Search results for: intellectual and developmental disability
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1774

Search results for: intellectual and developmental disability

154 The Power-Knowledge Relationship in the Italian Education System between the 19th and 20th Century

Authors: G. Iacoviello, A. Lazzini

Abstract:

This paper focuses on the development of the study of accounting in the Italian education system between the 19th and 20th centuries. It also focuses on the subsequent formation of a scientific and experimental forma mentis that would prepare students for administrative and managerial activities in industry, commerce and public administration. From a political perspective, the period was characterized by two dominant movements - liberalism (1861-1922) and fascism (1922-1945) - that deeply influenced accounting practices and the entire Italian education system. The materials used in the study include both primary and secondary sources. The primary sources used to inform this study are numerous original documents issued from 1890-1935 by the government and maintained in the Historical Archive of the State in Rome. The secondary sources have supported both the development of the theoretical framework and the definition of the historical context. This paper assigns to the educational system the role of cultural producer. Foucauldian analysis identifies the problem confronted by the critical intellectual in finding a way to deploy knowledge through a 'patient labour of investigation' that highlights the contingency and fragility of the circumstances that have shaped current practices and theories. Education can be considered a powerful and political process providing students with values, ideas, and models that they will subsequently use to discipline themselves, remaining as close to them as possible. It is impossible for power to be exercised without knowledge, just as it is impossible for knowledge not to engender power. The power-knowledge relationship can be usefully employed for explaining how power operates within society, how mechanisms of power affect everyday lives. Power is employed at all levels and through many dimensions including government. Schools exercise ‘epistemological power’ – a power to extract a knowledge of individuals from individuals. Because knowledge is a key element in the operation of power, the procedures applied to the formation and accumulation of knowledge cannot be considered neutral instruments for the presentation of the real. Consequently, the same institutions that produce and spread knowledge can be considered part of the ‘power-knowledge’ interrelation. Individuals have become both objects and subject in the development of knowledge. If education plays a fundamental role in shaping all aspects of communities in the same way, the structural changes resulting from economic, social and cultural development affect the educational systems. Analogously, the important changes related to social and economic development required legislative intervention to regulate the functioning of different areas in society. Knowledge can become a means of social control used by the government to manage populations. It can be argued that the evolution of Italy’s education systems is coherent with the idea that power and knowledge do not exist independently but instead are coterminous. This research aims to reduce such a gap by analysing the role of the state in the development of accounting education in Italy.

Keywords: education system, government, knowledge, power

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153 Greek Tragedy on the American Stage until the First Half of 20ᵗʰ: Identities and Intersections between Greek, Italian and Jewish Community Theatre

Authors: Papazafeiropoulou Olga

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The purpose of this paper focuses on exploring the emergence of Greek tragedy on the American stage until the first half of the 20th century through the intellectual processes and contributions of Greek, Italian and Jewish community theatre. Drawing on a wide range of sources, we trace Greek tragedy on the American stage, exploring the intricate processes of community’s theatre identities. The announcement aims to analyze the distinct yet related efforts of first Americans to intersect with Greek tragedy, searching simultaneously for the identities of immigrants. Ultimately, ancient drama became a vehicle not only for great developments in the American theater. In 1903, the Greek actor Dionysios Taboularis arrived in America, while the immigrant stream from Greece to America brought his artistic heritage, presenting in “Hall House” of Chicago the play Return. In 1906, in New York, an amateur group presented the play The Alosi of Messolonghi, and the next year in Chicago, an attempt was noted with a dramatic romance. In the decade 1907-1917, Nikolaos Matsoukas founded and directed the “Arbe theater”, while Petros Kotopoulis formed a troupe. In 1930, one of the greatest Greek theatrical events was the arrival of Marika’s Kotopoulis. Also, members of Vrysoula’s Pantopoulos formed the “Athenian Operetta”, with a positive influence on Greek American theatre. Italian immigrant community, located in tenement “Little Italies” throughout the city, and soon amateur theatrical clubs evolved. The earliest was the “Circolo Filodrammatico Italo-Americano” in 1880. Fausto Malzone’s artistic direction paved the way for the professional Italian immigrant theatre. Immigrant audiences heard the plays of their homeland, representing a major transition for this ethnic theatre. In 1900, the community had produced the major forces that created the professional theatre. By l905, the Italian American theatre had become firmly rooted in its professional phase. Yiddish Theater was both an import and a home-grown phenomenon. In 1878, The Sorceress was brought to America by Boris Thomashefsky. Between 1890 and 1940, many Yiddish theater companies appeared in America, presenting adaptations of classical plays. Αmerica’s people's first encounter with ancient texts was mostly academic. The tracing of tragedy as a form and concept that follows the evolutionary course of domestic social, aesthetic, and political ferments according to the international trends and currents draws conclusions about the early Greek, Italian, and Jewish immigrant’s theatre in relationship to the American scene until the first half of 20th century. Presumably, community theater acquired identity by intersecting with the spiritual reception of tragedy in America.

Keywords: American, community, Greek, Italian, identities, intersection, Jewish, theatre, tragedy

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152 Contrastive Focus Marking in Brazilian Children under Typical and Atypical Phonological Development

Authors: Geovana Soncin, Larissa Berti

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Some aspects of prosody acquisition remain still unclear, especially regarding atypical speech development processes. This work deals with prosody acquisition and its implications for clinical purposes. Therefore, we analyze speech samples produced by adult speakers, children in typical language development, and children with phonological disorders. Phonological disorder comprises deviating manifestations characterized by inconsistencies in the phonological representation of a linguistic system under acquisition. The clinical assessment is performed mostly based on contrasts whose manifestations occur in the segmental level of a phonological system. Prosodic organization of spoken utterances is not included in the standard assessment. However, assuming that prosody is part of the phonological system, it was hypothesized that children with Phonological Disorders could present inconsistencies that also occur at a prosodic level. Based on this hypothesis, the paper aims to analyze contrastive focus marking in the speech of children with Phonological Disorders in comparison with the speech of children under Typical Language Development and adults. The participants of all groups were native speakers of Brazilian Portuguese. The investigation was designed in such a way as to identify differences and similarities among the groups that could be interpreted as clues of normal or deviant processes of prosody acquisition. Contrastive focus in Brazilian Portuguese is marked by increasing duration, f0, and intensity on the focused element as well as by a particular type of pitch accent (L*+H). Thirty-nine subjects participated, thirteen from each group. Acoustic analysis was performed, considering duration, intensity, and intonation as parameters. Children with PD were recruited in sessions from a service provided by Speech-Language Pathology Therapy; children in TD, paired in age and sex with the first group, were recruited in a regular school; and 20-24 years old adults were recruited from a University class. In a game prepared to elicit focused sentences, all of them produced the sentence “Girls love red dress,” marking focus on different syntactic positions: subject, verb, and object. Results showed that adults, children in typical language development, and children with Phonological Disorders marked contrastive focus differently: typical children used all parameters like adults do; however, in comparison with them, they exaggerated duration and, in the opposite direction, they did not increase f0 in a sufficient magnitude as adults; children with Phonological Disorder presented inconsistencies in duration, not increasing it in some syntactic positions, and also in intonation, not producing the representative pitch accent of contrastive focus. The results suggest prosody is also affected by phonological disorder and give clues of developmental processes of prosody acquisition.

