Neuroimaging of Human Balance Control: A Systematic Review

This review examined 83 articles using neuroimaging modalities to investigate the neural correlates underlying static and dynamic human balance control, with aims to support future mobile neuroimaging research in the balance control domain. Furthermore, this review analyzed the mobility of the neuroimaging hardware and research paradigms as well as the analytical methodology to identify and remove movement artifact in the acquired brain signal. We found that the majority of static balance control tasks utilized mechanical perturbations to invoke feet-in-place responses (27 out of 38 studies), while cognitive dual-task conditions were commonly used to challenge balance in dynamic balance control tasks (20 out of 32 studies). While frequency analysis and event related potential characteristics supported enhanced brain activation during static balance control, that in dynamic balance control studies was supported by spatial and frequency analysis. Twenty-three of the 50 studies utilizing EEG utilized independent component analysis to remove movement artifacts from the acquired brain signals. Lastly, only eight studies used truly mobile neuroimaging hardware systems. This review provides evidence to support an increase in brain activation in balance control tasks, regardless of mechanical, cognitive, or sensory challenges. Furthermore, the current body of literature demonstrates the use of advanced signal processing methodologies to analyze brain activity during movement. However, the static nature of neuroimaging hardware and conventional balance control paradigms prevent full mobility and limit our knowledge of neural mechanisms underlying balance control

Assessment and Diagnostic Practices Relating to Autism Spectrum Disorder in the United States and Mexico

Purpose: The present study examined and compared professional assessment and diagnostic practices relating to autism spectrum disorder (ASD) in Mexico and the United States (U.S.). This information is of great importance because there is an extremely limited amount of information pertaining the assessment and diagnostic practices for ASD in Mexico and little is known about how these practices compare to those in the U.S. Methods: Archival data from a survey investigating ASD in the U.S. and Mexico was used for this study. Participants included 29 professionals from the U.S. and 7 professionals from Mexico. Professionals were from a variety of different occupations, but all reported to be involved in the diagnosis of ASD. Results: In both Mexico and the U.S., most professionals reported use of similar ASD related assessment and diagnostic practices, and ASD related assessment and diagnostic practices were frequently in alignment with current best practices recommendations. However, there were professionals from both Mexico and the U.S. that reported use of diagnostic tools and practices that did not adhere to recommendations, such as, use of outdated versions of the DSM, diagnosis of ASD individually, and evaluation of individuals in one setting. Conclusion: An understanding of the assessment and diagnostic practices currently being used in Mexico and in the U.S. provides both researchers and clinicians with a better understanding of what is being implemented by different professionals. Additionally, an understanding of the assessment and diagnostic practices for ASD in Mexico is of particular importance for professionals practicing in the U.S. as most immigrants in the U.S are from Mexico therefore it is likely professionals in the U.S. will encounter patients on their caseloads that received diagnoses of ASD in Mexico

Autism Spectrum Disorder Screening Practices in the United States and Mexico

Purpose: The purpose of this study was to explore screening practices for autism spectrum disorder (ASD) in Mexico and the United States (U.S.). Methods: Data from a larger study exploring the knowledge, screening, and diagnostic practices of healthcare practitioners from Mexico and the U.S. was used for the current study. The original survey was created by experts in ASD and consisted of 63 questions: 15 demographic questions, 20 questions relating to knowledge of ASD, 11 questions relating to screening practices, and 17 questions relating to diagnostic practices. All surveys were completed by professionals engaging in the screening and diagnosis of ASD. For this study, a total of thirty- five survey responses for the screening portion of the survey (30 from the U.S. and 5 from Mexico) were explored. Qualitative data and descriptive statistics were utilized. Results: Many of the responses relating to screening practices from professionals practicing in Mexico and the U.S. were consistent with best practice guidelines from the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and the Mexican Public Health Guide. Furthermore, many similarities were found in the screening practices of professionals from both countries. Differences in screening practices reported by professionals from Mexico and the U.S. were found in the type of professional involved in the screening process and professional referrals after a failed ASD screening. Additionally, some professionals from both the U.S. and Mexico reported the use of inappropriate screening tools, and the average age reportedly screened was much higher than the current recommendations of the American Academy of Pediatrics (Hyman et al., 2020). Conclusion: An understanding of the screening practices currently being used in Mexico and the U.S. provides both researchers and clinicians with a better understanding of what is being implemented by different professionals. This study identified areas of strength and areas of weaknesses in the screening process for ASD in both countries. These results can now be used in future studies and programs targeting improved screening processes in Mexico in the U.S. Improved screening processes are important because of the potential to result in an earlier age of diagnosis of ASD and provision of services at a younger age. The latter of which is associated with better outcomes for children with ASD

