Motor proficiency of learners with moderate to severe intellectual disabilities.

Background: Intellectual disabilities refer to a permanent brain condition that interferes with a learner's ability to perform basic living tasks, academic tasks and social interactions. By observing the motor proficiency levels of these learners, one can determine the extent of a learner's possible physical motor proficiency barriers. Objective: To determine the motor proficiency levels of learners with moderate to severe intellectual disabilities using the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) Brief Form. Method: This quantitative descriptive study included 46 learners (17 girls and 29 boys) from a Mangaung school for learners with special needs between the ages of 15 and 17 years. Results: Indicated that 31 learners (67.4%) out of 46 learners identified with moderate to severe intellectual disabilities had a well-below average; 11 learners (23.9%) had a below average and only 4 learners (8.7%) had average motor proficiency levels. Conclusion: Alarmingly, this indicates that the majority of learners have severe motor difficulties that may reduce these learners' abilities to perform tasks using gross and fine motor skills. Reported motor proficiency levels can be used as a guide to direct future motor intervention programmes. Contribution: Timely interventions are central to improving learners' motor difficulties. This study focused on providing information regarding the motor proficiency levels of South African learners with ID that was not previously explored. This was an attempt to bridge the gap in knowledge pertaining to the use of standardised motor proficiency tests for South African learners with ID.

Pyricularia Are Mostly Host-Specialized with Limited Reciprocal Cross-Infection Between Wheat and Endemic Grasses in Minas Gerais, Brazil.

Wheat blast, caused by Pyricularia oryzae Triticum (PoT), is an emerging threat to global wheat production. The current understanding of the population biology of the pathogen and epidemiology of the disease has been based on phylogenomic studies that compared the wheat blast pathogen with isolates collected from grasses that were invasive to Brazilian wheat fields. In this study, we performed a comprehensive sampling of blast lesions in wheat crops and endemic grasses found in and away from wheat fields in Minas Gerais. A total of 1,368 diseased samples were collected (976 leaves of wheat and grasses and 392 wheat heads), which yielded a working collection of 564 Pyricularia isolates. We show that, contrary to earlier implications, PoT was rarely found on endemic grasses, and, conversely, members of grass-adapted lineages were rarely found on wheat. Instead, most lineages were host-specialized, with constituent isolates usually grouping according to their host of origin. With regard to the dominant role proposed for signalgrass in wheat blast epidemiology, we found only one PoT member in 67 isolates collected from signalgrass grown away from wheat fields and only three members of Urochloa-adapted lineages among hundreds of isolates from wheat. Cross-inoculation assays on wheat and a signalgrass used in pastures (U. brizantha) suggested that the limited cross-infection observed in the field may be due to innate compatibility differences. Whether or not the observed level of cross-infection would be sufficient to provide an inoculum reservoir, or serve as a bridge between wheat growing regions, is questionable and, therefore, deserves further investigation.

Perianal Paget Disease: Different Entities With the Same Name.

Extramammary Paget disease (EMPD) is a rare form of cancer that involves skin areas rich in apocrine glands. The common sites of occurrence include the vulva, perianal region, perineum, and axilla. Perianal Paget disease (PPD) is a subset of EMPD, which arises in the perianal skin. The disease commonly presents with a thickened plaque-like lesion with erythema or white scaly appearance. It is generally classified into two categories based on the origin of the tumor cells: (1) primary PPD if the tumor arises from intraepidermal cells and (2) secondary PPD if cancer originates from the underlying colorectal or urinary tract neoplasm. Due to its rarity, only a few sporadic case reports have been published in the literature, and treatment methods are yet to be standardized. In light of this, we report two PPD cases with different etiopathogenesis and staging: one involved only the perianal skin without regional or metastatic disease, and was not accompanied by visceral adenocarcinomas although there was a previous history of sigmoid adenocarcinoma; the other was probably secondary to an anal canal tumor spreading with disseminated disease involving the perianal and perineum area with bilateral inguinal, pelvic lymph node, and liver metastasis. The treatment plans and the outcomes of both cases were necessarily different from each other.

Classification of Critical Levels of CO Exposure of Firefigthers through Monitored Heart Rate.

Smoke inhalation poses a serious health threat to firefighters (FFs), with potential effects including respiratory and cardiac disorders. In this work, environmental and physiological data were collected from FFs, during experimental fires performed in 2015 and 2019. Extending a previous work, which allowed us to conclude that changes in heart rate (HR) were associated with alterations in the inhalation of carbon monoxide (CO), we performed a HR analysis according to different levels of CO exposure during firefighting based on data collected from three FFs. Based on HR collected and on CO occupational exposure standards (OES), we propose a classifier to identify CO exposure levels through the HR measured values. An ensemble of 100 bagged classification trees was used and the classification of CO levels obtained an overall accuracy of 91.9%. The classification can be performed in real-time and can be embedded in a decision fire-fighting support system. This classification of FF' exposure to critical CO levels, through minimally-invasive monitored HR, opens the possibility to identify hazardous situations, preventing and avoiding possible severe problems in FF' health due to inhaled pollutants. The obtained results also show the importance of future studies on the relevance and influence of the exposure and inhalation of pollutants on the FF' health, especially in what refers to hazardous levels of toxic air pollutants.

