Guessability of Indian picture symbols for communication (IPSC) and picture communication symbols (PCS) among Malayalam-speaking typical adults.

The purpose of this study was to investigate the perceived symbol referent relationship for selected symbols in typical adults for two different symbol sets: Indian Picture Symbols for Communication (IPSC) and Picture Communication Symbols (PCS) to identify cultural influences on symbol recognition. A total of 240 typical adults, including 120 nonprofessionals, and 120 health professionals, from Kerala, a southern state in India, participated in the study. A guessability task involving IPSC and PCS symbols for 30 target referents was utilized. Guessability scores for each participant as well as each symbol stimuli across two symbol sets were determined. The guessability scores for IPSC were significantly (p <.001) higher than PCS. For both symbol sets, nouns were the most accurately guessed, followed by verbs, adjectives, and prepositions. The results also revealed that prompting and previous exposure to symbols tend to influence the transparency of symbols. Error analyses revealed that visual and conceptual cues within a symbol tend to influence guessability. The results indicate that cultural and linguistic factors play a role in symbol guessability. The study highlights the importance of investigating the iconicity of IPSC and PCS symbols across different populations within India, before using symbols for educational/clinical purposes.

Comparing verbal and aided single sentence productions in Malayalam-speaking adults with aphasia: a preliminary investigation.

The primary aim of the study was to investigate the semantic and syntactic aspects of verbal and aided single sentence productions in adults with aphasia and neurotypical adults to determine which mode allowed the exchange of information more effectively. The participants of this study included 20 adults with aphasia and 20 neurotypical adults who were native speakers of Malayalam, an Indo-Dravidian language spoken in the south-western state of Kerala in India. Thirteen action picture stimuli were constructed to elicit single sentences. The participants were expected to describe the action picture in a single sentence using spoken language as well as using Picture Communication Symbols (PCS). The semantic aspect of each sentence produced was analysed using Correct Information Unit (CIU) analyses, and the syntactic aspects were measured using (i) percentage of grammatically complete sentences, (ii) percentage of the correct number of verbs, and (iii) total number of syntactic errors. A sentence production accuracy scale was constructed to obtain a combined score for semantic and syntactic aspects of each sentence produced. The results suggested that while both verbal and aided modes were effectively used for the exchange of information by neurotypical adults and adults with anomic aphasia, the aided mode was used more effectively by adults with Broca's aphasia. To conclude, the study highlights the importance of (a) using visual symbols even for those with mild aphasia as it tends to improve phonological and articulatory abilities, (b) use of symbols to construct simple sentences to communicate in adults with severe aphasia, (c) evaluation of the ability to use alternate modes of communication and also the preferred mode of communication in adults with aphasia.

Effectiveness of Semantic-based Treatment in Persons with Aphasia.

BACKGROUND: Semantic-based treatment is the salient approach used to remediate word retrieval deficits in persons with aphasia (PWAs). It is deemed to improve semantic attributes around the target word, thus aids in restoring word retrieval abilities. Hence, the present study has developed a semantic-based therapy named semantic cueing of verbs and its thematic role (SCVTr). Also, this therapy uses verbs as a core element accompanied by graded levels of semantic cues. AIM: The current study Semantic Cueing of Verbs and its Thematic role (SCVTr) aimed to evaluate the effect of word retrieval abilities in PWAs. METHODS AND PROCEDURE: Three participants (n = 3) with aphasia were recruited for the study. All the participants in the study received SCVTr therapy, and the responses were analyzed at three distinct time points. That is pre-therapy assessment (before initiation of therapy), mid-therapy assessment (10th session), and post-therapy assessment (20th session). Nouns, verbs, and discourse abilities of PWAs were evaluated using standardized test batteries. OUTCOMES AND RESULTS: The study results have discerned positive gains across trained conditions and discourse genres across all the participants. However, participants exhibited marginal gains with untrained stimuli. In addition, SCVTr therapy aids in modifying the error pattern exhibited by PWAs. Concurrently, researchers noted that all participants showed ameliorated performance on the standardized language test batteries during post-therapy evaluation. CONCLUSIONS: SCVTr therapy has found to be effective in remediating word retrieval deficits in PWAs. This study extends the knowledge about strengthening the semantic network associated with the target word and its effect on generalization.

Effect of Distance between Marker Agreement Dependencies on Sentence Comprehension in Persons with Aphasia.

