Search results for: hypersensitive
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16

Search results for: hypersensitive

16 Effect of Three Desensitizers on Dentinal Tubule Occlusion and Bond Strength of Dentin Adhesives

Authors: Zou Xuan, Liu Hongchen

Abstract:

The ideal dentin desensitizing agent should not only have good biological safety, simple clinical operation mode, the superior treatment effect, but also should have a durable effect to resist the oral environmental temperature change and oral mechanical abrasion, so as to achieve a persistent desensitization effect. Also, when using desensitizing agent to prevent the post-operative hypersensitivity, we should not only prevent it from affecting crowns’ retention, but must understand its effects on bond strength of dentin adhesives. There are various of desensitizers and dentin adhesives in clinical treatment. They have different chemical or physical properties. Whether the use of desensitizing agent would affect the bond strength of dentin adhesives still need further research. In this in vitro study, we built the hypersensitive dentin model and post-operative dentin model, to evaluate the sealing effects and durability on exposed tubule by three different dentin desensitizers and to evaluate the sealing effects and the bond strength of dentin adhesives after using three different dentin desensitizers on post-operative dentin. The result of this study could provide some important references for clinical use of dentin desensitizing agent. 1. As to the three desensitizers, the hypersensitive dentin model was built to evaluate their sealing effects on exposed tubule by SEM observation and dentin permeability analysis. All of them could significantly reduce the dentin permeability. 2. Test specimens of three groups treated by desensitizers were subjected to aging treatment with 5000 times thermal cycling and toothbrush abrasion, and then dentin permeability was measured to evaluate the sealing durability of these three desensitizers on exposed tubule. The sealing durability of three groups were different. 3. The post-operative dentin model was built to evaluate the sealing effects of the three desensitizers on post-operative dentin by SEM and methylene blue. All of three desensitizers could reduce the dentin permeability significantly. 4. The influences of three desensitizers on the bonding efficiency of total-etch and self-etch adhesives were evaluated with the micro-tensile bond strength study and bond interface morphology observation. The dentin bond strength for Green or group was significantly lower than the other two groups (P<0.05).

Keywords: dentin, desensitizer, dentin permeability, thermal cycling, micro-tensile bond strength

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15 Sustainable Building Design for Energy Efficiency and Healthier Electromagnetic Environment

Authors: Riadh Habash, Kristina Djukic, Gandhi Habash

Abstract:

Sustainable design is one of the emerging milestones in building construction. This concept is defined as buildings that on a yearly average consume as much energy as they generate using renewable energy sources. Realization of sustainable buildings requires a wide range of technologies, systems and solutions with varying degrees of complexity and sophistication, depending upon the location and surrounding environmental conditions. This paper will address not only the role of the above technologies and solutions but will provide solutions to reduce the electromagnetic fields (EMFs) in the building as much as possible so that the occupiers can recover from electro-hyper-sensitivity, if any. The objective is to maximize energy efficiency, optimize occupant comfort, reduce dependency on the grid and provide safer and healthier EMF environment especially for hypersensitive people. Creative architectural and engineering solutions that capitalize on the design of energy efficient technologies; combined cooling, heating and power (CCHP) microgrid (MG); and EMF mitigation will be presented.

Keywords: sustainable buildings, energy efficiency, thermal simulation, electromagnetic environment

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14 Aerofloral Studies and Allergenicity Potentials of Dominant Atmospheric Pollen Types at Some Locations in Northwestern Nigeria

Authors: Olugbenga S. Alebiosu, Olusola H. Adekanmbi, Oluwatoyin T. Ogundipe

Abstract:

Pollen and spores have been identified as major airborne bio-particles inducing respiratory disorders such as asthma, allergic rhinitis and atopic dermatitis among hypersensitive individuals. An aeropalynological study was conducted within a one year sampling period with a view to investigating the monthly depositional rate of atmospheric pollen and spores; influence of the immediate vegetation on airborne pollen distribution; allergenic potentials of dominant atmospheric pollen types at selected study locations in Bauchi and Taraba states, Northwestern Nigeria. A tauber-like pollen trap was employed in aerosampling with the sampler positioned at a height of 5 feet above the ground, followed by a monthly collection of the recipient solution for the sampling period. The collected samples were subjected to acetolysis treatment, examined microscopically with the identification of pollen grains and spores using reference materials and published photomicrographs. Plants within the surrounding vegetation were enumerated. Crude protein contents extracted from pollen types found to be commonly dominant at both study locations; Senna siamea, Terminalia cattapa, Panicum maximum and Zea mays were used to sensitize Musmusculus. Histopathological studies of bronchi and lung sections from certain dead M.musculus in the test groups was conducted. Blood samples were collected from the pre-orbital vein of M.musculus and processed for serological and haematological (differential and total white blood cell counts) studies. ELISA was used in determining the levels of serological parameters: IgE and cytokines (TNF-, IL-5, and IL-13). Statistical significance was observed in the correlation between the levels of serological and haematological parameters elicited by each test group, differences between the levels of serological and haematological parameters elicited by each test group and those of the control, as well as at varying sensitization periods. The results from this study revealed dominant airborne pollen types across the study locations; Syzygiumguineense, Tridaxprocumbens, Elaeisguineensis, Mimosa sp., Borreria sp., Terminalia sp., Senna sp. and Poaceae. Nephrolepis sp., Pteris sp. and a trilete fern also produced spores. This study also revealed that some of the airborne pollen types were produced by local plants at the study locations. Bronchi sections of M.musculus after first and second sensitizations, as well as lung section after first sensitization with Senna siamea, showed areas of necrosis. Statistical significance was recorded in the correlation between the levels of some serological and haematological parameters produced by each test group and those of the control, as well as at certain sensitization periods. The study revealed some candidate pollen allergens at the study locations allergy sufferers and also established a complexity of interaction between immune cells, IgE and cytokines at varied periods of mice sensitization and forming a paradigm of human immune response to different pollen allergens. However, it is expedient that further studies should be conducted on these candidate pollen allergens for their allergenicity potential in humans within their immediate environment.

Keywords: airborne, hypersensitive, mus musculus, pollen allergens, respiratory, tauber-like

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13 The Overexpression of Horsegram MURLK Improves Regulation of Cell Death and Defense Responses to Microbial Pathogens

Authors: Shikha Masand, Sudesh Kumar Yadav

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Certain protein kinases have been shown to be crucial for plant cell signaling pathways associated with plant immune responses. Here we identified a horsegram [Macrotyloma uniflorum (Lam.) Verdc.] malectin-like leucine rich receptor-like protein kinase (RLK) gene MuRLK. The functional MuRLK protein preferentially binds to mannose and N-acetyl glucosamine residues. MuRLK exists in the cytoplasm and also localizes to the plasma membrane of plant cells via its N-terminus. Over-expression of MuRLK in Arabidopsis enhances the basal resistance to infection with Pseudomonas syringae pv. tomato, Alternaria brassicicola and Hyaloperonospora arabidopsidis, are associated with elevated ROS bursts, MAPK activation, thus ultimately leading to hypersensitive cell death. Moreover, salicylic acid-dependent and jasmonic acid-dependent defense responses are also enhanced in the MuRLK-overexpressed plants that lead to HR-induced cell death. Together, these results suggest that MuRLK plays a key role in the regulation of plant cell death, early and late defense responses after the recognition of microbial pathogens.

Keywords: horsegram, Pseudomonas syringae pv. tomato, MuRLK, ROS burst, cell death, plant defense

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12 Using Machine-Learning Methods for Allergen Amino Acid Sequence's Permutations

Authors: Kuei-Ling Sun, Emily Chia-Yu Su

Abstract:

Allergy is a hypersensitive overreaction of the immune system to environmental stimuli, and a major health problem. These overreactions include rashes, sneezing, fever, food allergies, anaphylaxis, asthmatic, shock, or other abnormal conditions. Allergies can be caused by food, insect stings, pollen, animal wool, and other allergens. Their development of allergies is due to both genetic and environmental factors. Allergies involve immunoglobulin E antibodies, a part of the body’s immune system. Immunoglobulin E antibodies will bind to an allergen and then transfer to a receptor on mast cells or basophils triggering the release of inflammatory chemicals such as histamine. Based on the increasingly serious problem of environmental change, changes in lifestyle, air pollution problem, and other factors, in this study, we both collect allergens and non-allergens from several databases and use several machine learning methods for classification, including logistic regression (LR), stepwise regression, decision tree (DT) and neural networks (NN) to do the model comparison and determine the permutations of allergen amino acid’s sequence.