Keywords: Brazilian Portuguese, contrastive focus, phonological disorder, prosody acquisition

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151 Recognition by the Voice and Speech Features of the Emotional State of Children by Adults and Automatically

Authors: Elena E. Lyakso, Olga V. Frolova, Yuri N. Matveev, Aleksey S. Grigorev, Alexander S. Nikolaev, Viktor A. Gorodnyi

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The study of the children’s emotional sphere depending on age and psychoneurological state is of great importance for the design of educational programs for children and their social adaptation. Atypical development may be accompanied by violations or specificities of the emotional sphere. To study characteristics of the emotional state reflection in the voice and speech features of children, the perceptual study with the participation of adults and the automatic recognition of speech were conducted. Speech of children with typical development (TD), with Down syndrome (DS), and with autism spectrum disorders (ASD) aged 6-12 years was recorded. To obtain emotional speech in children, model situations were created, including a dialogue between the child and the experimenter containing questions that can cause various emotional states in the child and playing with a standard set of toys. The questions and toys were selected, taking into account the child’s age, developmental characteristics, and speech skills. For the perceptual experiment by adults, test sequences containing speech material of 30 children: TD, DS, and ASD were created. The listeners were 100 adults (age 19.3 ± 2.3 years). The listeners were tasked with determining the children’s emotional state as “comfort – neutral – discomfort” while listening to the test material. Spectrographic analysis of speech signals was conducted. For automatic recognition of the emotional state, 6594 speech files containing speech material of children were prepared. Automatic recognition of three states, “comfort – neutral – discomfort,” was performed using automatically extracted from the set of acoustic features - the Geneva Minimalistic Acoustic Parameter Set (GeMAPS) and the extended Geneva Minimalistic Acoustic Parameter Set (eGeMAPS). The results showed that the emotional state is worse determined by the speech of TD children (comfort – 58% of correct answers, discomfort – 56%). Listeners better recognized discomfort in children with ASD and DS (78% of answers) than comfort (70% and 67%, respectively, for children with DS and ASD). The neutral state is better recognized by the speech of children with ASD (67%) than by the speech of children with DS (52%) and TD children (54%). According to the automatic recognition data using the acoustic feature set GeMAPSv01b, the accuracy of automatic recognition of emotional states for children with ASD is 0.687; children with DS – 0.725; TD children – 0.641. When using the acoustic feature set eGeMAPSv01b, the accuracy of automatic recognition of emotional states for children with ASD is 0.671; children with DS – 0.717; TD children – 0.631. The use of different models showed similar results, with better recognition of emotional states by the speech of children with DS than by the speech of children with ASD. The state of comfort is automatically determined better by the speech of TD children (precision – 0.546) and children with ASD (0.523), discomfort – children with DS (0.504). The data on the specificities of recognition by adults of the children’s emotional state by their speech may be used in recruitment for working with children with atypical development. Automatic recognition data can be used to create alternative communication systems and automatic human-computer interfaces for social-emotional learning. Acknowledgment: This work was financially supported by the Russian Science Foundation (project 18-18-00063).

Keywords: autism spectrum disorders, automatic recognition of speech, child’s emotional speech, Down syndrome, perceptual experiment

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150 A Standard-Based Competency Evaluation Scale for Preparing Qualified Adapted Physical Education Teachers

Authors: Jiabei Zhang

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Although adapted physical education (APE) teacher preparation programs are available in the nation, a consistent standards-based competency evaluation scale for preparing of qualified personnel for teaching children with disabilities in APE cannot be identified in the literature. The purpose of this study was to develop a standard-based competency evaluation scale for assessing qualifications for teaching children with disabilities in APE. Standard-based competencies were reviewed and identified based on research evidence documented as effective in teaching children with disabilities in APE. A standard-based competency scale was developed for assessing qualifications for teaching children with disabilities in APE. This scale included 20 standard-based competencies and a 4-point Likert-type scale for each standard-based competency. The first standard-based competency is knowledgeable of the causes of disabilities and their effects. The second competency is the ability to assess physical education skills of children with disabilities. The third competency is able to collaborate with other personnel. The fourth competency is knowledgeable of the measurement and evaluation. The fifth competency is to understand federal and state laws. The sixth competency is knowledgeable of the unique characteristics of all learners. The seventh competency is the ability to write in behavioral terms for objectives. The eighth competency is knowledgeable of developmental characteristics. The ninth competency is knowledgeable of normal and abnormal motor behaviors. The tenth competency is the ability to analyze and adapt the physical education curriculums. The eleventh competency is to understand the history and the philosophy of physical education. The twelfth competency is to understand curriculum theory and development. The thirteenth competency is the ability to utilize instructional designs and plans. The fourteenth competency is the ability to create and implement physical activities. The fifteenth competency is the ability to utilize technology applications. The sixteenth competency is to understand the value of program evaluation. The seventeenth competency is to understand professional standards. The eighteenth competency is knowledgeable of the focused instruction and individualized interventions. The nineteenth competency is able to complete a research project independently. The twentieth competency is to teach children with disabilities in APE independently. The 4-point Likert-type scale ranges from 1 for incompetent to 4 for highly competent. This scale is used for assessing if one completing all course works is eligible for receiving an endorsement for teaching children with disabilities in APE, which is completed based on the grades earned on three courses targeted for each standard-based competency. A mean grade received in three courses primarily addressing a standard-based competency will be marked on a competency level in the above scale. The level 4 is marked for a mean grade of A one receives over three courses, the level 3 for a mean grade of B over three courses, and so on. One should receive a mean score of 3 (competent level) or higher (highly competent) across 19 standard-based competencies after completing all courses specified for receiving an endorsement for teaching children with disabilities in APE. The validity, reliability, and objectivity of this standard-based competency evaluation scale are to be documented.

Keywords: evaluation scale, teacher preparation, adapted physical education teachers, and children with disabilities

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149 Nigerian Football System: Examining Meso-Level Practices against a Global Model for Integrated Development of Mass and Elite Sport

Authors: I. Derek Kaka’an, P. Smolianov, D. Koh Choon Lian, S. Dion, C. Schoen, J. Norberg

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This study was designed to examine mass participation and elite football performance in Nigeria with reference to advance international football management practices. Over 200 sources of literature on sport delivery systems were analyzed to construct a globally applicable model of elite football integrated with mass participation, comprising of the following three levels: macro- (socio-economic, cultural, legislative, and organizational), meso- (infrastructures, personnel, and services enabling sport programs) and micro-level (operations, processes, and methodologies for development of individual athletes). The model has received scholarly validation and showed to be a framework for program analysis that is not culturally bound. The Smolianov and Zakus model has been employed for further understanding of sport systems such as US soccer, US Rugby, swimming, tennis, and volleyball as well as Russian and Dutch swimming. A questionnaire was developed using the above-mentioned model. Survey questions were validated by 12 experts including academicians, executives from sport governing bodies, football coaches, and administrators. To identify best practices and determine areas for improvement of football in Nigeria, 120 coaches completed the questionnaire. Useful exemplars and possible improvements were further identified through semi-structured discussions with 10 Nigerian football administrators and experts. Finally, content analysis of Nigeria Football Federation’s website and organizational documentation was conducted. This paper focuses on the meso-level of Nigerian football delivery, particularly infrastructures, personnel, and services enabling sport programs. This includes training centers, competition systems, and intellectual services. Results identified remarkable achievements coupled with great potential to further develop football in different types of public and private organizations in Nigeria. These include: assimilating football competitions with other cultural and educational activities, providing favorable conditions for employees of all possible organizations to partake and help in managing football programs and events, providing football coaching integrated with counseling for prevention of antisocial conduct, and improving cooperation between football programs and organizations for peace-making and advancement of international relations, tourism, and socio-economic development. Accurate reporting of the sports programs from the media should be encouraged through staff training for better awareness of various events. The systematic integration of these meso-level practices into the balanced development of mass and high-performance football will contribute to international sport success as well as national health, education, and social harmony.

