Soles of the Feet Mindfulness-Based Program for Students with Autism Spectrum Disorder and Challenging Behavior

Mindfulness-based programs (MBPs) provide a way for children with autism spectrum disorder (ASD) to self-manage challenging behaviors, which may ameliorate the need for more intensive individual interventions in schools. Using a concurrent multiple baseline design, our study examined whether Meditation on the Soles of the Feet (SoF), a brief MBP, can reduce challenging behavior in children with ASD when delivered by a natural intervention agent in an elementary school setting. Three 9-to-10-year old children with ASD, presenting with high rates of challenging behavior and IQ scores above 85, were recruited from a private special education school. Following baseline data collection, SoF was implemented across five 20-30 minute sessions by the school mental health counselor one-on-one with each student and fidelity of implementation was monitored. Results found that, from pre- to post-treatment, all 3 students showed a significant mean baseline reduction of observed challenging behavior in individually identified problematic contexts, while 1 of 3 showed a decrease in overall teacher-reported challenging behavior on the SESBI-R. Teacher social validity ratings indicated the acceptability, feasibility, and effectiveness of SoF for use in school settings, while 2 of 3 students indicated that the treatment was socially valid. Although teacher-rated overall challenging behavior on the SESBI-R did not consistently decrease, SoF reduced individually-defined observable challenging behavior for each student in specific targeted contexts. Factors contributing to or limiting the effectiveness of SoF with students having ASD and challenging behavior are discussed

Familial Progressive Hyperpigmentation: A Case Report

Familial progressive hyperpigmentation (FPH) is a rare genodermatosis characterized by hyperpigmented patches in the skin and mucous membranes, present in early infancy, and increase in size and number with age. The genetic basis for FPH remains unknown. We report an unusual case of familial progressive hypermelanosis in a 17-year-old male patient with family history, who presented with a peculiar progressive oral pigmentation disorder. Diagnosis was confirmed by a series of hematological, biochemical, and histopathological investigations. Our paper stresses the need for the dentist to be aware of the systemic conditions that can also manifest in the oral cavity

Enhanced External Counterpulsation as a Novel Treatment for Post-acute COVID-19 Sequelae

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic. As patients recover from COVID-19, some continue to report persisting symptoms weeks to months after acute infection. These effects have been referred to as post-acute sequelae of SARS-CoV-2 infection (PASC). We report the case of a 38-year-old woman suffering from PASC symptoms following acute COVID-19 in October 2020. During her acute infection phase, she had a home recovery and reported her predominant symptoms as fatigue, headaches, body pain, and shortness of breath. After most of her symptoms were resolved, she continued to have periodic episodes of fatigue and headaches, along with random shortness of breath while at rest and during activities for months beyond the acute phase of the illness. She also noted the presence of “brain fog,” as if lacking the same clarity that she had prior to her illness. These symptoms persisted for three months before the patient underwent enhanced external counterpulsation (EECP) therapy in one-hour sessions, three times per week. This therapy was chosen based on the mechanism of action of EECP benefiting patients with ischemic cardiovascular diseases. After one week, her “brain fog” had improved, with shortness of breath improving after 1.5 weeks. The patient reported returning to pre-COVID health and fitness after approximately five weeks of EECP treatment. To our knowledge, this is the first case of using EECP for post-COVID shortness of breath, fatigue, and “brain fog.

PDGF-BB does not accelerate healing in diabetic mice with splinted skin wounds.

Topical application of platelet-derived growth factor-BB (PDGF-BB) is considered to accelerate tissue repair of impaired chronic wounds. However, the vast literature is plagued with conflicting reports of its efficacy in animal models and this is often influenced by a wide array of experimental variables making it difficult to compare the results across the studies. To mitigate the confounding variables that influence the efficacy of topically applied PDGF-BB, we used a controlled full thickness splinted excisional wound model in db/db mice (type 2 diabetic mouse model) for our investigations. A carefully-defined silicone-splinted wound model, with reduced wound contraction, controlled splint and bandage maintenance, allowing for healing primarily by reepithelialization was employed. Two splinted 8 mm dorsal full thickness wounds were made in db/db mice. Wounds were topically treated once daily with either 3 µg PDGF-BB in 30 µl of 5% PEG-PBS vehicle or an equal volume of vehicle for 10 days. Body weights, wound contraction, wound closure, reepithelialization, collagen content, and wound bed inflammation were evaluated clinically and histopathologically. The bioactivity of PDGF-BB was confirmed by in vitro proliferation assay. PDGF-BB, although bioactive in vitro, failed to accelerate wound healing in vivo in the db/db mice using the splinted wound model. Considering that the predominant mechanism of wound healing in humans is by re-epithelialization, the most appropriate model for evaluating therapeutics is one that uses splints to prevent excessive wound contraction. Here, we report that PDGF-BB does not promote wound closure by re-epithelialization in a murine splinted wound model. Our results highlight that the effects of cytoactive factors reported in vivo ought to be carefully interpreted with critical consideration of the wound model used

The Spitzer Survey of the Small Magellanic Cloud: Discovery of Embedded Protostars in the HII Region NGC 346

