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The emergence of robotic body augmentation provides exciting innovations that will revolutionize the fields of robotics, human-machine interaction and wearable electronics. Although augmentative devices such as extra robotic arms and fingers are informed by restorative technologies in many ways, they also introduce unique challenges for bidirectional human-machine collaboration. Can humans adapt and learn to operate a new robotic limb collaboratively with their biological limbs, without restricting other physical abilities? To successfully achieve robotic body augmentation, we need to ensure that, by giving a user an additional (artificial) limb, we are not trading off the functionalities of an existing (biological) one. Here, we introduce the 'neural resource allocation problem' and discuss how to allow the effective voluntary control of augmentative devices without compromising control of the biological body. In reviewing the relevant literature on extra robotic fingers and arms, we critically assess the range of potential solutions available for this neural resource allocation problem. For this purpose, we combine multiple perspectives from engineering and neuroscience with considerations including human-machine interaction, sensory-motor integration, ethics and law. In summary, we aim to define common foundations and operating principles for the successful implementation of robotic body augmentation., The development of extra fingers and arms is an exciting research area in robotics, human-machine interaction and wearable electronics. It is unclear, however, whether humans can adapt and learn to control extra limbs and integrate them into a new sensorimotor representation, without sacrificing their natural abilities. The authors review this topic and describe challenges in allocating neural resources for robotic body augmentation.

Aims. Total laryngectomy still plays an essential part in the treatment of laryngeal cancer and loss of voice is the most feared consequence of the surgery. Commonly used rehabilitation methods include esophageal voice, electrolarynx, and implantation of voice prosthesis. In this paper we focus on a new perspective of vocal rehabilitation utilizing alternative and augmentative communication (AAC) methods. Methods and Patients. 61 consecutive patients treated by means of total laryngectomy with or w/o voice prosthesis implantation were included in the study. All were offered voice banking and personalized speech synthesis (PSS). They had to voluntarily express their willingness to participate and to prove the ability to use modern electronic communication devices. Results. Of 30 patients fulfilling the study criteria, only 18 completed voice recording sufficient for voice reconstruction and synthesis. Eventually, only 7 patients started to use this AAC technology during the early postoperative period. The frequency and total usage time of the device gradually decreased. Currently, only 6 patients are active users of the technology. Conclusion. The influence of communication with the surrounding world on the quality of life of patients after total laryngectomy is unquestionable. The possibility of using the spoken word with the patient's personalized voice is an indisputable advantage. Such a form of voice rehabilitation should be offered to all patients who are deemed eligible.

Biological control is a worldwide trend and has been prominent as an effective and compatible strategy for use in Integrated Pest Management programs. In Brazil, the control of these organisms using biological agents has been used in several agricultural systems, including floriculture. This paper approaches biological control from the perspective of the interaction between organisms in nature, applied as a pest management strategy. Knowledge about the dependence and reciprocity among populations in a natural environment is fundamental to understanding that this control method is nothing more than an exploiting of a natural ecological service. Considering that, for the biological control of a pest we must increase the population density of natural enemies, we report on the two main ways to achieve this increase: conservative biological control and augmentative biological control. The first is done by modifying the environment’s vegetation structure to favor natural enemies’ maintenance or their attraction to the crops. The second is done by mass rearing entomophagous and entomopathogen species with attributes that can ensure their function as control agents when released in crops. Among such agents, we emphasize those produced and marketed in Brazil for application in ornamental plants. Finally, we report on the technologies most recently employed to increase the appropriate use and the efficiency of these biological control agents. Resumo O controle biológico é uma tendência mundial e tem se destacado como uma estratégia eficaz e compatível para uso em programas de Manejo Integrado de Pragas. No Brasil, o controle desses organismos, envolvendo agentes biológicos, tem sido utilizado em diversos sistemas agrícolas, inclusive, na floricultura. Neste artigo, o controle biológico é abordado sob o ponto de vista natural, por meio da interação entre os organismos na natureza, e aplicado, como estratégia para o manejo de pragas. O conhecimento sobre a dependência e reciprocidade existentes entre as populações na natureza é fundamental para a conscientização de que esse método de controle consiste na exploração de um serviço ecológico natural. Tendo-se em vista que, para o controle biológico de uma praga, a densidade populacional dos inimigos naturais deve ser aumentada, relatamos sobre as duas principais formas para se atingir esse incremento: o controle biológico conservativo e controle biológico aumentativo. A primeira, por meio da modificação do ambiente de cultivo de modo a oferecer uma estrutura vegetacional que favoreça a manutenção e/ou atração dos inimigos naturais, e a segunda, por meio da criação massal de entomófagos e entomopatógenos com características que possam garantir sua função como agentes de controle por ocasião da sua liberação nos cultivos. Entre tais agentes, enfatizamos aqueles que são produzidos e comercializados no Brasil para aplicação em plantas ornamentais. Por fim, relatamos sobre as tecnologias que têm sido mais recentemente empregadas para incrementar o uso adequado e a eficiência desses agentes biocontroladores.

Surgical procedures that render patients acutely aphonic can cause them to experience significant anxiety and distress. We queried patient perceptions after tracheostomy or laryngectomy and investigated whether introducing augmentative technology was associated with improvement in patient-reported outcomes.Participants included hospitalized patients who acutely lost the ability to speak due to tracheostomy or total laryngectomy from April 2018 to December 2019. We distributed questions regarding the patient communication experience and relevant questions from the validated V-RQOL questionnaire (Voice-Related Quality of Life). Patients were offered a tablet with the electronic communication application Verbally. Pre- and postintervention groups were compared with chi-square analyses.Surveys were completed by 35 patients (n = 18, preintervention; n = 17, postintervention). Prior to using augmentative technology, 89% of patients who were aphonic reported difficulty communicating, specifically noting breathing or suctioning (56%), treatment and discharge plans (78%), or immediate needs, such as pain and using the bathroom (39%). Communication difficulties caused anxiety (55%), depression (44%), or frustration (62%), and 92% of patients were interested in using an electronic communication device. Patients reported less trouble communicating after the intervention versus before (53% vs 89%,Acute loss of phonation arising from surgery can be highly distressing for patients, and use of augmentative technology may alleviate some of these challenges by improving communication. Further studies are needed to identify what additional strategies may improve overall well-being.Electronic communication devices may benefit patients with acute aphonia.

