Effectiveness of mind simulation on stuttering in a patient with spastic diplegia: A case report

BACKGROUND: Cerebral palsy (CP) is a non-progressive brain lesion that causes impaired muscle coordination. Diplegia is a type of limb paralysis that usually involves the symmetry organs, with the involvement of lower organs being more than the upper organs. Patients with diplegia have a type of secondary muscle tension dysphonia due to speech-breathing disorders and speech problems including stuttering. This study is conducted aiming to evaluate the effectiveness of the mind simulation method on improving stuttering in a patient with spastic diplegia.CASE REPORT: The patient was an 11-year-old boy diagnosed with spastic diplegia with stuttering disorder and had long been treated with chlorsospasm and was selected by purposive sampling method. After 21 days of assessment in the baseline stage (A), he was treated with mind simulation (B) for 10 weeks. Evaluations were carried out every 10 days and totally, 7 evaluations were carried out. Data were analyzed in a reversal design through visual method, chart slope analysis, and comparison of subjects' mean performance at baseline and intervention stages using SPSS software.CONCLUSION: The primary outcomes showed that the simulation method was associated with decreased stuttering in the patient (P < 0.01). The secondary outcomes showed decreasing scores of frequency indices, delay, movements of hand, head, face, body, mouth, and psychological factors in Stuttering Severity Instrument (SSI) (P < 0.01). The findings of this study indicated that the use of the mind simulation method as a complementary intervention could be associated with a decrease in stuttering symptoms in patients with spastic diplegia

A full investigation of the directional congestion in data envelopment analysis

One of interesting subjects in Data Envelopment Analysis (DEA) is estimation of congestion of Decision Making Units (DMUs). Congestion is evidenced when decreases (increases) in some inputs result in increases (decreases) in some outputs without worsening (improving) any other input/output. Most of the existing methods for measuring the congestion of DMUs utilize the traditional definition of congestion and assume that inputs and outputs change with the same proportion. Therefore, the important question that arises is whether congestion will occur or not if the decision maker (DM) increases or decreases the inputs dis-proportionally. This means that, the traditional definition of congestion in DEA may be unable to measure the congestion of units with multiple inputs and outputs. This paper focuses on the directional congestion and proposes methods for recognizing the directional congestion using DEA models. To do this, we consider two different scenarios: (i) just the input direction is available. (ii) none of the input and output directions are available. For each scenario, we propose a method consists in systems of inequalities or linear programming problems for estimation of the directional congestion. The validity of the proposed methods are demonstrated utilizing two numerical examples

Funciones ejecutables de las representaciones en el aprendizaje de los conceptos algebraicos

This study aimed to examine the role of multiple representations in learning algebraic concepts for high school students. Using the semiexperimental research method for teaching of numerical, symbolic, and graphical representations, and traditional teaching, 83 female students were selected from the tenth grade of a high school in Tehran. We concluded that there is a significant difference between the mean scores of mathematics in the control and experimental groups. Using the method based on different representations helped the students to become creative and provide similar Algebra examples; thereby analysis power will be increased.Este estudio tiene como objetivo examinar el papel de las representaciones múltiples en el aprendizaje de los conceptos algebraicos en estudiantes de educación secundaria. Se desarrolló una investigación semiexperimental para la enseñanza de representaciones numéricas, simbólicas y gráficas y la enseñanza tradicional, en este estudio participaron 83 estudiantes femeninas del décimo grado de una escuela secundaria en Teherán. Se concluyó que hay una diferencia significativa entre los puntajes promedio de matemáticas en el grupo control y los grupos experimentales. El uso del método basado en diferentes representaciones ayudó a las estudiantes a ser creativas y proporcionar ejemplos de álgebra similares; por lo tanto, la capacidad de análisis aumentará

Syntheses of hydroxyapatite from natural sources

Waste materials from natural sources are important resources for extraction and recovery of valuable compounds. Transformation of these waste materials into valuable materials requires specific techniques and approaches. Hydroxyapatite (HAp) is a biomaterial that can be extracted from natural wastes. HAp has been widely used in biomedical applications owing to its excellent bioactivity, high biocompatibility, and excellent osteoconduction characteristics. Thus, HAp is gaining prominence for applications as orthopaedic implants and dental materials. This review summarizes some of the recent methods for extraction of HAp from natural sources including mammalian, aquatic or marine sources, shell sources, plants and algae, and from mineral sources. The extraction methods used to obtain hydroxyapatite are also described. The effect of extraction process and natural waste source on the critical properties of the HAp such as Ca/P ratio, crystallinity and phase assemblage, particle sizes, and morphology are discussed herein

Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings

Mapping child growth failure across low- and middle-income countries

Child growth failure (CGF), manifested as stunting, wasting, and underweight, is associated with high 5 mortality and increased risks of cognitive, physical, and metabolic impairments. Children in low- and middle-income countries (LMICs) face the highest levels of CGF globally. Here we illustrate national and subnational variation of under-5 CGF indicators across LMICs, providing 2000–2017 annual estimates mapped at a high spatial resolution and aggregated to policy-relevant administrative units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the World Health 10 Organization’s ambitious Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and rates of progress exist across regions, countries, and within countries; our maps identify areas where high prevalence persists even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where subnational disparities exist and the highest-need populations reside, these geospatial estimates can support policy-makers in planning locally 15 tailored interventions and efficient directing of resources to accelerate progress in reducing CGF and its health implications

Mapping disparities in education across low- and middle-income countries

Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations. Educational attainment is an important social determinant of maternal, newborn, and child health(1-3). As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting(4-6). The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness(7,8); however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health(9-11). Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but-to our knowledge-no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries(12-14). By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.Peer reviewe

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH