Significant Group Differences Research Articles

Program for the Education and Enrichment of Relational Skills (PEERS®) for Italy: A Randomized Controlled Trial of a Social Skills Intervention for Autistic Adolescents.

The Program for the Education and Enrichment of Relational Skills (PEERS®) is an intervention targeting social skills for autistic adolescents and those with other social challenges. The efficacy of the PEERS® on adolescents has been extensively explored but the program has not been validated in Italy. In the present study, we adapted PEERS® to Italian culture and evaluated its efficacy in an Italian sample. A Randomized Controlled Trial was conducted, analyzing the results of 37 autistic adolescents who were randomly assigned to two groups: experimental group (TG) and waitlist group (WL). The primary outcomes (social abilities) and secondary outcomes (co-occurring conditions, executive functions) were assessed at four time points. No differences were found at pre-treatment between groups on baseline measures and primary outcomes. At post-treatment, significant group differences emerged in primary outcomes (social knowledge and social performance) and secondary outcomes (emotion regulation). The groups' results pooled together (TG + WL) confirmed the findings at post-treatment and showed further changes in primary outcomes (global social competence and social cognition) and secondary outcomes (externalizing problems, emotive and behavioral total problems, functional problems related to depressive symptoms). The improvements were maintained at a 3-month follow-up, except for global social competence and social cognition. Additionally, new results emerged regarding internalizing problems and global executive functioning. The efficacy of the Italian version of PEERS® was ascertained on primary and secondary outcomes. Innovative findings on emotion regulation, behavioral problems, and depression symptoms also emerged.Clinical trial registration information Program for the Education and Enrichment of Relational Skills (PEERS®) for Italy. An RCT's Study on Social Skills Intervention for Adolescents with Autism Spectrum Disorder (ASD). URL: http://clinicaltrials.gov . TRN: NCT05473104. Release Date: July 21, 2022.

Press-fit humeral implants in revision shoulder arthroplasty are as effective as cemented arthroplasty: a retrospective cohort study

BackgroundRevision shoulder arthroplasty (RSA) is an increasingly common procedure that can involve cemented or uncemented humeral implants. Although cement fixation is often advocated, it is not clear if the outcome is comparable to that of press-fit fixation. This study evaluated the survivorship and outcomes of cemented and press-fit humeral components in patients undergoing RSA at our institution. MethodsMedical records from adult patients who underwent RSA were reviewed retrospectively. Demographics and surgical data as well as subjective and objective outcome measures were collected. Patients were stratified into 3 groups according to their humeral revision type: cemented, uncemented, and retained stems. ResultsA total of 70 RSA patients with an average follow-up of 51.8 ± 43.9 months were included in the analysis: stems were cemented in 18.6% of the patients, uncemented in 61.4%, and retained in 20.0%. There were no significant group differences in patient characteristics. Follow-up data were available for 54 (77.1%) patients 2 or more years after RSA. There were no differences in patient-reported outcome measures among the groups. Active abduction at 1 year was greater for uncemented revisions than for cemented and retained stem components (128.9° ± 49.7° vs. 98.1° ± 55.7° and 100.8° ± 49.9°, respectively; P < .05). Patients in the uncemented and retained stem cohorts had greater strength in forward flexion, abduction, and external rotation than those in the cemented cohort, whereas patients in the cemented stem group had lower internal rotation strength at 1 and 2+ years of follow-up (P < .05). Postoperative radiographs indicated that none of the stems were at risk for failure. However, humeral bone loss was more common among those with uncemented stems (P = .02); in most of the cases, the loss was attributable to stress shielding. Survivorship of the implants did not differ among the groups, ranging from 91.1% to 92.3%. ConclusionPress-fit humeral components may be a viable option for RSA in patients with adequate humeral bone stock.