Keywords: football, high performance, mass participation, Nigeria, sport development

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148 Effects of Long-Term Exposure of Cadmium to the Ovary of Lithobius forficatus (Myriapoda, Chilopoda)

Authors: Izabela Poprawa, Alina Chachulska-Zymelka, Lukasz Chajec, Grazyna Wilczek, Piotr Wilczek, Sebastian Student, Magdalena Rost-Roszkowska

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Heavy metals polluting the environment, especially soil, have a harmful effect on organisms, because they can damage the organ structure, disturb their function and cause developmental disorders. They can affect not only the somatic tissues but also the germinal tissues. In the natural environment, plants and animals are exposed to short- and long-term exposure to these stressors, which have a major influence on the functioning of these organisms. Numerous animals have been treated as the bioindicators of the environment. Therefore, studies on any alterations caused by, e.g., heavy metals are in the center of interests of not only environmental but also medical and biological science. Myriapods are invertebrates which are bioindicators of the environment. One of the species which lives in the upper layers of soil, particularly under stones and rocks is Lithobius forficatus (Chilopoda), commonly known as the brown centipede or stone centipede. It is a European species of the family Lithobiidae. This centipede living in the soil is exposed to, e.g., heavy metals such as cadmium, lead, arsenic. The main goal of our project was to analyze the impact of long-term exposure to cadmium on the structure of ovary with the emphasis on the course of oogenesis. As the material for analysis of cadmium exposure to ovaries, we chose the centipede species, L. forficatus. Animals were divided into two experimental groups: C – the control group, the animals cultured in laboratory conditions in a horticultural soil; Cd2 – the animals cultured in a horticultural soil supplemented with 80 mg/kg (dry weight) of CdCl2 for 45 days – long-term exposure. Animals were fed with Acheta and Chironomus larvae maintained in tap water. The analyzes were carried out using transmission electron microscopy (TEM), flow cytometry and laser scanning (confocal) microscopy. Here we present the results of long-term exposure to cadmium concentration in soil on the organ responsible for female germ cell formation. Analysis with the use of the transmission electron microscope showed changes in the ultrastructure of both somatic and germ cells in the ovary. Moreover, quantitative analysis revealed the decrease in the percentage of cells viability, the increase in the percentage of cells with depolarized mitochondria and increasing the number of early apoptotic cells. All these changes were statistically significant compared to the control. Additionally, an increase in the ADP/ATP index was recorded. However, changes were not statistically significant to the control. Acknowledgment: The study has been financed by the National Science Centre, Poland, grant no 2017/25/B/NZ4/00420.

Keywords: cadmium, centipede, ovary, ultrastructure

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147 In Vitro Fermentation Of Rich In B-glucan Pleurotus Eryngii Mushroom: Impact On Faecal Bacterial Populations And Intestinal Barrier In Autistic Children

Authors: Georgia Saxami, Evangelia N. Kerezoudi, Evdokia K. Mitsou, Marigoula Vlassopoulou, Georgios Zervakis, Adamantini Kyriacou

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Autism Spectrum Disorder (ASD) is a complex group of developmental disorders of the brain, characterized by social and communication dysfunctions, stereotypes and repetitive behaviors. The potential interaction between gut microbiota (GM) and autism has not been fully elucidated. Children with autism often suffer gastrointestinal dysfunctions, while alterations or dysbiosis of GM have also been observed. Treatment with dietary components has been postulated to regulate GM and improve gastrointestinal symptoms, but there is a lack of evidence for such approaches in autism, especially for prebiotics. This study assessed the effects of Pleurotus eryngii mushroom (candidate prebiotic) and inulin (known prebiotic compound) on gut microbial composition, using faecal samples from autistic children in an in vitro batch culture fermentation system. Selected members of GM were enumerated at baseline (0 h) and after 24 h fermentation by quantitative PCR. After 24 h fermentation, inulin and P. eryngii mushroom induced a significant increase in total bacteria and Faecalibacterium prausnitzii compared to the negative control (gut microbiota of each autistic donor with no carbohydrate source), whereas both treatments induced a significant increase in levels of total bacteria, Bifidobacterium spp. and Prevotella spp. compared to baseline (t=0h) (p for all <0.05). Furthermore, this study evaluated the impact of fermentation supernatants (FSs), derived from P. eryngii mushroom or inulin, on the expression levels of tight junctions’ genes (zonulin-1, occludin and claudin-1) in Caco-2 cells stimulated by bacterial lipopolysaccharides (LPS). Pre-incubation of Caco-2 cells with FS from P. eryngii mushroom led to a significant increase in the expression levels of zonulin-1, occludin and claudin-1 genes compared to the untreated cells, the cells that were subjected to LPS and the cells that were challenged with FS from negative control (p for all <0.05). In addition, incubation with FS from P. eryngii mushroom led to the highest mean expression values for zonulin-1 and claudin-1 genes, which differed significantly compared to inulin (p for all <0.05). Overall, this research highlighted the beneficial in vitro effects of P. eryngii mushroom on the composition of GM of autistic children after 24 h of fermentation. Also, our data highlighted the potential preventive effect of P. eryngii FSs against dysregulation of the intestinal barrier, through upregulation of tight junctions’ genes associated with the integrity and function of the intestinal barrier. This research has been financed by "Supporting Researchers with Emphasis on Young Researchers - Round B", Operational Program "Human Resource Development, Education and Lifelong Learning."

Keywords: gut microbiota, intestinal barrier, autism spectrum disorders, Pleurotus Eryngii

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146 Distributional and Developmental Analysis of PM2.5 in Beijing, China

Authors: Alexander K. Guo

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PM2.5 poses a large threat to people’s health and the environment and is an issue of large concern in Beijing, brought to the attention of the government by the media. In addition, both the United States Embassy in Beijing and the government of China have increased monitoring of PM2.5 in recent years, and have made real-time data available to the public. This report utilizes hourly historical data (2008-2016) from the U.S. Embassy in Beijing for the first time. The first objective was to attempt to fit probability distributions to the data to better predict a number of days exceeding the standard, and the second was to uncover any yearly, seasonal, monthly, daily, and hourly patterns and trends that may arise to better understand of air control policy. In these data, 66,650 hours and 2687 days provided valid data. Lognormal, gamma, and Weibull distributions were fit to the data through an estimation of parameters. The Chi-squared test was employed to compare the actual data with the fitted distributions. The data were used to uncover trends, patterns, and improvements in PM2.5 concentration over the period of time with valid data in addition to specific periods of time that received large amounts of media attention, analyzed to gain a better understanding of causes of air pollution. The data show a clear indication that Beijing’s air quality is unhealthy, with an average of 94.07µg/m3 across all 66,650 hours with valid data. It was found that no distribution fit the entire dataset of all 2687 days well, but each of the three above distribution types was optimal in at least one of the yearly data sets, with the lognormal distribution found to fit recent years better. An improvement in air quality beginning in 2014 was discovered, with the first five months of 2016 reporting an average PM2.5 concentration that is 23.8% lower than the average of the same period in all years, perhaps the result of various new pollution-control policies. It was also found that the winter and fall months contained more days in both good and extremely polluted categories, leading to a higher average but a comparable median in these months. Additionally, the evening hours, especially in the winter, reported much higher PM2.5 concentrations than the afternoon hours, possibly due to the prohibition of trucks in the city in the daytime and the increased use of coal for heating in the colder months when residents are home in the evening. Lastly, through analysis of special intervals that attracted media attention for either unnaturally good or bad air quality, the government’s temporary pollution control measures, such as more intensive road-space rationing and factory closures, are shown to be effective. In summary, air quality in Beijing is improving steadily and do follow standard probability distributions to an extent, but still needs improvement. Analysis will be updated when new data become available.

Keywords: Beijing, distribution, patterns, pm2.5, trends

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145 Diversity and Inclusion in Focus: Cultivating a Sense of Belonging in Higher Education

Authors: Naziema Jappie

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South Africa is a diverse nation but with many challenges. The fundamental changes in the political, economic and educational domains in South Africa in the late 1990s affected the South African community profoundly. In higher education, experiences of discrimination and bias are detrimental to the sense of belonging of staff and students. It is therefore important to cultivate an appreciation of diversity and inclusion. To bridge common understandings with the reality of racial inequality, we must understand the ways in which senior and executive leadership at universities think about social justice issues relating to diversity and inclusion and contextualize these within the current post-democracy landscape. The position and status of social justice issues and initiatives in South African higher education is a slow process. The focus is to highlight how and to what extent initiatives or practices around campus diversity and inclusion have been considered and made part of the mainstream intellectual and academic conversations in South Africa. This involves an examination of the social and epistemological conditions of possibility for meaningful research and curriculum practices, staff and student recruitment, and student access and success in addressing the challenges posed by social diversity on campuses. Methodology: In this study, university senior and executive leadership were interviewed about their perceptions and advancement of social justice and examine the buffering effects of diverse and inclusive peer interactions and institutional commitment on the relationship between discrimination–bias and sense of belonging for staff and students at the institutions. The paper further explores diversity and inclusion initiatives at the three institutions using a Critical Race Theory approach in conjunction with a literature review on social justice with a special focus on diversity and inclusion. Findings: This paper draws on research findings that demonstrate the need to address social justice issues of diversity and inclusion in the SA higher education context. The reason for this is so that university leaders can live out their experiences and values as they work to transform students into being accountable and responsible. Documents were selected for review with the intent of illustrating how diversity and inclusion work being done across an institution can shape the experiences of previously disadvantaged persons at these institutions. The research has highlighted the need for institutional leaders to embody their own mission and vision as they frame social justice issues for the campus community. Finally, the paper provides recommendations to institutions for strengthening high-level diversity and inclusion programs/initiatives among staff, students and administrators. The conclusion stresses the importance of addressing the historical and current policies and practices that either facilitate or negate the goals of social justice, encouraging these privileged institutions to create internal committees or task forces that focus on racial and ethnic disparities in the institution.