Loop corrections for Kaluza-Klein AdS amplitudes

Recently we conjectured the four-point amplitude of graviton multiplets in ${\rm AdS}_5 \times {\rm S}^5$ at one loop by exploiting the operator product expansion of $\mathcal{N}=4$ super Yang-Mills theory. Here we give the first extension of those results to include Kaluza-Klein modes, obtaining the amplitude for two graviton multiplets and two states of the first KK mode. Our method again relies on resolving the large N degeneracy among a family of long double-trace operators, for which we obtain explicit formulas for the leading anomalous dimensions. Having constructed the one-loop amplitude we are able to obtain a formula for the one-loop corrections to the anomalous dimensions of all twist five double-trace operators.Comment: 37 pages. One ancillary file containing data on the correlator

Supporting Family Physician Maternity Care Providers

Maternity care access in the United States is in crisis. The American Congress of Obstetrics and Gynecology projects that by 2030 there will be a nationwide shortage of 9,000 obstetrician-gynecologists (OB/GYNs). Midwives and OB/GYNs have been called upon to address this crisis, yet in underserved areas, family physicians are often providing a majority of this care. Family medicine maternity care, a natural fit for the discipline, has been on sharp decline in recent years for many reasons including difficulties cultivating interdisciplinary relationships, navigating privileging, developing and maintaining adequate volume/competency, and preventing burnout. In 2016 and 2017, workshops were held among family medicine educators with resultant recommendations for essential strategies to support family physician maternity care providers. This article summarizes these strategies, provides guidance, and highlights the role family physicians have in addressing maternity care access for the underserved as well as presenting innovative ideas to train and retain rural family physician maternity care providers

Future Exploration Missions' Tasks Associated with the Risk of Inadequate Design of Human and Automation/Robotic Integration

NASA's Human Research Program (HRP) funds research efforts aimed at mitigating various human health and performance risks, including the Risk of Inadequate Design of Human and Automation/Robotic Integration (HARI). As such, within HRP, the Human Factors and Behavioral Performance (HFBP) Element tasked an evaluation of future HARI needs in order to scope and focus the HARI risk research plan. The objective was to provide a systematic understanding of the critical factors associated with effective HARI that will be necessary to achieve the future mission goals for near- and deep-space exploration. Future mission goals are specified by NASA Design Reference Missions (DRMs) that are pertinent to the HRP. The outcome of this evaluation is a set of NASA-relevant HARI tasks, factors, and interactions required for exploration-class missions

Randomized phase II study of stereotactic body radiotherapy and interleukin-2 versus interleukin-2 in patients with metastatic melanoma.

BACKGROUND: A pilot study of stereotactic body radiation therapy (SBRT) followed by high-dose interleukin-2 (IL-2) showed a higher than anticipated objective response rate (ORR) among patients with metastatic melanoma (MM). We performed a prospective randomized study to determine if the ORR of SBRT + IL-2 was greater than IL-2 monotherapy in patients with advanced melanoma. METHODS: Patients with MM who had adequate physiological reserve for IL-2 and at least one site suitable for SBRT were eligible. There was a 1:1 randomization to SBRT + IL-2 or IL-2 monotherapy. Patients received one or two doses of SBRT (20 Gy per fraction) with the last dose administered 3 days before starting the first cycle of IL-2. IL-2 (600,000 IU per kg via intravenous bolus infusion) was given every 8 hours for a maximum of 14 doses with a second cycle after a 2-week rest. Responding patients received up to six IL-2 cycles. Patients assigned to IL-2 monotherapy who exhibited progression of melanoma after cycle 2 were allowed to crossover and receive SBRT and additional IL-2. Response Evaluation Criteria in Solid Tumors 1.1 criteria were applied to non-irradiated lesions for response assessment. RESULTS: 44 patients were included in the analysis. The ORR in the SBRT + IL-2 group was 54%: 21% complete response (CR), 33% partial response (PR), 21% stable disease (SD) and 25% progressive disease (PD). The ORR in patients receiving IL-2 monotherapy was 35%: 15% CR, 20% PR, 25% SD and 40% PD. Seven patients assigned to IL-2 subsequently received SBRT + IL-2. One CR and two PRs were observed in the crossover group. There was no difference in progression-free or overall survival (OS). At 5 years the OS was 26% in the SBRT + IL-2 group and 25% in the IL-2 monotherapy group. The disease control rate (DCR) was higher in the SBRT + IL-2 group (75% vs 60%, p=0.34). CONCLUSIONS: SBRT + IL-2 induced more objective responses with a higher DCR compared to IL-2 monotherapy in MM. IL-2 monotherapy resulted in a significantly higher ORR than anticipated. Some patients in the crossover group also achieved objective responses. TRIAL REGISTRATION NUMBER: NCT01416831