Synergism of fermented feed and ginseng polysaccharide on growth performance, intestinal development, and immunity of Xuefeng black-bone chickens

Microbial fermented feed (MF) is considered a valuable strategy to bring advantages to livestock and is widely practiced. Oral supplementation of Ginseng polysaccharide (Gps) eliminated weight loss in chickens following vaccination. This study investigated the effects of the combined use of Gps and MF on growth performance and immune indices in Xuefeng black-bone chickens. A total of 400 Xuefeng black-bone chickens at the age of 1 day were randomly assigned to four groups. Normal feed group (Control group), ginseng polysaccharide (200 mg/kg) group (Gps group), microbially fermented feed (completely replace the normal feed) group (MF group), and microbially fermented feed and add ginseng polysaccharide just before use (MF + Gps group). Each group contained 5 pens per treatment and 20 birds per pen. The body weight and average daily gain in the Gps, MF, and MF + Gps groups increased significantly (P < 0.01), while the feed conversion ratio decreased significantly (P < 0.01). The combined use of MF and Gps showed a synergistic effect. There was no significant difference in villus height (cecal) between the experimental group and the Con group. The crypt depth of the three experimental groups exhibited a significantly lower value compared to the Control group (P < 0.05). The V/C ratio of the Gps group and MF + Gps was significantly increased (P < 0.05), but there was no significant difference in the MF group. Moreover, the diarrhea rate of the Gps and the MF + Gps groups was lower than that of the Con group, while that of the MF + Gps group decreased the mortality rate (P < 0.05). The serum tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) levels in the MF, Gps, and MF + Gps groups decreased significantly (P < 0.01), the serum immunoglobulin G (IgG) levels increased significantly (P < 0.01), while the combination of MF and Gps had a synergistic effect. The combined use of Gps and MF not only further improved growth performance and immune parameters, but also reduced the diarrhea rate and mortality.

Home-Use Transcranial Direct Current Stimulation for the Treatment of a Major Depressive Episode

Transcranial direct current stimulation (tDCS) is moderately effective for depression when applied by trained staff. It is not known whether self-applied tDCS, combined or not with a digital psychological intervention, is also effective. To determine whether fully unsupervised home-use tDCS, combined with a digital psychological intervention or digital placebo, is effective for a major depressive episode. This was a double-blinded, sham-controlled, randomized clinical trial with 3 arms: (1) home-use tDCS plus a digital psychological intervention (double active); (2) home-use tDCS plus digital placebo (tDCS only), and (3) sham home-use tDCS plus digital placebo (double sham). The study was conducted between April 2021 and October 2022 at participants' homes and at Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. Included participants were aged 18 to 59 years with major depression and a Hamilton Depression Rating Scale, 17-item version (HDRS-17), score above 16, a minimum of 8 years of education, and access to a smartphone and internet at home. Exclusion criteria were other psychiatric disorders, except for anxiety; neurologic or clinical disorders; and tDCS contraindications. tDCS was administered in 2-mA, 30-minute prefrontal sessions for 15 consecutive weekdays (1-mA, 90-second duration for sham) and twice-weekly sessions for 3 weeks. The digital intervention consisted of 46 sessions based on behavioral therapy. Digital placebo was internet browsing. Change in HDRS-17 score at week 6. Of 837 volunteers screened, 210 participants were enrolled (180 [86%] female; mean [SD] age, 38.9 [9.3] years) and allocated to double active (n = 64), tDCS only (n = 73), or double sham (n = 73). Of the 210 participants enrolled, 199 finished the trial. Linear mixed-effects models did not reveal statistically significant group differences in treatment by time interactions for HDRS-17 scores, and the estimated effect sizes between groups were as follows: double active vs tDCS only (Cohen d, 0.05; 95% CI, -0.48 to 0.58; P = .86), double active vs double sham (Cohen d, -0.20; 95% CI, -0.73 to 0.34; P = .47), and tDCS only vs double sham (Cohen d, -0.25; 95% CI, -0.76 to 0.27; P = .35). Skin redness and heat or burning sensations were more frequent in the double active and tDCS only groups. One nonfatal suicide attempt occurred in the tDCS only group. Unsupervised home-use tDCS combined with a digital psychological intervention or digital placebo was not found to be superior to sham for treatment of a major depressive episode in this trial. ClinicalTrials.gov Identifier: NCT04889976.

Effectiveness of a home-based music-paced physical activity programme on exercise-related outcomes after cardiac rehabilitation: a randomized controlled trial.