Keywords: allergy, classification, decision tree, logistic regression, machine learning

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11 Pitch Processing in Autistic Mandarin-Speaking Children with Hypersensitivityand Hypo-Sensitivity: An Event-Related Potential Study

Authors: Kaiying Lai, Suiping Wang, Luodi Yu, Yang Zhang, Pengmin Qin

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Abnormalities in auditory processing are one of the most commonly reported sensory processing impairments in children with Autism Spectrum Disorder (ASD). Tonal language speaker with autism has enhanced neural sensitivity to pitch changes in pure tone. However, not all children with ASD exhibit the same performance in pitch processing due to different auditory sensitivity. The current study aimed to examine auditory change detection in ASD with different auditory sensitivity. K-means clustering method was adopted to classify ASD participants into two groups according to the auditory processing scores of the Sensory Profile, 11 autism with hypersensitivity (mean age = 11.36 ; SD = 1.46) and 18 with hypo-sensitivity (mean age = 10.64; SD = 1.89) participated in a passive auditory oddball paradigm designed for eliciting mismatch negativity (MMN) under the pure tone condition. Results revealed that compared to hypersensitive autism, the children with hypo-sensitivity showed smaller MMN responses to pure tone stimuli. These results suggest that ASD with auditory hypersensitivity and hypo-sensitivity performed differently in processing pure tone, so neural responses to pure tone hold promise for predicting the auditory sensitivity of ASD and targeted treatment in children with ASD.

Keywords: ASD, sensory profile, pitch processing, mismatch negativity, MMN

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10 A Novel Gene Encoding Ankyrin-Repeat Protein, SHG1, Is Indispensable for Seed Germination under Moderate Salt Stress

Authors: H. Sakamoto, J. Tochimoto, S. Kurosawa, M. Suzuki, S. Oguri

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Salt stress adversely affects plant growth at various stages of development including seed germination, seedling establishment, vegetative growth and finally reproduction. Because of their immobile nature, plants have evolved mechanisms to sense and respond to salt stress. Seed dormancy is an adaptive trait that enables seed germination to coincide with favorable environmental conditions. We identified a novel locus of Arabidopsis, designated SHG1 (salt hypersensitive germination 1), whose disruption leads to reduced germination rate under moderate salt stress conditions. SHG1 encodes a transmembrane protein with an ankyrin repeat motif that has been implicated in diverse cellular processes such as signal transduction. The SGH1-disrupted Arabidopsis mutant died at the cotyledon stage when sown on salt-containing medium, although wild type plants could form true leaves under the same conditions. On the other hand, this mutant showed similar phenotypes to wild type plants when sown on medium without salt and transferred to salt-containing medium at the vegetative stage. These results suggested that SHG1 played indispensable role in the seed germination and seedling establishment under moderate salt stress conditions. SHG1 may be involved in the release of seed dormancy.

Keywords: germination, ankyrin repeat, arabidopsis, salt tolerance

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9 Effect of Manual Progressive Ischemic Pressure versus Post Isometric Facilitation in the Treatment of Latent Myofascial Trigger Points in Mechanical Neck Pain

Authors: Mohamed M. Diab, Fahmy E. Mohamed, Alaa Balbaa

Abstract:

Background: Myofascial pain syndrome a common type of non-articular musculoskeletal pain, is a condition associated with regional pain and muscle tenderness characterized by the presence of hypersensitive nodules. Objectives: the purpose of this study is to compare between the effects of manual progressive ischemic pressure versus the effect of post isometric facilitation in the treatment of Rhomboid latent myofascial trigger points. Methods: six patients had participated in this study. Patients divided into two groups. Group A treated by manual progressive ischemic pressure and traditional physical therapy program. Group B treated by post isometric facilitation and traditional physical therapy program. Treatment program was for 6 sessions over two week’s period. Result: Statistical analysis revealed that there is no significant difference in post treatment from pretreatment in pain severity (VAS) in myofascial trigger points with Rhomboid muscles) and Pain pressure threshold (PPT) for tenderness at both groups (A,B). Conclusion: ischemic pressure technique appear to be no more effective than post isometric facilitation in treatment of rhomboids latent myofacial trigger point.

