Validity of The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS): a daily activity criterion checklist for infants and toddlers.

BACKGROUND: The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) is a 50-item, criterion-specified questionnaire that assesses a child's adaptive skills in everyday context and can be used in high-risk follow-up settings to identify risk for adverse neurodevelopmental outcome. Our aim was to validate the WIDEA-FS by comparing a sample of typically developing children to children with special health needs and to compare results to the Capute Scales, which include domains of including both the Cognitive Adaptive Test (CAT) and the Clinical Linguistic and Auditory Milestone Scale (CLAMS). METHODS: Six hundred and sixty children (typically developing and having special healthcare needs) aged 0-36 months completed the WIDEA-FS, the CAT, and the CLAMS assessments. RESULTS: Children with special health needs scored significantly lower on the WIDEA than those with typical development. WIDEA-FS subscales were significantly associated with the CAT (WIDEA-FS self-care 0.87, social cognition 0.89) and the CLAMS (WIDEA-FS communication 0.96, social cognition 0.92) tests. CONCLUSIONS: The WIDEA-FS has concurrent validity with the CAT and CLAMS and construct validity in that children with special health needs have significantly poorer performance on the WIDEA-FS than children with typical development. IMPACT: The WIDEA-FS demonstrated both construct validity and concurrent validity with the Capute Scales, including the Cognitive Adaptive Test (CAT) and the Clinical Linguistic and Auditory Milestone Scale (CLAMS). This is the first study to validate the use of the WIDEA-FS in children with typical development and children with special healthcare needs. The WIDEA-FS is a quick and valid checklist that can be used to assess neurodevelopmental functioning during daily activities in typically developing children and those at risk for neurodevelopmental differences.

Partnering with Insurers in Caring for the Most Vulnerable Youth with Diabetes: NICH as an Integrator.

PURPOSE OF REVIEW: In this review, we outline barriers to appropriately caring for high-risk youth with diabetes and discuss efforts in partnering with insurers through Alternative Payment Models to achieve the Triple Aim (improved health, improved care, and reduced costs) for this population. RECENT FINDINGS: Current approaches in caring for youth with diabetes who evidence a high degree of social complexity are woefully ineffective. These youth are vulnerable to repeat diabetic ketoacidosis episodes, poor glycemic control, and excessive utilization of healthcare resources. To effectively pursue the Triple Aim, an "integrator" (i.e., an entity that accepts responsibility for all components of the Triple Aim for a specified population) must be identified; however, this does not fit into current fee-for-service models. Integrators for youth with diabetes are limited, but early examples of integrator efforts are promising. We present one successful "integrator," Novel Interventions in Children's Healthcare (NICH), and detail this program's efforts in partnering with insurers to serve high-risk youth with diabetes.

Revisiting Motion Parallax as a Source of 3-D Information.

There are many similarities between binocular disparity and motion parallax as sources of information about the structure and layout of 3-D objects and surfaces. The former can be thought of as a transformation that maps one eye's image onto the other while the latter is a transformation that maps the changes in one eye's image over time. There are many empirical similarities in the ways we use the two sources of information but there are also significant differences. A consideration of those differences leads to the conclusion that, rather than seeing motion parallax as a close analogue of binocular stereopsis, motion parallax is better thought of as a special case of the kinetic depth effect in which the depth order of the depicted 3-D object or surface can be disambiguated by vertical perspective information.

The Effectiveness of Vertical Perspective and Pursuit Eye Movements for Disambiguating Motion Parallax Transformations.

In the kinetic depth effect, the direction of the perceived depth and the direction of apparent rotation of a 3-D structure are linked, and typically ambiguous, whereas depth from motion parallax during both observer- and object-movement is stable and unambiguous. Rogers and Rogers demonstrated that the vertical perspective transformations play an important role in disambiguating the direction of the perceived depth in parallax-defined surfaces but more recently Nawrot et al. have proposed that pursuit eye movements provide the crucial disambiguating information. Theoretical considerations suggest that pursuit eye movements could not, in principle, provide the necessary information because 3-D objects as surfaces may rotate during observer- or object-movement. The empirical evidence presented here shows that vertical perspective transformations are sufficient for the unambiguous perception of parallax depth whereas pursuit eye movements are not necessary and may not even be sufficient.