A randomized controlled trial was conducted to examine the effects of a home-based music-paced physical activity programme guided by Information-Motivation-Strategy (IMS) model and Self-determination theory on exercise-related outcomes for patients with coronary heart disease (CHD) after cardiac rehabilitation (CR). A total of 130 patients with CHD from a regional CR centre in Hong Kong were recruited and randomly allocated into intervention (n = 65) or control groups (n = 65). The intervention group received theory-guided practical sessions on performing prescribed home-based physical activity with individualized synchronized music, and follow-up telephone calls. The primary outcome was exercise capacity. Secondary outcomes included exercise self-efficacy, physical activity level, and exercise self-determination. Data were collected at baseline, 3 months, and 6 months after study entry. The generalized estimating equations model was used to assess the intervention effects. Patients with CHD in the intervention group demonstrated significantly greater improvements in exercise capacity at 3 months [β = 35.68, 95% confidence interval (CI) 2.69-68.68, P = 0.034] and significantly improved exercise self-efficacy at 6 months (β = 3.72, 95% CI 0.11-7.32, P = 0.043) when compared with the control group. However, no significant group differences were found in physical activity level and exercise self-determination. The study findings provide evidence on an innovation on improving the exercise capacity and exercise self-efficacy of patients with CHD. The music-paced physical activity guided by the IMS model and Self-determination theory requires further investigation on its long-term effects in future studies. ChiCTR-IOR-17011015.

CPR Quality Officer role to improve CPR quality: A multi-centred international simulation randomised control trial

BackgroundAn out-of-hospital cardiac arrest requires early recognition, prompt and quality clinical interventions, and coordination between different clinicians to improve outcomes. Clinical team leaders and clinical teams have high levels of cognitive burden. We aimed to investigate the effect of a dedicated Cardio-Pulmonary Resuscitation (CPR) Quality Officer role on team performance. MethodsThis multi-centre randomised control trial used simulation in universities from the UK, Poland, and Norway. Student Paramedics participated in out-of-hospital cardiac arrest scenarios before randomisation to either traditional roles or assigning one member as the CPR Quality Officer. The quality of CPR was measured using QCPR® and Advanced Life Support (ALS) elements were evaluated. ResultsIn total, 36 teams (108 individuals) participated. CPR quality from the first attempt (72.45%, 95% confidence interval [CI] 64.94 to 79.97) significantly increased after addition of the CPR Quality role (81.14%, 95% CI 74.20 to 88.07, p = 0.045). Improvement was not seen in the control group. The time to first defibrillation had no significant difference in the intervention group between the first attempt (53.77, 95% CI 36.57–70.98) and the second attempt (48.68, 95% CI 31.31–66.05, p = 0.84). The time to manage an obstructive airway in the intervention group showed significant difference (p = 0.006) in the first attempt (168.95, 95% CI 110.54–227.37) compared with the second attempt (136.95, 95% CI 87.03–186.88, p = 0.1). ConclusionA dedicated CPR Quality Officer in simulated scenarios improved the quality of CPR compressions without a negative impact on time to first defibrillation, managing the airway, or adherence to local ALS protocols.

Relationships Between Vocal Fold Adduction Patterns, Vocal Acoustic Quality, and Vocal Effort in Individuals With and Without Hyperfunctional Voice Disorders

Increased vocal effort and aberrant vocal quality are often attributed to vocal fold hyperadduction in hyperfunctional voice disorders. However, there are currently no established methods to quantify vocal fold adduction beyond subjective descriptors in this clinical population. Furthermore, relationships between vocal fold adduction patterns, vocal effort severity, and vocal quality are not well characterized. Therefore, the objectives of this study were to (1) quantify vocal fold adduction, applying a previously validated method developed for patients with vocal fold paralysis, and (2) correlate these measures with acoustic vocal quality and self-perceived measures of vocal effort severity. A deep learning program, Automated Glottic Action Tracking using artificial Intelligence, was used to track glottic angle configurations and vocal fold adduction velocities on laryngoscopic videos across 60 laryngoscopies (20 primary muscle tension dysphonia [pMTD], 20 phonotraumatic lesions, and 20 healthy controls). Voice samples were also acquired, and cepstral peak prominence (CPP) and H1-H2 acoustic measures were used to quantify vocal quality. Participants were also asked to rate their vocal effort on a 100mm visual analog scale. There were no significant group differences in glottic angle configurations or vocal fold adduction velocities, although there were trends toward increased peak vocal fold adduction velocities in patients with hyperfunctional voice disorders compared to controls. Vocal effort was significantly higher in the two hyperfunctional groups compared to controls. CPP was significantly lower in the pMTD group, but there were no group differences in acoustic parameters between any of the other groups or for H1-H2 values. Despite significantly more vocal effort reported in patients with hyperfunctional voice disorders, there were no significant group differences in vocal fold adduction patterns. These findings suggest other physiologic mechanisms may also be responsible for the symptoms and genesis of pMTD and benign vocal fold lesions.