Keywords: Rhmoiboid trigger point, myofacila trigger point, ischemic pressure, post isometric facilitation

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8 Identification and Characterization of Enterobacter cloacae, New Soft Rot Causing Pathogen of Radish in India

Authors: B. S. Chandrashekar, M. K. Prasannakumar, P. Buela Parivallal, Sahana N. Banakar, Swathi S. Patil, H. B. Mahesh, D. Pramesh

Abstract:

Bacterial soft rot is one of the most often seen diseases in many plant species globally, resulting in considerable yield loss. Radish roots with dark water-soaked lesions, maceration of tissue, and a foul odour were collected in the Kolar region, India. Two isolates were obtained from rotted samples that demonstrated morphologically unpigmented, white mucoid convex colonies on nutrient agar medium. The isolated bacteria (RDH1 and RDH3) were gram-negative, rod-shaped bacteria with biochemically distinct characteristics similar to the type culture of Enterobacter cloacae ATCC13047 and Bergy's handbook of determinative bacteriology. The 16s rRNA gene was used to identify Enterobacter species. On carrot, potato, tomato, chilli, bell pepper, knolkhol, cauliflower, cabbage, and cucumber slices, the Koch′s postulates were fulfilled, and the pathogen was also pathogenic on radish, cauliflower, and cabbage seedlings were grown in a glasshouse. After 36 hours, both isolates exhibited a hypersensitive sensitivity to Nicotianatabacum. Semi-quantitative analysis revealed that cell wall degrading enzymes (CWDEs) such as pectin lyase, polygalacturonase, and cellulase (p=1.4e09) contributed to pathogenicity, whereas isolates produced biofilms (p=4.3e-11) that help in host adhesion. This is the first report in India of radish soft rot caused by E. cloacae.

Keywords: soft rot, enterobacter cloacae, 16S rRNA, nicotiana tabacum, and pathogenicity

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7 Stress-Controlled Senescence and Development in Arabidopsis thaliana by Root Associated Factor (RAF), a NAC Transcription Regulator

Authors: Iman Kamranfar, Gang-Ping Xue, Salma Balazadeh, Bernd Mueller-Roeber

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Adverse environmental conditions such as salinity stress, high temperature and drought limit plant growth and typically lead to precocious tissue degeneration and leaf senescence, a process by which nutrients from photosynthetic organs are recycled for the formation of flowers and seeds to secure reaching the next generation under such harmful conditions. In addition, abiotic stress affects developmental patterns that help the plant to withstand unfavourable environmental conditions. We discovered an NAC (for NAM, ATAF1, 2, and CUC2) transcription factor (TF), called RAF in the following, which plays a central role in abiotic drought stress-triggered senescence and the control of developmental adaptations to stressful environments. RAF is an ABA-responsive TF; RAF overexpressors are hypersensitive to abscisic acid (ABA) and exhibit precocious senescence while knock-out mutants show delayed senescence. To explore the RAF gene regulatory network (GRN), we determined its preferred DNA binding sites by binding site selection assay (BSSA) and performed microarray-based expression profiling using inducible RAF overexpression lines and chromatin immunoprecipitation (ChIP)-PCR. Our studies identified several direct target genes, including those encoding for catabolic enzymes acting during stress-induced senescence. Furthermore, we identified various genes controlling drought stress-related developmental changes. Based on our results, we conclude that RAF functions as a central transcriptional regulator that coordinates developmental programs with stress-related inputs from the environment. To explore the potential agricultural applications of our findings, we are currently extending our studies towards crop species.

Keywords: abiotic stress, Arabidopsis, development, transcription factor

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6 Modulation of Fish Allergenicity towards the Production of a Low Allergen Farmed Fish

Authors: Denise Schrama, Claudia Raposo, Pedro Rodrigues

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Background: Food allergies are conducted by a hypersensitive response of the immune system. These allergies are a global concern for the public health. Consumption of fish is increasing worldwide as it is a healthy meat with high nutritional value. Unfortunately, fish can cause adverse immune-mediate reactions, affecting part of the population with higher incidence in children. β-parvalbumin, a small, highly conserved stable, calcium or magnesium binding muscle protein is the main fish allergen. In fish-allergic patients, cross-reactivity between different fish species exist due to recognition of highly identical protein regions. Enolases, aldolases, or fish gelatin are other identified fish allergens in some fish species. With no available cure for fish allergies, clinical management is only based on an avoidance diet aiming at the total exclusion of offending food. Methods: Mediterranean fish (S. aurata and D. labrax) were fed specifically designed diets, enriched in components that target the expression or inactivation of parvalbumin (creatine and EDTA, respectively). After 90 days fish were sampled and biological tissues were excised. Proteomics was used to access fish allergens characterization and expression in muscle while IgE assays to confirm the lower allergenic potential are conducted in patients with history of fish allergies. Fish welfare and quality of flesh were established with biochemical, texture and sensorial analysis. Results: Fish welfare shows no major impact between diets. In case of creatine supplementation in D. labrax proteomic analysis show a slight decrease in parvalbumin expression. No accumulation of this compound was found in muscle. For EDTA supplementation in S. aurata IgE assay show a slight decrease in allergenicity when using sera of fish allergic patients. Conclusion: Supplementation with these two compounds seems to change slightly the allergenicity of the two mean Mediterranean species.

