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Background: The Extension for Community Health Outcomes (ECHO) Autism Program trains clinicians to screen, diagnose, and care for children with autism spectrum disorder (ASD) in primary care settings. This study will assess the feasibility and impact of integrating an artificial intelligence (AI)-based ASD diagnosis aid (the device) into the existing ECHO Autism Screening Tool for Autism in Toddlers and Young Children (STAT) diagnosis model. The prescription-only Software as a Medical Device, designed for use in children aged 18 to 72 months at risk for developmental delay, produces ASD diagnostic recommendations after analyzing behavioral features from 3 distinct inputs: a caregiver questionnaire, 2 short home videos analyzed by trained video analysts, and a health care provider questionnaire. The device is not a stand-alone diagnostic and should be used in conjunction with clinical judgment., Objective: This study aims to assess the feasibility and impact of integrating an AI-based ASD diagnosis aid into the ECHO Autism STAT diagnosis model. The time from initial ECHO Autism clinician concern to ASD diagnosis is the primary end point. Secondary end points include the time from initial caregiver concern to ASD diagnosis, time from diagnosis to treatment initiation, and clinician and caregiver experience of device use as part of the ASD diagnostic journey., Methods: Research participants for this prospective observational study will be patients suspected of having ASD (aged 18-72 months) and their caregivers and up to 15 trained ECHO Autism clinicians recruited by the ECHO Autism Communities research team from across rural and suburban areas of the United States. Clinicians will provide routine clinical care and conduct best practice ECHO Autism diagnostic evaluations in addition to prescribing the device. Outcome data will be collected via a combination of electronic questionnaires, reviews of standard clinical care records, and analysis of device outputs. The expected study duration is no more than 12 months. The study was approved by the institutional review board of the University of Missouri-Columbia (institutional review board-assigned project number 2075722)., Results: Participant recruitment began in April 2022. As of June 2022, a total of 41 participants have been enrolled., Conclusions: This prospective observational study will be the first to evaluate the use of a novel AI-based ASD diagnosis aid as part of a real-world primary care diagnostic pathway. If device integration into primary care proves feasible and efficacious, prolonged delays between the first ASD concern and eventual diagnosis may be reduced. Streamlining primary care ASD diagnosis could potentially reduce the strain on specialty services and allow a greater proportion of children to commence early intervention during a critical neurodevelopmental window., Trial Registration: ClinicalTrials.gov NCT05223374; https://clinicaltrials.gov/ct2/show/NCT05223374., International Registered Report Identifier (irrid): PRR1-10.2196/37576., (©Kristin Sohl, Rachel Kilian, Alicia Brewer Curran, Melissa Mahurin, Valeria Nanclares-Nogués, Stuart Liu-Mayo, Carmela Salomon, Jennifer Shannon, Sharief Taraman. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 19.07.2022.)

Individuals with autism spectrum disorder (ASD) struggle to access high-quality health care due to the shortage of trained providers. ECHO ( Extension for Community Healthcare Outcomes) Autism is a unique educational program that allows ASD experts to provide knowledge and skills to professionals in local communities to deliver evidence-based care to children with ASD and their families. The model teaches clinicians how to screen and diagnose ASD, as well as manage common co-occurring medical and mental health issues. ECHO Autism is particularly useful for addressing the complex needs of children with ASD and reducing disparities often present in rural and underserved communities. The model can be disseminated globally due to its flexibility in accommodating local and regional differences in social norms and constructs. This article provides an overview of the format of the ECHO Autism model, data supporting the model's efficacy, and discusses future research directions.

The continuously growing number of short-life electronics equipment inherently results in a massive amount of problematic waste, which poses risks of environmental pollution, endangers human health, and causes socioeconomic problems. Hence, to mitigate these negative impacts, it is our common interest to substitute conventional materials (polymers and metals) used in electronics devices with their environmentally benign renewable counterparts, wherever possible, while considering the aspects of functionality, manufacturability, and cost. To support such an effort, in this study, we explore the use of biodegradable bioplastics, such as polylactic acid (PLA), its blends with polyhydroxybutyrate (PHB) and composites with pyrolyzed lignin (PL), and multiwalled carbon nanotubes (MWCNTs), in conjunction with processes typical in the fabrication of electronics components, including plasma treatment, dip coating, inkjet and screen printing, as well as hot mixing, extrusion, and molding. We show that after a short argon plasma treatment of the surface of hot-blown PLA-PHB blend films, percolating networks of single-walled carbon nanotubes (SWCNTs) having sheet resistance well below 1 kΩ/□ can be deposited by dip coating to make electrode plates of capacitive touch sensors. We also demonstrate that the bioplastic films, as flexible dielectric substrates, are suitable for depositing conductive micropatterns of SWCNTs and Ag (1 kΩ/□ and 1 Ω/□, respectively) by means of inkjet and screen printing, with potential in printed circuit board applications. In addition, we exemplify compounded and molded composites of PLA with PL and MWCNTs as excellent candidates for electromagnetic interference shielding materials in the K-band radio frequencies (18.0-26.5 GHz) with shielding effectiveness of up to 40 and 46 dB, respectively.