Exotic generalist arthropod biological control agents (GABCAs) have been historically marginalized in classical and augmentative biological control due to their broad diet breadth, but an increasing demand for a more sustainable pest control is encouraging their reconsideration. This special issue compiles a collection of papers revealing that risks of several exotic GABCAs were overestimated, not all generalists are riskier than specialists and their environmental risk assessment (ERA) solely based on exposure analysis is inadequate. Three papers demonstrated that generalists were not involved in predicted non-target interactions: generalist idiobiont parasitoids probably do not exhibit interference competition with each other, an oligophagous exotic egg-larval koinobiont parasitoid does not compete with a native larval koinobiont, and an invasive generalist predator does not escape from its enemies. Two innovative methods for selecting non-target species are proposed, one based on existing food web data to predict indirect non-target effects, and the other on functional traits to predict competition with native natural enemies. Also a comprehensive GABCA-ERA method is proposed that integrates adverse effect analysis to the ‘conventional’ exposure analysis. The method was scrutinized by two studies: one suggesting that it could have resulted in faster and less costly decisions on two exotic generalists in New Zealand, and the other suggesting that eight exotic GABCAs released in Argentina might potentially reduce native natural enemies. We hope this special issue will stimulate the continued advance in the biosafety research of GABCAs so their safe use does not stagnate.

BACKGROUND Behavioural skills training (BST) has demonstrated effectiveness in training teachers in evidence-based interventions to increase communication for children with limited repertoires. However, research has yet to extend to youth with developmental disabilities who are learning to communicate using speech-generating devices. The emergent use of telehealth technology in applied behaviour analysis has been associated with greater access to therapeutic services. Although the use of telehealth has been extended as an avenue for parents to access behavioural intervention services for their child, fewer studies have evaluated the use of telehealth for teacher behavioural consultation or with adolescents and young adults with complex communication needs. METHOD In the present study, four teaching staff were trained via telehealth to implement communication facilitation strategies with augmentative and alterative communication users in a high school functional skills classroom. During the coaching sessions, the staff were provided BST on the basic behaviour analytic teaching strategies (e.g. assessing preference, environmental arrangement, and reinforcement strategies). Independent adapted ABAB designs were used to evaluate the effectiveness of modified BST delivered via telehealth on increased teaching staff-implemented communication opportunities within the functional skills classroom and the effectiveness of staff-implemented communication intervention on increased speech-generating device mands for four adolescents/young adults with developmental disabilities. RESULTS The results indicated that the improved staff fidelity of the communication interventions was associated with the increased level of independent student mands for each dyad. Lastly, social validity data suggest that the procedures were acceptable and feasible. These data indicate that the use of telehealth may be a viable model for specialised classroom consultation. CONCLUSION The use of a telehealth delivery model to train classroom staff may be a viable option when specialised support is necessary, but access is limited.

Objetivo: identificar los factores, inherentes a la práctica clínica, que determinan la atención odontológica de pacientes con discapacidad. Métodos: realización de estudio descriptivo, de alcance explicativo, cuantitativo y corte transversal; aplicación de encuesta dirigida a odontólogos que ejercen como profesionales independientes, con la cual se midieron variables de caracterización, conocimientos, habilidades, percepción, infraestructura y atención del paciente con discapacidad. También, se desarrolló un análisis descriptivo, correlacional y multivariado. Resultados: no todos los odontólogos recibieron formación para la atención clínica de personas con discapacidad; algunos conocen los métodos de comunicación alternativa y aumentativa y, de estos, una mayoría representativa no los sabe manejar. Sobre la infraestructura, se identificó que esta cumple parcialmente con la normatividad y que la mayoría de los profesionales se sienten medianamente preparados para llevar a cabo esta atención, por lo que el 67,3% (99) afirmó atender esta población con sus protocolos clínicos habituales, pero, el 83,7% (123) manifestó brindar la atención solo en casos de urgencia odontológica. Los factores que determinan la atención del paciente con discapacidad están relacionados con la cantidad de pacientes asistentes, las experiencias negativas previas, las habilidades en el manejo de la consulta, la sensación de preparación y los años de experiencia clínica. Conclusiones: las experiencias negativas previas en la práctica clínica con pacientes con discapacidad son determinantes; para su disminución se sugiere la urgente implementación de técnicas comunicativas, la adecuación de infraestructura y el desarrollo de habilidades para la atención integral e inclusiva.

Introduction: Amyotrophic Lateral Sclerosis (ALS) is a multisystemic impairment disease, among them, the total loss of communicative abilities. Augmentative and Alternative Communication (CAA) seeks to provide effective communication through specific resources. Objective: To verify the influence of ALS on aspects of personal, social and environmental life in patients who use the CAA. Methods: This is a qualitative, exploratory, longitudinal research of a series of cases. The patients with ALS were invited to participate of an evaluation with a sociodemographic and semi-structured questionnaire. Each participant obtained a CAA resource offered by the present research and returned for a reevaluation. Results: The analysis based on the reports that emerged from the spontaneous comments and generated five categories (socialization, social attitudes, communication and rights, services, systems and policies, and family interaction). Conclusion: Even with the use of CAA, ELA generates negative impacts on socialization and social participation due to social and environmental factors.

