Systemic lupus erythematosus (SLE), commonly known as lupus, is a complex autoimmune disease that presents a variety of symptoms and poses significant challenges in treatment.
One common form of lupus is cutaneous lupus erythematosus, which manifests as rashes on the face, scalp, and other parts of the body, leading to hair loss and skin scarring. These rashes are caused by inflammation resulting from the immune system attacking the body.
Traditional treatments for cutaneous lupus erythematosus involve immunosuppressants and biologic drugs to reduce inflammation. However, many patients with lupus already take multiple medications and are seeking alternative treatments.
A research team led by Dr. J. Michelle Kahlenberg, a professor of internal medicine at the University of Michigan Health, has been exploring one such alternative: a topical treatment called mupirocin. This study builds on Dr. Kahlenberg’s previous discovery that cutaneous lupus rashes are often colonized by a common skin bacteria, Staphylococcus aureus (staph), which contributes to inflammation.
Mupirocin is known to kill staph bacteria. In the study, patients with SLE who were experiencing cutaneous lupus flares were randomly selected to treat their skin lesions with either mupirocin or an inactive control, petrolatum jelly. Samples from the nose and affected skin were analyzed before and after treatment to measure staph levels and microbial community profiles.
Results showed that mupirocin treatment significantly decreased staph levels in the affected skin, which corresponded with a reduction in inflammatory signals, including interferon-driven gene expression. Dr. Kahlenberg noted that mupirocin also lowered skin monocyte levels, which are crucial in driving cutaneous lupus.
While these findings indicate that mupirocin can reduce inflammation, the study did not determine whether it can completely eliminate the rashes associated with cutaneous lupus erythematosus. Dr. Kahlenberg emphasized the need for larger studies to evaluate the effectiveness of topical antibiotics in treating these rashes.
Despite the need for further research, this study marks an exciting first step toward discovering additional treatments that can reduce inflammation beyond the conventional use of immunosuppressants and biologic drugs.
Over the past decade, researchers at the University of Kansas (KU) have developed an innovative virtual reality (VR) system aimed at helping students with disabilities, particularly those with autism r, to enhance their social skills. Now, this groundbreaking project is set to reach new heights with the addition of artificial intelligence (AI) components, thanks to a five-year, $2.5 million grant from the U.S. Office of Special Education Programs.
The project, titled Increasing Knowledge and Natural Opportunities With Social Emotional Competence (iKNOW), aims to create an extended reality (XR) experience that offers students more natural and immersive social interactions. Building on the success of the existing VR system known as Virtual reality Opportunity to Integrate Social Skills (VOISS), which has already proven effective in improving social skills for students with disabilities, iKNOW will integrate advanced AI technologies to enhance these capabilities further.
The original VOISS system includes 140 unique learning scenarios designed to teach 183 social skills in virtual school environments, such as classrooms, hallways, cafeterias, and buses. These scenarios are accessible through various platforms, including iPads, Chromebooks, and Oculus VR headsets, allowing students to practice social skills across multiple settings.
Introducing AI to Enhance Realism and Interaction
The new iKNOW system will leverage large language models and AI technologies to enable more natural user interactions. Instead of responding to pre-recorded narratives by pushing buttons, students can engage in real-time conversations, with AI accurately transcribing spoken language and generating appropriate video responses from avatars. This approach aims to make social skill practice more relatable and effective.
Amber Rowland, an assistant research professor at KU’s Center for Research on Learning and one of the grant’s co-principal investigators, explained, “Avatars in iKNOW can have certain reactions and behaviors based on what we want them to do. They can model the practices we want students to see. The system will harness AI to ensure students have more natural interactions and put them in the role of the ‘human in the loop’ by allowing them to speak, and it will respond like a normal conversation.”
Monitoring Progress and Ensuring Realism
iKNOW will also include a real-time student progress monitoring system, providing valuable feedback to students, educators, and families. This system will track metrics such as the length and frequency of spoken responses, the number of keywords used, and areas where students may have struggled, helping to enhance overall understanding and progress.
To ensure a realistic experience, all avatar voices in iKNOW are provided by real middle school students, educators, and administrators. This approach eliminates students’ potential discomfort when practising social skills with classmates in supervised sessions, allowing them to practice until they are confident enough to transfer these skills to real-life situations.
Benefits for Teachers and Students
Maggie Mosher, an assistant research professor at KU’s Achievement & Assessment Institute and co-principal investigator for the grant, emphasized the system’s potential to lighten teachers’ workloads and provide practical student tools. “It will leverage our ability to take something off of teachers’ plates and provide tools for students to learn these skills in multiple environments,” Mosher said.
Mosher’s doctoral dissertation compared VOISS to other social skills interventions and found it to be statistically significant and valid in improving social skills and knowledge across multiple domains. This research, published in high-impact journals, underscores the system’s effectiveness.
Future Prospects and Collaboration
The iKNOW project, supported by one of four OSEP Innovation and Development grants, will be presented at the annual I/ITSEC conference, the world’s most extensive modeling, simulation, and training event. The research team, including principal investigator Sean Smith, professor of special education, and other esteemed colleagues, will showcase their work at this prestigious event.
The team has successfully implemented VOISS in schools nationwide, and iKNOW is set to expand its reach. Interested parties can learn more about the system, access demonstrations and videos, and contact developers through the iKNOW website.
Additionally, iKNOW will provide resources for teachers and families through a dedicated website called iKNOW TOOLS (Teaching Occasions and Opportunities for Learning Supports), supporting the generalization of social skills across real-world settings.
“By combining our research-based social emotional virtual reality work (VOISS) with the increasing power and flexibility of AI, iKNOW will further personalize the learning experience for individuals with disabilities along with struggling classmates,” said Sean Smith. “Our hope and expectation is that iKNOW will further engage students to develop the essential social emotional skills to then apply in the real world to improve their overall learning outcomes.”