All Adventurous Women Do: HPV, Narrative, and HBO's Girls.

This study looks at media portrayals of sexual health through the popular HBO television show Girls. This rhetorical criticism of Girls delineates two emergent narrative themes. First, the show repeatedly discusses human papillomavirus (HPV) in terms of its severity, but it oscillates in terms of representing the degree of significance. Second, the show frames the source of infection as more important than other concerns related to HPV. Ultimately, this analysis demonstrates that Girls perpetuates a problematic narrative plot structure related to issues of HPV transmission; it also provides a largely scientifically accurate portrayal of HPV and promotes open and frank discussions of sexual health. It is argued that mediated narratives, such as Girls, might have the potential to transform social attitudes and actions and should thereby garner attention from health communication scholars and public health advocates.

Collateral Damage and Critical Turning Points: Public Health Implications of HPV Vaccine News Coverage for Boys and Men in 2011.

In 2009, the Food and Drug Administration (FDA) officially expanded approval of the Gardasil vaccine to include human papillomavirus (HPV) vaccination for boys and men, and in 2011, the Centers for Disease Control and Prevention (CDC) issued a formal recommendation for routine vaccination for this population. Despite these efforts, HPV vaccination rates for boys and men continue to fall short of public health targets. While news was breaking about the benefits of the HPV vaccine for boys and men, public attention shifted as a result of political debates concerning the vaccine. This study examines a pivotal time period for public health in which the vaccine became officially recommended for boys and men and at the same time became the center of political controversies in the lead-up to the 2012 presidential campaign. The current study extends previous research and presents a content analysis of newspaper articles (N = 154) about the HPV vaccine for the year 2011. Results indicate that the lack of comprehensive coverage of HPV and the HPV vaccine found in previous studies continued in this year. Results shed light on key political events that may have functioned to overshadow the recommendation of the HPV vaccine for boys and men. The implications of this pattern of news coverage can inform public health efforts to address low rates of HPV vaccination uptake among boys and men in present day.

When is a disparity not a disparity? Toward an old theory of three-dimensional vision.

The aims of this paper are twofold: first, to discuss and analyze the concept of binocular disparity and second, to contrast the traditional "air theory" of three-dimensional vision with the much older "ground theory," first suggested by Ibn al-Haytham more than a thousand years ago. The origins of an "air theory" of perception can be traced back to Descartes and subsequently to the philosopher George Berkeley, who claimed that distance "could not be seen" because points lying along the same line of sight (in an empty space) would all project to the same location on the retina. However, Descartes was also aware that the angle of convergence of the two eyes could solve the problem of the "missing" information for the monocular observer and, since then, most visual scientists have assumed that eye vergence plays an important role both in judging absolute distance and for scaling retinal size and binocular disparities. In contrast, al-Haytham's and Gibson's "ground theories," which are based on the geometry of the textured ground plane surface that has surrounded us throughout evolution and during our lifetimes, are not just more ecologically based but they also obviate the need for disparity scaling.

The turn of the dice: Patrick Hughes' Hollow Dice and Reverspectives.

Patrick Hughes' Reverspectives demonstrate the importance of perspective as a source of information about the structure and layout of the three-dimensional (3D) world. More recently, he has created a new work of art-Hollow Dice-in which the actual concave structure of the dice is seen as convex. In this article, we examine the similarities and differences between these two perceptual phenomena as well as attempting to explain how and why they arise. Popular interest in both effects is based on the fact that "what we perceive" does not correspond to "what the reality is." As a consequence, Reverspectives and Hollow Dice are often categorized and labeled as "illusions." However, if we consider the information that is available in patterns of light reaching our eyes-rather than the "actual" 3D structure of the Reverspectives and the Hollow Dice-we are in a better position to explain how the size, the viewing distance, the perspective features, the convexity bias, and observer movements determine what we see when viewing these novel and fascinating visual effects.

Preclinical Pharmacokinetic Profile of Topical Ophthalmic and Intravenous Delivery of QLS-101, a Novel ATP-Sensitive Potassium Channel Opening Ocular Hypotensive Agent.

