Treatment Outcomes for At-Risk Young Children With Behavior Problems: Toward a New Definition of Success

This study examined the outcomes of Early Pathways (EP), an in-home parent–child therapy program with 447 at-risk children younger than 5 years of age who were referred for severe behavior and emotional problems, such as aggression, oppositional behavior, and separation anxiety. EP emphasized parent-directed training of child behavior strategies including psychoeducation regarding child development, child-led play, and cognitive-behavioral techniques. Outcomes were assessed using a unique 2-dimensional definition of treatment completion, which consisted of treatment duration and an assessment of reliable change for the primary outcome measure of child behavior problems. Results showed that the majority of children (63.4%) met or exceeded treatment completion. In addition, repeated-measures multivariate analyses of variance at pretest, posttest, and follow-up revealed increased child prosocial behaviors, reduced child behavior problems, improved caregiver nurturing, an increase in parents’ developmentally appropriate expectations of children, improved parent–child relationships, and a decrease in clinical diagnoses following treatment. This study offers guidance for developing effective early-intervention services for families in poverty to enhance outcomes for their young children. Along with its existing large-scale, community-based effectiveness studies, future research should establish additional statistical support including a randomized, waitlist control design of EP

Clinical trial of FK 506 immunosuppression in adult cardiac transplantation

The new immunosuppressive agent FK 506 was used as primary immunotherapy in conjunction with low-dose steroids and azathioprine in 72 patients subsequent to orthotopic cardiac transplantation. Overall patient survival at a mean follow-up of 360 days was 92%. The number of episodes of cardiac rejection (grade 3A or greater) within 90 days of transplantation was 0.95 per patient. The actuarial freedom from rejection at 90 days was 41%. Achievement of this level of immunosuppression is comparable with that of cyclosporine-based triple-drug therapy with OKT3 immunoprophylaxis. Thirty percent of patients were tapered off all steroids, and the average steroid dose in the group who received steroids was 8.6 mg of prednisone per day. The incidence of infection reflected the diminished necessity for steroids: seven major infections (10%) and 11 minor infections (16%). Renal dysfunction occurred during the perioperative period in most patients in this trial. However, the incidence of hypertension was 54% compared with 70% during the cyclosporine era. Ten adults underwent successful rescue therapy with FK 506 after cardiac rejection refractory to conventional immunotherapy. Side effects of FK 506 were notably few, and the results of the trial are encouraging for the future of the cardiac transplant recipient. © 1992

Optical Torque from Enhanced Scattering by Multipolar Plasmonic Resonance

We present a theoretical study of the optical angular momentum transfer from a circularly polarized plane wave to thin metal nanoparticles of different rotational symmetries. While absorption has been regarded as the predominant mechanism of torque generation on the nanoscale, we demonstrate numerically how the contribution from scattering can be enhanced by using multipolar plasmon resonance. The multipolar modes in non-circular particles can convert the angular momentum carried by the scattered field, thereby producing scattering-dominant optical torque, while a circularly symmetric particle cannot. Our results show that the optical torque induced by resonant scattering can contribute to 80% of the total optical torque in gold particles. This scattering-dominant torque generation is extremely mode-specific, and deserves to be distinguished from the absorption-dominant mechanism. Our findings might have applications in optical manipulation on the nanoscale as well as new designs in plasmonics and metamaterials.Comment: main article 20 pages, 4 figures; supplementary material 6 pages, 2 figure

Electrocardiographic patch devices and contemporary wireless cardiac monitoring.

Cardiac electrophysiologic derangements often coexist with disorders of the circulatory system. Capturing and diagnosing arrhythmias and conduction system disease may lead to a change in diagnosis, clinical management and patient outcomes. Standard 12-lead electrocardiogram (ECG), Holter monitors and event recorders have served as useful diagnostic tools over the last few decades. However, their shortcomings are only recently being addressed by emerging technologies. With advances in device miniaturization and wireless technologies, and changing consumer expectations, wearable “on-body” ECG patch devices have evolved to meet contemporary needs. These devices are unobtrusive and easy to use, leading to increased device wear time and diagnostic yield. While becoming the standard for detecting arrhythmias and conduction system disorders in the outpatient setting where continuous ECG monitoring in the short to medium term (days to weeks) is indicated, these cardiac devices and related digital mobile health technologies are reshaping the clinician-patient interface with important implications for future healthcare delivery

Design and Benchmark Testing for Open Architecture Reconfigurable Mobile Spirometer and Exhaled Breath Monitor with GPS and Data Telemetry.

Portable and wearable medical instruments are poised to play an increasingly important role in health monitoring. Mobile spirometers are available commercially, and are used to monitor patients with advanced lung disease. However, these commercial monitors have a fixed product architecture determined by the manufacturer, and researchers cannot easily experiment with new configurations or add additional novel sensors over time. Spirometry combined with exhaled breath metabolite monitoring has the potential to transform healthcare and improve clinical management strategies. This research provides an updated design and benchmark testing for a flexible, portable, open access architecture to measure lung function, using common Arduino/Android microcontroller technologies. To demonstrate the feasibility and the proof-of-concept of this easily-adaptable platform technology, we had 43 subjects (healthy, and those with lung diseases) perform three spirometry maneuvers using our reconfigurable device and an office-based commercial spirometer. We found that our system compared favorably with the traditional spirometer, with high accuracy and agreement for forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), and gas measurements were feasible. This provides an adaptable/reconfigurable open access "personalized medicine" platform for researchers and patients, and new chemical sensors and other modular instrumentation can extend the flexibility of the device in the future

Effects of exoplanetary gravity on human locomotor ability

At some point in the future, if mankind hopes to settle planets outside the Solar System, it will be crucial to determine the range of planetary conditions under which human beings could survive and function. In this article, we apply physical considerations to future exoplanetary biology to determine the limitations which gravity imposes on several systems governing the human body. Initially, we examine the ultimate limits at which the human skeleton breaks and muscles become unable to lift the body from the ground. We also produce a new model for the energetic expenditure of walking, by modelling the leg as an inverted pendulum. Both approaches conclude that, with rigorous training, humans could perform normal locomotion at gravity no higher than 4 $g_{\textrm{Earth}}$.Comment: 12 pages, 4 figures, to be published in The Physics Teache