Keywords: diversity, higher education, inclusion, social justice

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144 Development of an Automatic Computational Machine Learning Pipeline to Process Confocal Fluorescence Images for Virtual Cell Generation

Authors: Miguel Contreras, David Long, Will Bachman

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Background: Microscopy plays a central role in cell and developmental biology. In particular, fluorescence microscopy can be used to visualize specific cellular components and subsequently quantify their morphology through development of virtual-cell models for study of effects of mechanical forces on cells. However, there are challenges with these imaging experiments, which can make it difficult to quantify cell morphology: inconsistent results, time-consuming and potentially costly protocols, and limitation on number of labels due to spectral overlap. To address these challenges, the objective of this project is to develop an automatic computational machine learning pipeline to predict cellular components morphology for virtual-cell generation based on fluorescence cell membrane confocal z-stacks. Methods: Registered confocal z-stacks of nuclei and cell membrane of endothelial cells, consisting of 20 images each, were obtained from fluorescence confocal microscopy and normalized through software pipeline for each image to have a mean pixel intensity value of 0.5. An open source machine learning algorithm, originally developed to predict fluorescence labels on unlabeled transmitted light microscopy cell images, was trained using this set of normalized z-stacks on a single CPU machine. Through transfer learning, the algorithm used knowledge acquired from its previous training sessions to learn the new task. Once trained, the algorithm was used to predict morphology of nuclei using normalized cell membrane fluorescence images as input. Predictions were compared to the ground truth fluorescence nuclei images. Results: After one week of training, using one cell membrane z-stack (20 images) and corresponding nuclei label, results showed qualitatively good predictions on training set. The algorithm was able to accurately predict nuclei locations as well as shape when fed only fluorescence membrane images. Similar training sessions with improved membrane image quality, including clear lining and shape of the membrane, clearly showing the boundaries of each cell, proportionally improved nuclei predictions, reducing errors relative to ground truth. Discussion: These results show the potential of pre-trained machine learning algorithms to predict cell morphology using relatively small amounts of data and training time, eliminating the need of using multiple labels in immunofluorescence experiments. With further training, the algorithm is expected to predict different labels (e.g., focal-adhesion sites, cytoskeleton), which can be added to the automatic machine learning pipeline for direct input into Principal Component Analysis (PCA) for generation of virtual-cell mechanical models.

Keywords: cell morphology prediction, computational machine learning, fluorescence microscopy, virtual-cell models

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143 Evaluation of Cooperative Hand Movement Capacity in Stroke Patients Using the Cooperative Activity Stroke Assessment

Authors: F. A. Thomas, M. Schrafl-Altermatt, R. Treier, S. Kaufmann

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Stroke is the main cause of adult disability. Especially upper limb function is affected in most patients. Recently, cooperative hand movements have been shown to be a promising type of upper limb training in stroke rehabilitation. In these movements, which are frequently found in activities of daily living (e.g. opening a bottle, winding up a blind), the force of one upper limb has to be equally counteracted by the other limb to successfully accomplish a task. The use of standardized and reliable clinical assessments is essential to evaluate the efficacy of therapy and the functional outcome of a patient. Many assessments for upper limb function or impairment are available. However, the evaluation of cooperative hand movement tasks are rarely included in those. Thus, the aim of this study was (i) to develop a novel clinical assessment (CASA - Cooperative Activity Stroke Assessment) for the evaluation of patients’ capacity to perform cooperative hand movements and (ii) to test its inter- and interrater reliability. Furthermore, CASA scores were compared to current gold standard assessments for upper extremity in stroke patients (i.e. Fugl-Meyer Assessment, Box & Blocks Test). The CASA consists of five cooperative activities of daily living including (1) opening a jar, (2) opening a bottle, (3) open and closing of a zip, (4) unscrew a nut and (5) opening a clipbox. Here, the goal is to accomplish the tasks as fast as possible. In addition to the quantitative rating (i.e. time) which is converted to a 7-point scale, also the quality of the movement is rated in a 4-point scale. To test the reliability of CASA, fifteen stroke subjects were tested within a week twice by the same two raters. Intra-and interrater reliability was calculated using the intraclass correlation coefficient (ICC) for total CASA score and single items. Furthermore, Pearson-correlation was used to compare the CASA scores to the scores of Fugl-Meyer upper limb assessment and the box and blocks test, which were assessed in every patient additionally to the CASA. ICC scores of the total CASA score indicated an excellent- and single items established a good to excellent inter- and interrater reliability. Furthermore, the CASA score was significantly correlated to the Fugl-Meyer and Box & Blocks score. The CASA provides a reliable assessment for cooperative hand movements which are crucial for many activities of daily living. Due to its non-costly setup, easy and fast implementation, we suggest it to be well suitable for clinical application. In conclusion, the CASA is a useful tool in assessing the functional status and therapy related recovery in cooperative hand movement capacity in stroke patients.

Keywords: activitites of daily living, clinical assessment, cooperative hand movements, reliability, stroke

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142 Effect of High Dose of Black Tea Extract on Physiological Parameters of Mother and Pups in Experimental Albino Rats

Authors: Avijit Dey, Antony Gomes, Subir Chandra Dasgupta

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Tea (Camellia sinensis) is the most popular beverages in the world and is ranked second after the water. Tea has been considered as a health promoting beverage since ancient times due to its health-promoting activity. Recently, immunomodulatory, anti-arthritic, antioxidant, anticancer and cardioprotective activity of tea has been established. Very few studies have demonstrated the effect of high dose of black tea on health. The aim of the present study was to evaluate the role of low & high dose of Black Tea Extract (BTE) on the different physiological parameters of mother and pups during prenatal and postnatal developmental period in the experimental rodent. BTE was orally administered in LD (50mg BTE/kg/day) and HD (100mg BTE/kg/day) except control groups of rats (n=6/group) throughout the prenatal (day 0-21) and postnatal (day 21-42) periods. During prenatal period (0, 7th, 14th, 20th days) body weight, urinary calcium, magnesium, urea and creatinine was measured. In postnatal period physical (0, 10th, 21th days) parameters of pups like body weight, cranial length, cranial diameter, neck width, tail length, craniosacral length of pups were analyzed. Liver and lungs from pups and kidney spleen, etc. from mothers were collected on day 42 for histopathological studies. The comparative urine strip and morphology of RBC was also analyzed by SEM from mothers of different groups on day 42. The level of cytokines like IL-1alpha, IL-1beta, IL-6, IL-10, TNF-alpha were analysed by enzyme-linked immunosorbent assay (ELISA) on day 0, day 20 and day 42. The body weight of LD and HD mothers were also significantly (P<0.05) less than control mothers at 20th day of pregnancy and there was also significant changes in urinary calcium, urea, creatinine. The bio morphometric analysis of pups showed significant alteration (P<0.05) in HD groups relative to control. Some histological alterations were also observed in pups and mothers. Comparative urine strip analysis and morphology of RBC showed significant changes in treated groups. LD and HD treated mothers showed an increase in proinflammatory cytokines like IL-1beta, TNF-alpha and decrease in anti-inflammatory cytokine-like IL-10 on day 20 compared to PC mothers. This study clearly indicated that high dose of BTE possesses detrimental effect on pregnant mother and the pup. Further studies are in progress to elucidate the molecular mechanism of actions. This project work has been sponsored by National Tea Research Foundation vide Project Sanction No.: 17 (305)/2013/4423 dated 11th March, 2014. All experimental protocols described in the study were approved by animal ethics committee.