Keywords: fish allergies, fish nutrition, proteomics, aquaculture

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5 Effects of Sensory Integration Techniques in Science Education of Autistic Students

Authors: Joanna Estkowska

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Sensory integration methods are very useful and improve daily functioning autistic and mentally disabled children. Autism is a neurobiological disorder that impairs one's ability to communicate with and relate to others as well as their sensory system. Children with autism, even highly functioning kids, can find it difficult to process language with surrounding noise or smells. They are hypersensitive to things we can ignore such as sight, sounds and touch. Adolescents with highly functioning autism or Asperger Syndrome can study Science and Math but the social aspect is difficult for them. Nature science is an area of study that attracts many of these kids. It is a systematic field in which the children can focus on a small aspect. If you follow these rules you can come up with an expected result. Sensory integration program and systematic classroom observation are quantitative methods of measuring classroom functioning and behaviors from direct observations. These methods specify both the events and behaviors that are to be observed and how they are to be recorded. Our students with and without autism attended the lessons in the classroom of nature science in the school and in the laboratory of University of Science and Technology in Bydgoszcz. The aim of this study is investigation the effects of sensory integration methods in teaching to students with autism. They were observed during experimental lessons in the classroom and in the laboratory. Their physical characteristics, sensory dysfunction, and behavior in class were taken into consideration by comparing their similarities and differences. In the chemistry classroom, every autistic student is paired with a mentor from their school. In the laboratory, the children are expected to wear goggles, gloves and a lab coat. The chemistry classes in the laboratory were held for four hours with a lunch break, and according to the assistants, the children were engaged the whole time. In classroom of nature science, the students are encouraged to use the interactive exhibition of chemical, physical and mathematical models constructed by the author of this paper. Our students with and without autism attended the lessons in those laboratories. The teacher's goals are: to assist the child in inhibiting and modulating sensory information and support the child in processing a response to sensory stimulation.

Keywords: autism spectrum disorder, science education, sensory integration techniques, student with special educational needs

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4 Investigating the Indoor Air Quality of the Respiratory Care Wards

Authors: Yu-Wen Lin, Chin-Sheng Tang, Wan-Yi Chen

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Various biological specimens, drugs, and chemicals exist in the hospital. The medical staffs and hypersensitive inpatients expose might expose to multiple hazards while they work or stay in the hospital. Therefore, the indoor air quality (IAQ) of the hospital should be paid more attention. Respiratory care wards (RCW) are responsible for caring the patients who cannot spontaneously breathe without the ventilators. The patients in RCW are easy to be infected. Compared to the bacteria concentrations of other hospital units, RCW came with higher values in other studies. This research monitored the IAQ of the RCW and checked the compliances of the indoor air quality standards of Taiwan Indoor Air Quality Act. Meanwhile, the influential factors of IAQ and the impacts of ventilator modules, with humidifier or with filter, were investigated. The IAQ of two five-bed wards and one nurse station of a RCW in a regional hospital were monitored. The monitoring was proceeded for 16 hours or 24 hours during the sampling days with a sampling frequency of 20 minutes per hour. The monitoring was performed for two days in a row and the AIQ of the RCW were measured for eight days in total. The concentrations of carbon dioxide (CO₂), carbon monoxide (CO), particulate matter (PM), nitrogen oxide (NOₓ), total volatile organic compounds (TVOCs), relative humidity (RH) and temperature were measured by direct reading instruments. The bioaerosol samples were taken hourly. The hourly air change rate (ACH) was calculated by measuring the air ventilation volume. Human activities were recorded during the sampling period. The linear mixed model (LMM) was applied to illustrate the impact factors of IAQ. The concentrations of CO, CO₂, PM, bacterial and fungi exceeded the Taiwan IAQ standards. The major factors affecting the concentrations of CO, PM₁ and PM₂.₅ were location and the number of inpatients. The significant factors to alter the CO₂ and TVOC concentrations were location and the numbers of in-and-out staff and inpatients. The number of in-and-out staff and the level of activity affected the PM₁₀ concentrations statistically. The level of activity and the numbers of in-and-out staff and inpatients are the significant factors in changing the bacteria and fungi concentrations. Different models of the patients’ ventilators did not affect the IAQ significantly. The results of LMM can be utilized to predict the pollutant concentrations under various environmental conditions. The results of this study would be a valuable reference for air quality management of RCW.