Recent research from Michigan Medicine at the University of Michigan reveals intriguing trends in ADHD medication use among children aged 5-17, following the national shortage of Adderall. The study, published in Pediatrics, highlights how the shortage has influenced prescription patterns and the overall management of ADHD in children.
Changes in ADHD Medication Use
At the onset of the COVID-19 pandemic in March 2020, there was a notable decrease in the dispensing of prescription stimulants for ADHD. The rate of prescriptions fell sharply but began to recover gradually, according to the researchers. However, the announcement of an Adderall shortage by the FDA in October 2022 caused another significant decline in Adderall prescriptions, while the use of alternative stimulants like dexmethylphenidate (commonly known as Focalin) surged.
The study, led by Sijia He, M.S., from the Susan B. Meister Child Health Evaluation and Research Center, analyzed stimulant dispensing rates using extensive national data. The findings indicate that many children did not stop stimulant therapy altogether but switched to alternative treatments during the Adderall shortage.
“This would be potentially concerning if the switches may have resulted in worsened ADHD control. We need more research to evaluate whether any switches led to adverse outcomes,” He said.
Variations by Age and Gender
The analysis also revealed interesting variations by age and gender. Among male adolescents (12-17 years), the rebound in stimulant dispensing was less pronounced compared to other groups, with a 19% lower rate than expected pre-pandemic trends by December 2023. On the other hand, stimulant dispensing rates for boys aged 5-11 years remained consistent with pre-pandemic expectations.
For girls aged 5-11 years, the stimulant dispensing rate was 9% higher than expected, aligning with prior studies showing an increase in ADHD diagnoses among girls during the pandemic. Senior author Kao-Ping Chua, M.D., Ph.D., from the University of Michigan Health C.S. Mott Children’s Hospital, suggests this might reflect a reduction in the underdiagnosis and undertreatment of ADHD in girls or an increase in symptoms of inattention during the pandemic.
Addressing Stimulant Shortages
The study’s findings underscore the broader implications of the Adderall shortage on children’s access to essential ADHD treatments. Chua emphasizes the need for policymakers to consider raising production limits for stimulants to ensure children are not deprived of necessary medications, even if adult demand continues to rise.
“Our findings indirectly demonstrate how increased demand for a medication class in adults may adversely affect access to these treatments for children,” Chua noted. “It’s crucial to address the shortage of stimulant medications because so many kids rely on them. Untreated ADHD symptoms can harm children’s health and learning.”
Implications and Future Directions
Given that ADHD is the most diagnosed neurobehavioral condition among U.S. children, ensuring a stable supply of stimulant medications is paramount. The study provides valuable insights into how medication shortages impact prescription trends and highlights the importance of accessible treatments for managing ADHD effectively.
As the medical community continues to navigate these challenges, ongoing research and policy initiatives will be vital in ensuring that all children with ADHD receive the necessary support and treatments to thrive.
In a groundbreaking development, researchers from Kennedy Krieger Institute and Nottingham Trent University have created a one-minute video game that accurately and efficiently identifies autism in children. This innovative tool, called the Computerized Assessment of Motor Imitation (CAMI), uses motion-tracking technology to detect differences in motor imitation skills.
Revolutionizing Autism Diagnosis
Diagnosing autism can be a complex and time-consuming process, often requiring highly trained clinicians and costing families an estimated $1,500 to $3,000 annually, according to the U.S. National Library of Medicine. However, CAMI offers a simpler, faster, and more cost-effective alternative. In a recent study involving 183 children aged 7-13, the video game demonstrated an 80% success rate in distinguishing children with autism from those who are neurotypical and a 70% success rate in differentiating autism from ADHD.
How CAMI Works
CAMI asks children to mimic dance-like movements of a video avatar for one minute while their imitation performance is measured. Dr. Stewart Mostofsky, a pediatric neurologist and director of the Center for Neurodevelopmental and Imaging Research at Kennedy Krieger Institute, emphasized the significance of this tool:
“Diagnosing autism can be challenging, especially when children have overlapping traits with other conditions like ADHD. If the condition is misdiagnosed, it can impact support and resources for the child.”
Dr. Bahar Tunçgenç, a social development expert at Nottingham Trent University, added:
“Autism is traditionally seen as a social-communication disorder, but we now know sensory-motor difficulties, like motor imitation, play a key role in shaping social and communication skills. CAMI identifies autism by tapping into these challenges, which are distinct from ADHD.”
The Future of Autism Diagnosis
What sets CAMI apart is its simplicity and adaptability. Video games are both enjoyable for children and provide clear, quick results for clinicians. With further development, CAMI could be adapted for younger children and those with more severe developmental challenges, broadening its impact. Researchers hope CAMI’s success will inspire new ways to simplify and improve diagnostic tools for other conditions.
“This tool could transform autism diagnoses worldwide,” said Dr. Mostofsky. “By identifying autism as precisely as possible, we can connect children to interventions that improve their quality of life and long-term outcomes. We want to see CAMI used widely in clinics to support diagnosis as an alternative that is quick, low-cost, and requires minimal set-up.”
This innovative technology marks a significant step forward in improving the accuracy and accessibility of autism diagnoses, potentially transforming the lives of many children worldwide.
Watch the CAMI Demonstration Video
For those interested in seeing CAMI in action, check out the demonstration video here.
Credit: Kennedy Krieger Institute and Nottingham Trent University
Autistic social gatherings are unique, and today I’d like to share five autistic traits I’ve noticed are common in autistic groups. Plus, as a bonus, I also discuss how to find autistic social spaces and communities you can access.
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