Keywords: black tea extract, pregnancy, prenatal and postnatal development, inflammation

Procedia PDF Downloads 252
141 Overcoming Reading Barriers in an Inclusive Mathematics Classroom with Linguistic and Visual Support

Authors: A. Noll, J. Roth, M. Scholz

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The importance of written language in a democratic society is non-controversial. Students with physical, learning, cognitive or developmental disabilities often have difficulties in understanding information which is presented in written language only. These students suffer from obstacles in diverse domains. In order to reduce such barriers in educational as well as in out-of-school areas, access to written information must be facilitated. Readability can be enhanced by linguistic simplifications like the application of easy-to-read language. Easy-to-read language shall help people with disabilities to participate socially and politically in society. The authors state, for example, that only short simple words should be used, whereas the occurrence of complex sentences should be avoided. So far, these guidelines were not empirically proved. Another way to reduce reading barriers is the use of visual support, for example, symbols. A symbol conveys, in contrast to a photo, a single idea or concept. Little empirical data about the use of symbols to foster the readability of texts exist. Nevertheless, a positive influence can be assumed, e.g., because of the multimedia principle. It indicates that people learn better from words and pictures than from words alone. A qualitative Interview and Eye-Tracking-Study, which was conducted by the authors, gives cause for the assumption that besides the illustration of single words, the visualization of complete sentences may be helpful. Thus, the effect of photos, which illustrate the content of complete sentences, is also investigated in this study. This leads us to the main research question which was focused on: Does the use of easy-to-read language and/or enriching text with symbols or photos facilitate pupils’ comprehension of learning tasks? The sample consisted of students with learning difficulties (N = 144) and students without SEN (N = 159). The students worked on the tasks, which dealt with introducing fractions, individually. While experimental group 1 received a linguistically simplified version of the tasks, experimental group 2 worked with a variation which was linguistically simplified and furthermore, the keywords of the tasks were visualized by symbols. Experimental group 3 worked on exercises which were simplified by easy-to-read-language and the content of the whole sentences was illustrated by photos. Experimental group 4 received a not simplified version. The participants’ reading ability and their IQ was elevated beforehand to build four comparable groups. There is a significant effect of the different setting on the students’ results F(3,140) = 2,932; p = 0,036*. A post-hoc-analyses with multiple comparisons shows that this significance results from the difference between experimental group 3 and 4. The students in the group easy-to-read language plus photos worked on the exercises significantly more successfully than the students who worked in the group with no simplifications. Further results which refer, among others, to the influence of the students reading ability will be presented at the ICERI 2018.

Keywords: inclusive education, mathematics education, easy-to-read language, photos, symbols, special educational needs

Procedia PDF Downloads 128
140 Choking among Babies, Toddlers and Children with Special Needs: A Review of Mechanisms, Implications, Incidence, and Recommendations of Professional Prevention Guidelines

Authors: Ella Abaev, Shany Segal, Miri Gabay

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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

Procedia PDF Downloads 144
139 Writing the Roaming Female Self: Identity and Romantic Selfhood in Mary Wollstonecraft’s Letters Written during a Short Stay in Sweden, Denmark, and Norway (1796)

Authors: Kalyani Gandhi

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The eighteenth century in Britain saw a great burst of activity in writing (letters, journals, newspapers, essays); often these modes of writing had a public-spirited bent in-step with the prevailing intellectual atmosphere. Mary Wollstonecraft was one of the leading intellectuals of that period who utilized letter writing to convey her thoughts on the exciting political developments of the late eighteenth century. Fusing together her anxieties and concerns about humanity in general and herself in particular, Wollstonecraft’s views of the world around her are filtered through the lens of her subjectivity. Thus, Wollstonecraft’s letters covered a wide range of topics on both the personal and political level (for the two are often entwined in Wollstonecraft’s characteristic style of analysis) such as sentiment, gender, nature, peasantry, the class system, the legal system, political duties and rights of both rulers and subjects, death, immortality, religion, family and education. Therefore, this paper intends to examine the manner in which Wollstonecraft utilizes letter-writing to constitute and develop Romantic self-hood, understand the world around her and illustrate her ideas on the political and social happenings in Europe. The primary text analyzed will be Mary Wollstonecraft's Letters Written During a Short Stay in Sweden, Denmark and Norway (1796) and the analysis of this text will be supplemented by researching 18th-century British letter writing culture, with a special emphasis on the epistolary habits of women. Within this larger framework, this paper intends to examine the manner in which this hybrid of travel and epistolary writing aided Mary Wollstonecraft's expression on Romantic selfhood and how it was complicated by ideas of gender. This paper reveals Wollstonecraft's text to be wrought with anxiety about the world around her and within her; thus, the personal-public nature of the epistolary format particularly suits her characteristic point of view that looks within and without. That is to say, Wollstonecraft’s anxieties about gender and self, are as much about the women she sees in the world around her as much as they are about her young daughter and herself. Wollstonecraft constantly explores and examines this anxiety within the different but interconnected realms of politics, economics, history and society. In fact, it is her complex technique of entwining these aforementioned concerns with a closer look at interpersonal relationships among men and women (she often mentions specific anecdotes and instances) that make Wollstonecraft's Letters so engaging and insightful. Thus, Wollstonecraft’s Letters is an exemplar of British Romantic writing due to the manner in which it explores the bond between the individual and society. Mary Wollstonecraft's nuances this exploration by incorporating her concerns about women and the playing out of gender in society. Thus, Wollstonecraft’s Letters is an invaluable contribution to the field of British Romanticism, particularly as it offers crucial insight on female Romantic writing that can broaden and enrich the current academic understanding of the field.

Keywords: British romanticism, letters, feminism, travel writing

Procedia PDF Downloads 182
138 Melancholia, Nostalgia: Bernardo Soares after Fernando Pessoa

Authors: Maria de Fátima Lambert

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Bernardo Soares is one of Fernando Pessoa' several heteronyms (and "half-heteronyms"). Perhaps the one that brought together the majority of his qualities and characters of self-identity within the famous inner-persona-alter-diversity. The Book of Disquiet by Bernardo Soares was released in 1983, consisting of ontological remarks caught by an obsessive inquiring about self-existence. The book became a highly valuable substance when focusing upon the philosophical grounds of Pessoa's aesthetics. For sure, we cannot consider a single aesthetic, admitting that each heteronym has its own particular one, developed after different principles and convictions. Regarding Bernardo Soares, his thought arises from sequenced self-clues expressing peculiar existential doubtless presented as certainties -and vice-versa. His written self-search-images are reported, molding the painful awareness of existence through the discredited tolerance of any conclusive dialogue with others. Given the nature of Soares’ [maybe] unfinished writings, it is obvious that he headed far from his self-insurance-capsule: the office, bedroom, or even the walkscapes through Lisbon. The idea of travel/journey is one of the most relevant when recognizing his profound - although undercover - anguish as melancholy and nostalgia. In Bernardo Soares, Aesthetics is taken agonizingly, grounded upon discreet poetic phraseology and terms. His poetical awareness developed compulsive titles such "Aesthetics of Indifference", "Aesthetics of Discouragement". Soares' Aesthetics emerges directly from oneself, understanding art as inner acts and living experienced issues. Art is not freed from the intellectual expression of oneself emotions. The Disquiet Book is an existential nightmare nourished by everyday life, single written thoughts, balanced by melancholia, nostalgia, and distress. One might wonder if it was dreams that guided his fictional literary persona or the narrow facts of life itself. Along with his endless disquiet writing, Pessoa’s semi-heteronymous traveled without physically going anywhere. The complexity of inner existence is fulfilled by lonely mental walks and travels, as in two texts titled The Never Accomplished Journey. Although we also can consider other fragments, these are the deepest reflections about travelling. Let’s recall that Fernando Pessoa’s ortonyms writings -poems and essays- also addressed this issue from a philosophical perspective. We believe that this theme is one of the meaningful concepts for featuring the main principles of his aesthetics. As we know, Fernando Pessoa did not travel to foreign countries (or in Portugal), except for the journey, with his family, from Lisbon to South Africa (as a child) and, some years later, the return back to Lisbon. One may wonder why the poet never undertook other journeys. Maybe due to a disbelief in moving away from his comfort zone or due to the fear of becoming addicted to endless travels and the loss of his convenient self-closeness. In The Book of Disquiet, the poet shared his internal visions of the outer world but mainly visualizing his deepest enigmas and experiences -so strongly incorporated into reality and fiction.