Keywords: respiratory care ward, indoor air quality, linear mixed model, bioaerosol

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3 Current Status of Scaled-Up Synthesis/Purification and Characterization of a Potentially Translatable Tantalum Oxide Nanoparticle Intravenous CT Contrast Agent

Authors: John T. Leman, James Gibson, Peter J. Bonitatibus

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There have been no potential clinically translatable developments of intravenous CT contrast materials over decades, and iodinated contrast agents (ICA) remain the only FDA-approved media for CT. Small molecule ICA used to highlight vascular anatomy have weak CT signals in large-to-obese patients due to their rapid redistribution from plasma into interstitial fluid, thereby diluting their intravascular concentration, and because of a mismatch of iodine’s K-edge and the high kVp settings needed to image this patient population. The use of ICA is also contraindicated in a growing population of renally impaired patients who are hypersensitive to these contrast agents; a transformative intravenous contrast agent with improved capabilities is urgently needed. Tantalum oxide nanoparticles (TaO NPs) with zwitterionic siloxane polymer coatings have high potential as clinically translatable general-purpose CT contrast agents because of (1) substantially improved imaging efficacy compared to ICA in swine/phantoms emulating medium-sized and larger adult abdomens and superior thoracic vascular contrast enhancement of thoracic arteries and veins in rabbit, (2) promising biological safety profiles showing near-complete renal clearance and low tissue retention at 3x anticipated clinical dose (ACD), and (3) clinically acceptable physiochemical parameters as concentrated bulk solutions(250-300 mgTa/mL). Here, we review requirements for general-purpose intravenous CT contrast agents in terms of patient safety, X-ray attenuating properties and contrast-producing capabilities, and physicochemical and pharmacokinetic properties. We report the current status of a TaO NP-based contrast agent, including chemical process technology developments and results of newly defined scaled-up processes for NP synthesis and purification, yielding reproducible formulations with appropriate size and concentration specifications. We discuss recent results of recent pre-clinical in vitro immunology, non-GLP high dose tolerability in rats (10x ACD), non-GLP long-term biodistribution in rats at 3x ACD, and non-GLP repeat dose in rats at ACD. We also include a discussion of NP characterization, in particular size-stability testing results under accelerated conditions (37C), and insights into TaO NP purity, surface structure, and bonding of the zwitterionic siloxane polymer coating by multinuclear (1H, 13C, 29Si) and multidimensional (2D) solution NMR spectroscopy.

Keywords: nanoparticle, imaging, diagnostic, process technology, nanoparticle characterization

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2 Childhood Sensory Sensitivity: A Potential Precursor to Borderline Personality Disorder

