Total Energy Expenditure and Body Composition of Children with Developmental Disabilities

Background Obesity prevalence is increased in children with developmental disabilities, specifically in children with spina bifida and Down syndrome. Energy expenditure, a critical aspect of weight management, has been extensively studied in the typically developing population, but not adequately studied in children with developmental disabilities. Objective Determine energy expenditure, fat-free mass and body fat percentile and the impact of these findings on recommended caloric intake in children with spina bifida and Down syndrome. Methods/Measures This pilot study included 36 children, 18 with spina bifida, 9 with Down syndrome and 9 typically developing children. Half of the children with spina bifida were non-ambulatory. Doubly labeled water was used to measure energy expenditure and body composition. Descriptive statistics described the sample and MANOVA and ANOVA methods were used to evaluate differences between groups. Results Energy expenditure was significantly less for children with spina bifida who primarily used a wheelchair (p = .001) and children with Down syndrome (p = .041) when compared to children without a disability when adjusted for fat-free mass. However, no significant difference was detected in children with spina bifida who ambulated without assistance (p = .072). Conclusions Children with spina bifida and Down syndrome have a significantly decreased energy expenditure which directly impacts recommended caloric intake. No significant difference was detected for children with spina bifida who ambulated, although the small sample size of this pilot study may have limited these findings. Validating these results in a larger study is integral to supporting successful weight management of these children

On the monotone stability approach to BSDEs with jumps: Extensions, concrete criteria and examples

We show a concise extension of the monotone stability approach to backward stochastic differential equations (BSDEs) that are jointly driven by a Brownian motion and a random measure for jumps, which could be of infinite activity with a non-deterministic and time inhomogeneous compensator. The BSDE generator function can be non convex and needs not to satisfy global Lipschitz conditions in the jump integrand. We contribute concrete criteria, that are easy to verify, for results on existence and uniqueness of bounded solutions to BSDEs with jumps, and on comparison and a-priori $L^{\infty}$-bounds. Several examples and counter examples are discussed to shed light on the scope and applicability of different assumptions, and we provide an overview of major applications in finance and optimal control.Comment: 28 pages. Added DOI https://link.springer.com/chapter/10.1007%2F978-3-030-22285-7_1 for final publication, corrected typo (missing gamma) in example 4.1

A guided tour of asynchronous cellular automata

Research on asynchronous cellular automata has received a great amount of attention these last years and has turned to a thriving field. We survey the recent research that has been carried out on this topic and present a wide state of the art where computing and modelling issues are both represented.Comment: To appear in the Journal of Cellular Automat

Exploring Tension in Hybrid Organizations in Times of Covid-19 Crisis. The Italian Benefit Corporations’ experience

The COVID-19 pandemic has caused an unprecedented social and economic crisis, not least for hybrid organisations, as they must manage the tension arising from their dual mission to create social and economic value. Building on a theoretical framework for hybrid tension, our work contextualises how tensions emerge and are managed in hybrid organisations when they are exposed to exogenous shocks. We address the following research question. How have hybrid organisations managed the tensions arising from their dual purpose during the COVID-19 crisis? Our focus is on Italian benefit corporations, which are organisations combining social and economic objectives. We conduct two focus groups with 12 Italian benefit corporations. Our findings show the emergence of four constructs that capture the responses to the COVID-19 crisis: social and/or commercial orientation; technological characterisation; internal and external stakeholder relationship; openness to changes. We explain the relationship of these constructs via a framework of performing, organising, learning, and belonging tensions

Mission, governance, and accountability of benefit corporations: Toward a commitment device for achieving commercial and social goals

Benefit corporations (BCs) are profit-with-purpose organizations regulated by a legal framework for establishing explicit commitments in terms of multi-stakeholder governance and accountability structures. We comprehensively analyze the theoretical alignment of four concepts (ownership, mission, governance, and accountability) to explain the legal rationale for BCs' unique corporate form. However, the boundaries of BC legislation are blurry, leaving them open to top-down governance arrangements and weak accountability. To explore this ambiguity, this paper investigates whether BCs implement a de facto (i.e., beyond the letter of the law) multi-stakeholder structure with governance models and downward accountability mechanisms that balance different stakeholders' interests, instead of focusing only on shareholder profits. This further highlight the soft boundaries imposed by the BC regulatory framework and suggests that more work is needed to explore the relationship between governance models that differently balance stakeholders' claims and the firm's social performance

A fretting fatigue setup for testing shrink-fit connections and experimental evidence of the strength enhancement induced by deep rolling