Keywords: aesthetic principles, Bernardo Soares, Fernando Pessoa , melancholia, nostalgia, non-accomplished travel, The Book of Disquiet

Procedia PDF Downloads 97
137 Neuropsychiatric Outcomes of Intensive Music Therapy in Stroke Rehabilitation A Premilitary Investigation

Authors: Honey Bryant, Elvina Chu

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Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

Procedia PDF Downloads 78
136 Nutritional Status of Children in a Rural Food Environment, Haryana: A Paradox for the Policy Action

Authors: Neha Gupta, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora

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The concurrent increasing prevalence of underweight and overweight/obesity among children with changing lifestyle and the rapid transitioning society has necessitated the need for a unifying/multi-level approach to understand the determinants of the problem. The present community-based cross-sectional research study was conducted to assess the associations between lifestyle behavior and food environment of the child at household, neighborhood, and school with the BMI of children (6-12 year old) (n=612) residing in three rural clusters of Palwal district, Haryana. The study used innovative and robust methods for assessing the lifestyle and various components of food environment in the study. The three rural clusters selected for the study were located at three different locations according to their access to highways in the SOMAARTH surveillance site. These clusters were significantly different from each other in terms of their socio-demographic and socio-economic profile, living conditions, environmental hygiene, health seeking behavior and retail density. Despite of being different, the quality of living conditions and environmental hygiene was poor across three clusters. The children had higher intakes of dietary energy and sugars; one-fifth share of the energy being derived from unhealthy foods, engagement in high levels of physical activity and significantly different food environment at home, neighborhood and school level. However, despite having a high energy intake, 22.5% of the recruited children were thin/severe thin, and 3% were overweight/obese as per their BMI-for-age categories. The analysis was done using multi-variate logistic regression at three-tier hierarchy including individual, household and community level. The factors significantly explained the variability in governing the risk of getting thin/severe thin among children in rural area (p-value: 0.0001; Adjusted R2: 0.156) included age (>10years) (OR: 2.1; 95% CI: 1.0-4.4), the interaction between minority category and poor SES of the household (OR: 4.4; 95% CI: 1.6-12.1), availability of sweets (OR: 0.9; 95% CI: 0.8-0.99) and cereals (OR: 0.9; 95% CI: 0.8-1.0) in the household and poor street condition (proxy indicator of the hygiene and cleanliness in the neighborhood) (OR: 0.3; 95% CI: 0.1-1.1). The homogeneity of other factors at neighborhood and school level food environment diluted the heterogeneity in the lifestyles and home environment of the recruited children and their households. However, it is evident that when various individual factors interplay at multiple levels amplifies the risk of undernutrition in a rural community. Conclusion: These rural areas in Haryana are undergoing developmental, economic and societal transition. In correspondence, no improvements in the nutritional status of children have happened. Easy access to the unhealthy foods has become a paradox.

Keywords: transition, food environment, lifestyle, undernutrition, overnutrition

Procedia PDF Downloads 157
135 Modeling Engagement with Multimodal Multisensor Data: The Continuous Performance Test as an Objective Tool to Track Flow

Authors: Mohammad H. Taheri, David J. Brown, Nasser Sherkat

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Engagement is one of the most important factors in determining successful outcomes and deep learning in students. Existing approaches to detect student engagement involve periodic human observations that are subject to inter-rater reliability. Our solution uses real-time multimodal multisensor data labeled by objective performance outcomes to infer the engagement of students. The study involves four students with a combined diagnosis of cerebral palsy and a learning disability who took part in a 3-month trial over 59 sessions. Multimodal multisensor data were collected while they participated in a continuous performance test. Eye gaze, electroencephalogram, body pose, and interaction data were used to create a model of student engagement through objective labeling from the continuous performance test outcomes. In order to achieve this, a type of continuous performance test is introduced, the Seek-X type. Nine features were extracted including high-level handpicked compound features. Using leave-one-out cross-validation, a series of different machine learning approaches were evaluated. Overall, the random forest classification approach achieved the best classification results. Using random forest, 93.3% classification for engagement and 42.9% accuracy for disengagement were achieved. We compared these results to outcomes from different models: AdaBoost, decision tree, k-Nearest Neighbor, naïve Bayes, neural network, and support vector machine. We showed that using a multisensor approach achieved higher accuracy than using features from any reduced set of sensors. We found that using high-level handpicked features can improve the classification accuracy in every sensor mode. Our approach is robust to both sensor fallout and occlusions. The single most important sensor feature to the classification of engagement and distraction was shown to be eye gaze. It has been shown that we can accurately predict the level of engagement of students with learning disabilities in a real-time approach that is not subject to inter-rater reliability, human observation or reliant on a single mode of sensor input. This will help teachers design interventions for a heterogeneous group of students, where teachers cannot possibly attend to each of their individual needs. Our approach can be used to identify those with the greatest learning challenges so that all students are supported to reach their full potential.

Keywords: affective computing in education, affect detection, continuous performance test, engagement, flow, HCI, interaction, learning disabilities, machine learning, multimodal, multisensor, physiological sensors, student engagement

Procedia PDF Downloads 69
134 Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score

Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, burns, FLAMES, scoring systems, outcome

Procedia PDF Downloads 305
133 From Preoccupied Attachment Pattern to Depression: Serial Mediation Model on the Female Sample

Authors: Tatjana Stefanovic Stanojevic, Milica Tosic Radev, Aleksandra Bogdanovic

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Depression is considered to be a leading cause of death and disability in the female population, and that is the reason why understanding the dynamics of the onset of depressive symptomatology is important. A review of the literature indicates the relationship between depressive symptoms and insecure attachment patterns, but very few studies have examined the mechanism underlying this relation. The aim of the study was to examine the pathway from the preoccupied attachment pattern to depressive symptomatology, as well as to test the mediation effect of mentalization, social anxiety and rumination in this relationship using a serial mediation model. The research was carried out on a geographical cluster sample from the general population of Serbia included within the project ‘Indicators and models of family and work roles harmonization’ funded by the Ministry of Education, Science and Technological Development of the Republic of Serbia. This research was carried out on a subsample of 791 working-age female adults from 37 urban and rural locations distributed through 20 administrative districts of Serbia. The respondents filled in a battery of instruments, including Relationship Questionnaire - Clinical Version (RQ - CV), The Mentalization Scale (MentS), Scale of Social Anxiety (SA), Patient Ruminative Thought Style Questionnaire (RTSQ), Health Questionnaire (PHQ-9). The results confirm our assumption that the total indirect effect of the preoccupied attachment pattern to depressive symptoms is significant across all mediators separately. More importantly, this effect is still present in a model with a sequential mediator relationship, where social anxiety, rumination, and mentalization were perceived as serial mediators of a relationship between preoccupied attachment and depressive symptoms (estimated indirect effect=0.004, boot-strapped 95% CI=0.002 to 0.007). Our findings suggest that there is a significant specific indirect effect of the preoccupied attachment pattern to depressive symptoms, occurring through mentalization, social anxiety and rumination, indicating that preoccupied attachment cause decrease of a self related mentalization, which in turn causes increasing of social anxiety and rumination, concluding in depressive symptoms as a final consequence. The finding that the path from the preoccupied attachment pattern to depressive symptoms is typical in women is understandable from the perspective of both evolutionary and culturally conditioned gender differences. The practical implications of the study are reflected in the recommendations for the prevention and forehand psychotherapy response among preoccupied women with depressive symptomatology. Treatment of this specific group of depressed patients should be focused on strengthening mentalization, learning to accept and to understand herself better, reducing anxiety in situations where mistakes are visible to others, and replacing the rumination strategy with more constructive coping strategies.