A workshop format is often the professional development (PD) model used by educators; however, research shows that workshops are often not sufficient to change educator behavior. Additionally, including caregivers in PD can promote shared decision-making and support children’s transfer of skills between home and school environments. This pilot study examined the effectiveness of a PD intervention delivered to caregiver-educator teams that included team-based coaching to target adults’ use of evidence-based strategies delivered in a planned instructional sequence (i.e., CPR - create a communication opportunity, prompt as needed, respond to child communication) designed to support reciprocal interactions with children and use of aided augmentative or alternative communication. Using a multiple baseline across five caregiver-educator-child triads, the effect of intervention on adults’ percentage of correct CPR cycles was compared to a baseline condition in which adults learned isolated strategy implementation in a workshop format. Five adults showed positive behavior changes when intervention was implemented at three different time points, demonstrating promise of the intervention; however, for reasons discussed herein, the study produced mixed results. Results are consistent with prior research, and may be useful to administrators, educators, or families interested in PD and collaboration across home and school settings.

Although the scientific literature is replete with reports that host and plant volatiles elicit behavioural responses in Trichogramma, most do not compare the relative importance of olfaction, visi...

This paper presents the first iteration of the design of a web application which supports its users to access and arrange pictures as a non-linguistic way of supporting communication. We motivate our initial design by examining related work on Augmentative Alternative Communication (AAC). We present our reflections on the use of a working prototype by two minimally-verbal users with intellectual disability and how this can inform future work.

The last twenty years have seen the development of gaze-controlled computer interfaces for augmentative communication and other assistive technology applications. In many applications, the user needs to look at symbols on a virtual on-screen keyboard and maintain gaze to make a selection. Executive control is essential to learning to use gaze-control, affecting the uptake of the technology. Specifically, the user of a gaze-controlled interface must suppress looking for its own sake, the so-called “Midas touch” problem. In a pre-registered study ( https://osf.io/2mak4 ), we tested whether gaze-typing performance depends on executive control and whether learning-dependent plasticity leads to improved executive control as measured using the antisaccade task. Forty-two university students were recruited as participants. After five 30-min training sessions, we found shorter antisaccade latencies in a gaze-control compared to a mouse-control group, and similar error-rates. Subjective workload ratings were also similar across groups, indicating the task in both groups was matched for difficulty. These findings suggest that executive control contributes to gaze-typing performance and leads to learning-induced plasticity.

Background People with intellectual disabilities (IDs) face significant communication barriers when accessing health care services; they find it difficult to identify and describe conditions clearly enough to support practitioners in making an accurate diagnosis. In addition, medical professionals generally have little knowledge and understanding of the needs of people with ID, which may result in the use of consultation techniques that do not cater to their patients’ skills. Objective This review aims to identify and synthesize the literature on alternative and augmentative communication technologies that are used to support adults with mild ID during the exchange of information with medical practitioners. Methods We performed a scoping review of studies published in English that describe the technologies that are used to promote communication with patients with mild ID during medical consultations. The databases searched were PubMed, ACM Digital Library, and Google Scholar. A qualitative framework-based approach was used to synthesize the data and discern key recurring themes across the identified literature. Results Of the 1557 articles screened, 15 (0.96%) met our inclusion criteria. The bulk of the communication aids used focused on low-tech solutions, including patient passports, note-based prompts, Talking Mats, health diaries, and easy-read information sheets. Their influence on current practice ranged from advancing medical professionals’ knowledge of the health and communication needs of people with ID to increasing interagency collaboration, patient advocacy skills, and health promotion activities. The major barriers to the implementation of low-tech aids were a lack of portability and increased maintenance efforts. Only 3 studies explored the use of mobile apps to promote communication. Their findings indicated that high-tech solutions offer greater customization with regard to the accessibility and health care needs of people with ID. Conclusions Alternative and augmentative communication technologies have the potential to increase the quality of care provided to patients with mild ID; however, little work has been carried out in this area. Greater emphasis must be placed on (high-tech) two-way communication aids that empower patients to become involved in decisions regarding their care. Quantitative evaluation methods should be used to discern the true benefits of such aids, and researchers should describe their study protocols in depth to promote replication and generalizability.

Introduction: Since around half of the patients with obsessive-compulsive disorder do not respond efficiently to current serotonin- reuptake inhibitors, the objective of the present study was to compare the effectiveness and safety of quetiapine against aripiprazole in patients with obsessive-compulsive disorder, who had not responded successfully to fluvoxamine. Methods: Forty-four patients with obsessive-compulsive disorder, who had not responded efficaciously to fluvoxamine, at maximum dose (300 milligrams per day) and duration (twelve weeks), were allocated randomly in a double-blind assessment to take quetiapine (n=22) or aripiprazole (n=22), plus their serotonin-reuptake inhibitor for twelve weeks. While treatment response was evaluated by the Yale- Brown Obsessive-Compulsive Scale (YBOCS), as the main outcome scale, Clinical Global Impressions-Severity Scale (CGI-S) was also used as an ancillary measure. Results: 54.54% of patients in the quetiapine group and 27.27% of them in the aripiprazole group responded partially to the abovementioned on treatment adds. According to the findings, the YBOCS score dropped from 31.18+/-4.93 to 27.97+/-3.71 (p Conclusion: This assessment indicated that patients with treatment-resistant obsessivecompulsive disorder could benefit more from adding quetiapine, in comparison with aripiprazole, to their current serotonergic medication.

