Screening for autism in preterm children : diagnostic utility of the Social Communication Questionnaire

Objective Preterm survivors are at high risk for autism spectrum disorders (ASD). The diagnostic utility of the Social Communication Questionnaire (SCQ) in screening for ASD was assessed in extremely preterm children at 11 years of age. Design All babies born at <26 weeks gestation in UK and Ireland from March through December 1995 were recruited to the EPICure Study. Of 307 survivors, 219 (71%) were assessed at 11 years. Parents of 173 children completed the SCQ to screen for autistic features and the Development and Well Being Assessment (DAWBA) psychiatric interview. A consensus diagnosis of ASD was assigned by two child psychiatrists following review of the DAWBA parental interview and corresponding DAWBA teacher questionnaire. Setting Community-based follow-up. Results Using the established SCQ cut-off (scores ≥15), 28 (16%) extremely preterm children screened positive for ASD. Eleven (6%) were assigned a diagnosis of ASD. Using this cut-off, the SCQ had 82% sensitivity and 88% specifi city for identifying ASD in this population. Using a receiver operating characteristic curve, SCQ scores ≥14 had optimal diagnostic utility (area under curve: 0.94; sensitivity: 91%; specifi city: 86%). Positive predictive value was relatively low (31%) resulting in numerous over-referrals. However, children with false positive screens had signifi cantly worse neuro-developmental, cognitive and behavioural outcomes than those with true negative screens. Conclusion The SCQ has good diagnostic utility for identifying ASD in extremely preterm children and is a useful screening tool in this population. Children with false positive screens represent a high-risk group in whom further diagnostic assessment would be benefi cial

Neuro-fuzzy controller for active ankle foot orthosis

SummaryThe ankle foot orthosis (AFO) is as an assistive device used in foot disability for gait improvement. The objective of this paper was to design a neuro fuzzy controller for an AFO. Adaptive neuro fuzzy inference system (ANFIS) was selected after a detailed study of existing neuro-fuzzy architectures. Data of gait pattern was collected with the help of analog gyro sensors. This data was fed to the ANFIS and a fuzzy rule base was created to complete the neuro-fuzzy system which was used to control the gait pattern. Angular velocity and angle of feet served as inputs to the controller and the output was actuation. The results obtained showed sigmoidal membership functions for the various inputs and outputs due to their close resemblance with the normal human gait. Output of the ANFIS showcased the initial data which was fed to the system; the modified data; changed membership functions and error after training

Report of Responses to the 2004, 2006, and 2008 Physician Assistant Re-Licensure Surveys

The Indiana State Department of Health and the Indiana Professional Licensing Agency developed a collaborative partnership to collect data through the licensing process to better understand the health professions workforce within the state. Beginning in 2004, physician assistants were asked to participate in voluntary surveys when renewing their licenses ever y two years. The purpose of this report is to summarize the participants’ responses to the survey items. The responses provide a detailed description of the physician assistant workforce in the state of Indiana to aid in the development of policies and programs to recruit and retain these health professionals where they are needed in Indiana

Why Are Radio-Galaxies Prolific Producers of Type Ia Supernovae?

An analysis of SNIa events in early type galaxies from the Cappellaro et al (1999) database provides conclusive evidence that the rate of type Ia Supernovae (SNe) in radio-loud galaxies is about 4 times higher than the rate measured in radio-quiet galaxies, i.e. SNIa-rate$(radio-loud galaxies) = 0.43^{+0.19}_{-0.14}h^2_{75}$ SNu as compared to SNIa-rate$(radio-quiet galaxies) = 0.11^{+0.06}_{-0.03}h^2_{75}$ SNu. The actual value of the enhancement is likely to be in the range $\sim 2-7$ (P$\sim 10^{-4}$). This finding puts on robust empirical grounds the results obtained by Della Valle & Panagia (2003) on the basis of a smaller sample of SNe. We analyse the possible causes of this result and conclude that the enhancement of SNIa explosion rate in radio-loud galaxies has the same origin as their being strong radio sources, but there is no causality link between the two phenomena. We argue that repeated episodes of interaction and/or mergers of early type galaxies with dwarf companions, on times-scale of about 1 Gyr, are responsible for inducing both strong radio activity observed in $\sim$14% of early type galaxies and to supply an adequate number of SNIa progenitors to the stellar population of ellipticals.Comment: 26 pages+6 figures, ApJ, in pres