Keywords: preoccupied attachment, depression, serial mediation model, mentalization, rumination

Procedia PDF Downloads 117
132 Sumac Sprouts: From in Vitro Seed Germination to Chemical Characterization

Authors: Leto Leandra, Guaitini Caterina, Agosti Anna, Del Vecchio Lorenzo, Guarrasi Valeria, Cirlini Martina, Chiancone Benedetta

Abstract:

To the best of our knowledge, this study represents the first attempt to investigate the in vitro germination response of Rhus coriaria L., and its sprout chemical characterization. Rhus coriaria L., a species belonging to the Anacardiaceae family, is commonly called "sumac" and is cultivated, in different countries of the Mediterranean and the Middle East regions, to produce a spice with a sour taste, obtained from its dried and ground fruits. Moreover, since ancient times, many beneficial properties have been attributed to this plant that has been used, in the traditional medicine of several Asian countries, against various diseases, including liver and intestinal pathologies, ulcers and various inflammatory states. In the recent past, sumac was cultivated in the Southern regions of Italy to treat leather, but its cultivation was abandoned, and currently, sumac plants grow spontaneously in marginal areas. Recently, in Italy, the interest in this species has been growing again, thanks to its numerous properties; thus, it becomes imperative to deepen the knowledge of this plant. In this study, in order to set up an efficient in vitro seed germination protocol, sumac seeds collected from spontaneous plants grown in Sicily, an island in the South of Italy, were, firstly, subjected to different treatments, scarification (mechanical, physical and chemical), cold stratification and imbibition, to break their physical and physiological dormancy, then, treated seeds were in vitro cultured on media with different gibberellic acid (GA3) concentrations. Results showed that, without any treatment, only 5% of in vitro sown seeds germinated, while the germination percentage increased up to 19% after the mechanical scarification. A further significative improvement of germination percentages was recorded after the physical scarification, with (40.5%) or without (36.5%) 8 weeks of cold stratification, especially when seeds were sown on gibberellin enriched cultured media. Vitro-derived sumac sprouts, at different developmental stages, were chemically characterized, in terms of polyphenol and tannin content, as well as for their antioxidant activity, to evaluate this matrix as a potential novel food or as a source of bioactive compounds. Results evidenced how more developed sumac sprouts and, above all, their leaves are a wealthy source of polyphenols (78.4 GAE/g SS) and tannins (21.9 mg GAE/g SS), with marked antioxidant activity. The outcomes of this study will be of support the nursery sector and sumac growers in obtaining a higher number of plants in a shorter time; moreover, the sprout chemical characterization will contribute to the process of considering this matrix as a new source of bioactive compounds and tannins to be used in food and non-food sectors.

Keywords: bioactive compounds, germination pre-treatments, rhus coriaria l., tissue culture

Procedia PDF Downloads 65
131 Sumac Sprouts: From in Vitro Seed Germination to Chemical Characterization

Authors: Leto Leandra, Guaitini Caterina, Agosti Anna, Del Vecchio Lorenzo, Guarrasi Valeria, Cirlini Martina, Chiancone Benedetta

Abstract:

To the best of our knowledge, this study represents the first attempt to investigate the in vitro germination response of Rhus coriaria L. and its sprout chemical characterization. Rhus coriaria L., a species belonging to the Anacardiaceae family, is commonly called "sumac” and is cultivated, in different countries of the Mediterranean and the Middle East regions, to produce a spice with a sour taste, obtained from its dried and ground fruits. Moreover, since ancient times, many beneficial properties have been attributed to this plant that has been used, in the traditional medicine of several Asian countries, against various diseases, including liver and intestinal pathologies, ulcers, and various inflammatory states. In the recent past, sumac was cultivated in the Southern regions of Italy to treat leather, but its cultivation was abandoned, and currently, sumac plants grow spontaneously in marginal areas. Recently, in Italy, the interest in this species has been growing again, thanks to its numerous properties; thus, it becomes imperative to deepen the knowledge of this plant. In this study, in order to set up an efficient in vitro seed germination protocol, sumac seeds collected from spontaneous plants grown in Sicily, an island in the South of Italy, were, firstly, subjected to different treatments, scarification (mechanical, physical and chemical), cold stratification and imbibition, to break their physical and physiological dormancy, then, treated seeds were in vitro cultured on media with different gibberellic acid (GA3) concentrations. Results showed that, without any treatment, only 5% of in vitro sown seeds germinated, while the germination percentage increased up to 19% after the mechanical scarification. A further significative improvement of germination percentages was recorded after the physical scarification, with (40.5%) or without (36.5%) 8 weeks of cold stratification, especially when seeds were sown on gibberellin enriched cultured media. Vitro-derived sumac sprouts, at different developmental stages, were chemically characterized, in terms of polyphenol and tannin content, as well as for their antioxidant activity, to evaluate this matrix as a potential novel food or as a source of bioactive compounds. Results evidenced how more developed sumac sprouts and, above all, their leaves are a wealthy source of polyphenols (78.4 GAE/g SS) and tannins (21.9 mg GAE/g SS), with marked antioxidant activity. The outcomes of this study will be of support the nursery sector and sumac growers in obtaining a higher number of plants in a shorter time; moreover, the sprout chemical characterization will contribute to the process of considering this matrix as a new source of bioactive compounds and tannins to be used in food and non-food sectors.

Keywords: bioactive compounds, germination pre-treatments, rhus coriaria l., tissue culture

Procedia PDF Downloads 53
130 The Use of Rotigotine to Improve Hemispatial Neglect in Stroke Patients at the Charing Cross Neurorehabilitation Unit

Authors: Malab Sana Balouch, Meenakshi Nayar

Abstract:

Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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129 Coastal Modelling Studies for Jumeirah First Beach Stabilization

Authors: Zongyan Yang, Gagan K. Jena, Sankar B. Karanam, Noora M. A. Hokal

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Jumeirah First beach, a segment of coastline of length 1.5 km, is one of the popular public beaches in Dubai, UAE. The stability of the beach has been affected by several coastal developmental projects, including The World, Island 2 and La Mer. A comprehensive stabilization scheme comprising of two composite groynes (of lengths 90 m and 125m), modification to the northern breakwater of Jumeirah Fishing Harbour and beach re-nourishment was implemented by Dubai Municipality in 2012. However, the performance of the implemented stabilization scheme has been compromised by La Mer project (built in 2016), which modified the wave climate at the Jumeirah First beach. The objective of the coastal modelling studies is to establish design basis for further beach stabilization scheme(s). Comprehensive coastal modelling studies had been conducted to establish the nearshore wave climate, equilibrium beach orientations and stable beach plan forms. Based on the outcomes of the modeling studies, recommendation had been made to extend the composite groynes to stabilize the Jumeirah First beach. Wave transformation was performed following an interpolation approach with wave transformation matrixes derived from simulations of a possible range of wave conditions in the region. The Dubai coastal wave model is developed with MIKE21 SW. The offshore wave conditions were determined from PERGOS wave data at 4 offshore locations with consideration of the spatial variation. The lateral boundary conditions corresponding to the offshore conditions, at Dubai/Abu Dhabi and Dubai Sharjah borders, were derived with application of LitDrift 1D wave transformation module. The Dubai coastal wave model was calibrated with wave records at monitoring stations operated by Dubai Municipality. The wave transformation matrix approach was validated with nearshore wave measurement at a Dubai Municipality monitoring station in the vicinity of the Jumeirah First beach. One typical year wave time series was transformed to 7 locations in front of the beach to count for the variation of wave conditions which are affected by adjacent and offshore developments. Equilibrium beach orientations were estimated with application of LitDrift by finding the beach orientations with null annual littoral transport at the 7 selected locations. The littoral transport calculation results were compared with beach erosion/accretion quantities estimated from the beach monitoring program (twice a year including bathymetric and topographical surveys). An innovative integral method was developed to outline the stable beach plan forms from the estimated equilibrium beach orientations, with predetermined minimum beach width. The optimal lengths for the composite groyne extensions were recommended based on the stable beach plan forms.