Comparison of Commercial ELISA Kits to Confirm the Absence of Transmission in Malaria Elimination Settings.

Background: Antimalarial antibody measurements are useful because they reflect historical and recent exposure to malaria. As such, they may provide additional information to assess ongoing transmission in low endemic or pre-elimination settings where cases are rare. In addition, the absence of antibody responses in certain individuals can indicate the cessation of transmission. Commercial malaria enzyme-linked immunosorbent assays (ELISA) detect antimalarial antibodies and are commonly used to screen blood donations for possible malaria infection. However, there is no standardized test to detect antimalarial antibodies for epidemiological use. Here we compared five commercially available ELISA kits (Trinity Biotech, newbio, DiaPro, Cellabs, and NovaTec) in search of a standardized tool for supporting claims of absence of malaria transmission. For comparison, a research-based (RB) ELISA protocol was performed alongside the commercial kits. Results: The commercial kits were first compared using serum samples from known malaria-unexposed individuals (n = 223) and Toxoplasma-infected individuals (n = 191) to assess specificity and cross-reactivity against non-malaria infections. In addition, 134 samples from ≥10-year-olds collected in a hyperendemic region in the Gambia in the early 1990s were used to assess sensitivity. Three out of five kits showed high sensitivity (90-92%), high specificity (98-99%), low cross-reactivity (0-3%) and were considered user-friendly (Trinity Biotech, newbio and NovaTec). Two of these kits (Trinity Biotech and NovaTec) were taken forward for epidemiological evaluation and results were compared to those using the RB-ELISA. Samples from two pre-elimination settings (Praia, Cape Verde; n = 1,396, and Bataan, the Philippines; n = 1,824) were tested. Serological results from both the Trinity Biotech kit and the RB-ELISA concurred with recent passively detected case counts in both settings. Results from the Trinity Biotech kit reflected a significant decrease in the number of reported cases in Bataan in the 1990s better than the RB-ELISA. Results from the NovaTec kit did not reflect transmission patterns in either setting. Conclusion: The Trinity Biotech commercial ELISA kit was considered reliable for epidemiological use and accurately described transmission patterns in two (previously) malaria endemic settings. The use of this simple and standardized serological tool may aid national control and elimination programs by confirming that regions are free from malaria.

Climate Suitability for Magnaporthe oryzae Triticum Pathotype in the United States.

Wheat blast, caused by the Triticum pathotype of Magnaporthe oryzae, is an emerging disease considered to be a limiting factor to wheat production in various countries. Given the importance of wheat blast as a high-consequence plant disease, weather-based infection models were used to estimate the probabilities of M. oryzae Triticum establishment and wheat blast outbreaks in the United States. The models identified significant disease risk in some areas. With the threshold levels used, the models predicted that the climate was adequate for maintaining M. oryzae Triticum populations in 40% of winter wheat production areas of the United States. Disease outbreak threshold levels were only reached in 25% of the country. In Louisiana, Mississippi, and Florida, the probability of years suitable for outbreaks was greater than 70%. The models generated in this study should provide the foundation for more advanced models in the future, and the results reported could be used to prioritize research efforts regarding the biology of M. oryzae Triticum and the epidemiology of the wheat blast disease.

BeMonitored: Monitoring psychophysiology and behavior using Android in phobias.

It is of the utmost importance that researchers can recreate, as accurately as possible, real-life conditions in psychological studies. However, that is not always possible. Given that phobias are rather context-specific, their study is the ideal candidate to assess the feasibility of using a mobile and wearable device for obtaining physiological and behavioral data. In this article, we propose BeMonitored, a smartphone-based solution to support more ecologically valid monitoring of psychological experiments. BeMonitored delivers customizable, specific context-dependent audiovisual stimuli and uses external resources connected via Bluetooth or a smartphone's own resources, while capturing the participant's behavior, physiology, and environment. We used BeMonitored in a spider phobia case study and showed that spider phobics differed from control participants in face motion, captured by the smartphone camera. Moreover, our results also revealed heart rate differences between spider and neutral stimuli in phobic participants. The presented results emphasize the usefulness of smartphones for phobia monitoring. Considering their intrinsic characteristics, smartphones may constitute the natural evolution from the lab to more realistic contexts.