A Mixed-Methods Analysis of Deception Detection by Neurodiverse Young Adults

Purpose: Differences in social cognition between autistic and nonautistic people may put autistic people at greater risk of being deceived. To inform communication interventions related to deception, the purposes of this mixed-methods study were to examine the deception detection strategies used by young adults with varying levels of autistic traits and to explore whether those strategies differed between groups or in terms of accuracy. Methods: Fifty-one young adults with varying levels of autistic traits watched a series of videos. For each video, the participant judged whether the recorded speaker was truthful and gave the reasoning for their judgment. Inductive thematic analysis was used to identify themes in participants' stated reasons, which were used to quantitatively examine (1) between-group differences based on self-reported autistic traits and (2) theme-based differences in accuracy. Results: Thematic analysis of the open-ended responses yielded four major themes: subjective descriptions of the person, nonverbal communication, observable features of the response, and nebulous reasons. Statistical analyses indicated no significant group differences in frequency of use of the four themes. When the four themes were compared with each other, observable response features yielded significantly more accurate judgments than nonverbal communication or subjective descriptions. Discussion: Findings are discussed within the framework of speech–language pathologists' role in helping communicators determine a speaker's truthfulness, with the ultimate goal of avoiding deception and/or manipulation. Suggestions for incorporating research findings into the design of communication interventions are included.

Subtle microstructural alterations in white matter tracts involved in socio-emotional processing after very preterm birth

Children born very preterm (VPT, < 32 weeks of gestation) have an increased risk of developing socio-emotional difficulties. Possible neural substrates for these socio-emotional difficulties are alterations in the structural connectivity of the social brain due to premature birth. The objective of the current study was to study microstructural white matter integrity in VPT versus full-term (FT) born school-aged children along twelve white matter tracts involved in socio-emotional processing. Diffusion MRI scans were obtained from a sample of 35 VPT and 38 FT 8-to-12-year-old children. Tractography was performed using TractSeg, a state-of-the-art neural network-based approach, which offers investigation of detailed tract profiles of fractional anisotropy (FA). Group differences in FA along the tracts were investigated using both a traditional and complementary functional data analysis approach. Exploratory correlations were performed between the Social Responsiveness Scale (SRS-2), a parent-report questionnaire assessing difficulties in social functioning, and FA along the tract. Both analyses showed significant reductions in FA for the VPT group along the middle portion of the right SLF I and an anterior portion of the left SLF II. These group differences possibly indicate altered white matter maturation due to premature birth and may contribute to altered functional connectivity in the Theory of Mind network which has been documented in earlier work with VPT samples. Apart from reduced social motivation in the VPT group, there were no significant group differences in reported social functioning, as assessed by SRS-2. We found that in the VPT group higher FA values in segments of the left SLF I and right SLF II were associated with better social functioning. Surprisingly, the opposite was found for segments in the right IFO, where higher FA values were associated with worse reported social functioning. Since no significant correlations were found for the FT group, this relationship may be specific for VPT children. The current study overcomes methodological limitations of previous studies by more accurately segmenting white matter tracts using constrained spherical deconvolution based tractography, by applying complementary tractometry analysis approaches to estimate changes in FA more accurately, and by investigating the FA profile along the three components of the SLF.

Increased iron in the substantia nigra pars compacta identifies patients with early Parkinson’s disease: A 3T and 7T MRI study

