The Sensory Processing 3-Dimensions Scale: Initial Studies of Reliability and Item Analyses

Background: The Sensory Processing 3-Dimensions Scale (SP-3D) is a performance-based measure for assessing sensory processing abilities and challenges, including sensory modulation, sensory discrimination, and sensory-based motor disorders. Initial studies of reliability were conducted, and item response theory was applied to assist in refining the measure. Methods: Descriptive and correlational methods were used to examine internal consistency of the scales and inter-rater reliability. Item response theory using Rasch analyses was applied to examine unidimensionality of scales, model fit, and item difficulty. Results: Internal consistency for most measures was acceptable, demonstrating the subtests, domains, and behavior scales as distinct constructs. Inter-rater reliability results were mixed, with fair to strong reliability coefficients for most sensory discrimination and postural and praxis subtests. Scales measuring sensory modulation and motor behaviors had moderate to poor inter-observer agreement. Rasch analyses supported subtests as unidimensional and identified the most rigorous items in the subtests. Conclusions: Preliminary results show promise of the SP-3D as a stable, reliable tool. A need for refinement of some operational definitions for behavior ratings was identified, and items to consider for elimination because of redundancy or ill-fit were exposed. Directions for research include refinement of the SP-3D and the need for further reliability and validity studies

Dimensioning V2N services in 5G networks through forecast-based scaling

With the increasing adoption of intelligent transportation systems and the upcoming era of autonomous vehicles, vehicular services (such as remote driving, cooperative awareness, and hazard warning) will have to operate in an ever-changing and dynamic environment. Anticipating the dynamics of traffic flows on the roads is critical for these services and, therefore, it is of paramount importance to forecast how they will evolve over time. By predicting future events (such as traffic jams) and demands, vehicular services can take proactive actions to minimize Service Level Agreement (SLA) violations and reduce the risk of accidents. In this paper, we compare several techniques, including both traditional time-series and recent Machine Learning (ML)-based approaches, to forecast the traffic flow at different road segments in the city of Torino (Italy). Using the the most accurate forecasting technique, we propose n-max algorithm as a forecast-based scaling algorithm for vertical scaling of edge resources, comparing its benefits against state-of-the-art solutions for three distinct Vehicle-to-Network (V2N) services. Results show that the proposed scaling algorithm outperforms the state-of-the-art, reducing Service Level Objective (SLO) violations for remote driving and hazard warning services.Work partially funded by the EU H2020 5GROWTH Project (grant no. 856709) and H2020 collaborative Europe/Taiwan research project 5G-DIVE (grant no. 859881)

The Sensory Processing 3-Dimensions Scale: Initial Studies of Reliability and Item Analyses

Background: The Sensory Processing 3-Dimensions Scale (SP 3D) is a performance-based measure for assessing sensory processing abilities and challenges, including sensory modulation, sensory discrimination, and sensory-based motor disorders. Initial studies of reliability were conducted, and item response theory was applied to assist in refining the measure. Methods: Descriptive and correlational methods were used to examine internal consistency of the scales and inter-rater reliability. Item response theory using Rasch analyses was applied to examine unidimensionality of scales, model fit, and item difficulty. Results: Internal consistency for most measures was acceptable, demonstrating the subtests, domains, and behavior scales as distinct constructs. Inter-rater reliability results were mixed, with fair to strong reliability coefficients for most sensory discrimination and postural and praxis subtests. Scales measuring sensory modulation and motor behaviors had moderate to poor inter observer agreement. Rasch analyses supported subtests as unidimensional and identified the most rigorous items in the subtests. Conclusions: Preliminary results show promise of the SP-3D as a stable, reliable tool. A need for refinement of some operational definitions for behavior ratings was identified, and items to consider for elimination because of redundancy or ill-fit were exposed. Directions for research include refinement of the SP-3D and the need for further reliability and validity studies

Bridging the Gap between Brazilian Startups and Business Processes – Process Thinking’s Initial Exploratory Case Study

