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New autism early detection technique analyses how children scan faces



Imagine that your son Tommy is about to turn two. He is a shy and sweet little boy, but his behaviours can be unpredictable. He throws the worst temper tantrums, sometimes crying and screaming inconsolably for an hour. The smallest changes in routines can throw him off.

Is this a bad case of the so-called “terrible twos”? Should you give Tommy some time to grow out of this phase? Or, are these signs of spectrum disorder (ASD) — the neurodevelopmental disorder that affects around two per cent of the population, the equivalent of about one or two children on a full school bus? And how will you find out?

Our research group at the Applied Mathematics Department at University of Waterloo has developed a new ASD detection technique that distinguishes different eye-gaze patterns to help doctors more quickly and accurately detect ASD in children.

We did this because there are so many benefits of early ASD diagnosis and intervention. Studies have found that interventions implemented before age four are associated with significant gains in cognition, language and adaptive behaviour. Similarly, researchers have linked the implementation of early interventions in ASD with improvements in daily living skills and social behaviour. Conversely, late diagnosis is associated with increased parental stress and delays early intervention, which is critical to positive outcomes over time.

Current ASD interventions

Symptoms of ASD typically appear in the first two years of life and affect the child’s ability to function socially. Although current treatments vary, most interventions focus on managing behaviour and improving social and communication skills. Because the capacity for change is greater the younger the child is, one can expect the best outcomes if diagnosis and intervention are made early in life.

Assessment of ASD includes a medical and neurological examination, an in-depth questionnaire about the child’s family history, behaviour and development or an evaluation from a psychologist.

Unfortunately, these diagnostic approaches are not really toddler-friendly and can be expensive. One can imagine that it is much easier for children to just look at something, like the animated face of a dog, than to answer questions in a questionnaire or be evaluated by a psychologist.

Mathematics as new microscope

You might wonder: What do mathematicians have to do with detection?

This is indeed an example of interdisciplinary research our group is involved in. We use mathematics as a microscope to understand biology and medicine. We build computer models to simulate the effects of various drugs and we apply mathematical techniques to analyze clinical data.

We believe that mathematics can objectively distinguish between behaviours of children with ASD from their neurotypical counterparts.

We know that individuals with ASD visually explore and scan a person’s face differently from neurotypical individuals. In developing the new technique for detecting eye-gaze patterns, we evaluated 40 children, mostly four- or five-year-olds. About half of these children are neurotypical, whereas others have ASD. Each participant was shown 44 photographs of faces on a screen, integrated into an eye-tracking system.

The infrared device interpreted and identified the locations on the stimuli at which each child was looking via emission and reflection of wave from the iris.

Patterns of eye movement

The images were separated into seven key areas — which we named features — in which participants focused their gaze: under the right eye, right eye, under the left eye, left eye, nose, mouth and other parts of the screen. We used four different concepts from network analysis to evaluate the varying degree of importance children placed on these features.

Not only did we want to know how much time the participants spent looking at each feature, we also wanted to know how they moved their eyes and scanned the faces.

For instance, researchers have known that when looking at a person’s face, a neurotypical child focuses more on the eyes whereas a child with ASD focuses more on the mouth. Furthermore, a child with ASD also scans faces differently. When moving their focus from someone’s eyes to their chin, for example, a neurotypical child likely moves their eyes more quickly, and via a different path than would a child with ASD.

Child-friendly diagnostic process

While it is not yet possible to enter a doctor’s office and request this test, our hope is that this research may eventually make the diagnostic process less stressful for children.

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To use this technology would require an infrared eye-tracker, which is commercially available, plus our network analysis technique. We have explained the algorithms so any software developers who wanted to could, theoretically, implement them.

By removing some of the barriers to early diagnosis, we hope that more children with ASD can receive early intervention, resulting in improved quality of life and more independence in the long term.

[ You’re smart and curious about the world. So are The Conversation’s authors and editors. You can read us daily by subscribing to our newsletter. ]

Anita Layton, Canada 150 Research Chair in Mathematical Biology and Medicine; Professor of Applied Mathematics, Pharmacy, and Biology, University of Waterloo and Mehrshad Sadria, M. Math Candidate, Applied Mathematics Department, University of Waterloo

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Sick hospital workers often expose patients to contagious illness



Hospital workers often come to work with contagious respiratory illnesses, against the recommendations of public regulators, a Canadian study suggests.

Nearly all of the 2,093 care workers in the study who had such symptoms came to work at some point while sick.

For the study, published in the Journal of Infection Control & Hospital Epidemiology, nurses, doctors, and support staff at nine across Canada filled in online illness diaries during four flu seasons, recording symptoms such as a runny or stuffy nose, fever, cough or scratchy throat.

Of the 1,036 participants who had contagious respiratory illnesses during the study period, 52% reported working on every scheduled day of work and 94.6% reported working at least one day of their illness.

The most common reason given for working while sick was that the illness seemed mild and manageable. Compared to other care workers, physicians were more likely to work while sick and nurses were less likely.