Degeneration in the substantia nigra (SN) pars compacta (SNc) underlies motor symptoms in Parkinson’s disease (PD). Currently, there are no neuroimaging biomarkers that are sufficiently sensitive, specific, reproducible, and accessible for routine diagnosis or staging of PD. Although iron is essential for cellular processes, it also mediates neurodegeneration. MRI can localize and quantify brain iron using magnetic susceptibility, which could potentially provide biomarkers of PD.We measured iron in the SNc, SN pars reticulata (SNr), total SN, and ventral tegmental area (VTA), using quantitative susceptibility mapping (QSM) and R2* relaxometry, in PD patients and age-matched healthy controls (HCs). PD patients, diagnosed within five years of participation and HCs were scanned at 3T (22 PD and 23 HCs) and 7T (17 PD and 21 HCs) MRI. Midbrain nuclei were segmented using a probabilistic subcortical atlas. QSM and R2* values were measured in midbrain subregions. For each measure, groups were contrasted, with Age and Sex as covariates, and receiver operating characteristic (ROC) curve analyses were performed with repeated k-fold cross-validation to test the potential of our measures to classify PD patients and HCs. Statistical differences of area under the curves (AUCs) were compared using the Hanley-MacNeil method (QSM versus R2*; 3T versus 7T MRI).PD patients had higher QSM values in the SNc at both 3T (padj = 0.001) and 7T (padj = 0.01), but not in SNr, total SN, or VTA, at either field strength. No significant group differences were revealed using R2* in any midbrain region at 3T, though increased R2* values in SNc at 7T MRI were marginally significant in PDs compared to HCs (padj = 0.052). ROC curve analyses showed that SNc iron measured with QSM, distinguished early PD patients from HCs at the single-subject level with good diagnostic accuracy, using 3T (mean AUC = 0.83, 95 % CI = 0.82–0.84) and 7T (mean AUC = 0.80, 95 % CI = 0.79–0.81) MRI. Mean AUCs reported here are from averages of tests in the hold-out fold of cross-validated samples. The Hanley-MacNeil method demonstrated that QSM outperforms R2* in discriminating PD patients from HCs at 3T, but not 7T. There were no significant differences between 3T and 7T in diagnostic accuracy of QSM values in SNc.This study highlights the importance of segmenting midbrain subregions, performed here using a standardized atlas, and demonstrates high accuracy of SNc iron measured with QSM at 3T MRI in identifying early PD patients. QSM measures of SNc show potential for inclusion in neuroimaging diagnostic biomarkers of early PD. An MRI diagnostic biomarker of PD would represent a significant clinical advance.

EFFECT OF DIFFERENT SUPPLEMENTARY FEEDS ON THE GROWTH OF COMMON CARP (CYPRINUS CARPIO)

The present experiment was conducted in a rectangular aquarium for three months to evaluate the growth performance of common carp (Cyprinus carpio). Growth performance of Common Carp were studied under four different feed supplements i.e. Feed contained Rice and Wheat bran (CG), Fish meal (T1), Poultry meal (T2) and waste proteins (T3). These four different supplementary feed were supplied to fish which were kept in four different tanks at Aquarium (Fisheries Lab) in Zoology department UAJ and K Muzaffarabad, at the rate of 0.25 gm/per day. Initially, at the time of stocking, the morphometric characteristics, viz, average body weight and average body length was measured. After initiation of experiment, these morphometric characteristics as well as physico-chemical parameters (pH and water temperature) of the water were recorded on daily basis throughout the study period. Average Body weight of Common Carp was recorded as, 13.91±1.592, 10.88±0.617, 11.96±0.967, 10.841±0.725 gm under treatment T1, T2 and T3 and Control group respectively. The final body weight of fish in Control group and treatment groups showed that fish kept in T1 (P-Value=0.003) have gained the maximum body weight, while other treatment groups showed no significant statistical difference. Final Body Length of Common Carp was recorded as 7.44±0.169, 11.28±1.407, 8.031±0.473, 9.293±1.490cm under Control group, T1, T2 and T3, respectively. The final body length of fish in Control group and treatment groups showed that fish kept in T1 (P-Value = 0.001) gained more length followed by T3 (P-Value = 0.007). There is no significant statistical difference in Control group and T2. These results suggest that T1 containing the 30% wheat and rice bran supplementary diets can increase the fish maximum body weight and body length.

Relined fiberglass posts: influence of resin opacity on the bond strength to intraradicular dentin.

This study aimed to evaluate the bond strength between relined fiberglass posts with different composite resin opacities in different thirds of the intraradicular dentin. Thirty single-rooted premolars were endodontically treated and divided into three groups (n=10): fiberglass posts relined with translucent composite resin, fiberglass posts relined with opaque composite resin, and fiberglass posts without relining. After cementation of the posts, the specimens were cut perpendicular to the long axis of the tooth in slices of approximately 1.3 mm of each third to be analyzed (cervical, middle, and apical) and then subjected to the push-out test. The bond strength (MPa) data were subjected to Shapiro-Wilk normality tests and two-way repeated measures analysis of variance, considering the experimental groups and different regions as study factors. Tukey's post-hoc test (p<.05) was applied for comparisons between the groups. In the cervical third, higher values of bond strength were found for the group relined with translucent resin, with a statistically significant difference for the other groups. In the other regions, both opaque and translucent resins showed similar results, but both showed higher values of bond strength compared to fiberglass posts without relining. The bond strength of fiberglass posts to different thirds of intraradicular dentin is influenced by composite resin relining as well as the opacity of the resin. The use of translucent composite resin is a more effective alternative for fiberglass posts relining.