Startup is a new business segment that has been growing up in the last years. These companies have an innovative spirit and are usually searching for new solutions to real problems that can be transformed into scalable businesses. The majority of these companies are not aware of their processes and how the company need to be organized. For this kind of companies, we propose Process Thinking, an innovative approach that makes the business process management viable in the daily lives of startups. This paper presents the Process Thinking framework, which prescribes 10 main processes that a startup needs and a utility belt to help the startup to organize their processes. We illustrate this proposal through an exploratory case study with a real IT startup company that used a 5-step methodology in an immediate implementation of proposed processes and artifacts. The results indicate a positive impact in the short and medium term strategies and management of the startup. However, these results cannot be generalized to other startups and should be received with caution, since this is an initial exploratory study limited to a single company

Fixed-Dose Artesunate-Amodiaquine Combination vs Chloroquine for Treatment of Uncomplicated Blood Stage P. vivax Infection in the Brazilian Amazon: An Open-Label Randomized, Controlled Trial

BACKGROUND: Despite increasing evidence of the development of Plasmodium vivax chloroquine (CQ) resistance, there have been no trials comparing its efficacy with that of artemisinin-based combination therapies (ACTs) in Latin America. METHODS: This randomized controlled trial compared the antischizontocidal efficacy and safety of a 3-day supervised treatment of the fixed-dose combination artesunate-amodiaquine Winthrop(R) (ASAQ) versus CQ for treatment of uncomplicated P. vivax infection in Manaus, Brazil. Patients were followed for 42 days. Primary endpoints were adequate clinical and parasitological responses (ACPR) rates at day 28. Genotype-adjustment was performed. RESULTS: From 2012 to 2013, 380 patients were enrolled. In the per-protocol (PP) analysis, adjusted-ACPR was achieved in 100% (165/165) and 93.6% (161/172) of patients in the ASAQ and CQ arm (difference 6.4%, 95% CI 2.7%; 10.1%) at day 28 and in 97.4% (151/155) and 77.7% (129/166), respectively (difference 19.7%, 95% CI 12.9%; 26.5%), at day 42. Apart from ITT D28 assessment, superiority of ASAQ on ACPR was demonstrated. ASAQ presented faster clearance of parasitaemia and fever. Based on CQ blood level measurements, CQ resistance prevalence was estimated at 11.5% (95% CI: 7.5-17.3) up to day 42. At least one emergent adverse event (AE) was recorded for 79/190 (41x6%) in the ASAQ group and for 85/190 (44x7%) in the CQ group. Both treatments had similar safety profiles. CONCLUSIONS: ASAQ exhibited high efficacy against CQ resistant P. vivax and is an adequate alternative in the study area. Studies with an efficacious comparator, longer follow-up and genotype-adjustment can improve CQR characterization

Diagnostic performance of anti-Zika virus IgM, IgAM and IgG ELISAs during co-circulation of Zika, dengue, and chikungunya viruses in Brazil and Venezuela