Fretting tests are usually performed on flat specimens with lateral contacting pads. The shrink-fitted connection, which experiences fretting at the edge of the contact, prompted the alternative use of a round-shaped specimen. This simplified the equipment and provided an accurate alignment between the fretting specimen and the external hub which plays the role of the pad. The deep rolling treatment can also be efficiently applied to a round shape, which would otherwise be difficult on the flat specimen geometry. After introducing this solution for fretting testing, the paper shows an experimental campaign on three shrink-fitted connections with different sizes and material combinations. There was a significant improvement in fretting fatigue strength, induced by the deep rolling, for all three specimen types. Finally, scanning electron microscopic analyses provided insights into the fretting fatigue nucleation mechanisms both for untreated and deep-rolled specimens

Utilising the Intel RealSense camera for measuring health outcomes in clinical research

Applications utilising 3D Camera technologies for the measurement of health outcomes in the health and wellness sector continues to expand. The Intel® RealSense™ is one of the leading 3D depth sensing cameras currently available on the market and aligns itself for use in many applications, including robotics, automation, and medical systems. One of the most prominent areas is the production of interactive solutions for rehabilitation which includes gait analysis and facial tracking. Advancements in depth camera technology has resulted in a noticeable increase in the integration of these technologies into portable platforms, suggesting significant future potential for pervasive in-clinic and field based health assessment solutions. This paper reviews the Intel RealSense technology’s technical capabilities and discusses its application to clinical research and includes examples where the Intel RealSense camera range has been used for the measurement of health outcomes. This review supports the use of the technology to develop robust, objective movement and mobility-based endpoints to enable accurate tracking of the effects of treatment interventions in clinical trials

A paediatric pain assessment and management survey at Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa

Background. Painful experiences are common in the paediatric inpatient population. Immaturity and cognitive impairment may preclude clear description of such experiences, and requests for analgesia when needed. Methods of pain assessment and guidelines for treatment in the paediatric population are well established, but are not widely used. Limited data suggest that the situation is similar in South Africa (SA).Objectives. To review the assessment and management of pain in SA medical paediatric inpatients. The primary objective was to determine the proportion of children who receive analgesia where indicated. The secondary objectives were to determine the prevalence of pain, at presentation and among admitted patients, whether pain evaluations were performed and pain treated, and the adequacy of such treatment.Methods. A prospective cross-sectional survey of medical paediatric inpatients at Rahima Moosa Mother and Child Hospital (RMMCH) in Johannesburg, SA, was conducted. The tool used for data collection was specifically designed for the study, with sections for demographic data, patient or caregiver interview, and chart review. Pain assessments were done using the revised Face, Legs, Activity, Cry, Consolability Scale and the Neonatal/Infant Pain Scale. The analysis consisted of descriptive statistics of epidemiological data and comparative statistics using grouped variables, with the level of significance set at p<0.05.Results. The sample consisted of 74 children, aged between 3 days and 4 years. Male patients accounted for 58% of the cohort. The prevalence of pain at admission was 73% (n=53). Eight percent (n=6) of the study sample had pain evaluation at admission, and only 1 child had been evaluated for pain within the preceding 24 hours. Of the 74 patients reviewed, 10% (n=7) received appropriate analgesia. Paracetamol was given to 31% of patients (n=23), either for pyrexia or for an undocumented indication. More than half of the study sample (59%; n=44) received no analgesia. The presence of pain, both by caregiver report (p=0.62) and by pain score (p=0.074), was not associated with the administration of analgesia.Conclusion. Pain in the paediatric population at RMMCH was found to be common, but it was seldom assessed, and validated pain scores were rarely used. The result was inadequate pain management in all the four domains of assessment, intervention, reassessment and ongoing management

Estimation of Orofacial Kinematics in Parkinson's Disease: Comparison of 2D and 3D Markerless Systems for Motion Tracking

Orofacial deficits are common in people with Parkinson's disease (PD) and their evolution might represent an important biomarker of disease progression. We are developing an automated system for assessment of orofacial function in PD that can be used in-home or in-clinic and can provide useful and objective clinical information that informs disease management. Our current approach relies on color and depth cameras for the estimation of 3D facial movements. However, depth cameras are not commonly available, might be expensive, and require specialized software for control and data processing. The objective of this paper was to evaluate if depth cameras are needed to differentiate between healthy controls and PD patients based on features extracted from orofacial kinematics. Results indicate that 2D features, extracted from color cameras only, are as informative as 3D features, extracted from color and depth cameras, differentiating healthy controls from PD patients. These results pave the way for the development of a universal system for automatic and objective assessment of orofacial function in PD.Comment: 4 pages, 1 tabl