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Adelson RP, Ciobanu M, Garikipati A, Castell NJ, Singh NP, Barnes G, Rumph JK, Mao Q, Roane HS, Vaish A, Das R. Family-Centric Applied Behavior Analysis Facilitates Improved Treatment Utilization and Outcomes. J Clin Med 2024; 13:2409. [PMID: 38673682 PMCID: PMC11051390 DOI: 10.3390/jcm13082409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objective: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by lifelong impacts on functional social and daily living skills, and restricted, repetitive behaviors (RRBs). Applied behavior analysis (ABA), the gold-standard treatment for ASD, has been extensively validated. ABA access is hindered by limited availability of qualified professionals and logistical and financial barriers. Scientifically validated, parent-led ABA can fill the accessibility gap by overcoming treatment barriers. This retrospective cohort study examines how our ABA treatment model, utilizing parent behavior technicians (pBTs) to deliver ABA, impacts adaptive behaviors and interfering behaviors (IBs) in a cohort of children on the autism spectrum with varying ASD severity levels, and with or without clinically significant IBs. Methods: Clinical outcomes of 36 patients ages 3-15 years were assessed using longitudinal changes in Vineland-3 after 3+ months of pBT-delivered ABA treatment. Results: Within the pBT model, our patients demonstrated clinically significant improvements in Vineland-3 Composite, domain, and subdomain scores, and utilization was higher in severe ASD. pBTs utilized more prescribed ABA when children initiated treatment with clinically significant IBs, and these children also showed greater gains in their Composite scores. Study limitations include sample size, inter-rater reliability, potential assessment metric bias and schedule variability, and confounding intrinsic or extrinsic factors. Conclusion: Overall, our pBT model facilitated high treatment utilization and showed robust effectiveness, achieving improved adaptive behaviors and reduced IBs when compared to conventional ABA delivery. The pBT model is a strong contender to fill the widening treatment accessibility gap and represents a powerful tool for addressing systemic problems in ABA treatment delivery.
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Affiliation(s)
- Robert P. Adelson
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Madalina Ciobanu
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Anurag Garikipati
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Natalie J. Castell
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Navan Preet Singh
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Gina Barnes
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Jodi Kim Rumph
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Qingqing Mao
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Henry S. Roane
- Madison-Irving Medical Center, Upstate Medical University, 475 Irving Avenue, Syracuse, NY 13210-1756, USA;
| | - Anshu Vaish
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
| | - Ritankar Das
- Montera, Inc., dba Forta, Research and Development, 548 Market St., PMB 89605, San Francisco, CA 94104-5401, USA; (R.P.A.); (M.C.); (A.G.); (N.J.C.); (N.P.S.); (G.B.); (A.V.); (R.D.)
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Iyengar K, Mishra A, Vaish A, Kurisunkal V, Vaishya R, Botchu R. Primary synovial chondromatosis of the hip joint (PrSC of the hip): A retrospective cohort analysis and review of the literature. J Clin Orthop Trauma 2022; 35:102068. [PMID: 36420107 PMCID: PMC9676389 DOI: 10.1016/j.jcot.2022.102068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/16/2022] [Accepted: 11/11/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction Primary synovial osteochondromatosis (SOCM) or Synovial chondromatosis (SC) of the hip is a benign metaplastic condition of the synovium that is rare and may present with a spectrum of clinical features and radiological findings. Patients and methods A retrospective search using the keyword 'Synovial chondromatosis' (SC) of the hip was performed at a tertiary care orthopaedic referral centre in the UK and a hospital in India. The radiology images were collected from our Picture Archiving and Communication System (PACS) and Radiology Information System (RIS), over 15 years. The patient's data was collated with Electronic Patient Records (EPR), RIS, and correlated with histo-pathology laboratory records where available. The demographic details of the patients, their clinical symptoms, imaging details, and management outcomes were collected. Results We found 15 cases, with a mean age of 36.53 years (range: 14-50 years). There were 9 male and 6 female patients. The follow-up ranged from 1 year to 6 years. Predominantly unilateral presentation with insidious onset of symptoms was found. A spectrum of radiological Imaging was undertaken. Management strategies included supervised observation, arthroscopic or open synovectomy, and hip arthroplasty. No malignant transformation was found in the analysed cohort. Conclusion Primary 'Synovial chondromatosis' of the hip had a male preponderance in our cohort, presenting with a range of clinical features. Radiologically, Magnetic Resonance Imaging (MRI) was the commonest modality of cross-sectional imaging utilised and crucial for the diagnosis, evaluating underlying articular involvement including guiding appropriate patient management presenting with Primary 'Synovial chondromatosis' of the hip.
