Extended-release guanfacine appears to be safe and effective for reducing hyperactivity, impulsiveness, and distractibility in children with ASD.
Recent developments in rapid prototyping provide evidence of the maturing of some areas of application. New applications continue to surface and new systems/processes are being introduced on a regular basis. The Fifth International Conference on Rapid Prototyping (Dayton, Ohio, 1994) provided an opportunity to bring together leaders in the commercial development and application of RP technology and to hear their perspectives on the current capabilities and future directions. A “Manufacturers round table” provided the forum for the audience to submit questions. Relates participants’ responses.
Setting Standards W e have been fortunate to witness the golden years in the development of fracture fixation technology over the last 30 years. In the 1980s, plating was the pre-eminent fixation method, and the AO (manufactured by Mathys, Straumann, and Synthes) supplied most implants used worldwide. The system comprised large, small, and mini fragment plating sets. Each set had its respective screwdriver; large hex, small hex, and mini cruciate. Each driver had a distinct handle, designed and sized to enable the user to generate the proper torque for screw insertion. This made both insertion and extraction of screws straightforward.When Synthes introduced locking technology, it came with a new driver, the T-25 StarDrive, enabling the user to generate the torque needed to lock the screw while avoiding stripping. Shortly after this, cannulated screws of all sizes became ubiquitous, each with its own distinct screwdriver head and handle. By 2010, a plethora of screws of all sizes and types (and by a variety of manufacturers) were in use. Screw insertion remained rather straightforward (one used the instrument set provided by the manufacturer), but screw removal-particularly screws inserted by other surgeons-was a more difficult prospect. In some cases, one could identify the manufacturer by knowing the plate design, but many generic plates and their screws looked identical on x-ray. In addition, when percutaneous screws were placed independently, it was impossible to identify the manufacturer because, for all intents and purposes, the screws all looked alike.The problem here should be obvious. When we started practice, 3 screwdrivers were sufficient to remove virtually any screw encountered when revising a nonunion/malunion or removing implants due to infection. Today, however, the variety of screw head sizes and types makes it virtually impossible to know, from an x-ray, what specific screwdriver is necessary. In addition, even if the screw seems to be a "standard" size (eg, a 6.5-mm cannulated screw), the "standard" large fragment hex screwdriver may still not fit. Directly visualizing the screw head does not solve the problem because it is possible that the correct screwdriver may not be at hand, despite having the latest removal sets in the OR. An examination of one manufacturer's universal screw removal set reveals nearly 20 screwdriver head sizes/configurations, and yet, these still do not fit every screw encountered. This adds complexity, cost, and time to the case and frustration for the surgeon-all for an issue that could be remedied through standardization. It seems incongruous that one can remove a wheel from nearly any passenger vehicle in the United States with 1 of 4 lug wrench sockets, yet some bone screws cannot be removed with a modern instrument set including nearly 20 screwdriver head options.The fix seems simple enough but is actually rather complex. For major orthopaedic implant manufacturers, each plating or screw set has well over 1000 trays in the field; furthermore, each tray is stocked wi...
Children who are diagnosed with attention deficit hyperactivity disorder (or who engage in behavior consistent with such a diagnosis) are often prescribed stimulant medications for hyperactive or inattentive behaviors. However, the mechanisms by which stimulant medications affect individuals' behavior are rarely evaluated. The purpose of the current study was to evaluate the effects of stimulant medication on response allocation when antecedents and consequences were held constant and equated. Results indicated that the presence of an amphetamine medication (Adderall) influenced response allocation across two concurrently available responses while all other stimulus conditions were held constant.
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