BACKGROUND: Serological diagnosis of Zika virus (ZIKV) infection is challenging because of the antibody cross-reactivity among flaviviruses. At the same time, the role of Nucleic Acid Testing (NAT) is limited by the low proportion of symptomatic infections and the low average viral load. Here, we compared the diagnostic performance of commercially available IgM, IgAM, and IgG ELISAs in sequential samples during the ZIKV and chikungunya (CHIKV) epidemics and co-circulation of dengue virus (DENV) in Brazil and Venezuela. METHODOLOGY/PRINCIPAL FINDINGS: Acute (day of illness 1-5) and follow-up (day of illness ≥ 6) blood samples were collected from nine hundred and seven symptomatic patients enrolled in a prospective multicenter study of symptomatic patients recruited between June 2012 and August 2016. Acute samples were tested by RT-PCR for ZIKV, DENV, and CHIKV. Acute and follow-up samples were tested for IgM, IgAM, and IgG antibodies to ZIKV using commercially available ELISAs. Among follow-up samples with a RT-PCR confirmed ZIKV infection, anti-ZIKV IgAM sensitivity was 93.5% (43/48), while IgM and IgG exhibited sensitivities of 30.3% (10/35) and 72% (18/25), respectively. An additional 24% (26/109) of ZIKV infections were detected via IgAM seroconversion in ZIKV/DENV/CHIKV RT-PCR negative patients. The specificity of anti-ZIKV IgM was estimated at 93% and that of IgAM at 85%. CONCLUSIONS/SIGNIFICANCE: Our findings exemplify the challenges of the assessment of test performance for ZIKV serological tests in the real-world setting, during co-circulation of DENV, ZIKV, and CHIKV. However, we can also demonstrate that the IgAM immunoassay exhibits superior sensitivity to detect ZIKV RT-PCR confirmed infections compared to IgG and IgM immunoassays. The IgAM assay also proves to be promising for detection of anti-ZIKV seroconversions in sequential samples, both in ZIKV PCR-positive as well as PCR-negative patients, making this a candidate assay for serological monitoring of pregnant women in future ZIKV outbreaks

Observing the Evolution of the Universe

How did the universe evolve? The fine angular scale (l>1000) temperature and polarization anisotropies in the CMB are a Rosetta stone for understanding the evolution of the universe. Through detailed measurements one may address everything from the physics of the birth of the universe to the history of star formation and the process by which galaxies formed. One may in addition track the evolution of the dark energy and discover the net neutrino mass. We are at the dawn of a new era in which hundreds of square degrees of sky can be mapped with arcminute resolution and sensitivities measured in microKelvin. Acquiring these data requires the use of special purpose telescopes such as the Atacama Cosmology Telescope (ACT), located in Chile, and the South Pole Telescope (SPT). These new telescopes are outfitted with a new generation of custom mm-wave kilo-pixel arrays. Additional instruments are in the planning stages.Comment: Science White Paper submitted to the US Astro2010 Decadal Survey. Full list of 177 author available at http://cmbpol.uchicago.ed

Time-dependent changes in mortality and transformation risk in MDS

In myelodysplastic syndromes (MDSs), the evolution of risk for disease progression or death has not been systematically investigated despite being crucial for correct interpretation of prognostic risk scores. In a multicenter retrospective study, we described changes in risk over time, the consequences for basal prognostic scores, and their potential clinical implications. Major MDS prognostic risk scoring systems and their constituent individual predictors were analyzed in 7212 primary untreated MDS patients from the International Working Group for Prognosis in MDS database. Changes in risk of mortality and of leukemic transformation over time from diagnosis were described. Hazards regarding mortality and acute myeloid leukemia transformation diminished over time from diagnosis in higher-risk MDS patients, whereas they remained stable in lower-risk patients. After approximately 3.5 years, hazards in the separate risk groups became similar and were essentially equivalent after 5 years. This fact led to loss of prognostic power of different scoring systems considered, which was more pronounced for survival. Inclusion of age resulted in increased initial prognostic power for survival and less attenuation in hazards. If needed for practicability in clinical management, the differing development of risks suggested a reasonable division into lower- and higher-risk MDS based on the IPSS-R at a cutoff of 3.5 points. Our data regarding time-dependent performance of prognostic scores reflect the disparate change of risks in MDS subpopulations. Lower-risk patients at diagnosis remain lower risk whereas initially high-risk patients demonstrate decreasing risk over time. This change of risk should be considered in clinical decision making

Clinical evaluation of dengue and identification of risk factors for severe disease: protocol for a multicentre study in 8 countries

