Construction of a tool for assessment of joint attention in Egyptian Cairene children

Background Joint attention (JA) is a basic social communicative skill important for language development. JA deficits appear prior to language acquisition. Because autism is often not diagnosed until a child is three or four years of age, it is important to look for indicators prior to language acquisition such as JA to provide appropriate treatment at a younger age. Therefore, the aim of this study is to construct an objective tool for assessment of joint attention skills in young Egyptian children to detect the presence of autistic behaviour in high-risk children in order to conduct plans for early intervention. The questionnaire was constructed to assess the five main components of JA and was termed Egyptian Joint Attention Questionnaire. The questions were formulated in the colloquial Egyptian Arabic language and in an ‘easy-to understand’ design that would be comprehensible by mothers. No question was directly translated from another questionnaire. Ten typically developing (TD) children, with an age range of 18–54 months, were included in the pilot study of the test design. It was applied to 90 TD children and 30 autistic children (contrast group) within the same age range. Participant's responses were statistically analysed to assess the validity and reliability of the questionnaire and to compare the responses related to TD children and autistic children. Results There was high internal consistency and reliability of the questionnaire (Cronbach’s α = 0.9, Intra-class correlation = .776), with a statistically significant difference between TD and autistic children (P < 0.001). Conclusions The questionnaire is a valid and reliable assessment tool that could be used in early detection of autistic Egyptian children.

Preventing maternal phenylketonuria (PKU) syndrome: important factors to achieve good metabolic control throughout pregnancy

Background Insufficient metabolic control during pregnancy of mothers with phenylketonuria (PKU) leads to maternal PKU syndrome, a severe embryo-/fetopathy. Since maintaining or reintroducing the strict phenylalanine (Phe) limited diet in adults with PKU is challenging, we evaluated the most important dietary and psychosocial factors to gain and sustain good metabolic control in phenylketonuric women throughout pregnancy by a questionnaire survey with 38 questions concerning therapy feasibility. Among them, the key questions covered 5 essential items of PKU care as follows: General information about maternal PKU, PKU training, diet implementation, individual metabolic care, personal support. In addition, all participating PKU mothers were asked to estimate the quality of their personal metabolic control of the concluded pregnancies. 54 PKU mothers with 81 pregnancies were approached at 12 metabolic centers in Germany and Austria were included. According to metabolic control, pregnancies of PKU women were divided in two groups: group “ideal” (not more than 5% of all blood Phe concentrations during pregnancy > 360 µmol/l; n = 23) and group “suboptimal” (all others; n = 51). Results The demand for support was equally distributed among groups, concerning both amount and content. Personal support by the direct social environment (partner, family and friends) (“suboptimal” 71% vs “ideal” 78%) as well as individual metabolic care by the specialized metabolic center (both groups around 60%) were rated as most important factors. The groups differed significantly with respect to the estimation of the quality of their metabolic situation (p < 0.001). Group “ideal” presented a 100% realistic self-assessment. In contrast, group “suboptimal” overestimated their metabolic control in 53% of the pregnancies. Offspring of group “suboptimal” showed clinical signs of maternal PKU-syndrome in 27%. Conclusion The development of training programs by specialized metabolic centers for females with PKU in child bearing age is crucial, especially since those mothers at risk of giving birth to a child with maternal PKU syndrome are not aware of their suboptimal metabolic control. Such programs should provide specific awareness training for the own metabolic situation and should include partners and families.

Robust and Nonrobust Linking of Two Groups for the Rasch Model with Balanced and Unbalanced Random DIF: A Comparative Simulation Study and the Simultaneous Assessment of Standard Errors and Linking Errors with Resampling Techniques

In this article, the Rasch model is used for assessing a mean difference between two groups for a test of dichotomous items. It is assumed that random differential item functioning (DIF) exists that can bias group differences. The case of balanced DIF is distinguished from the case of unbalanced DIF. In balanced DIF, DIF effects on average cancel out. In contrast, in unbalanced DIF, the expected value of DIF effects can differ from zero and on average favor a particular group. Robust linking methods (e.g., invariance alignment) aim at determining group mean differences that are robust to the presence of DIF. In contrast, group differences obtained from nonrobust linking methods (e.g., Haebara linking) can be affected by the presence of a few DIF effects. Alternative robust and nonrobust linking methods are compared in a simulation study under various simulation conditions. It turned out that robust linking methods are preferred over nonrobust alternatives in the case of unbalanced DIF effects. Moreover, the theory of M-estimation, as an important approach to robust statistical estimation suitable for data with asymmetric errors, is used to study the asymptotic behavior of linking estimators if the number of items tends to infinity. These results give insights into the asymptotic bias and the estimation of linking errors that represent the variability in estimates due to selecting items in a test. Moreover, M-estimation is also used in an analytical treatment to assess standard errors and linking errors simultaneously. Finally, double jackknife and double half sampling methods are introduced and evaluated in a simulation study to assess standard errors and linking errors simultaneously. Half sampling outperformed jackknife estimators for the assessment of variability of estimates from robust linking methods.