BACKGROUND: Rules and regularities are embedded in all the language structures. Extracting these helps in speech-language acquisition and processing. Sentence processing relies on transitional probability of the dependencies and its distance which are present within the sentence. AIM: To investigate the effect of distance between marker agreement dependencies on sentence comprehension in Persons with Aphasia (PWA) and Neuro- Typical Individuals (NTI). METHODS: Ten PWA and Ten NTI were recruited for the study. Participants whose native language was Kannada (a South Indian Language) and received formal education of minimum 10th grade were selected. MATERIALS: A total of 60 Kannada sentences were used and grouped into three categories i.e., short sentence (had short distance between dependencies) (SSD); Longer sentences (had long distance between dependencies) (LLD) and longer sentences (had short distance between dependencies) (LSD). The agreement markers in the sentence were manipulated w.r.t distance among them and grouped it as adjacent (short distance) and non-adjacent (long distance) type of sentences. PROCEDURE: The participants were instructed to read the sentence and judge whether it is grammatically correct or not by pressing the key corresponding to 'yes' or 'no' on the keyboard. In addition, modified N-back task was administered. RESULTS AND DISCUSSION: Accuracy and reaction time measures were derived for each sentence types. NTI showed better performance than PWA in sentence judgment task. Both the groups, performed poorly on LSD type of sentence when compared to other sentence types. LSD type was more complex due to the syntactic demands placed by the antecedent preposition, pronoun and adverb placed nearer to the verb and also longer distance between subject agreement to the verb.

Clinical Profiling of a Bilingual Client with Anomic Aphasia.

BACKGROUND: Aphasia is an acquired condition affecting auditory comprehension, verbal expression, reading, writing and word-finding abilities along with sensory-motor impairments. Anomia refers to difficulty in word retrieval or naming which is seen irrespective of the type of aphasia. However, if a patient shows word-finding difficulty, in specific, a diagnosis of Anomic aphasia is made. There are variations within anomic aphasia on which the management and recovery depend. The article provides one such case report. PURPOSE: Speech and language profiling in anomic aphasia, specific treatment strategies, the effect of bilingualism on recovery. METHODS: Mr S, a 38-year-old bilingual male reported 5 months post-stroke with difficulty in expressing, difficulty in writing and weakness in the right side of the body. Medical history was checked and speech and language evaluations including both formal and informal assessments were performed. After this, a diagnosis of Anomic aphasia with mild dysarthria was made. An appropriate speech-language therapeutic plan and specific activities were formulated for Mr S in his first language (L1) and he was given a therapy for a span of 3 months. A follow-up evaluation in both first and second language of the patient yielded differential recovery patterns. RESULTS: The diagnosis was affected by different variants of anomic aphasia; treatment was specific to the clinical profiling and followed life-participation approach of aphasia. The recovery was affected by differential recovery patterns between the languages. DISCUSSION: Factors pertaining to diagnosis, recovery, bilingualism and treatment of the client with anomic aphasia are discussed.

A Systematic Review of the Influence of Bolus Characteristics on Respiratory Measures in Healthy Swallowing.

There have been a number of studies on the effect of bolus volume, consistency, texture, temperature and taste on the oropharyngeal swallowing physiology. However, its influence on the respiratory function associated with swallow is not well understood. This study aimed at systematically analysing and documenting the prevailing research literature on respiratory functions before, during, and after healthy swallows of boluses with varied characteristics. The PRISMA guidelines were followed for retrieval of relevant research. From among the 48,329 reports screened for inclusion criteria, 25 articles were included for data extraction. Each of these reports was evaluated for its design, methodology and reporting quality and also the level of evidence provided by them. The results revealed that the scientific evidence in this regard was restricted to level II. Majority of the studies included considered bolus volume as the variable than bolus consistency, taste or temperature. Expiratory phase was preferred surrounding the apnea irrespective of volume, consistency or taste but changed with temperature variations across age groups. The reports are equivocal on the duration of respiratory apnea, and length of respiratory cycles before and after the apnea. The temporal coordination of pharyngeal swallow events was found to be independent of bolus volume. This review concluded that bolus characteristics have differential effects on the respiratory functions during swallow beyond a 'central sensory threshold' level. Objective standardization of bolus characteristics may be the immediate requirement for generalization of future research findings in this direction.

Capacity & capability building for applied dementia research in low- & middle-income countries: Two exemplars from South Asia.