The Benefits of Using Platelet-rich Plasma with Dermal Substitutes for Extremity Posttraumatic Skin Defects: A Short-term Outcome.

Skin injuries are very common. Skin grafting is an ongoing wound management procedure. The artificial dermis, PELNAC, has been considered in the treatment of several acute and chronic skin injuries. Platelet-rich plasma (PRP) is blood plasma with a platelet count higher than the baseline. It is presumed to act in a synergetic pattern to promote the healing of wounds. This study was conducted to assess the potential benefit of adding PRP to PELNAC as adjuvant therapy in treating posttraumatic skin. In this study, adult patients who were admitted to the hospital with extremity traumatic skin and soft tissue defects with exposed bare bone, exposed tendons, or exposed cartilage in the period between October 2019 and March 2021 were allocated to either being managed with dermal substitute (PELNAC) together with PRP (group I) or PELNAC alone (group II). Patients in group I showed a higher mean graft take rate and a lower mean time for neovascularization of the acellular dermal matrix, with a statistically highly significant difference. The Vancouver Scar Scale values showed no significant difference in either group. The PRP-treated group showed statistically significant shorter hospital stays. The addition of PRP to the treatment protocol showed better outcomes in terms of graft take rate, time for neovascularization of acellular dermal matrix, and length of hospital stay, with no side effects. The present study findings emphasize the promising outcome of PRP in addition to the standard treatment of complex wounds to achieve rapid and safe healing.

Videofluoroscopic measures of swallowing in people with stable COPD compared to healthy aging.

Swallowing impairment is a serious extra-pulmonary manifestation of Chronic Obstructive Pulmonary Disease (COPD). Previous studies suggest that individuals with stable COPD show atypical values for several videofluoroscopy measures of swallowing, compared to healthy adults under age 60. However, it is unclear to what degree these changes are attributable to healthy aging. In this study, we aimed to clarify how swallowing in people with stable COPD differs from age-matched healthy controls. We performed a retrospective analysis of videofluoroscopy data from two previously-collected datasets: a) a sample of 28 adults with stable COPD (18 male); b) a sample of 76 healthy adults, from which 28 adults were selected, matched for sex and age to participants in the COPD cohort. In both prior studies, participants swallowed 20% w/v liquid barium prepared in different consistencies (thin; mildly, moderately, and extremely thick). Blinded duplicate ratings were performed according to a standard procedure, yielding measures of laryngeal vestibule closure (LVC) integrity and timing, swallow timing, upper esophageal sphincter (UES) opening, pharyngeal constriction and pharyngeal residue. Mann-Whitney U tests and odds ratios were performed to determine significant group differences (p<.05). Across the consistencies tested, participants with COPD showed significantly shorter durations of LVC, earlier onsets and shorter durations of UES opening, and reduced pharyngeal constriction. No significant differences were seen in other measures. These results point to features of swallowing in people with stable COPD that differ from changes seen with healthy aging, and which represent risks for potential aspiration.

Social Recognition of Joint Attention Cycles in Children With Autism Spectrum Disorders.

Autism Spectrum Disorders (ASD) are characterized by impairments in joint attention (JA) comprising two components: responding to JA (RJA) and initiating JA (IJA). RJA and IJA are considered two interrelated aspects of JA, related to different stages of infant development. While recent technologies have been used to characterize RJA emerging in earlier childhood, only a limited number of studies have attempted to explore IJA, which progressively becomes evident as a hallmark of ASD. This study aims to achieve the social recognition of both RJA and IJA by vision-based human behavior perception through a multi-modal framework automatically and comprehensively. The first three layers of this framework leverage localization, feature extraction, and activity recognition. On this basis, three critical activities in JA are recognized: attention estimation, spontaneous pointing, and showing actions. Then different behaviors are linked through the fourth layer, semantic interpretation, to model the JA event. The proposed framework is evaluated on experiments of four groups: 7 children with ASD, 5 children with mental retardation (MR), 5 children with developmental language disorder (DLD), and 3 typically developed children (TD). Experimental results compared with human codings demonstrate recognition reliability with an intra-class coefficient of 0.959. In addition, statistical analysis suggests significant group difference and correlations. The multi-modal human behavior perception-based framework is a feasible solution for the recognition of joint attention in unconstrained environments. Thus the proposed approach has the potential to improve the clinical diagnosis of autism by offering quantitative monitoring and statistical analysis.