Objectives: People with motor neurone disease (pwMND) experience communication impairments due to speech and motor dysfunction. Communication support in the form of Augmentative and Alternative Communication (AAC) in conjunction with Assistive Technology (AT) access methods are available, however, variation in provision care pathways exists across Scotland. We conducted a baseline study of communication support for pwMND in Scotland to inform and improve future service provision. Methods: A cross-sectional population-based study was undertaken. Anonymised demographic and clinical phenotypic data for all pwMND in Scotland were extracted from the Care Audit Research Evaluation of MND (CARE-MND) platform, the National MND Register for Scotland. Additional information for AT loans was provided by the third sector charitable organization MND Scotland (MNDS). Results: In total, 371 pwMND were included, 43% of all pwMND were recorded as having impaired speech (recent ALSFRS-R score assessment ≤3) and 69% had been referred to Speech and Language Therapist (SLT) services, although there was variation in referral time from diagnosis date. AAC equipment had been acquired by 17.3% of all pwMND; most commonly iPads and the LightwriterTM speech generating device. Conclusions: Our data highlight a high prevalence of speech impairment in pwMND irrespective of the subtype diagnosis. We therefore recommend standardized care pathways and earlier access to coordinated SLT and Occupational Therapist services to enable prospective and personalized decision making. Our findings further highlight the need for qualitative research to understand the preferences and impact of such interventions from the perspective of the user and their communication partners.

After studying this article, the reader should be able to understand how various implants, osteotomies, and reductive tissue techniques affect the aesthetic outcomes of chin reshaping surgery. The roles of standard versus custom chin implants, the operative steps and indications for a bony genioplasty and the techniques for chin reduction are described with emphasis on proper patient selection and avoiding their common complications.

Objectives/hypothesis Describe augmentative communication tools and strategies used by pediatric patients referred to inpatient speech-language pathologists prior to tracheostomy placement. Study design Retrospective review. Methods A review of patients who underwent initial tracheostomy placement from 2013-2016 was conducted at a tertiary pediatric center. Eligible patients were those who were referred to a specialized speech-language pathologist prior to the date of the tracheostomy placement to support communication abilities. Patients were identified by surgical procedural and billing codes. Data collected included patient demographics, speech and language disorders, and interventions performed. Chart review and cross analysis of billing data for types of assessment and intervention procedures were conducted by two speech-language pathologists for consensus agreement. Results Forty-six patients (aged 1 month-27 years, mean = 12.9 years) were included in the study. Average time between the bedside communication assessment and tracheostomy procedure date was 17 days. Baseline speech-language disorders were identified in 11 patients (24%). Thirty-eight (83%) patients were nonspeaking at the time of consultation. Thirty-two (70%) patients utilized an electronic communication tool, and 36 (78%) utilized low-technology communication strategies during the preoperative period. A total of 32 (70%) patients were documented as using no-technology or speech-enhancement strategies during the acute hospitalization. Conclusions Multidisciplinary tracheostomy teams should consider consultation to speech-language pathologists for patients prior to tracheostomy placement to assess for utility of high-technology, low-technology, and no-technology augmentative and alternative communication strategies. Level of evidence 4 Laryngoscope, 130:1817-1822, 2020.

With advances in the treatment of femoral shaft nonunion after intramedullary nailing, the optimal option remains controversial. This study aimed to quantitatively investigate outcomes in a comparison of exchange nailing and augmentative plating for femoral shaft nonunion after intramedullary nailing. The EMBASE, PubMed, Cochrane library and Clinical databases were systematically searched dating from their inception to March 2018. All retrospective controlled and prospective trials evaluating exchange nailing and augmentative plating for the treatment of femoral shaft nonunion after intramedullary nailing were identified. Two investigators extracted all related data independently and we used the review manager software to perform the meta-analysis. Three studies with a total of 232 patients were eligible for data extraction in our study. The meta-analysis indicated that the augmentative plating group had a lower nonunion rate, shorter time to union, less intra-operative blood loss, and shorter operative time than the exchange nailing group. While for the infection rate, there was no significant difference between augmentative plating and exchange nailing group. The available evidence has shown that augmentative plating is superior to exchange nailing for femoral shaft nonunion after intramedullary nailing. Cite this article: EFORT Open Rev 2019;4:513-518. DOI: 10.1302/2058-5241.4.180054

In this article we present a novel system for natural language generation ( nlg ) of Spanish sentences from a minimum set of meaningful words (such as nouns, verbs and adjectives) which, unlike other state-of-the-art solutions, performs the nlg task in a fully automatic way, exploiting both knowledge-based and statistical approaches. Relying on its linguistic knowledge of vocabulary and grammar, the system is able to generate complete, coherent and correctly spelled sentences from the main word sets presented by the user. The system, which was designed to be integrable, portable and efficient, can be easily adapted to other languages by design and can feasibly be integrated in a wide range of digital devices. During its development we also created a supplementary lexicon for Spanish, aLexiS, with wide coverage and high precision, as well as syntactic trees from a freely available definite-clause grammar. The resulting nlg library has been evaluated both automatically and manually (annotation). The system can potentially be used in different application domains such as augmentative communication and automatic generation of administrative reports or news.

About 21% -35% of patients with acute stroke experience aphasia or motor impairment language interpretation. Impact because of the lack of action independence of the nurse in improving Augmentative Alternative Communication (AAC) is not the fulfillment of the needs of the patient. AAC is media in the form of electronic devices, alphabet boards, drawing boards that contain the basic needs which may be designated by the patient that helps in communicating. The research method is a literature research, focused on the search of some previous research. The results of the research show that the role of transformational leadership increase the AAC in stroke patients aphasia motor through insiparasional motivation where the leader becomes an example to be emulated by subordinates, providing a strong motivation for change with guidance and training, individualizad consideration that is hear input to want to change apply the AAC, Idealized influence where the leader as a mentor who has charisma makes followers want to practice the AAC, and intellectual stimulation is to encourage the subordinates to see problems in aphasia motor can be minimized with the AAC. Thus it can be concluded that the Style of transformational leadership has a used of therapeutic AAC to nurses practice.