BACKGROUND & OBJECTIVES: Cognitive and other neurodegenerative conditions related to ageing have become public health priorities in low- and middle-income countries. However, contextually based, applied research to support the development of awareness, diagnosis and care pathways for people with dementia in South Asia is still largely undeveloped. This study was aimed to use applied research studies for dementia in South Asia as exemplars of how individual-level capacity and capability building for dementia research can be achieved. METHODS: Using Theory of Change as a framework, we embedded capacity and capability building into the studies through six domains: people (human resources), research integrity and governance, study delivery skills, international collaborative working, patient and public involvement (PPI) (awareness raising, stigma and health literacy) and development of 'pathways'. For each aspect, development goals were defined and how they would be achieved. RESULTS: New principal investigators, research assistants (including outcome raters), study coordinators and intervention practitioners were trained across eight study sites in India, Pakistan, and Bangladesh, for dementia research. Training was delivered at study start, and through booster sessions, using workshops, face-to-face sessions, online training and video-link sessions. International collaborations were fostered, leading to a proposal for international funding. Each study site co-created PPI events to raise awareness and to inform the research. The recruitment pathways and study logistics fostered the development dementia diagnosis and care pathways. INTERPRETATION & CONCLUSIONS: Embedding capacity and capability building in applied dementia research in South Asia fosters the sustainability of dementia research, which is essential in developing diagnostic and care pathways.

Investigation of flow dynamics of wastewater in a pilot-scale constructed wetland using radiotracer technique.

Constructed wetlands (CWs) are used for the treatment of wastewater by natural processes. Knowledge of the flow dynamics of wastewater through the CWs is required to evaluate their performance, operation and design. The residence time distribution (RTD) approach was used to evaluate the above-mentioned parameters in a CW. The RTD of wastewater flowing through a pilot-scale CW was measured using Technetium-99 m (99mTc) as a radiotracer. The measured data were analyzed, and mean residence time and stagnant volumes were quantified under different operating conditions. A plug flow component in series along with a tank-in-series model with an exchange between the active and dead zones was used to simulate the measured RTD curves and investigate the flow dynamics of the flowing wastewater. The results of the study showed that the optimum flow rate and wastewater level in the CW was 2.3 m3/s and 0.6 m, respectively. Moreover, the results of the study will help in the operation and design of the existing wetland and design of new wetlands.

Design, synthesis and molecular docking of pyrazolo [3,4d] thiazole hybrids as potential anti-HIV-1 NNRT inhibitors.

A series of pyrazolo[3.4,d]thiazole hybrids 6 were synthesized from 5-arylidene-2-imino-3-(4-arylthiazol-2-yl)-thiazolidin-4-ones 5. The 5-arylidene-2-imino-3-(4-arylthiazol-2-yl)-thiazolidin-4-ones 5 were synthesized from 2-amino-4-arylthiazoles 1 and 2-chloro-acetamido-4-arylthiazoles 2 via the formation of 2-imino-3-(4-substituted-arylthiazol-2-yl)-thiazolidin-4-ones 3 using substituted aldehydes 4. The 5-acrylidene derivative 5 on cyclisation with phenyl hydrazine give the pyrazolo [3, 4, d] thiazole derivatives 6. The obtained pyrazolo [3.4, d]thiazole derivatives were studied as anti-HIV-1 NNRT inhibitors. It was found that these compounds might have potent RT inhibition activity.

Magnetic field compatible circuit quantum electrodynamics with graphene Josephson junctions.

Circuit quantum electrodynamics has proven to be a powerful tool to probe mesoscopic effects in hybrid systems and is used in several quantum computing (QC) proposals that require a transmon qubit able to operate in strong magnetic fields. To address this we integrate monolayer graphene Josephson junctions into microwave frequency superconducting circuits to create graphene based transmons. Using dispersive microwave spectroscopy we resolve graphene's characteristic band dispersion and observe coherent electronic interference effects confirming the ballistic nature of our graphene Josephson junctions. We show that the monoatomic thickness of graphene renders the device insensitive to an applied magnetic field, allowing us to perform energy level spectroscopy of the circuit in a parallel magnetic field of 1 T, an order of magnitude higher than previous studies. These results establish graphene based superconducting circuits as a promising platform for QC and the study of mesoscopic quantum effects that appear in strong magnetic fields.

Community Health Centre-Based Outreach Clinic for undergraduate dental education: Experience in Helsinki over 8 years.