Keywords: composite groyne, equilibrium beach orientation, stable beach plan form, wave transformation matrix

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128 Distribution and Diversity of Pyrenocarpous Lichens in India with Special Reference to Forest Health

Authors: Gaurav Kumar Mishra, Sanjeeva Nayaka, Dalip Kumar Upreti

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Our nature exhibited presence of a number of unique plants which can be used as indicator of environmental condition of particular place. Lichens are unique plant which has an ability to absorb not only organic, inorganic and metaloties but also absorb radioactive nuclide substances present in the environment. In the present study pyrenocarpous lichens will used as indicator of good forest health in a particular place. The Pyrenocarpous lichens are simple crust forming with black dot like perithecia have few characters for their taxonomical segregation as compared to their foliose and fruticose brethrean. The thallus colour and nature, presence and absence of hypothallus are only few characters of thallus are used to segregate the pyrenocarpous taxa. The fruiting bodies of pyrenolichens i.e. ascocarps are perithecia. The perithecia and the contents found within them posses many important criteria for the segregation of pyrenocarpous lichen taxa. The ascocarp morphology, ascocarp arrangement, the perithecial wall, ascocarp shape and colour, ostiole shape and position, ostiole colour, ascocarp anatomy including type of paraphyses, asci shape and size, ascospores septation, ascospores wall and periphyses are the valuable charcters used for segregation of different pyrenocarpous lichen taxa. India is represented by the occurrence of the 350 species of 44 genera and eleven families. Among the different genera Pyrenula is dominant with 82 species followed by the Porina with 70 species. Recently, systematic of the pyrenocarpous lichens have been revised by American and European lichenologists using phylogenetic methods. Still the taxonomy of pyrenocarpous lichens is in flux and information generated after the completion of this study will play vital role in settlement of the taxonomy of this peculiar group of lichens worldwide. The Indian Himalayan region exhibit rich diversity of pyrenocarpous lichens in India. The western Himalayan region has luxuriance of pyrenocarpous lichens due to its unique topography and climate condition. However, the eastern Himalayan region has rich diversity of pyrenocarpous lichens due to its warmer and moist climate condition. The rich moist and warmer climate in eastern Himalayan region supports forest with dominance of evergreen tree vegetation. The pyrenocarpous lichens communities are good indicator of young and regenerated forest type. The rich diversity of lichens clearly indicates that moist of the forest within the eastern Himalayan region has good health of forest. Due to fast pace of urbanization and other developmental activities will defiantly have adverse effects on the diversity and distribution of pyrenocarpous lichens in different forest type and the present distribution pattern will act as baseline data for carried out future biomonitoring studies in the area.

Keywords: lichen diversity, indicator species, environmental factors, pyrenocarpous

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127 Predictors of Sexually Transmitted Infection of Korean Adolescent Females: Analysis of Pooled Data from Korean Nationwide Survey

Authors: Jaeyoung Lee, Minji Je

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Objectives: In adolescence, adolescents are curious about sex, but sexual experience before becoming an adult can cause the risk of high probability of sexually transmitted infection. Therefore, it is very important to prevent sexually transmitted infections so that adolescents can grow in healthy and upright way. Adolescent females, especially, have sexual behavior distinguished from that of male adolescents. Protecting female adolescents’ reproductive health is even more important since it is directly related to the childbirth of the next generation. This study, thus, investigated the predictors of sexually transmitted infection in adolescent females with sexual experiences based on the National Health Statistics in Korea. Methods: This study was conducted based on the National Health Statistics in Korea. The 11th Korea Youth Behavior Web-based Survey in 2016 was conducted in the type of anonymous self-reported survey in order to find out the health behavior of adolescents. The target recruitment group was middle and high school students nationwide as of April 2016, and 65,528 students from a total of 800 middle and high schools participated. The study was conducted in 537 female high school students (Grades 10–12) among them. The collected data were analyzed as complex sampling design using SPSS statistics 22. The strata, cluster, weight, and finite population correction provided by Korea Center for Disease Control & Prevention (KCDC) were reflected to constitute complex sample design files, which were used in the statistical analysis. The analysis methods included Rao-Scott chi-square test, complex samples general linear model, and complex samples multiple logistic regression analysis. Results: Out of 537 female adolescents, 11.9% (53 adolescents) had experiences of venereal infection. The predictors for venereal infection of the subjects were ‘age at first intercourse’ and ‘sexual intercourse after drinking’. The sexually transmitted infection of the subjects was decreased by 0.31 times (p=.006, 95%CI=0.13-0.71) for middle school students and 0.13 times (p<.001, 95%CI=0.05-0.32) for high school students whereas the age of the first sexual experience was under elementary school age. In addition, the sexually transmitted infection of the subjects was 3.54 times (p < .001, 95%CI=1.76-7.14) increased when they have experience of sexual relation after drinking alcohol, compared to those without the experience of sexual relation after drinking alcohol. Conclusions: The female adolescents had high probability of sexually transmitted infection if their age for the first sexual experience was low. Therefore, the female adolescents who start sexual experience earlier shall have practical sex education appropriate for their developmental stage. In addition, since the sexually transmitted infection increases, if they have sexual relations after drinking alcohol, the consideration for prevention of alcohol use or intervention of sex education shall be required. When health education intervention is conducted for health promotion for female adolescents in the future, it is necessary to reflect the result of this study.

Keywords: adolescent, coitus, female, sexually transmitted diseases

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126 The Use of Stroke Journey Map in Improving Patients' Perceived Knowledge in Acute Stroke Unit

Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon

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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.

Keywords: acute stroke, education, ischemic stroke, knowledge, stroke

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125 Pentosan Polysulfate Sodium: A Potential Treatment to Improve Bone and Joint Manifestations of Mucopolysaccharidosis I

Authors: Drago Bratkovic, Curtis Gravance, David Ketteridge, Ravi Krishnan, Michael Imperiale

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The mucopolysaccharidoses (MPSs) are a group of lysosomal storage diseases that have a common defect in the catabolism of glycosaminoglycans (GAGs). MPS I is the most common of the MPS diseases. Manifestations of MPS I include coarsening of facial features, corneal clouding, developmental delay, short stature, skeletal manifestations, hearing loss, cardiac valve disease, hepatosplenomegaly, and umbilical and inguinal hernias. Treatments for MPS I restore or activate the missing or deficient enzyme in the case of enzyme replacement therapy (ERT) and haematopoietic stem cell transplantation (HSCT). Pentosan polysulfate sodium (PPS) is a potential treatment to improve bone and joint manifestations of MPS I. The mechanisms of action of PPS that are relevant to the treatment of MPS I are the ability to: (i) Reduce systemic and accumulated GAG, (ii) Reduce inflammatory effects via the inhibition of NF-kB, resulting in the reduction in pro-inflammatory mediators. (iii) Reduce the expression of the pain mediator nerve growth factor in osteocytes from degenerating joints. (iv) Inhibit the cartilage degrading enzymes related to joint dysfunction in MPS I. PPS is being evaluated as an adjunctive therapy to ERT and/or HSCT in an open-label, single-centre, phase 2 study. Patients are ≥ 5 years of age with a diagnosis of MPS I and previously received HSCT and/or ERT. Three white, female, patients with MPS I-Hurler, ages 14, 15, and 19 years, and one, white male patient aged 15 years are enrolled. All were diagnosed at ≤2 years of age. All patients received HSCT ≤ 6 months after diagnosis. Two of the patients were treated with ERT prior to HSCT, and 1 patient received ERT commencing 3 months prior to HSCT. Two patients received 0.75mg/kg and 2 patients received 1.5mg/kg of PPS. PPS was well tolerated at doses of 0.75 and 1.5 mg/kg to 47 weeks of continuous dosing. Of the 19 adverse events (AEs), 2 were related to PPS. One AE was moderate (pre-syncope) and 1 was mild (injection site bruising), experienced in the same patient. All AEs were reported as mild or moderate. There have been no SAEs. One subject experienced a COVID-19 infection and PPS was interrupted. The MPS I signature GAG fragments, sulfated disaccharide and UA-HNAc S, tended to decrease in 3 patients from baseline through Week 25. Week 25 GAG data are pending for the 4th patient. Overall, most biomarkers (inflammatory, cartilage degeneration, and bone turnover) evaluated in the 3 patients with 25-week assessments have indicated either no change or a reduction in levels compared to baseline. In 3 patients, there was a trend toward improvement in the 2MWT from baseline to Week 48 with > 100% increase in 1 patient (01-201). In the 3 patients that had Week 48 assessments, patients and proxies reported improvement in PGIC, including “worthwhile difference” (n=1), or “made all the difference” (n=2).

Keywords: MPS I, pentosan polysulfate sodium, clinical study, 2MWT, QoL

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