Non-augmentative surgical therapy of peri-implantitis is indicated for cases with primarily horizontal bone loss or wide defects with limited potential for bone regeneration and/or re-osseointegration. This treatment approach includes a variety of different techniques (e.g., open flap debridement, resection of peri-implant mucosa, apically positioned flaps, bone re-contouring, implantoplasty, etc.) and various relevant aspects should be considered during treatment planning. The present mini review provides an overview on what is known for the following components of non-augmentative surgical treatment of peri-implantitis and on potential future research challenges: (1) decontamination of the implant surface, (2) need of implantoplasty, (3) prescription of antibiotics, and (4) extent of resective measures.

Biocontrol activities in Iran have started since 1934 by the successful introduction of Novius beetle. During this time, some other efforts were made for classical biocontrol but now, the main current programs rely on augmentation and conservation strategies. The data about the conservation part has been and determined major attempts are on improving the augmentative application. Here we will show the status of the main biocontrol agents including the key macro agent, Trichogramma, some species of predatory bugs and mites and microbial pesticides. The challenges toward the improvement of Trichogramma during the three decades will present. In the case of microbial agents, we will consider their mass production, registration and application issues. We considered the significant role of academia in the improvement of biocontrol. In the last section, the farmer’s issues related to the development of biocontrol have been reviewed and also the role of the government and its responsibilities has presented. The text highlighted the challenges and shows some solutions for those problems for increase quality control and performance of biological control within the Integrated Pest Management philosophy, including startups support for being involved in biocontrol plans.

Background:Cognitive behavioural therapy (CBT) is currently the treatment of choice for most anxiety disorders. Yet, with recovery rates of approximately 50%, many patients fail to achieve complete remission. This has led to increased efforts to enhance treatment efficacy. Physical exercise (PE) has in recent years been advocated as means to augment the effects of CBT for anxiety disorders. PE appears to reduce anxiety through other mechanisms than CBT, some of which might also have the potential to augment the effects of psychological treatment.Aims:The current review aimed to summarize and discuss the current research status on CBT augmented with PE for anxiety.Method:A systematic literature search was conducted in the databases PsychInfo, Medline and Web of Science to evaluate the potential augmentative effect of combining PE with CBT for anxiety disorders. These effects were intended to be evaluated in a meta-analysis, but findings from the few and diverse studies were better summarized in a systematic review.Results:Eight articles were included in this review, of which two had no control group, while six had from two to four experimental arms. Six of the studies concluded in favour of benefits of add-on PE, while two studies found no added benefits of the combined interventions.Conclusions:The combination of PE and CBT appears feasible. Add-on PE seems to be more beneficial for clinical populations, when administered regularly several times per week, across several weeks. Future studies should investigate further how and for whom to best combine PE and CBT.

This document exposes a technological tool built under the guidelines of the augmentative and alternative communication system - PECS, which consists of six phases and aims to promote independent communication of children with Autism Spectrum Disorders. The obtained tool is an application for Windows OS developed on the Unity and Arduino platforms to facilitate physical user interaction. The methodology used was iterative design, whose agile development approach allows improving the product incrementally in each iteration with the contribution of a multidisciplinary team made up of experts in information and communication technology, language rehabilitation, education, and graphic design. As a result, an augmentative and alternative communication system of easy installation, learning and configuration by the therapist was obtained. Its design and implementation were done considering the requirements of the users.

Today, mobile devices are cheap, affordable and are a part of our day to day life. It has paved its way into learning inside and outside the class. These devices have become a part of our body; it is with us $\mathbf{24\ x\ 7}$ . These smart devices provide us with learning beyond the classroom and textbooks. It has not only enhanced teacher-student interaction but has also solved many classroom related issues. With the advent of mobile devices MOOCs, m-learning, e-learning have grown exponentially in last few years. These pervasive devices are not only used for communication, but also for teaching, learning and development purpose. In this work we try to find the modalities which will be regulated by systematic inclusion of Bring Your Own Device (BYOD) based classroom interaction. The system used task technology fit (TTF) model to find if this technology is fit for the educational aid. This study includes survey to find the cognitive behaviour of students towards mobile devices including laptop, tablet, and smart phones. The parametric data collected over survey have been analysed for finding out the variation in treatment group and control group using Bayesian paired sample t-test, which clearly shows the effective use of BYOD based interaction in classroom for enhancing teaching learning process.

A lot of people with severe disabilities such as amyotrophic lateral sclerosis, motor neuron diseases, cerebral palsy, stroke, and spinal cord injury with intubation always have different degrees of communication problems. Therefore, it is very important to develop an effective and easy use assistive communication system for the severely disabled. In this study, a wireless home assistive system (WHAS) with different types of assistive input accessories sensors, Morse code translator, and human machine interface is developed and tested to help the severely disabled communicate with people and machines. A Morse code translator is implemented as an assistive communication core device to facilitate the input of the severely disabled. For the proposed human&ndash, machine interfaces, personal computer-based alternative augmentative communication is developed for patients to communicate with other people easily. To promote the quality of life, the home appliance control interface is developed for the severely disabled to directly control the functions of home appliances by themselves. The experimental results showed that the proposed WHAS is practical and feasible. Therefore, the proposed approach can help severely disabled individuals effectively interact with their surroundings.