Próteses totais fixas tipo protocolo bimaxilares. Relato de caso / Fixed full-arch prosthesis type protocol bimaxillary. Case report

Os implantes osseointegrados promoveram importantes mudanças nas formas de reabilitação de pacientes parcial ou totalmente desdentados. Os pacientes totalmente desdentados apresentam clara predileção pelas próteses fixas implantossuportas, sobretudo porque proporcionam maior eficiência mastigatória e conforto, menos reparo e manutenção, além de favorecer o aspecto psicológico, uma vez que elimina o caráter removível das overdentures. Dentre os possíveis desenhos de próteses fixas as do tipo protocolo são as que apresentam maior aplicação clínica, e se caracterizam na mandíbula pela colocação de 4 a 6 implantes na região anterior, entre os forames mentuais, e cantilever distal bilateral para substituir os dentes posteriores. Na maxila recomenda-se a colocação de 6 a 8 implantes. Neste tipo de prótese utiliza-se uma infraestrutura metálica e uma base de resina para uni-la aos dentes de resina acrílica. O objetivo deste trabalho foi relatar um caso clínico de próteses totais fixas tipo protocolo bimaxilares, em que foram adotados critérios bem definidos de diagnóstico e planejamento, e empregadas técnicas cirúrgicas e protéticas com fundamentação científica.

The dental implants promoted important changes in the forms of rehabilitation of partially or fully edentulous patients. Edentulous patients show clear preference for implant-supported fixed prosthesis, mainly because they provide greater chewing efficiency and comfort, less repair and maintenance, in addition to promoting the psychological aspect, considering that eliminates the character removable of overdentures. Among the possible designs of the fixed prosthesis, the type protocols are the which have greater clinical application, and characterized by placing the jaw 4-6 implant in the anterior region between the foramina mentuals, and bilateral distal cantilevers to replace the posterior teeth. In the maxilla is recommended to put 6-8 implants. In this type of prosthesis is used a metal infrastructure and a resin base to attach it to the teeth of acrylic resin. The objective of this study was to report a case of protocol type full-arch fixed prosthesis bimaxillaries with employment of well-defined criteria for diagnosis and planning, and surgical and prosthetic techniques scientific evidence-based.

Upper limb automatisms differ quantitatively in temporal and frontal lobe epilepsies.

We quantitatively evaluated the localizing and lateralizing characteristics of ictal upper limb automatisms (ULAs) in patients with temporal lobe epilepsy (TLE; n=38) and frontal lobe epilepsy (FLE; n=20). Movement speed, extent, length, and duration of ULAs were quantitatively analyzed with motion capturing techniques. Upper limb automatisms had a larger extent (p<0.001), covered more distance (p<0.05), and were faster (p<0.001) in FLE than in TLE. In TLE, the maximum speed of ULAs was higher ipsilaterally than contralaterally (173 vs. 84pixels/s; p=0.02), with no significant difference in FLE (511 vs. 428). The duration of ictal automatisms in relation to the total seizure duration was shorter in TLE than in FLE (median 36% vs. 63%; p<0.001), with no difference in the absolute duration (26s vs. 27s). These results demonstrate that quantitative movement analysis of ULAs differentiates FLE from TLE, which may aid in the localization of the epileptogenic zone.

Retalho posicionado lateralmente e enxerto de tecido conjuntivo subeptelial no tratamento das recessões teciduais marginais / Laterally positioned flap and subepithelial connective tissue graft for marginal tissue recession treatment

Introdução: As cirurgias mucogengivais têm sido amplamente utilizadas para o tratamento de problemas periodontais. Nos casos de recobrimento radicular diversas são as técnicas utilizadas, dentre elas, o retalho posicionado lateralmente (RPL) e o enxerto de tecido conjuntivo subepitelial (ETCS). Objetivo: Apresentar um caso clínico de recobrimento radicular no qual foram utilizadas conjuntamente as técnicas de RPL e ETCS. Relato: Paciente procurou tratamento periodontal com queixa principal de sensibilidade dental. Foram observadas recessões classe I de Miller nos dentes 23, 24 e 25 e faixa de tecido queratinizado de 1 mm na região dos dentes em questão. A técnica escolhida para tratamento das recessões foi o enxerto de tecido conjuntivo associado ao retalho posicionado lateralmente. Resultados: Após 35 dias observou-se completa cobertura da superfície radicular e ganho de tecido queratinizado de 4 a 5 mm.

Introduction: Mucogingival surgeries have been widely used for the treatment of periodontal problems. In cases of root coverage many techniques are used, among them, the laterally positioned flap (LPF) and subepithelial connective tissue graft (SCTG). Objective: To present a clinical case of root coverage in which was used together the techniques of LPF and SCTG. Report: The patient sought for periodontal treatment complaining of tooth sensitivity. It was observed Miller Class I recessions on teeth 23, 24 and 25 and 1 mm of keratinized tissue track in the region of these teeth. The technique used for treatment of recessions was the connective tissue graft associated with the laterally positioned flap. Results: After 35 days was observed complete coverage of the root surface and keratinized tissue gain 4 to 5 mm.

A real time, wearable ECG and continous blood pressure monitoring system for first responders.

The study of stress and fatigue among First Responders is a major step in mitigating this public health problem. Blood pressure, heart rate variability and fatigue related arrhythmia are three of the main "windows" to study stress and fatigue. In this paper we present a wearable medical device, capable of acquiring an electrocardiogram and estimating blood pressure in real time, through a pulse wave transit time approach. The system is based on an existent certified wearable medical device called "Vital Jacket" and is aimed to become a tool to allow cardiologists in studying stress and fatigue among first response professionals.