Background: The burden of dengue continues to increase globally, with an estimated 100 million clinically apparent infections occurring each year. Although most dengue infections are asymptomatic, patients can present with a wide spectrum of clinical symptoms ranging from mild febrile illness through to severe manifestations of bleeding, organ impairment, and hypovolaemic shock due to a systemic vascular leak syndrome. Clinical diagnosis of dengue and identification of which patients are likely to develop severe disease remain challenging. This study aims to improve diagnosis and clinical management through approaches designed a) to differentiate between dengue and other common febrile illness within 72 h of fever onset, and b) among patients with dengue to identify markers that are predictive of the likelihood of evolving to a more severe disease course. Method/Design: This is a prospective multi-centre observational study aiming to enrol 7–8000 participants aged ≥ 5 years presenting with a febrile illness consistent with dengue to outpatient health facilities in 8 countries across Asia and Latin America. Patients presenting within 72 h of fever onset who do not exhibit signs of severe disease are eligible for the study. A broad range of clinical and laboratory parameters are assessed daily for up to 6 days during the acute illness, and also at a follow up visit 1 week later. Discussion: Data from this large cohort of patients, enrolled early with undifferentiated fever, will be used to develop a practical diagnostic algorithm and a robust clinical case definition for dengue. Additionally, among patients with confirmed dengue we aim to identify simple clinical and laboratory parameters associated with progression to a more severe disease course. We will also investigate early virological and serological correlates of severe disease, and examine genetic associations in this large heterogeneous cohort. In addition the results will be used to assess the new World Health Organization classification scheme for dengue in practice, and to update the guidelines for “Integrated Management of Childhood Illness” used in dengue-endemic countries. Trial registration: NCT01550016. Registration Date: March 7, 201

Association between the use of total dental prosthesis (denture) and the type of oral health care service used by toothless elderly individuals

A reabilitação protética foi prevista pela política nacional de saúde bucal em função da alta prevalência de perda de todos os dentes e do baixo uso de prótese dentária entre idosos. Há necessidade de se avaliar o impacto dessa política de reabilitação. Portanto, objetivou-se investigar se o tipo de serviço odontológico utilizado foi um dos fatores associados ao uso de prótese dentária total entre idosos. Trata-se de um estudo transversal conduzido em uma amostra probabilística de idosos (60 anos ou mais) residentes na zona urbana de um município brasileiro de pequeno porte populacional por examinadores calibrados. Realizaram-se análises descritiva, bivariada e múltipla (Regressão logística - odds ratio - OR). Participaram 287 idosos, destes, 186 (64,8%) faziam uso de prótese dentária total. O uso de prótese dentária total foi associado a maiores chances de uso de serviços odontológicos supletivos ou particulares (OR = 4,19; p < 0,001) e a presença de lesão no palato (OR = 7,52; p = 0,002) e, também, a menores chances em idades maiores ou iguais a 73 anos (OR = 0,52; p = 0,023) e entre os com comprometimento na dimensão incapacidade física do OHIP-14 (OR = 0,20; p = 0,002). O uso de prótese dentária total foi associado ao tipo de serviço odontológico entre idosos, sendo maior o uso entre usuários dos serviços supletivos ou particulares24933453356Oral rehabilitation with dental prosthesis was mandated by national oral health policy in Brazil, due to the high prevalence of total teeth loss and low use of dental prosthesis among the elderly. There is a pressing need to assess the impact of this rehabilitation policy. An attempt was therefore made to investigate if the dental service used was one of the factors associated with the use of total dental prosthesis among the elderly. To achieve this, a cross-sectional study using a probabilistic sample of elderly (60 years and above) urban-area residents of a small city was conducted by qualified examiners. Descriptive, bivariate and multiple (logistic regression/odds ratio - OR) analyses were conducted on 287 elderly people, of which 186 (64.8%) used dental prosthesis. The use of total dental prosthesis was associated with a higher probability of being attended by private dental services (OR = 4.19; p < 0.001) and the presence of lesions on the palate (OR = 7.52; p = 0.002). Conversely, it was associated with lower probability in ages greater than or equal to 73 years (OR = 0.52; p = 0.023) and among those with impairment of OHIP-14 (OR = 0.20; p = 0.002) in the physical disability dimension. The use of total dental prosthesis was associated with the type of dental service used by the elderly, it being greater among private service user