Background Children with autism spectrum disorder (ASD) display impressive clinical heterogeneity, also involving treatment response. Genetic variants can contribute to explain this large interindividual phenotypic variability. Methods Array‐CGH (a‐CGH) and whole genome sequencing (WGS) were performed on a multiplex family with two small children diagnosed with ASD at 17 and 18 months of age. Both brothers received the same naturalistic intervention for one year according to the Early Start Denver Model (ESDM), applied by the same therapists, yielding dramatically different treatment outcomes. Results The older sibling came out of the autism spectrum, while the younger sibling displayed very little, in any, improvement. This boy was subsequently treated applying a structured Early Intensive Behavioral Intervention paired with Augmentative Alternative Communication, which yielded a partial response within another year. The ESDM nonresponsive child carries a novel maternally inherited 65 Kb deletion at chr. 13q32.2 spanning FARP1. Farp1 is a synaptic scaffolding protein, which plays a significant role in neural plasticity. Conclusion These results represent a paradigmatic example of the heuristic potential of genetic markers in predicting treatment response and possibly in supporting the targeted prescription of specific early intervention approaches., This is the first study addressing the involvement of FARP1 in a human disorder and the genetic basis of response to early behavioral intervention in child psychiatry. Though limited to one family, these results are a paradigmatic example of how genetic variants may represent useful treatment markers, able to aid clinicians in predicting response and in prescribing the therapeutic approach most likely to succeed in the single patient.

Biological control with arthropod natural enemies and microbial control agents has been applied since the year 1895 in Latin America and the Caribbean and is currently used on a very large scale. Sources about the history and current situation of biocontrol in this region were not easy to trace and are, therefore, presented in this chapter. Next, organizations working on biocontrol in this region are listed. This is followed by a description of natural, conservation, classical and augmentative biocontrol with some regional examples. Then, an approach to find, evaluate and use biocontrol agents is sketched, as guidance for research projects. Often, tens to a hundred biocontrol candidates are found in association with a pest. A well organized research approach using evaluation criteria allows for quick exclusion of unsuitable or problematic candidate species. Biocontrol research has limited funding and early elimination of poor candidates results in spending more money on promising candidates. Regulations concerning import and release of agents that have been implemented during the past 30 years are summarized. Effects of these regulations are that prospecting for exotic natural enemies is now very difficult and that fewer new biocontrol agents have become available. Finally, the structure of the book is explained.

Farmers in Niger are vulnerable to high millet yield losses due to the millet head miner, Heliocheilus albipunctella De Joannis (Lepidoptera: Noctuidae), for which pest control options are limited. Researchers have developed a procedure to multiply and spread an augmentative biological control agent Habrobracon hebetor Say (Hymenoptera: Braconidae) which is effective in limiting millet yield losses due to the pest. This study assesses the economic viability of small businesses to produce and sell biological control agents. It analyzes the profitability of the businesses under alternative pricing regimes given estimated costs to produce and distribute biological control agents. The economic assessment provides budget analysis for potential businesses and discusses options for scaling, price setting, and organizing. Our study suggests that the small H. hebetor industry should turn a profit in Niger at relatively low prices for the biological control agents of $3.00-$4.00 per bag with 15 bags needed per village. Competitive wages are achievable for the businesses that sell to at least 13 villages. Each business would hire three workers from late May to late August. Commercialization of H. hebetor would generate opportunities for wide geographic distribution of the technology on a sustainable basis in Niger.

Kakataibo (a Panoan language spoken in Peru) encodes emotional meanings by means of various morphological and prosodic devices. Some of them may be related to pragmatic implications (like the expression of affection by the diminutive), but others constitute dedicated emotional markers (as is the case of the illocutionary suffixes, augmentative nominalizers and nasalized imperatives). The fact that almost all the emotional markers carry nasalization is interpreted here as a possible case of language-internal sound-symbolism between nasalization and (negative) emotional meanings. This paper also shows that in Kakataibo we find a systematic pattern according to which dedicated emotional markers express negative emotions and never positive ones. Both the phonological and the semantic systems described in this paper may reveal patterns relevant for the cross-linguistic research on the grammar of emotions.

Autism is a lifelong developmental condition that affects how people perceive the world and interact with others. Challenges with typical social engagement, common in the autism experience, can have a significant negative impact on the quality of life of individuals and families living with autism. Recent advances in sensing, intelligent, and interactive technologies can enable new forms of assistive and augmentative technologies to support social interactions. However, researchers have not yet demonstrated effectiveness of these technologies in long-term real-world use. This article presents an overview of the social and sensory challenges of autism, which offer great opportunities and challenges for the design and development of assistive technologies. We review existing work on developing wearable technologies for autism particularly to assist social interactions, analyze their potential and limitations, and discuss future research directions.

Background and aim Aphasia as a common consequence of stroke, is an acquired neurologic communication disorder that can affect symbol language processing. Different types of intervention approaches have been introduced. Multimodal Communication Program (MCP) is a new augmentative alternative communication approach in chronic aphasia. The aim of this study was to investigate the effect of MCP on communication skills of patients with chronic aphasia. Methods This prospective, single subject, A-B-A design study was done during 2016 in Semnan, Iran. Participants were two patients with severe aphasia with a single left-hemisphere stroke. Three phases, including baseline, intervention and follow-up were administered. The patients received nine-hour intervention, over 10 working days. Results Three different scores were calculated for each patient: verbal efforts, the frequency of each modality and the accuracy of switching between modalities and the reaction time. The frequency of verbal modality increased for both patients. They could switch between modalities more successfully than before the intervention. The results for the reaction time, however were challenging. The onset reaction time decreased for patient 1, and increased during switching between modalities, and patient 2 showed the opposite. Conclusion The MCP can improve the communication skills in patients with chronic post stroke aphasia. However, some factors, such as reduction of the patients' reaction time is probably related to the amount of allocated resources during intervention. Trial registration The trial was registered at IRCT center with ID: IRCT2016032325194N3. Funding The study was financed by Semnan University of Medical Sciences (Grant no.: A-10-333-3).