Authors: Valerie Porr, Sydney A. DeCaro

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TARA for borderline personality disorder (BPD), an education and advocacy organization, helps families to compassionately and effectively deal with troubling BPD behaviors. Our psychoeducational programs focus on understanding underlying neurobiological features of BPD and evidence-based methodology integrating dialectical behavior therapy (DBT) and mentalization based therapy (MBT,) clarifying the inherent misunderstanding of BPD behaviors and improving family communication. TARA4BPD conducts online surveys, workshops, and topical webinars. For over 25 years, we have collected data from BPD helpline callers. This data drew our attention to particular childhood idiosyncrasies that seem to characterize many of the children who later met the criteria for BPD. The idiosyncrasies we observed, heightened sensory sensitivity and hypervigilance, were included in Adolf Stern’s 1938 definition of “Borderline.” This aspect of BPD has not been prioritized by personality disorder researchers, presently focused on emotion processing and social cognition in BPD. Parents described sleep reversal problems in infants who, early on, seem to exhibit dysregulation in circadian rhythm. Families describe children as supersensitive to sensory sensations, such as specific sounds, heightened sense of smell, taste, textures of foods, and an inability to tolerate various fabrics textures (i.e., seams in socks). They also exhibit high sensitivity to particular words and voice tones. Many have alexithymia and dyslexia. These children are either hypo- or hypersensitive to sensory sensations, including pain. Many suffer from fibromyalgia. BPD reactions to pain have been studied (C. Schmahl) and confirm the existence of hyper and hypo-reactions to pain stimuli in people with BPD. To date, there is little or no data regarding what comprises a normative range of sensitivity in infants and children. Many parents reported that their children were tested or treated for sensory processing disorder (SPD), learning disorders, and ADHD. SPD is not included in the DSM and is treated by occupational therapists. The overwhelming anecdotal data from thousands of parents of children who later met criteria for BPD led TARA4BPD to develop a sensitivity survey to develop evidence of the possible role of early sensory perception problems as a pre-cursor to BPD, hopefully initiating new directions in BPD research. At present, the research community seems unaware of the role supersensory sensitivity might play as an early indicator of BPD. Parents' observations of childhood sensitivity obtained through family interviews and results of an extensive online survey on sensory responses across various ages of development will be presented. People with BPD suffer from a sense of isolation and otherness that often results in later interpersonal difficulties. Early identification of supersensitive children while brain circuits are developing might decrease the development of social interaction deficits such as rejection sensitivity, self-referential processes, and negative bias, hallmarks of BPD, ultimately minimizing the maladaptive methods of coping with distress that characterizes BPD. Family experiences are an untapped resource for BPD research. It is hoped that this data will give family observations the critical credibility to inform future treatment and research directions.

Keywords: alexithymia, dyslexia, hypersensitivity, sensory processing disorder

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1 Quality in Healthcare: An Autism-Friendly Hospital Emergency Waiting Room

Authors: Elena Bellini, Daniele Mugnaini, Michele Boschetto

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People with an Autistic Spectrum Disorder and an Intellectual Disability who need to attend a Hospital Emergency Waiting Room frequently present high levels of discomfort and challenging behaviors due to stress-related hyperarousal, sensory sensitivity, novelty-anxiety, communication and self-regulation difficulties. Increased agitation and acting out also disturb the diagnostic and therapeutic processes, and the emergency room climate. Architectural design disciplines aimed at reducing distress in hospitals or creating autism-friendly environments are called for to find effective answers to this particular need. A growing number of researchers are considering the physical environment as an important point of intervention for people with autism. It has been shown that providing the right setting can help enhance confidence and self-esteem and can have a profound impact on their health and wellbeing. Environmental psychology has evaluated the perceived quality of care, looking at the design of hospital rooms, paths and circulation, waiting rooms, services and devices. Furthermore, many studies have investigated the influence of the hospital environment on patients, in terms of stress-reduction and therapeutic intervention’ speed, but also on health professionals and their work. Several services around the world are organizing autism-friendly hospital environments which involve the architecture and the specific staff training. In Italy, the association Spes contra spem has promoted and published, in 2013, the ‘Chart of disabled people in the hospital’. It stipulates that disabled people should have equal rights to accessible and high-quality care. There are a few Italian examples of therapeutic programmes for autistic people as the Dama project in Milan and the recent experience of Children and Autism Foundation in Pordenone. Careggi’s Emergency Waiting Room in Florence has been built to satisfy this challenge. This project of research comes from a collaboration between the technical staff of Careggi Hospital, the Center for autism PAMAPI and some architects expert in the sensory environment. The methodology of focus group involved architects, psychologists and professionals through a transdisciplinary research, centered on the links between the spatial characteristics and clinical state of people with ASD. The relationship between architectural space and quality of life is studied to pay maximum attention to users’ needs and to support the medical staff in their work by a specific program of training. The result of this research is a sum of criteria used to design the emergency waiting room, that will be illustrated. A protected room, with a clear space design, maximizes comprehension and predictability. The multisensory environment is thought to help sensory integration and relaxation. Visual communication through Ipad allows an anticipated understanding of medical procedures, and a specific technological system supports requests, choices and self-determination in order to fit sensory stimulation to personal preferences, especially for hypo and hypersensitive people. All these characteristics should ensure a better regulation of the arousal, less behavior problems, improving treatment accessibility, safety, and effectiveness. First results about patient-satisfaction levels will be presented.

Keywords: accessibility of care, autism-friendly architecture, personalized therapeutic process, sensory environment

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