Purpose: To evaluate the pharmacokinetic profiles of the ocular hypotensive agent QLS-101, a novel ATP-sensitive potassium channel opening prodrug, and its active moiety levcromakalim, following topical ophthalmic and intravenous dosing of normotensive rabbits and dogs. Methods: Dutch belted rabbits (n = 85) and beagle dogs (n = 32) were dosed with QLS-101 (0.16-3.2 mg/eye/dose) or formulation buffer for 28 days. Pharmacokinetic profiles of QLS-101 and levcromakalim were evaluated in ocular tissues and blood by LC-MS/MS. Tolerability was assessed by clinical and ophthalmic examinations. Maximum systemic tolerated dose was evaluated in beagle dogs (n = 2) following intravenous bolus administrations of QLS-101 (0.05 to 5 mg/kg). Results: Plasma analysis following topical dosing of QLS-101 (0.8-3.2 mg/eye/dose) for 28 days indicated an elimination half-life (T1/2) of 5.50-8.82 h and a corresponding time (Tmax) range of 2-12 h in rabbits, and a T1/2 of 3.32-6.18 h with a Tmax range of 1-2 h in dogs. Maximum tissue concentration (Cmax) values ranged from 54.8-540 (day 1) to 50.5-777 ng/mL (day 28) in rabbits, and 36.5-166 (day 1) to 47.0-147 ng/mL (day 28) in dogs. Levcromakalim plasma T1/2 and Tmax were similar to QLS-101, while Cmax was consistently lower. Topical ophthalmic delivery of QLS-101 was well tolerated in both species, with sporadic mild ocular hyperemia noted in the group treated with the highest concentration (3.2 mg/eye/dose). Following topical ophthalmic dosing, QLS-101 and levcromakalim were found primarily in the cornea, sclera, and conjunctiva. Maximum tolerated dose was determined to be 3 mg/kg. Conclusions: QLS-101 was converted to its active moiety levcromakalim and showed characteristic absorption, distribution, and safety profiles of a well-tolerated prodrug.

Use of Machine Learning and Lay Care Coaches to Increase Advance Care Planning Conversations for Patients With Metastatic Cancer.

PURPOSE: Patients with metastatic cancer benefit from advance care planning (ACP) conversations. We aimed to improve ACP using a computer model to select high-risk patients, with shorter predicted survival, for conversations with providers and lay care coaches. Outcomes included ACP documentation frequency and end-of-life quality measures. METHODS: In this study of a quality improvement initiative, providers in four medical oncology clinics received Serious Illness Care Program training. Two clinics (thoracic/genitourinary) participated in an intervention, and two (cutaneous/sarcoma) served as controls. ACP conversations were documented in a centralized form in the electronic medical record. In the intervention, providers and care coaches received weekly e-mails highlighting upcoming clinic patients with < 2 year computer-predicted survival and no prior prognosis documentation. Care coaches contacted these patients for an ACP conversation (excluding prognosis). Providers were asked to discuss and document prognosis. RESULTS: In the four clinics, 4,968 clinic visits by 1,251 patients met inclusion criteria (metastatic cancer with no prognosis previously documented). In their first visit, 28% of patients were high-risk (< 2 year predicted survival). Preintervention, 3% of both intervention and control clinic patients had ACP documentation during a visit. By intervention end (February 2021), 35% of intervention clinic patients had ACP documentation compared with 3% of control clinic patients. Providers' prognosis documentation rate also increased in intervention clinics after the intervention (2%-27% in intervention clinics, P < .0001; 0%-1% in control clinics). End-of-life care intensity was similar in intervention versus control clinics, but patients with ≥ 1 provider ACP edit met fewer high-intensity care measures (P = .04). CONCLUSION: Combining a computer prognosis model with care coaches increased ACP documentation.

When is an illusion not an illusion? An alternative view of the illusion concept.

What is an "illusion"? I would like to argue that (A) there is no coherent and meaningful definition of the word "illusion" and (B) the majority of the things we have previously labelled as "illusions" can be better categorised into three classes of perceptual effects: (i) those that should not be regarded as illusory according to any definition; (ii) those that are simply consequences of "how our perceptual systems work" and (iii) those that are a consequence of using artificial or impoverished stimulus situations.

