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Yunusova Y.,University of Toronto | Yunusova Y.,Sunnybrook Health Science Center | Green J.R.,University of Nebraska - Lincoln | Green J.R.,Munroe Meyer Institute | And 4 more authors.
Folia Phoniatrica et Logopaedica | Year: 2012

Objective: The relations between acoustic measures and their articulatory bases have rarely been tested in dysarthria but are important for diagnostic and treatment purposes. We tested the association between acoustic measures of F2 range and F2 slope with kinematic measures of tongue movement displacement and speed in individuals with amyotrophic lateral sclerosis (ALS) and healthy controls speaking at normal and slow rates. Relations between acoustic and kinematic measures and speech intelligibility were examined. Results: As healthy controls reduced their speaking rate, their F2 slopes and movement speeds decreased. In talkers with ALS, acoustic and kinematic variables were associated with changes in speaking rate, characteristic of disease progression. Participants with slow rate had shallower F2 slopes and slower movement speeds than those with normal rate. Relations between F2 range and tongue displacement were weaker. F2 slope, displacement, and duration were correlated with speech intelligibility most consistently. Conclusion: Findings suggested that F2 slope is a useful marker for tracking disease progression in ALS. F2 slope reflects changes in tongue function with disease progression and is linked to speech intelligibility. Changes in movement speed, however, might be the earliest sign of disease in the tongue. © 2012 S. Karger AG, Basel.

Allen K.D.,Munroe Meyer Institute | Wallace D.P.,Childrens Mercy Hospital | Greene D.J.,Munroe Meyer Institute | Bowen S.L.,Prevention Group | Burke R.V.,Prevention Group
Focus on Autism and Other Developmental Disabilities | Year: 2010

The authors examined the benefits of video modeling to teach a unique vocational skill set to an adolescent and two young adults with Autism Spectrum Disorders. Video modeling was used to teach skills necessary to entertain customers and promote products in a retail setting while wearing a WalkAround' costume. The three participants were observed before and after watching a video model perform the skills in the costume in scripted and naturalistic scenes. Data can be interpreted to conclude that all participants learned to use the skills in combination or sequence after watching the video model. The skills generalized to an actual job opportunity. The participants reported they enjoyed the work, and comments from supervisors were positive. Implications are discussed. © 2010 Hammill Institute on Disabilities.

Lomas J.E.,Marcus Institute | Fisher W.W.,Munroe Meyer Institute | Kelley M.E.,Munroe Meyer Institute
Journal of Applied Behavior Analysis | Year: 2010

Prior research indicates that reinforcement of an appropriate response (e.g., compliance) can produce concomitant reductions in problem behavior reinforced by escape when problem behavior continues to produce negative reinforcement (e.g., Lalli et al., 1999). These effects may be due to a preference for positive over negative reinforcement or to positive reinforcement acting as an abolishing operation, rendering demands less aversive and escape from demands less effective as negative reinforcement. In the current investigation, we delivered a preferred food item and praise on a variable-time 15-s schedule while providing escape for problem behavior on a fixed-ratio 1 schedule in a demand condition for 3 participants with problem behavior maintained by negative reinforcement. Results for all 3 participants showed that variable-time delivery of preferred edible items reduced problem behavior even though escape continued to be available for these responses. These findings are discussed in the context of motivating operations.

Mathews T.L.,Munroe Meyer Institute | King M.L.,University of Nebraska Medical Center | Kupzyk K.A.,Munroe Meyer Institute | Lake C.M.,Wedgwood Christian Services
Journal of Pediatric Health Care | Year: 2014

Introduction: The primary goal of this article is to describe an intake process and results of screening for developmental and autism spectrum disorders in children referred to a tertiary center. A secondary analysis of abnormal screening results, demographic variables, and parental concerns of autism was conducted, along with a correlation analysis between developmental and autism-specific screening tools. Methods: A total of 379 children younger than 6 years were "prescreened" with the Ages and Stages Questionnaire-3 and the Modified Checklist for Autism in Toddlers or the Social Communication Questionnaire. Medical records were reviewed to identify demographic variables and parental primary concerns. Results: In approximately 11% of participants who screened positive for autism, no parental concerns of autism were present. Medium effect size correlations were found between the failed autism screening tools and delays in two domains on the Ages and Stages Questionnaire-3. Discussion: Clinical implications are addressed concerning diligent use of developmental and autism-specific rating scales to identify children at risk. © 2014 National Association of Pediatric Nurse Practitioners.

Perry A.M.,University of Manitoba | Nelson M.,Munroe Meyer Institute | Sanger W.G.,Munroe Meyer Institute | Bridge J.A.,Munroe Meyer Institute | And 2 more authors.
In Vivo | Year: 2013

Background: The identification of chromosomal abnormalities in many hematopoietic and mesenchymal neoplasms has contributed significantly to classification systems. Follicular dendritic cell (FDC) sarcoma is an intermediate-grade malignancy with morphological and immunophenotypic features of follicular dendritic cells. Available data on genetic changes in this neoplasm are limited, with only isolated case reports of cytogenetic abnormalities. Case Report: We reviewed histological, immunophenotypic and cytogenetic findings in two cases of FDC sarcoma. The two cases of FDC sarcoma, were observed in female patients, one was nodal and one extranodal and they exhibited relatively complex karyotypes, characterized by structural abnormalities and loss of multiple chromosomes. One patient had several disease recurrences. At the last follow-up both patients were alive with no residual disease. Conclusion: The cytogenetic findings in these two cases, coupled with the few previously described abnormal karyotypes, suggest that FDC sarcoma is cytogenetically diverse.

