic T-channel. In this system, one fluid stream is engineered to have a higher conductivity relative to its neighbor which has a higher permittivity. When a “low” frequency (< 1 MHz) alternating current (AC) electrical field is applied normal to this fluidic electrical interface the fluid stream with high conductivity displaces into the low conductive stream. Conversely, when a “high” frequency (20MHz) AC electric field is applied, the high permittivity stream deflects across the microfluidic channel. There is, however, a critical frequency sensitive to the electrical differences between each fluid phase – the fDEP crossover frequency – between these two events where no fluid deflection is observed, and the interface remains fixed when exposed to an external field. To perform biomolecular detection, two streams flow side-by-side in a microfluidic T-channel: one fluid stream with an analyte of choice and an adjacent stream with a specific receptor to the chosen target. The two fluid streams merge and the fDEP crossover frequency is measured at different axial positions down the resulting liquid

Keywords: biodetection, fluidic dielectrophoresis, interfacial polarization, liquid interface

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910 Optimal Design of Submersible Permanent Magnet Linear Synchronous Motor Based Design of Experiment and Genetic Algorithm

Authors: Xiao Zhang, Wensheng Xiao, Junguo Cui, Hongmin Wang

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Submersible permanent magnet linear synchronous motors (SPMLSMs) are electromagnetic devices, which can directly drive plunger pump to obtain the crude oil. Those motors have been gradually applied in oil fields due to high thrust force density and high efficiency. Since the force performance closely depends on the concrete structural parameters, the seven different structural parameters are investigated in detail. This paper presents an optimum design of an SPMLSM to minimize the detent force and maximize the thrust by using design of experiment (DOE) and genetic algorithm (GA). The three significant structural parameters (air-gap length, slot width, pole-arc coefficient) are separately screened using 27 1/16 fractional factorial design (FFD) to investigate the significant effect of seven parameters used in this research on the force performance. Response surface methodology (RSM) is well adapted to make analytical model of thrust and detent force with constraints of corresponding significant parameters and enable objective function to be easily created, respectively. GA is performed as a searching tool to search for the Pareto-optimal solutions. By finite element analysis, the proposed PMLSM shows merits in improving thrust and reducing the detent force dramatically.

Keywords: optimization, force performance, design of experiment (DOE), genetic algorithm (GA)

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909 Reducing System Delay to Definitive Care For STEMI Patients, a Simulation of Two Different Strategies in the Brugge Area, Belgium

Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

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Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

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908 Review of Current Literature on Use of Prazosin for Treatment of Post-Traumatic Stress Disorder Related Sleep Disturbances in Child and Adolescent Population

Authors: Davit Khachatryan, Shuo Xiang

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Numerous published studies on the use of prazosin in the treatment of PTSD-related sleep disturbances in adult population have resulted in updates to the recommendation for prazosin for nightmares that showed its strength of evidence elevated from C to B in the US Department of Veterans Affairs clinical practice guideline. In addition, the American Academy of Sleep Medicine clinical practice guideline gave prazosin a level-A recommendation for the treatment of PTSD-associated nightmares. The aim of this review is to summarize the available literature for prazosin use for nightmares and other sleep disturbances in children and adolescents with PTSD. Method: A comprehensive search for studies on prazosin use for sleep disturbances in child and adolescent population with PTSD has been performed. We looked at MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, Scopus, Web of Science, and Cochrane CENTRAL databases. Results: Compared to adult population with similar psychopathology, the available literature in child and adolescent population is scarce. Despite increased interest in prazosin in the management of PTSD, only six studies investigating this medication in children and adolescents have been published. Conclusion: A large randomized control trial on this topic is needed for more definite evidence on the efficacy and safety of prazosin in the treatment of nightmares in children and adolescents with PTSD.

Keywords: guidelines, prazosin, PTSD, sleep disturbance

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