Children with mental retardation are children who have intellectual mental disorders with intelligence levels far below the average normal child and their social adaptation is hampered. With the ...limited development of intelligence experienced by slow learner children, education is needed that can train their mindset so that they can develop in such a way. One of them is by using educational games intended for children who have mental retardation. Educational games are the right solution to help improve logic and understanding of learning material in the form of attractive visual technology for slow learnerchildren. With these problems, the authors designed a prototype design of an educational game application for recognizing letters and numbers for slow learnerchildren using the User Centered Design (UCD) method. In evaluating the success of the high-fidelity prototype using the Heuristic Evaluation method. The Heuristic Evaluation questionnaire was distributed to three evaluators and processed using a Likert scale measurement. The results obtained are that the design of the letter and number recognition educational game application for slow learnerchildren meets the usability criteria which is the effectiveness, efficiency, and user satisfaction in using the application as much as 79.13% which is on an attractive scale.
Challenging Place: Leaving home for sex Agustin, Laura Ma
Development (Society for International Development),
03/2002, Volume:
45, Issue:
1
Journal Article
Laura MaAgustín delves into the marginal world of migrant sex workers. She argues that there is a discontinuity between the images that NGO workers, government agents and others have of them as ...deprived of their home and undergoing traumatic experiences as trafficked sex workers, and the experiences, expectation and narratives of the migrant prostitutes themselves. Migrant sex workers are not always forcibly displaced, and even when they are, their trajectories after leaving home can, and often do, lead them into positive outcomes (meeting new and interesting people, finding their 'place in the world', etc.). Agustín offers a description of the places - the 'milieux' - created and lived in by migrant women and transsexual sex workers.
Bigna y is a Philippine indigenous berry rich in phenolic compounds with antioxidant activity. This can be dehydrated and used as a functional ingredient, but dehydration followed by digestion ...results to changes in the bioactive compounds modifying their bioaccessibility. Most bioaccessibility studies are on different fresh berries and fruits while very limited on dried or processed fruits. Thus, this study investigated the effect of simulated digestion on the bioaccessibility of phenolic compounds and antioxidant activity of freeze dried, oven dried, and spray dried bignay as well as cookies with added dehydrated bignay. Total phenolic content (TPC), total flavonoid content (TFC), total anthocyanin content (TAC), and antioxidant activity using 1,1-diphenyl-2-picryl hydrazyl (DPPH) scavenging activity, ferric reducing antioxidant power (FRAP), and 2,2-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) assays were determined. The TPC, TFC, TAC, and antioxidant activity of the dehydrated bignay and cookies showed significant differences (p≤ 0.05) at the end of each digestion stage. Among the dehydrated samples, the freeze dried bignay had the highest TPC, TFC, TAC and antioxidant activity after the gastric and intestinal stages resulting in a bioaccessibility of 66.39 % for TPC, 78.93 % for TFC, and 70.43 % for TAC along with a bioaccessibility of 81.45 % for DPPH, 82.28 % for FRAP, and 75.64 % for ABTS. Furthermore, the cookies with the added freeze dried bignay had the highest TPC, TFC, TAC and antioxidant activity at the end of both gastric and intestinal stages. This resulted in a bioaccessibility of 48.85 % for TPC, 47.26 % for TFC, 33.16 % for TAC, 62.60 % for DPPH, 64.39 % for FRAP, and 36.39 % for ABTS. Simulated digestion favored the release of phenolic compounds with antioxidant activity, although the contents were lower than that obtained before the simulated digestion. The total phenolics, flavonoids, anthocyanin, and antioxidant activity were better preserved by freeze drying followed by oven drying and least by spray drying.
The technique of chromosomal microarray analysis identifies genetic imbalance. Evaluation of its diagnostic role in pediatrics is still underway. We describe our experience with chromosomal ...microarrays. We retrospectively reviewed the charts of children in the Sections of Neurology and Clinical Genetics at St. Christopher's Hospital for Children who had undergone microarray analysis between 2006 and 2009. Collected data included age, sex, and the presence of mental retardation, developmental delay, autism, learning disability, hypotonia, dysmorphic features, and epilepsy, and the use of microarray technique. Statistical analysis was performed using SPSS. There were 82 children (mean age ± S.D., 5.7 ± 5 years), including 45 (55%) boys and 37 (45%) girls. All patients exhibited a normal karyotype. Microarray analysis produced abnormal results in 20 (23.5%). Deletions comprised 74% of all abnormalities. Patients with ≥4 clinical variables demonstrated a 30.5% incidence of abnormal chromosomal microarray findings, compared with 8.7% of patients with ≤3 clinical variables ( P = 0.039, χ2 test). Logistic regression indicated that motor impairment ( P = 0.039) and presence of epilepsy ( P = 0.024) independently contributed to the model. The likelihood of an abnormal microarray result increased with the number of clinical abnormalities. Microarray analysis will likely become the diagnostic genetic test of choice in children with neurodevelopmental disorders or epilepsy.
