Accessible Learning Management Systems: Students’ Experiences and Insights

Learning Management System (LMS) is a type of an e-learning system is one of the main infrastructural requirements that improves access to higher education for persons with disabilities. The primary aim of the research study[1] was to explore perceptions of students with disabilities regarding the use and accessibility of learning management systems and benefits and/or barriers in e-learning. Students mainly have negative experiences while attempting to enter university web-sites/libraries/LMSs because of the inadequate adaptation to the specific needs of students with disabilities. In countries that do not have a developed LMS, the prevalent mean of communication with professors is via e-mail, in those where there is a LMS, there is not a fully accessibility of entire content and services for students with special needs. This research defined the need for creation of an accessible LMS or adjusted already existing LMS with accessibility solutions such as: a text-to-speech engine for blind students, a mode with sign language support for deaf students and a mode which supports dyslexic.Â

Excess Mortality in a Nephrology Clinic during First Months of Coronavirus Disease-19 Pandemic: A Pragmatic Approach

BACKGROUND: Excess mortality is defined as mortality above what would be expected based on the non-crisis mortality rate in the population of interest. AIM: In this study, we aimed to access weather the coronavirus disease (COVID)-19 pandemic had impact on the in-hospital mortality during the first 6 months of the year and compare it with the data from the previous years. METHODS: A retroprospective study was conducted at the University Clinic of Nephrology Skopje, Republic of Macedonia. In-hospital mortality rates were calculated for the first half of the year (01.01–30.06) from 2015 until 2020, as monthly number of dead patients divided by the number of non-elective hospitalized patents in the same period. The excess mortality rate (p-score) was calculated as ratio or percentage of excess deaths relative to expected average deaths: (Observed mortality rate–expected average death rate)/expected average death rate *100%. RESULTS: The expected (average) overall death mortality rate for the period 2015–2019 was 8.9% and for 2020 was 15.3%. The calculated overall excess mortality in 2020 was 72% (pscore 0.72). CONCLUSION: In this pragmatic study, we have provided clear evidence of high excess mortality at our nephrology clinic during the 1st months of the COVID-19 pandemic. The delayed referral of patients due to the patient and health care system-related factors might partially explain the excess mortality during pandemic crises. Further analysis is needed to estimate unrecognized probable COVID-19 deaths

Predictors for developmental delay in children with cerebral palsy and at-risk children

The first three years of life (zero to three) are a period of great importance when discovering the congenital, as well as the acquired disorders and developmental delays. Recognizing milestones and manifestations of certain behaviors helps us identify developmental delays and disruptions. With this research we intended to determine the segments of developmental achievements and developmental discrepancies of psycho-motor development (general development achievements, motor functions, surrounding motor functions and communication) in infancy and early childhood (zero to three years old) in three groups of respondents. The research sample included 104 respondents. Sixty-three of them had been diagnosed with cerebral palsy (thirty-three were without comorbidity convulsions, and thirty were with comorbidity convulsions-epilepsy), and forty-one respondents were born with a risk factor for a developmental delay. The research was conducted using the standardized developmental instrument Chuturic Developmental Scale for evaluation of the psycho-motor development, which encompasses oculomotorics, emotional development, speech, hearing-motor reactions, communication, socialization and verbalization, of infants and small children. The analysis of results concluded that there is a discrepancy in the developmental achievements of the three groups of respondents. Based on analysis of the values of the Global Development Coefficient (GDC), we have determined that the most affected group is the group of children with cerebral palsy and comorbidity convulsions where the average value of GDC is 47.77. Early and precision diagnostics, as well as knowledge of the developmental characteristics of different categories of developmental delays will improve the prognosis and contribute to better utilization of the brain plasticity in children with cerebral damage and children born at risk. Early intervention and stimulation are more than necessary to maximize the child's full potential, reduce the primary effects of the damage or prevent secondary damages and difficulties

Fostering Accessible Study Technologies (FAST): accessible Learning Management System in Humanities and Social Sciences

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Predictive performance and clinical application of COV50, a urinary proteomic biomarker in early COVID-19 infection : a prospective multicentre cohort study

Background: The SARS-CoV-2 pandemic is a worldwide challenge. The CRIT-CoV-U pilot study generated a urinary proteomic biomarker consisting of 50 peptides (COV50), which predicted death and disease progression from SARS-CoV-2. After the interim analysis presented for the German Government, here, we aimed to analyse the full dataset to consolidate the findings and propose potential clinical applications of this biomarker. Methods: CRIT-CoV-U was a prospective multicentre cohort study. In eight European countries (Austria, France, Germany, Greece, North Macedonia, Poland, Spain, and Sweden), 1012 adults with PCR-confirmed COVID-19 were followed up for death and progression along the 8-point WHO scale. Capillary electrophoresis coupled with mass spectrometry was used for urinary proteomic profiling. Statistical methods included logistic regression and receiver operating characteristic curve analysis with a comparison of the area under curve (AUC) between nested models. Hospitalisation costs were derived from the care facility corresponding with the Markov chain probability of reaching WHO scores ranging from 3 to 8 and flat-rate hospitalisation costs adjusted for the gross per capita domestic product of each country. Findings: From June 30 to Nov 19, 2020, 228 participants were recruited, and from April 30, 2020, to April 14, 2021, 784 participants were recruited, resulting in a total of 1012 participants. The entry WHO scores were 1–3 in 445 (44%) participants, 4–5 in 529 (52%) participants, and 6 in 38 (4%) participants; and of all participants, 119 died and 271 had disease progression. The odds ratio (OR) associated with COV50 in all 1012 participants for death was 2·44 (95% CI 2·05–2·92) unadjusted and 1·67 (1·34–2·07) when adjusted for sex, age, BMI, comorbidities, and baseline WHO score; and for disease progression, the OR was 1·79 (1·60–2·01) when unadjusted and 1·63 (1·41–1·91) when adjusted (p<0·0001 for all). The predictive accuracy of the optimised COV50 thresholds was 74·4% (71·6–77·1%) for mortality (threshold 0·47) and 67·4% (64·4–70·3%) for disease progression (threshold 0·04). When adjusted for covariables and the baseline WHO score, these thresholds improved AUCs from 0·835 to 0·853 (p=0·033) for death and from 0·697 to 0·730 (p=0·0008) for progression. Of 196 participants who received ambulatory care, 194 (99%) did not reach the 0·04 threshold. The cost reductions associated with 1 day less hospitalisation per 1000 participants were million Euro (M€) 0·887 (5–95% percentile interval 0·730–1·039) in participants at a low risk (COV50 <0·04) and M€2·098 (1·839-2·365) in participants at a high risk (COV50 ≥0·04). Interpretation: The urinary proteomic COV50 marker might be predictive of adverse COVID-19 outcomes. Even in people with mild-to-moderate PCR-confirmed infections (WHO scores 1–4), the 0·04 COV50 threshold justifies earlier drug treatment, thereby potentially reducing the number of days in hospital and associated costs. Funding: German Federal Ministry of Health