But nurses who thought their managers expected them to show up unless they were too sick were more likely to feel obligated to work.

For most people, in fact, feeling obligated was a driving factor behind their decision to come to work sick, as was their perceptions of what managers expected from them. Younger workers, and workers without paid sick leave, were more likely to say they could not afford to stay home.

“It is only by knowing these reasons that managers and employers can take steps to mitigate the risk of infection to other people,” said Brenda Coleman, senior study author of the study from the Dalla Lana School of Public Health, University of Toronto, in email to Reuters Health. Eleven percent of the hospital workers said they had come to work even while feeling miserable because they had “things to do.” Physicians were under-represented in the study, and self-reporting of the illnesses may also confound the results, the authors acknowledge in their report.

The US Centers for Disease Control and Prevention advises workers to take seven days off or consider temporary reassignment if they have a fever and respiratory symptoms.

The research team suggests that changing sick leave policies and cultural norms could help reduce the risk of disease transmission from sick health care workers to patients.

Also needed, the researchers say, is an understanding of how to balance the costs and risks of absenteeism by sick workers against the costs and risks of illness transmission associated with working while ill.

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First two cases of Ebola confirmed in Congo’s South Kivu: Officials



A woman and her child were the first two cases confirmed with in Congo’s South Kivu region this week, opening a new front in the fight against the outbreak.

Health officials said on Friday that the latest cases were more than 700 km (430 miles) south of where the outbreak was first detected.

has killed at least 1,900 people in Democratic Republic of Congo over the past year. This is the second biggest toll ever and militia violence combined with local resistance have made the outbreak harder to contain.

The 24-year-old woman had been identified as a high-risk contact of another case in Beni, more than 700 km north, last month, according to a government statement issued on Friday.

She travelled by bus, boat and road with her two children to Mwenga, in South Kivu, where she died on Tuesday night, according to a slide from a presentation by health officials.

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Research shows how nordic walking may benefit breast cancer patients



Nordic walking, an aerobic activity performed with walking poles similar to ski poles, may benefit patients with breast cancer, according to a review of existing research.

The low-impact exercise improved swelling, physical fitness, disability and quality of life, the study authors conclude in the European Journal of Cancer Care.

“The main strategy in rehabilitation for women with is a change of habits, where physical exercise is a fundamental tool,” said study co-author Jorge Torres of the Faculty of Educational Sciences and Sports at the University of Vigo in Pontevedra, Spain.

“It’s not easy to turn a sedentary person into an amateur athlete, so sports such as Nordic walking are accepted more easily,” Torres told Reuters Health by email, particularly since the activity doesn’t require expensive equipment, can be done in a group with others, and is easy to learn.

Introduced in the 1980s as a summer training exercise that was similar to cross-country, or Nordic, skiing, Nordic walking became more widespread in the 2000s. It’s now part of some exercise-based rehabilitation programs, especially in Northern Europe where it is more common, Torres noted.

He also owns a personal training company, Vigo Entrena, that creates physical activity programs for people with specific needs, including injuries, obesity, pregnancy, postpartum and women with breast cancer, and he specializes in Nordic walking training.

To see if this form of exercise helps women treated for to reduce side effects like arm swelling, and offers other benefits of exercise, Torres and his colleagues analyzed nine studies. Four studies were randomized controlled trials comparing Nordic walking to other activities; the other studies focused on specific effects of Nordic walking.

Periods of exercise in the studies ranged from 30 to 80 minutes and were performed on one to five days a week for up to 12 weeks.

In eight of the nine studies, Nordic walking had a positive effect on a number of symptoms, including lymphedema, fitness, upper-body strength, disability and perceptions of pain and swelling.

A handful of studies also showed improvements in depression, self-efficacy for managing pain and improvements in physical activity levels. They didn’t find any adverse effects, and the study participants seemed to stick with the programs.

The biomechanical gesture of Nordic walking, compared to just walking, seemed to counteract some of the side effects that can come from cancer treatment, such as shoulder-arm mobility and postural problems, the study team writes.

“(Many) health professionals and therapists do not realize that there are contraindicated exercises during breast cancer rehabilitation and that alternatives such as Nordic walking can be very effective,” Torres said.

“Nordic walking is a structured form of physical activity which nowadays has been shown to be ‘more complete’ than basic walking,” said Marco Bergamin of the University of Padova in Italy, who wasn’t involved in the research review.

“Another important point that is less stressed by these authors: quality of life,” Bergamin said in an email. “Nordic walking gives huge benefits because breast cancer patients are survivors, and from a socio-psychological point of view, that really impacts their life.”

Future studies should also investigate the intensity, frequency, duration, and length of exercise needed to help breast cancer patients, said Lucia Cugusi of the University of Cagliari in Italy, who also wasn’t involved in the review.

“What is most evident is the growing interest of the scientific community in tracking the needs, interests and preferences of patients,” Cugusi said by email.

“Offering them novel forms of physical activity that are both effective and engaging has become one of the new and stimulating research fields in cancer therapy and management.”

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