Structural and functional effects of acoustic exposure in goldfish: evidence for tonotopy in the teleost saccule.

BACKGROUND: Mammalian and avian auditory hair cells display tonotopic mapping of frequency along the length of the cochlea and basilar papilla. It is not known whether the auditory hair cells of fishes possess a similar tonotopic organization in the saccule, which is thought to be the primary auditory receptor in teleosts. To investigate this question, we determined the location of hair cell damage in the saccules of goldfish (Carassius auratus) following exposure to specific frequencies. Subjects were divided into six groups of six fish each (five treatment groups plus control). The treatment groups were each exposed to one of five tones: 100, 400, 800, 2000, and 4000 Hz at 176 dB re 1 µPa root mean squared (RMS) for 48 hours. The saccules of each fish were dissected and labeled with phalloidin in order to visualize hair cell bundles. The hair cell bundles were counted at 19 specific locations in each saccule to determine the extent and location of hair cell damage. In addition to quantification of anatomical injury, hearing tests (using auditory evoked potentials) were performed on each fish immediately following sound exposure. Threshold shifts were calculated by subtracting control thresholds from post-sound exposure thresholds. RESULTS: All sound-exposed fish exhibited significant hair cell and hearing loss following sound exposure. The location of hair cell loss varied along the length of the saccule in a graded manner with the frequency of sound exposure, with lower and higher frequencies damaging the more caudal and rostral regions of the saccule, respectively. Similarly, fish exposed to lower frequency tones exhibited greater threshold shifts at lower frequencies, while high-frequency tone exposure led to hearing loss at higher frequencies. In general, both hair cell and hearing loss declined as a function of increasing frequency of exposure tone, and there was a significant linear relationship between hair cell loss and hearing loss. CONCLUSIONS: The pattern of hair cell loss as a function of exposure tone frequency and saccular rostral-caudal location is similar to the pattern of hearing loss as a function of exposure tone frequency and hearing threshold frequency. This data suggest that the frequency analysis ability of goldfish is at least partially driven by peripheral tonotopy in the saccule.

Quantification of intraoral pressures during nutritive sucking: methods with normal infants.

We report quantitative measurements of ten parameters of nutritive sucking behavior in 91 normal full-term infants obtained using a novel device (an Orometer) and a data collection/analytical system (Suck Editor). The sucking parameters assessed include the number of sucks, mean pressure amplitude of sucks, mean frequency of sucks per second, mean suck interval in seconds, sucking amplitude variability, suck interval variability, number of suck bursts, mean number of sucks per suck burst, mean suck burst duration, and mean interburst gap duration. For analyses, test sessions were divided into 4 × 2-min segments. In single-study tests, 36 of 60 possible comparisons of ten parameters over six pairs of 2-min time intervals showed a p value of 0.05 or less. In 15 paired tests in the same infants at different ages, 33 of 50 possible comparisons of ten parameters over five time intervals showed p values of 0.05 or less. Quantification of nutritive sucking is feasible, showing statistically valid results for ten parameters that change during a feed and with age. These findings suggest that further research, based on our approach, may show clinical value in feeding assessment, diagnosis, and clinical management.

Optic Flow: Perceiving and Acting in a 3-D World.

In 1979, James Gibson completed his third and final book "The Ecological Approach to Visual Perception". That book can be seen as the synthesis of the many radical ideas he proposed over the previous 30 years - the concept of information and its sufficiency, the necessary link between perception and action, the need to see perception in relation to an animal's particular ecological niche and the meanings (affordances) offered by the visual world. One of the fundamental concepts that lies beyond all of Gibson's thinking is that of optic flow: the constantly changing patterns of light that reach our eyes and the information it provides. My purpose in writing this paper has been to evaluate the legacy of Gibson's conceptual ideas and to consider how his ideas have influenced and changed the way we study perception.

Lysine 63-linked ubiquitination is important for arachidonic acid-induced cellular adhesion and migration.