The eosinophil cationic protein (ECP) is a human antimicrobial protein involved in the host immune defense that belongs to the pancreatic RNase A family. ECP displays a wide range of antipathogen activities. The protein is highly cationic and its bactericidal activity is dependant on both cationic and hydrophobic surface exposed residues. Previous studies on ECP by site-directed mutagenesis indicated that the RNase activity is not essential for its bactericidal activity. To further understand the ECP bactericidal mechanism, we have applied enzymatic and chemical limited cleavage to search for active sequence determinants. Following a search for potential peptidases we selected the Lys-endoproteinase, which cleaves the ECP polypeptide at the carboxyl side of its unique Lys residue, releasing the N-terminal fragment (0-38). Chemical digestion using cyanogen bromide released several complementary peptides at the protein N-terminus. Interestingly, ECP treatment with cyanogen bromide represents a new example of selective chemical cleavage at the carboxyl side of not only Met but also Trp residues. Recombinant ECP was denatured and carboxyamidomethylated prior to enzymatic and chemical cleavage. Irreversible denaturation abolishes the protein bactericidal activity. The characterization of the digestion products by both enzymatic and chemical approaches identifies a region at the protein N-terminus, from residues 11 to 35, that retains the bactericidal activity. The most active fragment, ECP(0-38), is further compared to ECP derived synthetic peptides. The region includes previously identified stretches related to lipopolysaccharide binding and bacteria agglutination. The results contribute to define the shortest ECP minimized version that would retain its antimicrobial properties. The data suggest that the antimicrobial RNase can provide a scaffold for the selective release of cytotoxic peptides., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

In view of more morphological and physiological similarities between human and porcine skin than for other laboratory animal species, the minipig is a preferred model to evaluate the safety profile of dermally applied xenobiotics. Different methods of dermal administration and examples of non-invasive and invasive investigations during the in-life phase of the studies are described. Routine and special post-mortem examinations in dermal studies are presented to assess responses to the topical treatment of minipig skin. Challenges in dermal minipig studies are discussed with respect to animal welfare and husbandry, test formulations, application methods and different types of investigations. One of the most significant issues for dermal minipig studies is the extensive measures required to prevent cross-contamination of blood and tissue samples taken to monitor local and systemic exposure to the test item.

Use of electromyography (EMG) to monitor mastication is a relatively new concept in assessing food physical and sensory properties. Although expert assessment of cheese characteristics is widely used, the effect of training in sensory analysis on mastication patterns, as assessed using EMG is not well known. Nine samples of the same Mahon cheese (60 days ripening) were given to 24 subjects (8 experts, 16 untrained) and EMG recorded for each chewing sequence. Three samples were tested in a single session by each subject, and three sessions carried out on different days. EMG was recorded from four masticatory muscles for each subject. From EMG records the following was extracted: number of chews, chewing time, mean and maximum voltage of EMG bursts (i.e. chews) across chewing sequence, chewing work and chewing rate. No gender bias was found for the EMG parameters considered, therefore, as regards gender, each group was considered to be homogeneous. Variability within-subjects across samples was greater for experts than untrained subjects. Significant differences in chewing time, chewing work and chewing rate were found between the expert and untrained groups. Data analysis of the three sessions showed an influence of cognitive constructs, mediating states, on the chewing process. The experts were found to be goal driven as to their mastication process. Experts showed no significant differences between sessions, untrained subjects were found to vary their EMG output in successive sessions for number of chews, chewing time, mean voltage, and chewing work.

Treatment of male rats and dogs with CGP 32,349 (formestane), a steroidal aromatase inhibitor, and CGS 20,267 (letrozole), a non-steroidal aromatase inhibitor, induced different alterations in testicular interstitial Leydig cells in the two species. Whereas in dogs Leydig cells were hypertrophic and hyperplastic, in rats either no effect (CGS 20,267) or atrophy of Leydig cells (CGP 32,349) was reported. The different response of the two species can be explained by different regulating mechanisms of gonadotropin secretion by the anterior pituitary.