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Affiliation(s)
- K.P. Iyengar
- Department of Orthopaedics, Southport and Ormskirk, Southport, UK
| | - A. Mishra
- Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India
| | - A. Vaish
- Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India
| | - V. Kurisunkal
- Department of Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham, UK
| | - R. Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India
| | - R. Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
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Jena A, Goyal N, Rana P, Taneja S, Vaish A, Botchu R, Vaishya R. Differential 18F-NaF uptake in various compartments in knee osteoarthritis: an observational study using PET/MRI. Clin Radiol 2022; 77:613-620. [PMID: 35589431 DOI: 10.1016/j.crad.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/11/2022] [Indexed: 11/03/2022]
Abstract
AIM To investigate if the pattern of fluorine-18-labelled sodium fluoride (18F-NaF) uptake on integrated positron-emission tomography (PET)/magnetic resonance imaging (MRI) of bone marrow lesions (BML) and osteophytes differs between different knee compartments. MATERIALS AND METHODS Sixteen patients with no prior history of knee injury with or without pain were recruited for the study. The images of both knees were acquired on simultaneous PET/MRI. The acquisition was done after 45 minutes of intravenous injection of 18F-NaF 185-370 MBq (5-10 mCi) for 40 minutes. Each knee was divided into eight compartments patella, trochlea, medial central femur, lateral central femur, medial posterior femur, lateral posterior femur, medial tibia, lateral tibia, and cruciate ligament insertion specifically for BML. BML and osteophytes were scored using MRI Osteoarthritis Knee Score (MOAKS) criteria and their corresponding maximum standardised uptake values (SUVmax) recorded. RESULTS BML and osteophytes both showed statistically significant differences among knee compartments, i.e., p-value <0.000 and < 0.043 respectively. SUVmax for BML and osteophytes was greatest in the medial tibia. CONCLUSION 18F-NaF PET/MRI showed that BML and osteophytes had differential uptake values due to bone remodelling amongst the various knee compartments and this may help to design disease-modifying osteoarthritis drugs in the future.
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Affiliation(s)
- A Jena
- PET Suite (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, New Delhi, India
| | - N Goyal
- Department of Radiodiagnosis and Imaging, Indraprastha Apollo Hospitals, New Delhi, India
| | - P Rana
- PET Suite (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, New Delhi, India; Apollo Hospitals Education & Research Foundation, Indraprastha Apollo Hospitals, New Delhi, India
| | - S Taneja
- PET Suite (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, New Delhi, India
| | - A Vaish
- Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, India
| | - R Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK.
| | - R Vaishya
- Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, India
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Abstract
The presence of lytic lesions in the bones of foot raises a number of diagnostic possibilities ranging from infection, inflammatory pathology to neoplastic conditions. Although the radiological picture is not pathognomonic of any pathology, clinical history and histopathological examination can help to clinch the diagnosis. We present a case of multiple lytic lesions of the foot and discuss possible differential diagnoses. The patient was diagnosed as a case of madura foot and the lesions responded to surgical debridement and anti-fungal treatment with a good functional outcome. Madura foot is an uncommon, chronic granulomatous fungal or bacterial infection with a predilection in people who walk barefoot. Although known for a specific geographical distribution, madura foot should be kept as a possible diagnosis in patients presenting with lytic lesions of the foot due to population emigration across the world.
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Affiliation(s)
- R Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospitals, New Delhi, India
| | - V Vijay
- Department of Orthopaedics, Indraprastha Apollo Hospitals, New Delhi, India
| | - P Ghogare
- Department of Orthopaedics, Indraprastha Apollo Hospitals, New Delhi, India
| | - A Vaish
- Department of Orthopaedics, Sancheti Institute of Orthopaedics, Pune, India
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Shuster MJ, Vaish A, Cao HH, Guttentag AI, McManigle JE, Gibb AL, Martinez-Rivera M, Martinez MM, Nezarati RM, Hinds JM, Liao WS, Weiss PS, Andrews AM. Patterning small-molecule biocapture surfaces: microcontact insertion printing vs. photolithography. Chem Commun (Camb) 2011; 47:10641-3. [PMID: 21874174 DOI: 10.1039/c1cc13002a] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Chemical patterns prepared by self-assembly, combined with soft lithography or photolithography, are directly compared. Pattern fidelity can be controlled in both cases but patterning at the low densities necessary for small-molecule probe capture of large biomolecule targets is better accomplished using microcontact insertion printing (μCIP). Surfaces patterned by μCIP are used to capture biomolecule binding partners for the small molecules dopamine and biotin.
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Affiliation(s)
- M J Shuster
- Center for Nanoscale Science, The Pennsylvania State University, University Park, PA 16802, USA
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