Objective To systematically review the literature reporting outcomes of augmentative family-based treatment (FBT) interventions for adolescents with restrictive eating disorders (EDs). Method Articles were identified through a systematic search of five electronic databases (PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Database). Results Thirty articles were included, reporting on FBT augmentations featuring adjunctive treatment components, modified treatment structure and/or content with adherence to FBT principles, and adaptations allowing FBT delivery in different settings. All reported significant improvements in weight and/or ED symptoms at end-of-treatment, although few compared augmentative and standard FBT interventions and good quality follow-up data was generally lacking. Conclusions There is early evidence for the effectiveness of augmentative FBT-based approaches in facilitating weight and/or ED symptom improvements for adolescents with restrictive EDs. There remains a lack of robust evidence demonstrating superior effects of such approaches over standard FBT, and further controlled studies are required to expand on the current evidence. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Purpose This paper aims to review the literature on assistive technologies used in libraries and in schools, as portrayed on blogs, wikis and the internet, in the past year to highlight new trends. Design/methodology/approach Reports from blogs, internet sources and databases in the past year on the topic were read dealing with practical examples of assistive technologies in libraries and the education sector. Findings Assistive technologies are used to aid persons with disabilities, to make them more productive. The technologies can be low- or high-tech, depending on use and information available on new improvements and augmentative technologies being used. Originality/value This paper presents an overview of the past year and the current trends in the use of assistive technologies in libraries and schools worldwide.

In this study we wanted to determine the presence of teachers’ information-communication-technological competencies in working with students with special educational needs. Desk research provides an overview of policy and support in inclusive education in Montenegro, with a focus on teachers’ inclusive training. From 2015 to 2018, 148 trainings were realized in the field of inclusive education and 3848 teachers were trained - most often, these were one-day trainings, duration - 8 hours, and the topics were: Working with specific disabilities, adaptation, individualization. Systematic observation based on a protocol was conducted with 15 children from the second to the sixth grade of primary school: autism; intellectual, visual, hearing, combined disabilities and difficulties: speech, language, reading and writing. The findings indicate that teachers are educated to an individualize approach. We observed the application of the approach and the use of learning and communication technology. The effects of teachers’ work and competencies are better after training, coaching and when they get support from the professional associates of the school and/or resource center. Teachers’ attitudes are positive, they show creativity, adaptability, use the technologies after they have been trained about the characteristics of students, and recommended approaches for working with them.

The uptake of augmentative biological control agents (BCAs) is still limited, particularly in many low- to lower- middle- income countries. This study focuses on factors that affect the uptake of BCAs for arthropod pests by national extension partners (NEPs) in Plantwise—an agricultural development programme facilitating the establishment of plant clinics where farmers can obtain diagnosis and plant health advice. Using data generated by NEPs, BCA recommendations in extension material and given by extension workers in Ghana, Kenya, Zambia, India, Nepal and Pakistan were analysed. The rate of BCA recommendation ranged from 13.0 (Zambia) to 61.1% (India) in extension materials and from 0.0 (Zambia) to 18.2% (India) in recommendations given by extension workers. Knowledge, availability and price were identified as the main factors affecting the uptake of BCAs by NEPs. This baseline study gives novel insight into the potential of NEPs to facilitate the use of BCAs.

A developing nation like, Bangladesh, has been experiencing a transformation from individualized computing to a versatile mobile technology recently. It makes the chance to manufacture defensible solutions for individuals who are verbally challenged and facilitate their method for correspondence. Inexpensive Smart Electronic devices are presenting fresher correspondence potential outcomes that were not even believable a couple of years back. In view of the effect of these inconceivably prevalent electronic devices and their technologies on the clients, we have looked into and advanced an Android application named “Bolbo Kotha”. The goal was to construct an effective communication to elucidate the verbally challenged individual with customized facilities, adequate costing and general flexibilities. The ease of use and viability of the application have been assessed in view of four criteria, to be specific, customization capacity of the application in light of client's need, creating abilities to work out the application, insignificant resources and time required to adapt with the application, general costing of the overall framework, keeping in mind about the preferable cost of the users. In real life, the outcome demonstrates that proposed application is profoundly encouraged by the verbally challenged individuals, which can be utilized as an ultimate solution to upgrade communication abilities.

Bulbar impairment represents a hallmark feature of Amyotrophic Lateral Sclerosis (ALS) that significantly impacts survival and quality of life. Speech and swallowing dysfunction are key contributors to the clinical heterogeneity of ALS and require well-timed and carefully coordinated interventions. The accurate clinical, radiological and electrophysiological assessment of bulbar dysfunction in ALS is one of the most multidisciplinary aspects of ALS care, requiring expert input from speech-language pathologists (SLPs), neurologists, otolaryngologists, augmentative alternative communication (AAC) specialists, dieticians, and electrophysiologists—each with their own evaluation strategies and assessment tools. The need to systematically evaluate the comparative advantages and drawbacks of various bulbar assessment instruments and to develop integrated assessment protocols is increasingly recognized. In this review, we provide a comprehensive appraisal of the most commonly utilized clinical tools for assessing and monitoring bulbar dysfunction in ALS based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) evaluation framework. Despite a plethora of assessment tools, considerable geographical differences exist in bulbar assessment practices and individual instruments exhibit considerable limitations. The gaps identified in the literature offer unique opportunities for the optimization of existing and development of new tools both for clinical and research applications. The multicenter validation and standardization of these instruments will be essential for guideline development and best practice recommendations.

Artificial intelligence (AI) is increasingly being integrated into core business strategies for cognitive advancement. AI and its allied applications are impacting the function of all disciplines, processes and the fellow professionals in emerging business ecosystem today. It has transformed the way an enterprise work and how it exploits new technology and business avenues improving the quality of solutions in field support. This in turn, has also built an ecosystem right from the design, construction of system application and managing it through virtual interface. This study aims to uncover strategic imperatives of AI and productive impact of corresponding AR (Augmentative Reality) technologies with the help of a case-study of an IT (information-technology) firm. In this paper, the author explores the conceptual as well as application competence of AR by thoroughly examining the literature, contemporary trends and innovative applications.