A community-based child health and parenting intervention to improve child HIV testing, health, and development in rural Lesotho (Early Morning Star): a cluster-randomised, controlled trial

When caregivers live in remote settings characterised by extreme poverty, poor access to health services, and high rates of HIV/AIDS, their caregiving ability and children's development might be compromised. We aimed to test the effectiveness of a community-based child health and parenting intervention to improve child HIV testing, health, and development in rural Lesotho. We implemented a matched cluster-randomised, controlled trial in the Mokhotlong district in northeastern Lesotho with 34 community clusters randomly assigned to intervention or wait-list control groups within a pair. Eligible clusters were villages with non-governmental organisation partner presence and an active preschool. Participants were caregiver-child dyads, where the child was 12-60 months old at baseline. The intervention consisted of eight group sessions delivered at informal preschools to all children in each village. Mobile health events were hosted for all intervention (n=17) and control (n=17) clusters, offering HIV testing and other health services to all community members. Primary outcomes were caregiver-reported child HIV testing, child language development, and child attention. Assessments were done at baseline, immediately post-intervention (3 months post-baseline), and 12 months post-intervention. We assessed child language by means of one caregiver-report measure (MacArthur-Bates Communicative Development Inventory [CDI]) and used two observational assessments of receptive language (the Mullen Scales of Early Learning receptive language subscale, and the Peabody Picture Vocabulary Test 4th edn). Child attention was assessed by means of the Early Childhood Vigilance Task. Assessors were masked to group assignment. Analysis was by intention to treat. This trial was registered with ISRCTN.com, ISRCTN16654287 and is completed. Between Aug 8, 2015, and Dec 10, 2017, 1040 children (531 intervention; 509 control) and their caregivers were enrolled in 34 clusters (17 intervention; 17 control). Compared with controls, the intervention group reported significantly higher child HIV testing at the 12-month follow-up (relative risk [RR] 1·46, 95% CI 1·29 to 1·65, p<0·0001), but not immediately post-intervention. The intervention group showed significantly higher child receptive language on the caregiver report (CDI) at immediate (effect size 3·79, 95% CI 0·78 to 6·79, p=0·028) but not at 12-month follow-up (effect size 2·96, 95% CI -0·10 to 5·98, p=0·056). There were no significant group differences for the direct assessments of receptive language. Child expressive language and child attention did not differ significantly between groups. Integrated child health and parenting interventions, delivered by trained and supervised lay health workers, can improve both child HIV testing and child development. United States Agency for International Development (USAID) and the President's Emergency Plan for AIDS Relief (PEPFAR).

The Experience of Music in Aphantasia: Emotion, Reward, and Everyday Functions

Visual imagery has been proposed to be one of eight mechanisms by which music induces emotion in listeners. Initial research into aphantasia, a condition referring to individuals who do not (or only minimally) form visual imagery in their mind's eye, suggests that aphantasics may experience reduced emotional experiences in response to imagined stimuli. In this two-part online investigation, we sought to explore the emotional experiences of aphantasics within the context of music listening. In Survey 1, we compared 51 aphantasics to 51 control individuals in terms of their experiences of visual imagery, liking, and felt emotional intensity when listening to three film music excerpts. We found significant group differences in terms of visual imagery and felt emotional intensity, but not liking. In Survey 2, we examined aphantasics’ ability to recognize emotions conveyed by music, and their patterns of experience of, and engagement with, music in everyday life by comparing the responses of 29 aphantasics with 29 matched controls. We found no differences in terms of emotion discrimination ability. However, aphantasics generally experienced less Reminiscence (dimension from the Adaptive Functions of Music Listening scale) to music, as well as fewer Episodic Memories (dimension from the MecScale). Aphantasics and control listeners did not exhibit differences in terms of sensitivity to musical reward (measured using the BMRQ) or in terms of musical sophistication (measured using the Gold-MSI). Finally, our findings suggest nuanced differences between controls and those with pure and minimal aphantasia. In all, we reveal the influence that aphantasia can have on emotional responses to music and thus provide further evidence for the relationship between visual imagery and music-induced emotion.