Arachidonic acid, a dietary cis-polyunsaturated fatty acid, stimulates adhesion and migration of human cancer cells on the extracellular matrix by activation of intracellular signaling pathways. Polyubiquitin chains bearing linkages through different lysine residues convey distinct structural and functional information that is important for signal transduction. We investigated whether ubiquitination was required for arachidonic acid-induced cellular adhesion and migration of MDA-MB-435 cells on collagen type IV. An E1 (ubiquitin-activating enzyme) inhibitor, PYR-431, completely abrogated arachidonic acid-stimulated adhesion. Additionally, expression of a lysine null mutant ubiquitin prevented activation of cellular adhesion. Cells expressing ubiquitin in which lysine 63 (K63) was mutated to arginine (K63R) were unable to adhere to collagen upon exposure to arachidonic acid. When K63 was the only lysine present, the cells retained the ability to adhere, indicating that K63-linked ubiquitin is both necessary and sufficient. Moreover, K63-linked ubiquitin was required for the induction of cell migration by arachidonic acid. The ubiquitin mutants and PYR-431 did not prevent arachidonic acid-induced phosphorylation of TGF-ß activated kinase-1 (TAK1) and p38 MAPK, suggesting K63-linked ubiquitination occurs downstream of MAPK. These novel findings are the first to demonstrate a role for K63-linked ubiquitination in promoting cell adhesion and migration.

Increased expression of catalase and superoxide dismutase 2 reduces cone cell death in retinitis pigmentosa.

Oxidative and nitrosative damage are major contributors to cone cell death in retinitis pigmentosa (RP). In this study, we explored the effects of augmenting components of the endogenous antioxidant defense system in models of RP, rd1, and rd10 mice. Unexpectedly, overexpression of superoxide dismutase 1 (SOD1) in rd1 mice increased oxidative damage and accelerated cone cell death. With an elaborate mating scheme, genetically engineered rd10 mice with either inducible expression of SOD2, Catalase, or both in photoreceptor mitochondria were generated. Littermates with the same genetic background that did not have increased expression of SOD2 nor Catalase provided ideal controls. Coexpression of SOD2 and Catalase, but not either alone, significantly reduced oxidative damage in the retinas of postnatal day (P) 50 rd10 mice as measured by protein carbonyl content. Cone density was significantly greater in P50 rd10 mice with coexpression of SOD2 and Catalase together than rd10 mice that expressed SOD2 or Catalase alone, or expressed neither. Coexpression of SOD2 and Catalase in rd10 mice did not slow rod cell death. These data support the concept of bolstering the endogenous antioxidant defense system as a gene-based treatment strategy for RP, and also indicate that coexpression of multiple components may be needed.

Study of the Effect of Methyldiethanolamine Initiator on the Recording Properties of Acrylamide Based Photopolymer.

The use of Holographic Optical Elements (HOEs) in applications, such as in light shaping and redirection, requires certain characteristics such as a high Diffraction Efficiency, low angular selectivity and stability against UV damage. In order to maximize the performance of the HOEs, photosensitive materials are needed that have been optimised for the characteristics that are of particular importance in that application. At the core of the performance of these devices is the refractive index modulation created during holographic recording. Typically, a higher refractive index modulation will enable greater light Diffraction Efficiency and also operation with thinner devices, which in turn decreases the angular selectivity and the stability of the refractive index modulation introduced during recording, which is key to the longevity of the device. Solar concentrators based on volume HOEs can particularly benefit from thinner devices, because, for a solar concentrator to have a high angular working range, thinner photopolymer layers with a smaller angular selectivity are required. This paper presents an optimisation of an acrylamide-based photopolymer formulation for an improved refractive index modulation and recording speed. This was achieved by studying the effect of the concentration of acrylamide and the influence of different initiators in the photopolymer composition on the diffraction efficiency of holographic gratings. Two initiators of different molecular weights were compared: triethanolamine (TEA) and methyldiethanolamine (MDEA). A fivefold increase in the rate of grating formation was achieved through the modification of the acrylamide concentration alone, and it was also found that holograms recorded with MDEA as the initiator performed the best and recorded up to 25% faster than a TEA-based photopolymer. Finally, tests were carried out on the stability of the protected and unprotected photopolymer layers when subjected to UV light. The properties exhibited by this photopolymer composition make it a promising material for the production of optical elements and suitable for use in applications requiring prolonged exposure to UV light when protected by a thin melinex cover.