Effectiveness and Determinant Variables of Augmentative and Alternative Communication Interventions in Cerebral Palsy Patients with Communication Deficit: a Systematic Review

ABSTRACT Purpose Assess the effectiveness of augmentative and alternative communication (AAC) interventions in patients with CP and to reveal determinant variables of main intervention outcomes: receptive and expressive language. Research strategies The search was performed in following databases: MEDLINE (Ovid); PubMed (NLM); Embase (Ovid); Cochrane Database of Systematic Reviews; Cumulative Index to Nursing and Allied Health Literature; Database of Abstracts of Reviews of Effects; Cochrane Central Register of Controlled Trials; Health Technology Assessment database and PEDro. Selection criteria Full-text and peer-reviewed studies in English studying the effectiveness of AAC in patients with cerebral palsy were included. Studies with patients (<18 years) diagnosed with CP were included. Data analysis A narrative analysis was conducted to evaluate the efficacy of AAC methods. A random-effects model meta-analysis was used to assess determinants of AAC intervention outcomes. Results The online database and manual reference search revealed 445 records. Nine studies investigating a total of 294 subjects with CP met predefined eligibility criteria: 4 studies with single subject, multiple baseline research designs, 3 longitudinal cohort studies, 1 case control study and 1 case series. Results revealed moderate-quality evidence that AAC interventions improve the receptive and expressive communication skills in patients with CP. The random-effects model meta-analysis revealed the power of identified determinant variables affecting the AAC intervention outcomes. Conclusion Diversity of CP patients requires proper analysis of determinant variables to ensure the efficacy of AAC assessment and intervention. More studies of high methodological and practical quality assessing the efficacy of AAC interventions are needed to clarify the evidence.

Meta-análisis para evaluar eficiencia de selección genómica en cereales: Meta-analysis for evaluating the efficiency of genomic selection in cereals

La selección genómica (SG) es usada para predecir el mérito de un genotipo respecto a un carácter cuantitativo a partir de datos moleculares o genómicos. Estadísticamente, la SG requiere ajustar un modelo de regresión con múltiples variables predictoras asociadas a los estados de los marcadores moleculares (MM). El modelo se calibra en una población en la que hay datos fenotípicos y genómicos. La abundancia y la correlación de la información de los MM dificultan la estimación, y por ello existen distintas estrategias para el ajuste del modelo basadas en: mejor predictor lineal insesgado (BLUP), regresiones Bayesianas y aprendizaje automático. La correlación entre el fenotipo observado y el mérito genético predicho por el modelo ajustado, provee una medida de eficiencia (capacidad predictiva) de la SG. El objetivo de este trabajo fue realizar un meta-análisis de la eficiencia de la SG en cereales. Se realizó una revisión sistemática de estudios relacionados a SG y se llevó a cabo un meta-análisis, para obtener una medida global de la eficiencia de la SG en trigo y maíz, bajo diferentes escenarios (cantidad de MM y método estadístico usado para la SG). El metaanálisis indicó un coeficiente de correlación promedio de 0,61 entre los méritos genéticos predichos y los fenotipos observados. No se observaron diferencias significativas en la eficiencia de la SG realizada con modelos basados en BLUP (RR-BLUP y GBLUP), enfoque estadístico más comúnmente usado. El incremento de MM no cambia significativamente la eficiencia de la SG.

Genomic selection (GS) is used to predict the merit of a genotype with respect to a quantitative trait from molecular or genomic data. Statistically, GS requires fitting a regression model with multiple predictors associated with the molecular markers (MM) states. The model is calibrated in a population with phenotypic and genomic data. The abundance and correlation of MM information make model estimation challenging. For that reason there are diverse strategies to adjust the model: based on best linear unbiased predictors (BLUP), Bayesian regressions and machine learning methods. The correlation between the observed phenotype and the predicted genetic merit by the fitted model provides a measure of the efficiency (predictive ability) of the GS. The objective of this work was to perform a metaanalysis on the efficiency of GS in cereals. A systematic review of related GS studies and a meta-analysis, in wheat and maize, was carried out to obtain a global measure of GS efficiency under different scenarios (MM quantity and statistical models used in GS). The meta-analysis indicated an average correlation coefficient of 0.61 between observed and predicted genetic merits. There were no significant differences in the efficiency of the GS based on BLUP (RR-BLUP and GBLUP), the most common statistical approach. The increase of MM data, make GS efficiency do not vary widely.

Impacto de la intensidad horaria de la estadística en las pruebas saber 11 / Impact of the time intensity of statistics in the saber 11 tests / Impacto da intensidade temporal da estatística sobre as provas saber 11

Resumen Introducción. En Colombia la Ley General de Educación dio la potestad a las instituciones educativas de organizar sus propios currículos acorde con los proyectos educativos institucionales. Con base en esta autonomía, algunas instituciones fragmentaron el área de matemáticas en asignaturas como estadística y geometría con distribución de tiempo semanal a cada una de ellas. Otras instituciones se organizan en temas y los desarrollan en momentos particulares del año escolar. En ese sentido, conocer los efectos que podrían tener una u otra organización en los procesos educativos representa un interés para profesores, investigadores e instituciones educativas. Objetivo. Determinar el efecto que la distribución de la intensidad horaria de la asignatura estadística podría tener en el desempeño de los estudiantes en la Prueba Saber 11° en instituciones educativas públicas de Medellín-Colombia. Materiales y métodos. Los datos se extrajeron de los resultados de Pruebas Saber 11. Se hizo ajuste de un modelo lineal con efectos mixtos. Resultados. Después de controlar el efecto institución, algunas variables específicas de los estudiantes sí inciden en los resultados obtenidos en matemáticas, pero la distribución de la intensidad horaria que se dedica a la enseñanza de la estadística no es un factor significativo. Conclusiones. La distribución del tiempo e intensidad horaria dedicada a la estadística no tiene un efecto automático ni inmediato en el desempeño de los estudiantes, las instituciones deben considerar estrategias para promover competencias de los estudiantes acordes con su condición económica y social.

