Clinical initiatives have aimed to reduce the age at ASD diagnosis in the UK. This study investigated whether the median age at diagnosis in childhood has reduced in recent years, and identified the ...factors associated with earlier diagnosis in the UK. Data on 2134 children with ASD came from two large family databases. Results showed that the age of ASD diagnosis has not decreased. The median age of diagnosis of all ASDs was 55 months. Factors associated with earlier age of diagnosis were autism diagnosis (compared with other ASD), language regression, language delay, lower socioeconomic status, and greater degree of support required. Effective clinical strategies are needed to identify children with characteristics that have in the past delayed ASD diagnosis.
This pilot study explored the effects of a mindfulness meditation intervention on nurses’ perceived stress and compassion. A quasi-experimental pre-test/post-test design was used. Nurses (n = 90) ...working at three university teaching hospitals completed the Perceived Stress Scale and Compassion Scale at the beginning of the training and 64 completed the scales at the end of the training. The 64 matched data sets were analysed using the t-test, chi-square test and analysis of variance. The findings indicated that the nurses’ perceived stress was significantly reduced after the intervention. Notably, compassion scores were increased after the intervention, and this finding was significant for nurses working at one of the hospitals. There were no significant differences between results from a 6-week and an 8-week mindfulness intervention. The results suggest that mindfulness meditation training can impact positively on nurses’ perceived stress and also enhance nurses’ compassion. Mindfulness may well be a suitable self-care, stress-management intervention that can effectively teach nurses coping skills to assist them in managing the daily stressors inherent in their home and work life.
Early intervention for autism spectrum disorder (ASD) tends to focus on enhancing social-communication skills. We report the acceptability, feasibility and impact on child functioning of a new ...8 weeks parent-group intervention to manage restricted and repetitive behaviours (RRB) in young children with ASD aged 3–7 years. Forty-five families took part in the pilot RCT. A range of primary and secondary outcome measures were collected on four occasions (baseline, 10, 18 and 24 weeks) to capture both independent ratings and parent-reported changes in RRB. This pilot established that parents were willing to be recruited and randomised, and the format and content of the intervention was feasible. Fidelity of delivery was high, and attendance was 90 %. A fully powered trial is now planned.
► We compared two functional behavioral assessment methods, the Questions About Behavioral Function and experimental functional analysis. ► Functions of aggressive/destructive behavior, ...self-injurious behavior and stereotypy in 32 people diagnosed with autism were examined. ► Exact agreement on function(s) between the two assessments was shown for 24 participants and partial agreement for six participants. ► SIB was mostly maintained by automatic reinforcement and escape from task demands. ► Stereotypy was mostly maintained by automatic reinforcement.
We compared two functional behavioral assessment methods: the Questions About Behavioral Function (QABF; a standardized test) and experimental functional analysis (EFA) to identify behavioral functions of aggressive/destructive behavior, self-injurious behavior and stereotypy in 32 people diagnosed with autism. Both assessments found that self injurious behavior (SIB) was mostly maintained by automatic reinforcement and escape from task demands. Aggressive/destructive behavior was found to be maintained by escape and access to tangibles, whereas stereotypy was mostly maintained by automatic reinforcement. There was exact agreement on function(s) between the two assessments for 24 participants and partial agreement for six participants. Results suggest that the QABF has clinical utility and is an effective tool for ascribing behavioral function. Implications of the present findings for future assessment of behavioral function are discussed.
Moxifloxacin has potent activity against Mycobacterium tuberculosis in vitro and in a mouse model of antituberculosis (TB) chemotherapy, but data regarding its activity in humans are limited.
Our ...objective was to compare the antimicrobial activity and safety of moxifloxacin versus isoniazid during the first 8 weeks of combination therapy for pulmonary TB.
Adults with sputum smear-positive pulmonary TB were randomly assigned to receive either moxifloxacin 400 mg plus isoniazid placebo, or isoniazid 300 mg plus moxifloxacin placebo, administered 5 days/week for 8 weeks, in addition to rifampin, pyrazinamide, and ethambutol. All doses were directly observed. Sputum was collected for culture every 2 weeks. The primary outcome was negative sputum culture at completion of 8 weeks of treatment.