Practitioner review: pathways to care for ADHD - a systematic review of barriers and facilitators

Background. Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder starting in childhood that may persist into adulthood. It can be managed through carefully monitored medication and nonpharmacological interventions. Access to care for children at risk of ADHD varies both within and between countries. A systematic literature review was conducted to investigate the research evidence related to factors which influence children accessing services for ADHD

Does Attending a Regional Medical Campus Influence the Training Outcomes of Family Medicine Residents?

Introduction: Indiana University School of Medicine (IUSM) is the largest medical school in the nation, with its main campus located in Indianapolis and eight regional medical campuses (RMC) distributed across the state. In this study, we compared the survey responses of family medicine residents who had attended medical school at the main campus in Indianapolis versus an RMC to see if there were any noticeable differences in their residency training outcomes. Methods: From 2012 to 2017, in the spring of each year, a cross-sectional survey was administered to all final-year family medicine residents graduating from the eleven family medicine residency programs in Indiana. A total of 519 out of 520 residents completed the survey. Of whom, 132 respondents indicated they had graduated from IUSM; 45 reported they had attended the Indianapolis campus and 87 had attended one of the RMCs in the state. Our dataset for this study was comprised of these 132 respondents. Chi-square test or Fisher’s exact test were used to compare responses between groups. P-values ≤ 0.05 were considered statistically significant. Results: In the ACGME competency areas, the residents who attended an RMC versus the Indianapolis campus were significantly more likely to report being fully competent in Medical Knowledge (90% vs. 76%, p = 0.032) and Systems-Based Practice (83% vs. 64%, p = 0.019). Additionally, the residents who attended an RMC compared to their Indianapolis counterparts reported significantly higher rates of being trained to serve rural populations (73% vs. 52%, p = 0.017) as well as being fully competent to serve rural populations (69% vs. 42%, p = 0.003). However, the residents who attended an RMC were no more likely to establish a practice in a rural area than were the residents who attended Indianapolis (18% vs. 17%, p = 0.845). Conclusions: Based on these self-reported data, the family medicine residents who attended an RMC may perceive themselves to be better-prepared in a few core competency areas, as well as in serving rural populations, compared to those who attended the Indianapolis campus. These findings suggest that IUSM’s complex statewide system of medical education may offer some unique advantages in preparing students for residency, especially in family medicine

Reliability and Reproducibility of Landmark Identification in Unilateral Cleft Lip and Palate Patients: Digital Lateral Vis-A-Vis CBCT-Derived 3D Cephalograms

Background: The aim of the retrospective observational study was to compare the precision of landmark identification and its reproducibility using cone beam computed tomography-derived 3D cephalograms and digital lateral cephalograms in unilateral cleft lip and palate patients. Methods: Cephalograms of thirty-one (31) North Indian children (18 boys and 13 girls) with a unilateral cleft lip and palate, who were recommended for orthodontic treatment, were selected. After a thorough analysis of peer-reviewed articles, 20 difficult-to-trace landmarks were selected, and their reliability and reproducibility were studied. These were subjected to landmark identification to evaluate interobserver variability; the coordinates for each point were traced separately by three different orthodontists (OBA, OBB, OBC). Statistical analysis was performed using descriptive and inferential statistics with paired t-tests to compare the differences measured by the two methods. Real-scale data are presented in mean ± SD. A p-value less than 0.05 was considered as significant at a 95% confidence level. Results: When comparing, the plotting of points posterior nasal spine (PNS) (p &lt; 0.05), anterior nasal spine (ANS) (p &lt; 0.01), upper 1 root tip (p &lt; 0.05), lower 1 root tip (p &lt; 0.05), malare (p &lt; 0.05), pyriforme (p &lt; 0.05), porion (p &lt; 0.01), and basion (p &lt; 0.05) was statistically significant. Conclusion: In patients with a cleft lip and palate, the interobserver identification of cephalometric landmarks was significantly more precise and reproducible with cone beam computed tomography -derived cephalograms vis-a-vis digital lateral cephalograms