In a complex case of speech disorder, the communication is entrusted to systems equipped with a speech synthesizer. When the user has a motor disability, in addition, hardware and software interfaces are personalized to make technology more accessible. Interaction design methods can be applied to develop improved assistive systems and, particularly, for Augmentative and Alternative Communication (AAC). Interaction design methods and usability evaluation could have a positive impact in reducing product barriers and improving performances as the effort state associated to its use can be reduced. Minimizing cognitive and physical efforts through the development of new solutions and interface optimization can be challenging. A usability test and an interface optimization of a personalized AAC system developed for a student of the University of Naples Federico II with complex communication needs due to a traumatic injury and motor impairment are discussed to fix usability issues, highlight critical areas and design new prototypes.

Autologous cartilages or synthetic nasal implants have been utilized in augmentative rhinoplasty to reconstruct the nasal shape for therapeutic and cosmetic purposes. Autologous cartilage is considered to be an ideal graft, but has drawbacks, such as limited cartilage source, requirements of additional surgery for obtaining autologous cartilage, and donor site morbidity. In contrast, synthetic nasal implants are abundantly available but have low biocompatibility than the autologous cartilages. Moreover, the currently used nasal cartilage grafts involve additional reshaping processes, by meticulous manual carving during surgery to fit the diverse nose shape of each patient. The final shapes of the manually tailored implants are highly dependent on the surgeons’ proficiency and often result in patient dissatisfaction and even undesired separation of the implant. This study describes a new process of rhinoplasty, which integrates three-dimensional printing and tissue engineering approaches. We established a serial procedure based on computer-aided design to generate a three-dimensional model of customized nasal implant, and the model was fabricated through three-dimensional printing. An engineered nasal cartilage implant was generated by injecting cartilage-derived hydrogel containing human adipose-derived stem cells into the implant containing the octahedral interior architecture. We observed remarkable expression levels of chondrogenic markers from the human adipose-derived stem cells grown in the engineered nasal cartilage with the cartilage-derived hydrogel. In addition, the engineered nasal cartilage, which was implanted into mouse subcutaneous region, exhibited maintenance of the exquisite shape and structure, and striking formation of the cartilaginous tissues for 12 weeks. We expect that the developed process, which combines computer-aided design, three-dimensional printing, and tissue-derived hydrogel, would be beneficial in generating implants of other types of tissue.

OBJECTIVES To address the focused question: "In patients with osseointegrated implants diagnosed with periimplantitis, what are the clinical and radiographic outcomes of augmentative surgical interventions compared with nonaugmentative surgical measures"? MATERIAL AND METHODS Literature screening was performed in MEDLINE through the PubMed database, for articles published until January 1, 2018. Human studies reporting on the clinical (ie, bleeding on probing [BOP] and probing depth [PD] changes) and/or radiographic (ie, periimplant defect reduction and/or fill) treatment outcomes after surgical augmentative periimplantitis therapy, and/or comparing augmentative and nonaugmentative surgical approaches were searched. RESULTS Thirteen comparative and 11 observational clinical studies were included. Surgical augmentative periimplantitis therapy resulted in mean BOP and PD reduction ranging from 26% to 91%, and 0.74 to 5.4 mm, respectively. The reported mean radiographic fill of intrabony defects ranged between 57% and 93.3%, and defect vertical reduction varied from 0.2 to 3.77 mm. Three randomized controlled clinical studies failed to demonstrate the superiority of augmentative therapy compared with nonaugmentative approach in terms of PD and BOP reduction. CONCLUSIONS The available evidence to support superiority of augmentative surgical techniques for periimplantitis management on the treatment outcomes over nonaugmentative methods is limited.

Augmentative biological control uses mass-reared natural enemies for releases in large numbers to reduce pest populations. Augmentative biocontrol is increasingly applied worldwide in many different crops. It is a cornerstone of integrated pest management (IPM) programmes and plays a key sustainability-determining role in IPM. This chapter describes the scale of augmentative biological control and where this type of biocontrol is applied. The chapter describes the natural enemies commercially available and gives information on their mass production. The chapter discusses the important role of biocontrol in IPM programmes, and its practical use in very different agricultural production systems. Finally, the chapter presents the advantages and disadvantages of this control method, and looks ahead to future research trends in this area.

Objective: To explore the indications and efficacy of augmentative locking compression plate (LCP) or less invasive stabilization system (LISS)with autogenous bone grafting (BG) in treating distal femoral nonunion subsequent to failed retrograde intramedullary nailing (RIN). Methods: A retrospective study was performed for 21 patients with distal femoral nonunion subsequent to failed RIN, who received therapy with either augmentative LCP (n = 11) or LISS with autogenous BG (n = 13). Operation time, time to union, union rate, time to renonunion, complication rate and SF-36 scores a year after hardware removal were compared between the two groups. Results: The bone union occurred in 13/13 (100%) cases in augmentative LISS group versus 9/11 (81.8%) cases in augmentative LCP group [odds ratio (OR) = 3.21, 95% confidence interval (CI) 0.7–13]. Time to union, time to renonunion, complication rate of the augmentative LCP group were significantly more than that of the augmentative LISS with autogenous BG group (p = 0.023, p = 0.021 and p = 0.033). No significant difference was found in the average operation time of two groups (p = 0.121). At the follow-up a year after hardware removal, statistically significant HRQOL improvement in the augmentive LISS group was measured at the level of pain (p = 0.003) and general health perception (p = 0.011), as compared to the augmentive LCP group. Conclusions: We suggest augmentative LCP, for distal femoral nonunios after RIN, may be optimal for that of typeAO33A fractures, whereas augmentative LISS for that of typeAO33C fractures more. Keywords: Retrograde intramedullary nailing, Distal femoral nonunion, Augmentative locking plate, Autologous bone grafting