Robust and Nonrobust Linking of Two Groups for the Rasch Model with Balanced and Unbalanced Random DIF: A Comparative Simulation Study and the Simultaneous Assessment of Standard Errors and Linking Errors with Resampling Techniques

In this article, the Rasch model is used for assessing a mean difference between two groups for a test of dichotomous items. It is assumed that random differential item functioning (DIF) exists that has the potential to bias group differences. The case of balanced DIF is distinguished from the case of unbalanced DIF. In balanced DIF, DIF effects cancel out on average. In contrast, in unbalanced DIF, the expected value of DIF effects can differ from zero and favors a particular group on average. Robust linking methods (e.g., invariance alignment) aim at determining group mean differences that are robust to the presence of DIF. In contrast, group differences obtained from nonrobust linking methods (e.g., Haebara linking) can be affected by the presence of a few DIF effects. Alternative robust and nonrobust linking methods are compared in a simulation study under various simulation conditions. It turned out that robust linking methods are preferred over nonrobust alternatives in the case of unbalanced DIF effects. Moreover, M-estimation theory is used for studying the asymptotic behavior of linking estimators if the number of items tends to infinity. These results give insights into asymptotic bias and the estimation of linking errors that represent the variability in estimates due to selecting items in a test. Moreover, M-estimation theory is also used in an analytical treatment to assess standard errors and linking errors simultaneously. Finally, double jackknife and double half sampling methods are introduced and evaluated in a simulation study to assess standard errors and linking errors simultaneously. Half sampling outperformed jackknife estimators for the assessment of variability of estimates from robust linking methods.

Ultrasound Images Guided under Deep Learning in the Anesthesia Effect of the Regional Nerve Block on Scapular Fracture Surgery

In order to discuss the clinical characteristics of patients with scapular fracture, deep learning model was adopted in ultrasound images of patients to locate the anesthesia point of patients during scapular fracture surgery treated with the regional nerve block. 100 patients with scapular fracture who were hospitalized for emergency treatment in the hospital were recruited. Patients in the algorithm group used ultrasound-guided regional nerve block puncture, and patients in the control group used traditional body surface anatomy for anesthesia positioning. The ultrasound images of the scapula of the contrast group were used for the identification of the deep learning model and analysis of anesthesia acupuncture sites. The ultrasound images of the scapula anatomy of the patients in the contrast group were extracted, and the convolutional neural network model was employed for training and test. Moreover, the model performance was evaluated. It was found that the adoption of deep learning greatly improved the accuracy of the image. It took an average of 7.5 ± 2.07 minutes from the time the puncture needle touched the skin to the completion of the injection in the algorithm group (treated with artificial intelligence ultrasound positioning). The operation time of the control group (anatomical positioning) averaged 10.2 ± 2.62 min. Moreover, there was a significant difference between the two groups ( p < 0.05 ). The method adopted in the contrast group had high positioning accuracy and good anesthesia effect, and the patients had reduced postoperative complications of patients (all P < 0.005 ). The deep learning model can effectively improve the accuracy of ultrasound images and measure and assist the treatment of future clinical cases of scapular fractures. While improving medical efficiency, it can also accurately identify patient fractures, which has great adoption potential in improving the effect of surgical anesthesia.

Research and Nursing Experience of Recombinant Human Epidermal Growth Factor Gel Promoting Oral Mucosal Erosion Lesion Healing

Erosion is a primary clinical manifestation of oral mucosal lesions. Contact between food and the mucosal surface during chewing can easily cause oral mucosal infection and adversely affect the daily lives of patients. Conventional clinical treatment cannot overcome the problems of oral mucosal erosion. This study aimed to analyze the application effect of recombinant human epidermal growth factor (rhEGF) gel on oral mucosal erosion lesions. The subjects of this study were 120 patients with oral mucosal erosion lesions, who were divided, according to random number table method, into a contrast group and rhEGF group with 60 cases in each. The patients in the contrast group were treated with ethacridine lactate, and the rhEGF group patients were treated with rhEGF gel. Patients in both groups received corresponding nursing measures. Compared with the contrast group, the rhEGF group had a lower visual analog scale score, Reticulation/keratosis, erythema, and ulceration score, and inflammatory cytokine levels, as well as a higher total effective rate and faster patient recovery, indicating that the rhEGF gel had significant efficacy and is worthy of promotion.

