ABSTRACT
The purpose of this study was to examine the effects of using an iPad to assist students with autism in learning communication skills. Three, 10 years old learners diagnosed with autism who present little or no functional speech, participated in the study. A multiple baseline design with AB phases across academic and social settings was used. During the baseline, students were given access to an iPad with the SonoFlex speech-generating device application, while no communicative attempts were observed. During the intervention, the students were taught to use the iPad to communicate with their teacher and peers for 6 weeks. With a least-to-most prompting hierarchy, all students increased initiating requests, responding to questions and making social comments in both class and recess settings.
Subject(s)
Autistic Disorder/psychology , Autistic Disorder/therapy , Communication Aids for Disabled/statistics & numerical data , Communication , Computers, Handheld/statistics & numerical data , Students/psychology , Child , Female , Humans , Learning , Male , Peer Group , SpeechABSTRACT
BACKGROUND: Myocardial perfusion imaging by positron-emission tomography (PET MPI) is regarded as a valid technique for the diagnosis of coronary artery disease (CAD), but the incremental prognostic value of PET MPI among individuals with known or suspected CAD is not firmly established. HYPOTHESIS: Myocardial perfusion defect sizes as measured by PET MPI using automated software will provide incremental prognostic value for cardiac and all-cause mortality. METHODS: This study included 3739 individuals who underwent rest-stress rubidium-82 PET MPI for the evaluation of known or suspected CAD. Rest, stress, and stress-induced myocardial perfusion defect sizes were determined objectively by automated computer software. Study participants were followed for a mean of 5.2 years for cardiac and all-cause mortality. Cox proportional hazards models were developed to evaluate the incremental prognostic value of PET MPI. RESULTS: A strong correlation was observed between perfusion defect sizes assessed visually and by automated software (r = 0.76). After adjusting for cardiac risk factors, known CAD, noncoronary vascular disease, and use of cardioprotective medications, stress perfusion defect size was strongly associated with cardiac death (P < 0.001). Rest perfusion defects demonstrated a stronger association with cardiac death (P < 0.001) than stress-induced perfusion defects (P = 0.01), yet both were highly significant. Similar patterns held for all-cause death. CONCLUSIONS: The current study is the largest to date demonstrating PET MPI provides incremental prognostic value among individuals with known or suspected CAD. Automated calculation of perfusion defect sizes may provide valuable supplementary information to visual assessment.
Subject(s)
Coronary Artery Disease/diagnostic imaging , Image Interpretation, Computer-Assisted , Myocardial Perfusion Imaging/methods , Positron-Emission Tomography , Software , Aged , Automation , Cause of Death , Chi-Square Distribution , Coronary Artery Disease/mortality , Coronary Artery Disease/physiopathology , Disease Progression , Female , Humans , Male , Middle Aged , New York/epidemiology , Predictive Value of Tests , Prognosis , Proportional Hazards Models , Risk Assessment , Risk Factors , Rubidium Radioisotopes , Time FactorsABSTRACT
OBJECTIVES: As accumulation of monocytes and macrophages is a feature of atherosclerotic plaque at all stages, inflammatory gene expression profiling of peripheral blood mononuclear cells may provide a more reliable measure of atherogenesis than systemic inflammatory markers. The aim of this study was to determine whether expression patterns of inflammatory regulators in blood are correlated with severity and progression of coronary artery disease. METHODS: PCR expression arrays were used to profile mRNA levels of 84 candidate genes in blood from three patients with persistent perfusion defects, three with improved perfusion, and two without perfusion defects as measured by serial PET myocardial perfusion imaging. A case-control study compared expression of inflammatory genes in 25 patients with stress-induced perfusion defects and 25 controls using quantitative real-time PCR. RESULTS: Expression array analysis identified IL-8, CXCR1, and CXCR2 as genes showing increased expression in patients with persistent perfusion defects. The case-control study confirmed a significant increase in CXCR1 (P=0.04) and CXCR2 (P=0.002) mRNAs in blood in males with obstructive CAD, but not in females. There was no difference in IL-8 mRNA level between cases and controls (P=0.1). Coordinated expression of CXCR1 and CXCR2 mRNA was more pronounced in controls (r=0.96) than in patients with perfusion defects (r=0.73). CONCLUSIONS: mRNA levels for CXCR1 and CXCR2 are increased in blood in males with obstructive CAD and decreased in patients with improved perfusion, suggesting that these genes may serve as markers of disease severity and progression.