We use Spitzer Space Telescope observations from the Spitzer Survey of the Small Magellanic Cloud (S3MC) to study the young stellar content of N66, the largest and brightest HII region in the SMC. In addition to large numbers of normal stars, we detect a significant population of bright, red infrared sources that we identify as likely to be young stellar objects (YSOs). We use spectral energy distribution (SED) fits to classify objects as ordinary (main sequence or red giant) stars, asymptotic giant branch stars, background galaxies, and YSOs. This represents the first large-scale attempt at blind source classification based on Spitzer SEDs in another galaxy. We firmly identify at least 61 YSOs, with another 50 probable YSOs; only one embedded protostar in the SMC was reported in the literature prior to the S3MC. We present color selection criteria that can be used to identify a relatively clean sample of YSOs with IRAC photometry. Our fitted SEDs indicate that the infrared-bright YSOs in N66 have stellar masses ranging from 2 Msun to 17 Msun, and that approximately half of the objects are Stage II protostars, with the remaining YSOs roughly evenly divided between Stage I and Stage III sources. We find evidence for primordial mass segregation in the HII region, with the most massive YSOs being preferentially closer to the center than lower-mass objects. Despite the low metallicity and dust content of the SMC, the observable properties of the YSOs appear consistent with those in the Milky Way. Although the YSOs are heavily concentrated within the optically bright central region of N66, there is ongoing star formation throughout the complex and we place a lower limit on the star formation rate of 3.2 x 10^-3 Msun/yr over the last ~1 Myr.Comment: 13 pages, 5 figures (3 in color), 2 tables. Accepted for publication in Ap

Development and validation of a pragmatic natural language processing approach to identifying falls in older adults in the emergency department

BACKGROUND: Falls among older adults are both a common reason for presentation to the emergency department, and a major source of morbidity and mortality. It is critical to identify fall patients quickly and reliably during, and immediately after, emergency department encounters in order to deliver appropriate care and referrals. Unfortunately, falls are difficult to identify without manual chart review, a time intensive process infeasible for many applications including surveillance and quality reporting. Here we describe a pragmatic NLP approach to automating fall identification. METHODS: In this single center retrospective review, 500 emergency department provider notes from older adult patients (age 65 and older) were randomly selected for analysis. A simple, rules-based NLP algorithm for fall identification was developed and evaluated on a development set of 1084 notes, then compared with identification by consensus of trained abstractors blinded to NLP results. RESULTS: The NLP pipeline demonstrated a recall (sensitivity) of 95.8%, specificity of 97.4%, precision of 92.0%, and F1 score of 0.939 for identifying fall events within emergency physician visit notes, as compared to gold standard manual abstraction by human coders. CONCLUSIONS: Our pragmatic NLP algorithm was able to identify falls in ED notes with excellent precision and recall, comparable to that of more labor-intensive manual abstraction. This finding offers promise not just for improving research methods, but as a potential for identifying patients for targeted interventions, quality measure development and epidemiologic surveillance

Motivations and Predictors of Cheating in Pharmacy School

Objective. To assess the prevalence, methods, and motivations for didactic cheating among pharmacy students and to determine predictive factors for cheating in pharmacy colleges and schools. Methods. A 45-item cross-sectional survey was conducted at all four doctor of pharmacy programs in Northern California. For data analysis, t test, Fisher exact test, and logistic regression were used. Results. Overall, 11.8% of students admitted to cheating in pharmacy school. Primary motivations for cheating included fear of failure, procrastination, and stress. In multivariate analysis, the only predictor for cheating in pharmacy school was a history of cheating in undergraduate studies. Conclusion. Cheating occurs in pharmacy schools and is motivated by fear of failure, procrastination, and stress. A history of past cheating predicts pharmacy school cheating. The information presented may help programs better understand their student population and lead to a reassessment of ethical culture, testing procedures, and prevention programs

Understanding Sleep Disturbances in Prostate Cancer—A Scientometric Analysis of Sleep Assessment, Aetiology, and Its Impact on Quality of Life

Prostate cancer is the most commonly diagnosed cancer in the United Kingdom. While androgen-deprivation therapy is the most common treatment for prostate cancer, patients undergoing this treatment typically experience side effects in terms of sleep disturbances. However, the relation between prostate cancer and sleep and the way in which sleep interventions may benefit oncological patients is underinvestigated in the literature. The current study aims to review in a data-driven approach the existing literature on the field of prostate cancer and sleep to identify impactful documents and major thematic domains. To do so, a sample of 1547 documents was downloaded from Scopus, and a document co-citation analysis was conducted on CiteSpace software. In the literature, 12 main research domains were identified as well as 26 impactful documents. Research domains were examined regarding the link between prostate cancer and sleep, by taking into account variations in hormonal levels. A major gap in the literature was identified in the lack of use of objective assessment of sleep quality in patients with prostate cancer

Implementation of an Accelerated Physical Examination Course in a Doctor of Pharmacy Program

Objective. To describe the implementation of a 1-day accelerated physical examination course for a doctor of pharmacy program and to evaluate pharmacy students’ knowledge, attitudes, and confi- dence in performing physical examination. Design. Using a flipped teaching approach, course coordinators collaborated with a physician faculty member to design and develop the objectives of the course. Knowledge, attitude, and confidence survey questions were administered before and after the practical laboratory. Assessment. Following the practical laboratory, knowledge improved by 8.3% (p,0.0001). Students’ perceived ability and confidence to perform a physical examination significantly improved (p,0.0001). A majority of students responded that reviewing the training video (81.3%) and reading material (67.4%) prior to the practical laboratory was helpful in learning the physical examination. Conclusion. An accelerated physical examination course using a flipped teaching approach was successful in improving students’ knowledge of, attitudes about, and confidence in using physical examination skills in pharmacy practice