Distinct Signature of Altered Homeostasis in Aging Rod Photoreceptors: Implications for Retinal Diseases

Advanced age contributes to clinical manifestations of many retinopathies and represents a major risk factor for age-related macular degeneration, a leading cause of visual impairment and blindness in the elderly. Rod photoreceptors are especially vulnerable to genetic defects and changes in microenvironment, and are among the first neurons to die in normal aging and in many retinal degenerative diseases. The molecular mechanisms underlying rod photoreceptor vulnerability and potential biomarkers of the aging process in this highly specialized cell type are unknown.To discover aging-associated adaptations that may influence rod function, we have generated gene expression profiles of purified rod photoreceptors from mouse retina at young adult to early stages of aging (1.5, 5, and 12 month old mice). We identified 375 genes that showed differential expression in rods from 5 and 12 month old mouse retina compared to that of 1.5 month old retina. Quantitative RT-PCR experiments validated expression change for a majority of the 25 genes that were examined. Macroanalysis of differentially expressed genes using gene class testing and protein interaction networks revealed overrepresentation of cellular pathways that are potentially photoreceptor-specific (angiogenesis and lipid/retinoid metabolism), in addition to age-related pathways previously described in several tissue types (oxidative phosphorylation, stress and immune response).Our study suggests a progressive shift in cellular homeostasis that may underlie aging-associated functional decline in rod photoreceptors and contribute to a more permissive state for pathological processes involved in retinal diseases

Radiation Sensitivity in a Preclinical Mouse Model of Medulloblastoma Relies on the Function of the Intrinsic Apoptotic Pathway

While treatments that induce DNA damage are commonly used as anti-cancer therapies, the mechanisms through which DNA damage produces a therapeutic response are incompletely understood. Here we have tested whether medulloblastomas must be competent for apoptosis to be sensitive to radiation therapy. Whether apoptosis is required for radiation sensitivity has been controversial. Medulloblastoma, the most common malignant brain tumor in children, is a biologically heterogeneous set of tumors typically sensitive to radiation and chemotherapy; 80% of medulloblastoma patients survive long-term after treatment. We used functional genetic studies to determine if the intrinsic apoptotic pathway is required for radiation to produce a therapeutic response in mice with primary, Shh-driven medulloblastoma. We found that cranial radiation extended the survival of medulloblastoma-bearing mice and induced widespread apoptosis. Expression analysis and conditional deletion studies showed that p53 was the predominant transcriptional regulator activated by radiation and was strictly required for treatment response. Deletion of Bax, which blocked apoptosis downstream of p53, was sufficient to render tumors radiation resistant. In apoptosis-incompetent, Bax-deleted tumors, radiation activated p53-dependent transcription without provoking cell death and caused two discrete populations to emerge. Most radiated tumor cells underwent terminal differentiation. Perivascular cells, however, quickly resumed proliferation despite p53 activation, behaved as stem cells, and rapidly drove recurrence. These data show that radiation must induce apoptosis in tumor stem cells to be effective. Mutations that disable the intrinsic apoptotic pathways are sufficient to impart radiation resistance. We suggest that medulloblastomas are typically sensitive to DNA-damaging therapies because they retain apoptosis competence