Of 433 participants enrolled, 328 were eligible for the primary efficacy analysis. Of these, 35 (11%) were HIV positive, 248 (76%) had cavitation on baseline chest radiograph, and 213 (65%) were enrolled at African sites. Negative cultures at Week 8 were observed in 90/164 (54.9%) participants in the isoniazid arm, and 99/164 (60.4%) in the moxifloxacin arm (P = 0.37). In multivariate analysis, cavitation and enrollment at an African site were associated with lower likelihood of Week-8 culture negativity. The proportion of participants who discontinued assigned treatment was 31/214 (14.5%) for the moxifloxacin group versus 22/205 (10.7%) for the isoniazid group (RR, 1.35; 95% CI, 0.81, 2.25).
Substitution of moxifloxacin for isoniazid resulted in a small but statistically nonsignificant increase in Week-8 culture negativity.
A visual cortical prosthesis (VCP) has long been proposed as a strategy for restoring useful vision to the blind, under the assumption that visual percepts of small spots of light produced with ...electrical stimulation of visual cortex (phosphenes) will combine into coherent percepts of visual forms, like pixels on a video screen. We tested an alternative strategy in which shapes were traced on the surface of visual cortex by stimulating electrodes in dynamic sequence. In both sighted and blind participants, dynamic stimulation enabled accurate recognition of letter shapes predicted by the brain’s spatial map of the visual world. Forms were presented and recognized rapidly by blind participants, up to 86 forms per minute. These findings demonstrate that a brain prosthetic can produce coherent percepts of visual forms.
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•Visual cortical prosthetic stimulation paradigms were examined•Letters or other shapes were traced on the surface of cortex with electrical current•Static stimulation was unable to produce letter percepts in participants•Dynamic current steering evoked percepts of letter forms by blind and sighted participants
Dynamic stimulation of visual cortex allows both sighted and blind subjects to recognize a variety of letter shapes without training and with high accuracy.
Post-acute sequelae of COVID-19 (PASC) represent an emerging global crisis. However, quantifiable risk factors for PASC and their biological associations are poorly resolved. We executed a deep ...multi-omic, longitudinal investigation of 309 COVID-19 patients from initial diagnosis to convalescence (2–3 months later), integrated with clinical data and patient-reported symptoms. We resolved four PASC-anticipating risk factors at the time of initial COVID-19 diagnosis: type 2 diabetes, SARS-CoV-2 RNAemia, Epstein-Barr virus viremia, and specific auto-antibodies. In patients with gastrointestinal PASC, SARS-CoV-2-specific and CMV-specific CD8+ T cells exhibited unique dynamics during recovery from COVID-19. Analysis of symptom-associated immunological signatures revealed coordinated immunity polarization into four endotypes, exhibiting divergent acute severity and PASC. We find that immunological associations between PASC factors diminish over time, leading to distinct convalescent immune states. Detectability of most PASC factors at COVID-19 diagnosis emphasizes the importance of early disease measurements for understanding emergent chronic conditions and suggests PASC treatment strategies.
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•Longitudinal multi-omics associate PASC with auto-antibodies, viremia, and comorbidities•Reactivation of latent viruses during initial infection may contribute to PASC•Subclinical auto-antibodies negatively correlate with anti-SARS-CoV-2 antibodies•Gastrointestinal PASC uniquely present with post-acute expansion of cytotoxic T cells
By correlating patient symptoms with in-depth profiling of blood cells and plasma components throughout COVID-19 infection, this study identifies factors that may predict sustained disease.
Wildfires are an important source of nitrous acid (HONO), a photolabile radical precursor, yet in situ measurements and quantification of primary HONO emissions from open wildfires have been scarce. ...We present airborne observations of HONO within wildfire plumes sampled during the Western Wildfire Experiment for Cloud chemistry, Aerosol absorption and Nitrogen (WE-CAN) campaign. ΔHONO/ΔCO close to the fire locations ranged from 0.7 to 17 pptv ppbv–1 using a maximum enhancement method, with the median similar to previous observations of temperate forest fire plumes. Measured HONO to NO x enhancement ratios were generally factors of 2, or higher, at early plume ages than previous studies. Enhancement ratios scale with modified combustion efficiency and certain nitrogenous trace gases, which may be useful to estimate HONO release when HONO observations are lacking or plumes have photochemical exposures exceeding an hour as emitted HONO is rapidly photolyzed. We find that HONO photolysis is the dominant contributor to hydrogen oxide radicals (HO x = OH + HO2) in early stage (<3 h) wildfire plume evolution. These results highlight the role of HONO as a major component of reactive nitrogen emissions from wildfires and the main driver of initial photochemical oxidation.
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