INTRODUCTION: The University Dental Clinic of the City of Helsinki (UDC) developed a Community Health Centre-Based Outreach Clinic, with emphasis on paediatric dentistry. This study aimed to summarise the experiences and explore the student perspectives of the health centre-based outreach teaching clinic. METHODS: The study data were from the years 2010 to 2016. The dental procedures carried out by the third- to fifth-year dental students were based on electronic health record of patients. The students' self-perceived benefits and free-text comments on the outreach training were collected as part of a yearly questionnaire survey. RESULTS: A vast majority of the paediatric dental procedures that are required for competencies of dental students were performed in the outreach clinic. The most common procedures were fillings with local anaesthesia followed by preventive procedures. The majority of the students were very motivated to participate in the outreach training and reported that it was a useful educational approach to broaden their understanding of oral diseases and clinical experience. CONCLUSION: The outreach clinic gives dental students a chance to gain valuable clinical experience through the number and diversity of the dental procedures they carry out. They gain confidence and get an opportunity to get acquainted with the primary healthcare system and social determinants of oral diseases. Outreach appears to provide complementary clinical experiences that fulfil learning outcomes. Learning objectives should be taken into account when planning the outreach programme in order to offer meaningful and motivating education.

Autophagy and oral cancers: A short review.

Autophagy is a catabolic process, which involves recycling of cellular elements and it seems to play a major role in etiopathogenesis of cancers. Autophagy is thought to buffer metabolic stress, thereby aiding in cell survival. Also, it is found that inhibiting autophagy under deficient nutrition can restore cell death to apoptosis. Therefore, autophagy plays a dual role in cancer therapeutics. Globally oral cancer is a major concern of numerous deaths, so comprehensive work needs to be undertaken in the field of its progression and to determine positive treatment modalities. There exists a serious dearth of knowledge to understand and comprehend the process of autophagy, and it is beyond doubt that further research in this field would bring forth several new methods of cancer prevention and treatment.

Pectoral nerve block1 versus modified pectoral nerve block2 for postoperative pain relief in patients undergoing modified radical mastectomy: a randomized clinical trial.

BACKGROUND: Pectoral nerve block1 (PEC1) given between pectoralis major and minor, and modified pectoral nerve block2 (mPEC2) performed between pectoralis minor and serratus anterior, can provide continuous analgesia after modified radical mastectomy (MRM) when catheters are placed before skin closure. This study was designed to compare PEC1 and mPEC2 block for providing postoperative pain relief after MRM. METHODS: Sixty-two physically fit patients undergoing MRM were assigned into two groups (Group PEC1, n=31 and Group mPEC2, n=31). Before wound closure, epidural catheter was placed in the group designated muscle plane and 30ml of 0.25% bupivacaine was injected through the catheter after wound closure. Bupivacaine 15ml of 0.25% top up was given on patient's demand or whenever visual analogue scale (VAS) score was>4. Time for first analgesia (TFA), number of top ups and VAS was recorded at 0.5, 6, 12, 18, 24 h after surgery. Sensory blockade was assessed 30 min after extubation. RESULTS: Analgesia was significantly prolonged in group mPEC2 [mean(SD)] 313.45(43.05) vs 258.87(34.71) min in group PEC1, P<0.001. Total pain experienced over 24 h was significantly less in group mPEC2 [mean(SD)] 9.77(6.93) than in group PEC1 24.19(10.81), P<0.0001. Consequently, top up requirements were significantly reduced in group mPEC2 than in group PEC1 [median(range)] 3(2-4) vs 4(3-5) respectively, P<0.001. Lateral pectoral (77.42% and 35.48%) and thoracodorsal nerves (93.55% and 48.39%) had higher incidence of sensory block in group mPEC2 than group PEC1, P<0.001. CONCLUSIONS: mPEC2 provides better postoperative analgesia than PEC1 when catheters are placed under direct vision after MRM. CLINICAL TRIAL REGISTRATION: CTRI/2017/02/007811 (REF/2015/11/010185).

Current-Phase Relation of Ballistic Graphene Josephson Junctions.

The current-phase relation (CPR) of a Josephson junction (JJ) determines how the supercurrent evolves with the superconducting phase difference across the junction. Knowledge of the CPR is essential in order to understand the response of a JJ to various external parameters. Despite the rising interest in ultraclean encapsulated graphene JJs, the CPR of such junctions remains unknown. Here, we use a fully gate-tunable graphene superconducting quantum intereference device (SQUID) to determine the CPR of ballistic graphene JJs. Each of the two JJs in the SQUID is made with graphene encapsulated in hexagonal boron nitride. By independently controlling the critical current of the JJs, we can operate the SQUID either in a symmetric or asymmetric configuration. The highly asymmetric SQUID allows us to phase-bias one of the JJs and thereby directly obtain its CPR. The CPR is found to be skewed, deviating significantly from a sinusoidal form. The skewness can be tuned with the gate voltage and oscillates in antiphase with Fabry-Pérot resistance oscillations of the ballistic graphene cavity. We compare our experiments with tight-binding calculations that include realistic graphene-superconductor interfaces and find a good qualitative agreement.