The Effect of Replications on Citation Patterns: Evidence From a Large-Scale Reproducibility Project

Replication of existing research is often referred to as one of the cornerstones of modern science. In this study, I tested whether the publication of independent replication attempts affects the citation patterns of the original studies. Investigating 95 replications conducted in the context of the Reproducibility Project: Psychology, I found little evidence for an adjustment of citation patterns in response to the publication of these independent replication attempts. This finding was robust to the choice of replication criterion, various model specifications, and the composition of the contrast group. I further present some suggestive evidence that shifts in the underlying composition of supporting and disputing citations have likely been small. I conclude with a review of the evidence in favor of the remaining explanations and discuss the potential consequences of these findings for the workings of the scientific process.

Experimental Study on the Piezoresistivity of Concrete Containing Steel Fibers, Carbon Black, and Graphene

Adding conductive materials to cement-based composites can lead to pressure-sensitive properties. In this study, different scales of conductive materials were incorporated, including macro-scale steel fibers, micro-scale carbon black powder, and nano-scale graphene. The coupling effect of three scales of materials ensured that the intelligent concrete had improved strength, lower cost, and comparable pressure-sensitive performance. The results show that the strength of intelligent concrete with multi-scale conductive materials is higher than that of the contrast group of ordinary concrete and intelligent concrete when adding nano-scale graphene alone. Especially, the addition of steel fibers significantly improved the crack resistance of the intelligent concrete. In the elastic stage, the resistivity of intelligent concrete of multi-scale conductive materials decreases with the increase in compression, and the decrease range of resistivity is approximately proportional to the external force. After reaching the peak load, the resistivity of the intelligent concrete gradually increases and can illustrate the damage evolution. This study lays a foundation for the application of intelligent concrete in deformation and damage monitoring.

Embracing TVET education: The effectiveness of project based learning on secondary school students’ achievement

Project based learning (PBL) has long been used especially in developing countries. Various results of PBL-related studies have also been found to be effective and have a positive impact on students. However, although it has been introduced in Malaysia, it is still considered foreign to students and teachers. Therefore, this study was conducted to look at the effectiveness of applying the PBL method in the topic of project design on form two students' learning process. An experimental study with mixed method approach was conducted through pre and post-tests on one control and one treatment group. A total of 60 form two students were involved, of which 30 were treatment students and another 30 were control students. Five students from the treatment group were randomly selected to go through a semi structured interview process. This interview was conducted to confirm the results of the quantitative study. The results of analysis of covariance (ANCOVA) showed that students in the PBL group performed significantly better in project design learning process than those in the contrast group. Therefore, this study demonstrated that the PBL method had a positive impact on students' learning process. Based on the interviews, all respondents agreed that PBL was an excellent approach because the learning activities were interesting and different from the normal learning environment. In addition, the interview results also showed that the respondents suggested that the PBL method should be continued and implemented in other topics and subjects.

Influence of Dental Glass Fibers and Orthopedic Mesh on the Failure Loads of Polymethyl Methacrylate Denture Base Resin

The aim of the present study was to evaluate the fracture loads of polymethyl methacrylate (PMMA) complete denture bases reinforced with glass-fiber mesh and orthopedic casting tape (OCT) in comparison to conventional PMMA dentures under artificial aging. Dental fiberglass framework (Group 1) and OCT (Group 2 and 3) reinforced PMMA acrylic dentures were fabricated on the edentulous ridge. Ten PMMA dentures without reinforcement (Group 4) were included as controls. All specimens were placed in a chewing simulator chamber, and fatigue load was applied. To assess the fracture loads, static loads with a universal testing machine were applied. Fractured specimens in each group were evaluated under a scanning electron microscope. The data were statistically analyzed employing analysis of variance and Tukey post-hoc test. The association of denture weight and thickness on fracture load was assessed using Pearson and Spearman correlations. Dental fiberglass (Group 1) displayed the highest fracture load (692.33 ± 751.41 N), and Group 4 (control) exhibited the lowest fracture loads (281.41 ± 302.51 N). Dentures reinforced with fiberglass mesh framework exhibited intact fractures. In contrast, Group 2 and 3 specimens using OCT demonstrated ditching fractures. It was observed that the thickness and weight of all the reinforced specimens influenced the load required to fracture the dentures (p < 0.001). Denture specimens strengthened with OCT (Groups 2 and 3) exhibited failure loads lower than dental fiberglass (Group 1) specimens but higher than unreinforced controls.