The rate and the origin of type Ia supernovae in radiogalaxies

An analysis of type Ia supernova (SNIa) events in early type galaxies from Evans et al (1989) database provides strong evidence that the rate of type Ia supernovae (SNe) in radio-loud galaxies is about 6 times higher than the rate measured in radio-quiet galaxies, i.e. SNIa-rate$(radio-loud galaxies)=0.47^{+0.23}_{-0.15} h^2_{50}$ SNe per century and per 10$^{10}$L$^{B}_\odot$ (SNU) as compared to SNIa-rate(radio-quiet galaxies)\lsim 0.080 h^2_{50} SNU. The exact value of the enhancement is still rather uncertain, but is likely to be in the range $\sim 4-15$. We discuss the possible causes of this result and we conclude that that the enhancement of SNIa explosion rate in radio-loud galaxies has the same common origin as their being strong radio sources, but that there is no causality link between the two phenomena. We argue that repeated episodes of interaction and/or mergers of early type galaxies with dwarf companions are responsible for inducing both strong radio activity in $\sim$14% of early type galaxies, and the $\sim1$ Gyr old stellar population needed to supply an adequate number SNIa progenitors. Within this scenario we predict that the probability of detecting a core-collapse SN event in radio-loud elliptical galaxies amounts to about 4% of their SNIa events.Comment: 17 pages, 1 figure, accepted for publication in ApJ

Effects of Single versus Multiple Warnings on Driver Performance

Objective: To explore how a single master alarm system affects drivers’ responses when compared to multiple, distinct warnings. Background: Advanced driver warning systems are intended to improve safety, yet inappropriate integration may increase the complexity of driving, especially in high workload situations. This study investigated the effects of auditory alarm scheme, reliability, and collision event-type on driver performance. Method: A 2x2x4 mixed factorial design investigated the impact of two alarm schemes (master vs. individual) and two levels of alarm reliability (high and low) on distracted drivers’ performance across four collision event-types (frontal collision warnings, left and right lane departure warnings, and follow vehicle fast approach). Results: Participants’ reaction times and accuracy rates were significantly affected by the type of collision event and alarm reliability. The use of individual alarms, rather than a single master alarm, did not significantly affect driving performance in terms of reaction time or response accuracy. Conclusion: Even though a master alarm is a relatively uninformative warning, it produced statistically no different reaction times or accuracy results when compared to information-rich auditory icons, some of which were spatially located. In addition, unreliable alarms negatively impacted driver performance, regardless of event type or alarm scheme. Application: These results have important implications for the development and implementation of multiple driver warning systems.This project was sponsored by the Ford Motor Company

Dental Workforce Report of Indiana University School of Dentistry Graduates and Other Practicing Dentists in Indiana

All dentists who renewed their Indiana licenses on - line in 2010 or 2012 were asked to complete a voluntary survey instrument that ha d a 95.4% response rate 1 in 2010 and 80.7% response rate 2 in 2012. The purpose of this study was to describe the dental workforce in Indiana with a focus on comparing graduates from the Indiana University School of Dentistry (IUSD) to all other practicing ( n on - IUSD ) dentists in Indiana. Of primary interest is how well the graduates of IUSD are meeting the oral health needs of the population of the state, particularly in the rural and underserved areas. Using data from the Office of Alumni Relations at IUPUI, license numbers of IUSD alumni were matched to the license numbers of individuals in the 2010 or 2012 Indiana Dentist Licensure Survey datasets. Individuals whose license numbers matched with the alumni list were identified as “IUSD” graduates and those that did not match were identified as “non - IUSD” graduates. This report compares responses between 2,203 IUSD and 835 n on - IUSD graduates who renewed their licenses and completed the Indiana Dentist Licensure Surveys in 2010 or 2012, respectively. Lastly, most of the differences between groups were found to be statistically significant due to the large sample size of IUSD graduates compared to non - IUSD graduates. Thus, for the purposes of this report if the differences between groups were noted to be at least 10 percent they were considered remarkable and reported as such