Rodriguez N.M.,Munroe Meyer Institute | Thompson R.H.,Western New England University | Stocco C.S.,Western New England University | Schlichenmeyer K.,Western New England University
Journal of Intellectual and Developmental Disability | Year: 2013

Background There is a need for a more accurate characterisation of higher level restricted and repetitive behaviour (RRB) in autism spectrum disorder (ASD), including why it might be considered problematic and events associated with its occurrence. Method We selected one form of higher level RRB-Arranging and ordering-that was rated as severe for a large percentage of the population sampled. We interviewed 20 students' teachers and conducted naturalistic observations for 15 of those students. Results The characteristics of arranging and ordering varied across, and sometimes within, individuals. Problems associated with compulsive-like behaviour also varied, with several unanticipated reported problems. With the exception of attention, social consequences were relatively infrequent. Conclusions These data highlight the need for research on the assessment and treatment of arranging and ordering and clinical attention to compulsive-like behaviour in ASD. Interviews and naturalistic observations are useful for structuring additional observations and analyses. © 2013 Australasian Society for Intellectual Disability, Inc.

Meadows T.,University of Nebraska Medical Center | Meadows T.,Munroe Meyer Institute | Valleley R.,University of Nebraska Medical Center | Thorson R.,University of Nebraska Medical Center | Evans J.,University of Nebraska Medical Center
Clinical Pediatrics | Year: 2011

Objective: To examine pediatricians time spent, and resulting reimbursement payments for, addressing behavioral health concerns in a rural primary care pediatric practice. Methods: Research assistants observed 228 patient visits in a rural pediatric primary care office. The length of the visit (in minutes), content of visit, number and type of codes billed, and related insurance reimbursement amounts were recorded. Interrater reliability, scored for 22% of patient visits, was ≥90%. Results: Medical only visits lasted, on average, 8 minutes as compared with behavioral only visits that required nearly 20 minutes of physician time. Pediatricians billed up to 10 different billing codes for medical only visits but only billed 1 code for behavioral only visits. Consequently, pediatricians were reimbursed significantly less, per minute, for behavioral only visits as compared with those sessions addressing medical only or a combination of medical and behavior concerns. Conclusion: Findings converge with previous research, demonstrating that behavioral health concerns dramatically affect the length of visit for primary care physicians. Moreover, this study is the first to document the specific impact of such concerns on pediatrician reimbursement for providing behavioral services. These results provide further support for integrating behavioral health services into pediatric primary care settings, thus allowing physicians to refer more difficult patients with behavioral issues to in-house collaborating behavioral health providers who can spend additional time necessary to address the behavioral health issue and who are licensed to receive mental health reimbursement. © The Author(s) 2011.

Zhao Z.,Munroe Meyer Institute | Verma V.,University of Nebraska Medical Center | Zhang M.,University of Nebraska Medical Center
Cancer Biology and Therapy | Year: 2015

Anaplastic lymphoma kinase (ALK) is correlated with oncogenesis in different types of cancers, such as anaplastic large cell lymphoma, lung cancer, neuroblastoma, and even breast cancer, by abnormal fusion of ALK or non-fusion ALK activation. ALK is a receptor tyrosine kinase, with a single transmembrane domain, that plays an important role in development. Upon ligand binding to the extracellular domain, the receptor undergoes dimerization and subsequent autophosphorylation of the intracellular kinase domain. In recent years, ALK inhibitors have been developed for cancer treatment. These inhibitors target ALK activity and show effectiveness in ALK-positive non-small cell lung cancer. However, acquired treatment resistance makes the future of this therapy unclear; new strategies are underway to overcome the limitations of current ALK inhibitors. © 2015 Taylor & Francis Group, LLC.

PubMed | Munroe Meyer Institute and University of Nebraska Medical Center
Type: Journal Article | Journal: JCI insight | Year: 2016

The creation of a humanized chimeric mouse nervous system permits the study of human neural development and disease pathogenesis using human cells in vivo. Humanized glial chimeric mice with the brain and spinal cord being colonized by human glial cells have been successfully generated. However, generation of humanized chimeric mouse brains repopulated by human neurons to possess a high degree of chimerism have not been well studied. Here we created humanized neuronal chimeric mouse brains by neonatally engrafting the distinct and highly neurogenic human induced pluripotent stem cell (hiPSC)-derived rosette-type primitive neural progenitors. These neural progenitors predominantly differentiate to neurons, which disperse widely throughout the mouse brain with infiltration of the cerebral cortex and hippocampus at 6 and 13 months after transplantation. Building upon the hiPSC technology, we propose that this potentially unique humanized neuronal chimeric mouse model will provide profound opportunities to define the structure, function, and plasticity of neural networks containing human neurons derived from a broad variety of neurological disorders.

PubMed | Munroe Meyer Institute
Type: Journal Article | Journal: Occupational therapy in health care | Year: 2013

Stroke is one of the most disabling conditions affecting adults today. Much research has been performed on rehabilitation interventions targeting hemiparesis after stroke. Constraint-induced therapy is a treatment technique that focuses on restraining the unaffected upper extremity while forcing use of the affected extremity to promote purposeful movement. This study presents a meta-analysis of applicable current literature on this treatment approach. It is concluded that constraint-induced therapy may be an effective treatment option for hemiparesis experienced after stroke.

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