Effect of an innovative relaxation technique on dental anxiety among 8- to 11-year-olds during infiltrative anesthetic procedures: a randomized control trial

BACKGROUND: Dental procedures especially involving local anesthesia have ranked highest in anxiety as the anaesthetic needle's appearance and feel are the most fear eliciting stimuli in children. AIM: To evaluate the efficacy of an innovative reframing behaviour management technique by the combination of breathing and foot rotation in reducing dental fear. METHOD: In this randomized control trial, 50 children aged 8- 11 years of age, requiring local anesthesia in the maxillary arch and also based on inclusion criteria were selected. Subjects were divided by using flip of coin method of randomization. Children in the test group were taught to carry out deep breathing and simultaneous feet rotation in which the right foot was rotated in clockwise and left foot in anticlockwise direction. The exercises were asked to perform while the local anaesthesia was injected. No exercises were performed in control group. CFSS-DS scale was used as a tool and children fearful for injection were included. Pulse rate, SPO2 were used as physiologic parameters while FLACC scale was used to analyze fear. RESULT: In our study which included both subjective and objective recordings of anxiety during anaesthesia statistically significant variation between the two groups was observed. The FLACC score and pulse rate showed a statistically significant difference (p value &lt;0.05) in the intervention group. There was a marked reduction for fear of injections after the treatment in case group. CONCLUSION: Within the limitations of the study, the innovative exercise reduced the anxiety in children during anesthetic procedures and can be used as an alternative behaviour management strategy.

Distraction Technique using a Cooling Vibrator Reduces the Pain of Vein-puncture in Children

Background: Typhoid fever is commony found disease at the hospital. One of the treatments for typhoid fever is intravenous fluid therapy. This procedure certainly causing pain. Actions to minimize pain to children when infusion is carried out are part of the principles of atraumatic care. One of the atraumatic principle can be performed on children is the use of vibrators and cold compresses to minimize pain.Purpose: To determine the effectiveness of vibrator and cold compress against pain in children when taking venous blood.Methods: This research using true experimental with a post-test in control group and divided into 2 groups, intervention and control groups. This research will determine the effectiveness of cooling vibrator. Assessing children's pain using the FLACC instrument. The study was conducted at Tidore Islands Hospital. Data processing was tested with Mann-Whitney test.Result: Mostly respondents are 4 years old. both of them experiencing of having blood drawn before. Most of the control and intervention groups were women. There are differences pain scores founded, in the intervention group was 3.13 and in the control group was 7.87. The results of statistical tests showed that there was a significant difference in pain during venipuncture in the intervention group and the control group.Conclusion: The statistical test show there was a significant difference in intervention group and the control group. The use of a cooling vibrator can be an alternative to reduce pain in children during venipuncture.

Childhood adversity severity modulates the associations between adaptive psychological changes and amygdala volumetric changes in response to behavioral interventions

BackgroundAdverse Childhood Experience (ACE) has been shown to have detrimental impact on amygdala structure. Prior research found that adaptive psychological changes after Mindfulness-Based Interventions (MBI) were associated with amygdala volumetric changes. The present study aims to further investigate whether such effects also occur among ACE survivors and whether the effects are unique to MBI. MethodsA total of 64 young adult childhood adversity survivors were randomized to an eight-week MBI or Stress Management Education (SME) as an active control condition. Anatomical MRI and questionnaires on mindfulness, stress and psychological health were collected at baseline and post-intervention. Due to subject dropout, the final sample included 39 subjects (MBI:20, SME:19). ResultsBoth groups showed increased mindfulness levels, reduced stress, and improved psychological symptoms (depression, anxiety, and somatization), with no significant group by time interaction effect. There was no significant group difference on amygdala volumetric changes. Within the MBI group, childhood maltreatment severity was a significant mediator between changes of mindfulness levels and right amygdala volumetric changes. Across pooled sample of both groups, childhood maltreatment was a significant moderator for the effect of trait anxiety level changes on left amygdala volumetric changes. LimitationsModest sample size, relatively low retention rates, suboptimal monitoring of home practice. ConclusionsMBI did not demonstrate overall better clinical effects than SME. Psychological-change-dependent amygdala volumetric change was not specific to MBI. Childhood maltreatment severity modulated the relationships between adaptive psychological changes and amygdala volumetric changes.