A twelve-year-old African-American female presented with two week history of progressively worsening headache and fatigue, and vision difficulties for the past week. The physical examination was ...normal. The neurological evaluation was normal, except for cranial nerves (CN) testing, which showed bilateral restriction of adduction (CN III) and up gaze (CN IV) motions, vertical nystagmus, and left side facial paresis of central origin (CN VII). The bilateral exotropia and ophthalmoplegia are characteristics of WEBINO (Wall-Eyed Bilateral Intranuclear Ophthalmoplegia) syndrome, associated to a brain stem structural lesion. The following causes were evaluated and ruled out: tumor, infection, ischemic stroke, non-infectious inflammation. Pediatric Acquired Demyelinating Syndromes were then considered. Neuromyelitis Optica was ruled out in the absence of neuritis and normal spinal cord MRI. The differential diagnosis between Clinically Isolated Syndrome and Acute Demyelinating Encephalomyelitis, causing an isolated brain stem syndrome, is discussed.
Vascular Anomalies of the Mediastinum Fernandez-Pineda, Israel, MD; De Agustin Asensio, Juan Carlos, MD
The Annals of thoracic surgery,
07/2011, Volume:
92, Issue:
1
Journal Article
The two-dimensional (2D) proximal isovelocity surface area (PISA) method has some technical limitations, mainly the geometric assumptions of PISA shape required to calculate effective regurgitant ...orifice area (EROA). Recently developed single-beat, real-time three-dimensional (3D) color Doppler imaging allows direct measurement of PISA without geometric assumptions. The aim of this study was to validate this novel method in patients with chronic mitral regurgitation (MR).
Thirty-three patients were included, 25 (75.7%) with degenerative MR and eight (24.2%) with functional MR. EROA and regurgitant volume were assessed using transthoracic 2D and 3D PISA methods. The quantitative Doppler method and 3D transesophageal echocardiographic planimetry of EROA were used as reference methods.
Both EROA and regurgitant volume assessed using the 3D PISA method had better correlations with the reference methods than conventional 2D PISA. A consistent significant underestimation of EROA and regurgitant volume using 2D PISA was observed, particularly in the assessment of eccentric jets. On the basis of 3D transesophageal echocardiographic planimetry of EROA, 14 patients had severe MR (EROA ≥ 0.4 cm(2)). Of these 14 patients, 42.8% (6 of 14) were underestimated as having nonsevere MR (EROA ≤ 0.4 cm(2)) by the 2D PISA method. In contrast, the 3D PISA method had 92.9% (13 of 14) agreement with 3D transesophageal planimetry in classifying severe MR. Good intraobserver and interobserver agreement for 3D PISA measurements was observed, with intraclass correlation coefficients of 0.96 and 0.92, respectively.
Direct measurement of PISA without geometric assumptions using single-beat, real-time 3D color Doppler echocardiography is feasible in the clinical setting. MR quantification using this methodology is more accurate than the conventional 2D PISA method.
Fishing in the Heart Montero-Cabezas, José Manuel, MD; Velázquez-Martín, María Teresa, MD; Fernández-Casares, Sagrario, MD ...
Journal of the American College of Cardiology,
04/2013, Volume:
61, Issue:
13
Journal Article
Peer reviewed
Open access
Surgery was contraindicated because of her comorbidities; therefore, percutaneous closure of the defect was planned. Because of the existence of a prosthetic aortic valve and an occluder device at ...the interatrial septum, a transapical approach was used to access the left ventricle.
The Reverse Enzyme Immunoassay (REIA) method for the detection of specific IgE recently described by us has been applied to the diagnosis of Vespula spp. sensitivity. To do so, 0.5 mg of Vespula ...venom of commercial origin was conjugated with peroxidase according to a previously described technique. The results obtained from the study of 50 nonallergic patients have demonstrated the specificity of the method in as much as no positive value was found. In addition, only one low positive value was obtained from a group of 47 atopic patients showing no evidence of sensitivity to insect stings. On the contrary, very high ELISA values from a group of 23 patients with suspected sensitivity to insect venom were obtained. With these results, we conclude that this method can constitute an aid in the diagnosis of these patients, besides being a low-cost method free from the interference of blocking antibodies. It is our opinion however, that this method is not as reliable as the RAST.
A 19-month-old, white, Pennsylvanian boy, with an unremarkable medical history, presented to our hospital with a 3-week history of nonbloody, nonbilious emesis up to 5 times a day and nonbloody ...diarrhea. Ten days before admission, his gait became progressively unsteady, until he finally refused to walk. A day before admission, he found it difficult to move his eyes. The patient was hypoactive. History, physical and neurologic examination, blood and cerebrospinal (CSF) fluid studies, and neuroimaging studies ruled out the most frequent causes of acute ataxia. The etiology of bilateral, complete ophthalmoplegia was also taken into consideration. Magnetic resonance imaging (MRI) findings of bilateral thalami and mammillary bodies provided diagnostic clues. Additional history and specific tests established the final diagnosis and treatment plan. The patient improved to a normal neurologic state. This case provides important practical information about an unusual malnutrition cause of acute ataxia, particularly in young children of developing countries.
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