Volatile organic compounds and good laboratory practices in the in vitro fertilization laboratory: the important parameters for successful outcome in extended culture.

PURPOSE: This study aims to describe the role of implementing good laboratory practices to improve in vitro fertilization (IVF) outcomes which are of great interest for practitioners dealing with infertility. METHODS: Certain modifications were introduced in May 2015 in our IVF laboratory like high-efficiency particulate air CODA system, steel furniture instead of wooden, use of new disinfectants like oosafe, and restriction of personnel entry along with avoidance of cosmetics like perfume to improve pregnancy rates. Volatile organic compound (VOC) meter reading was monitored at two time points and five different places in the laboratory to compare the embryonic development parameters before (group A: July 2014-April 2015) and after (group B: July 2015-April 2016) remodeling. RESULTS: The IVF outcomes from 1036 cycles were associated in this study. Reduction in VOC meter readings, enhanced air quality, improvement in blastocyst formation rate, implantation, and clinical pregnancy rate were observed in the laboratory after implementation of new facilities. Results illustrated that the attention must be focused on potential hazards which expose laboratories to elevated VOC levels. Blastocyst formation rate increased around 18%. Implantation rate, clinical pregnancy rate, and live birth rate increased by around 11, 10, and 8%, respectively. CONCLUSION: In conclusion, with proper engineering and material selection, we have been able to reduce chemical contamination and adverse effects on culture with optimized IVF results. SUPPORT: None.

Side Gate Tunable Josephson Junctions at the LaAlO3/SrTiO3 Interface.

Novel physical phenomena arising at the interface of complex oxide heterostructures offer exciting opportunities for the development of future electronic devices. Using the prototypical LaAlO3/SrTiO3 interface as a model system, we employ a single-step lithographic process to realize gate-tunable Josephson junctions through a combination of lateral confinement and local side gating. The action of the side gates is found to be comparable to that of a local back gate, constituting a robust and efficient way to control the properties of the interface at the nanoscale. We demonstrate that the side gates enable reliable tuning of both the normal-state resistance and the critical (Josephson) current of the constrictions. The conductance and Josephson current show mesoscopic fluctuations as a function of the applied side gate voltage, and the analysis of their amplitude enables the extraction of the phase coherence and thermal lengths. Finally, we realize a superconducting quantum interference device in which the critical currents of each of the constriction-type Josephson junctions can be controlled independently via the side gates.

Variants in Pharmacokinetic Transporters and Glycemic Response to Metformin: A Metgen Meta-Analysis.

Therapeutic response to metformin, a first-line drug for type 2 diabetes (T2D), is highly variable, in part likely due to genetic factors. To date, metformin pharmacogenetic studies have mainly focused on the impact of variants in metformin transporter genes, with inconsistent results. To clarify the significance of these variants in glycemic response to metformin in T2D, we performed a large-scale meta-analysis across the cohorts of the Metformin Genetics Consortium (MetGen). Nine candidate polymorphisms in five transporter genes (organic cation transporter [OCT]1, OCT2, multidrug and toxin extrusion transporter [MATE]1, MATE2-K, and OCTN1) were analyzed in up to 7,968 individuals. None of the variants showed a significant effect on metformin response in the primary analysis, or in the exploratory secondary analyses, when patients were stratified according to possible confounding genotypes or prescribed a daily dose of metformin. Our results suggest that candidate transporter gene variants have little contribution to variability in glycemic response to metformin in T2D.

Circumpolar distribution and carbon storage of thermokarst landscapes.

Thermokarst is the process whereby the thawing of ice-rich permafrost ground causes land subsidence, resulting in development of distinctive landforms. Accelerated thermokarst due to climate change will damage infrastructure, but also impact hydrology, ecology and biogeochemistry. Here, we present a circumpolar assessment of the distribution of thermokarst landscapes, defined as landscapes comprised of current thermokarst landforms and areas susceptible to future thermokarst development. At 3.6 × 106 km2, thermokarst landscapes are estimated to cover ∼20% of the northern permafrost region, with approximately equal contributions from three landscape types where characteristic wetland, lake and hillslope thermokarst landforms occur. We estimate that approximately half of the below-ground organic carbon within the study region is stored in thermokarst landscapes. Our results highlight the importance of explicitly considering thermokarst when assessing impacts of climate change, including future landscape greenhouse gas emissions, and provide a means for assessing such impacts at the circumpolar scale.