Abstract Introduction. In Colombia, the General Education Law gave Educational Institutions the authority to organize their academic curricula according to their corresponding Educational Projects. Based on this institutional autonomy, some educational institutions have divided the area of mathematics into subjects such as statistics and geometry; also they have allocated a weekly time to each one of these subjects. In contrast, other institutions organize the area of mathematics by themes developed at specific times during the school year. In this sense, knowing the effects that one or another allocation could have on educational processes represents an interest for research and for teachers and educational institutions. Objective. Determine the effect that the allocation of teaching hours spent on the statistics subject could have on student performance on the Saber 11th Test in public educational institutions from Medellín-Colombia. Materials and Method. Data were extracted from the Saber 11-test results. A linear model was adjusted with mixed effects. Results. After controlling for the institution effect, it was found that some student-specific variables do impact the results in mathematics. However, allocation of teaching hours spent on statistics is not a significant factor. Conclusions. Time allocation and teaching hours spent on a statistics course do not have automatic or immediate impact on student performance. Every institution should consider strategies to promote student competencies according to their economic and social conditions.

Resumo Introdução. Na Colômbia a Lei Geral da Educação forneceu o poder às instituições educativas de organizar seus próprios currículos conforme com os projetos educativos institucionais. Com base nesta autonomia, algumas instituições fragmentaram a área de matemáticas em disciplinas como estatística e geometria com distribuição do tempo semanal em cada uma delas. Outras instituições organizam-se em temas e os desenvolvem em momentos particulares do ano escolar. Neste sentido, conhecer os efeitos que poderiam ter uma ou outra organização nos processos educativos representa um interesse para professores, pesquisadores e instituições educativas. Objetivo. Determinar o efeito que a distribuição da intensidade temporal da disciplina estatística poderia ter no desempenho dos estudantes nas Prova Saber 11° em instituições educativas públicas de Medellín-Colômbia. Materiais e Métodos. Os dados foram extraídos dos resultados das Provas Saber 11. Realizou-se o ajuste de um modelo lineal com efeitos misturados. Resultados. Depois de controlar o efeito instituição, algumas variáveis específicas dos estudantes sim incidiram nos resultados obtidos em matemáticas, mas a distribuição da intensidade temporal que se dedica ao ensino da estatística não é um fator significativo. Conclusões. A distribuição do tempo e intensidade temporal dedicada à estatística não tem um efeito automático e nem imediato no desempenho dos estudantes, as instituições devem considerar estratégias para promover habilidades dos estudantes acordes com sua condição econômica e social.

Hospitalization for Respiratory Syncytial Virus in Children with Down Syndrome Less than 2 Years of Age: A Systematic Review and Meta-Analysis.

OBJECTIVES: To compare the respiratory syncytial virus (RSV)-related hospitalization rate, hospital length of stay (LOS), and need for assisted ventilation in children aged <2 years with Down syndrome and those without Down syndrome. STUDY DESIGN: MEDLINE, Embase, and CINAHL databases were searched from inception up to December 2017. Studies that provided data on RSV-related hospitalization in children aged <2 years with Down syndrome and those without Down syndrome were included. Data were independently extracted in pairs by 2 reviewers and synthesized with random-effects meta-analysis. RESULTS: In 10 studies including a total of 1 748 209 children, 12.6% of the children with Down syndrome (491 of 3882) were hospitalized with RSV infection. The presence of Down syndrome was associated with a significantly higher risk of RSV-related hospitalization (relative risk [RR], 6.06; 95% CI, 4.93-7.45; I2 = 65%; Grading of Recommendations, Assessment, Development and Evaluation [GRADE], moderate). RSV-related LOS (mean difference, 2.11 days; 95% CI, 1.47-2.75 days; I2 = 0%; GRADE, low), and the need for assisted ventilation (RR, 5.82; 95% CI, 1.81-18.69; I2 = 84%; GRADE, low). Children with Down syndrome without congenital heart disease (RR, 6.31; 95% CI, 4.83-8.23; GRADE, moderate) also had a significantly higher risk of RSV-related hospitalization. The risk of RSV-related hospitalization remained significant in the subgroup of children aged <1 year (RR, 6.25; 95% CI, 4.71-8.28; GRADE, high). CONCLUSION: RSV-related hospitalization, hospital LOS, and the need for assisted ventilation are significantly higher in children with Down syndrome aged <2 years compared with those without Down syndrome. The results should prompt reconsideration of the need for routine RSV prophylaxis in children with Down syndrome up to 2 years of age.

A systematic review and mixed treatment comparison of monotherapy in early Parkinson's disease: implications for Latin America.

Parkinson's disease (PD) is the second most common neurodegenerative disease. There are no clinical trials comparing all available pharmacological therapies for the treatment of early PD. The objective of this review is to indirectly analyze the efficacy of antiparkinson drugs currently available in Latin America. A systematic review was performed exploring only placebo-controlled randomized trials comparing antiparkinson monotherapy (levodopa, pramipexole, rasagiline, or selegiline) in patients with PD on Hoehn and Yahr stages I through III published from January 1994 to May 2014. The primary outcome was the mean change in the Unified PD Rating Scale (UPDRS) I, II and III. A mixed treatment comparison analysis (indirect comparisons) through a random-effects model was performed. Levodopa demonstrated the highest effects in terms of UPDRS score improvement both from baseline and when compared to other treatments. Levodopa showed a 60.1% probability of granting the greatest reduction in UPDRS I, II and III.