Sleep and Activity Patterns in Autism Spectrum Disorder

Background

Autism spectrum disorder (ASD) is a highly heritable and heterogeneous neurodevelopmental disorder characterized by impaired social interactions, repetitive behaviors, and a wide range of comorbidities. Between 44-83% of autistic individuals report sleep disturbances, which may share an underlying neurodevelopmental basis with ASD.

Methods

We recruited 382 ASD individuals and 223 of their family members to obtain quantitative ASD-related traits and wearable device-based accelerometer data spanning three consecutive weeks. An unbiased approach identifying traits associated with ASD was achieved by applying the elastic net machine learning algorithm with five-fold cross-validation on 6,878 days of data. The relationship between sleep and physical activity traits was examined through linear mixed-effects regressions using each night of data.

Results

This analysis yielded 59 out of 242 actimetry measures associated with ASD status in the training set, which were validated in a test set (AUC: 0.777). For several of these traits (e.g. total light physical activity), the day-to-day variability, in addition to the mean, was associated with ASD. Individuals with ASD were found to have a stronger correlation between physical activity and sleep, where less physical activity decreased their sleep more significantly than that of their non-ASD relatives.

Conclusions

The average duration of sleep/physical activity and the variation in the average duration of sleep/physical activity strongly predict ASD status. Physical activity measures were correlated with sleep quality, traits, and regularity, with ASD individuals having stronger correlations. Interventional studies are warranted to investigate whether improvements in both sleep and increased physical activity may improve the core symptoms of ASD.

Association of Baseline Frailty with Patient-Reported Outcomes in Systemic Lupus Erythematosus at 1 Year

The relationship of baseline frailty with subsequent patient-reported outcomes in systemic lupus erythematosus (SLE) remains unclear. We assessed these associations in a pilot prospective cohort study. Frailty based on the FRAIL scale and the Fried phenotype and patient-reported outcomes, namely Patient Reported Outcomes Measurement Information System computerized adaptive tests and Valued Life Activities disability, were measured at baseline and 1 year among women aged 18-70 years with SLE enrolled at a single center. Differences in Patient Reported Outcomes Measurement Information System computerized adaptive tests between frail and non-frail participants were evaluated using Wilcoxon rank sum tests, and the association of baseline frailty with self-report disability at 1 year was estimated using linear regression. Of 51 participants, 24% (FRAIL scale) and 16% (Fried phenotype) met criteria for frailty at baseline despite median age of 55.0 and 56.0 years, respectively. Women with (versus without) baseline frailty using either measure had worse 1-year Patient Reported Outcomes Measurement Information System computerized adaptive test scores across multiple domains and greater self-report disability. Baseline frailty was significantly associated with self-report disability at 1 year (FRAIL scale: parameter estimate 0.55, 95% confidence interval (CI) 0.21-0.89, p<0.01; Fried phenotype: parameter estimate 0.61, 95% CI 0.22-1.00, p<0.01), including only slight attenuation after adjustment for SLE cumulative organ damage (FRAIL scale: parameter estimate 0.45, 95% CI 0.09-0.81, p=0.02; Fried phenotype: parameter estimate 0.49, 95% CI 0.09-0.90, p=0.02). These preliminary findings support frailty as an independent risk factor for clinically relevant patient-reported outcomes, including disability onset, among women with SLE.

Thoracoscopic repair of congenital diaphragmatic hernia in neonates: Tips and tricks learned from an institutional experience

BACKGROUND

Congenital diaphragmatic hernia (CDH) is an anomaly with significant morbidity in neonates. It has been traditionally managed by an open approach with a recent trend toward a minimally invasive approach.

AIM

This is a retrospective study of our institutional experience with neonatal thoracoscopic management of CDH, with the impact of few technical nuances.

PATIENTS AND METHODS

The data was collected on neonatal thoracoscopic CDH repair between January 2015 and December 2018, in terms of the demographics, intra-operative parameters, post-operative status, recurrence, and mortality. While analyzing data, we found few technical modifications adopted by the surgeon such as trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO₂, maximal use of muscle relaxant, extra-corporeal corner hitch stitch at some point, and continuation for further cases. An internal comparison was made to analyze the technical modifications influencing the outcomes, by dividing them into two groups, those with (group A) and without modifications (group B). The data was analyzed using SPSS software (IBM, Version 23). A P value of <0.05 was considered statistically significant.

RESULTS

Out of 45 newborns 64.4% were males with an average birth weight of 2.6 kg. Baseline variables were comparable between the groups. The operating time significantly reduced after a higher-level camera port was used (P-value: 0.0001). The mean follow-up was 30.8 months. There were totally seven recurrences (6 in group A and 1 in group B), all within 12 months. Seven parents gave the overall post-treatment feedback as "unsatisfied". The operating time, recurrence rate, and parental satisfaction feedback were significantly less in group B (P-value: 0.001).

CONCLUSION

We recommend trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO₂, maximal use of muscle relaxant, extra-corporeal corner hitch stitch to reduce the operating time, and recurrence after thoracoscopic CDH repair.

Investigating the relationships between resilience, autism-related quantitative traits, and mental health outcomes among adults during the COVID-19 pandemic

Resilience is a dynamic process through which people adjust to adversity and buffer anxiety and depression. The COVID-19 global pandemic has introduced a shared source of adversity for people across the world, with detrimental implications for mental health. Despite the pronounced vulnerability of autistic adults to anxiety and depression during the COVID-19 pandemic, relationships among autism-related quantitative traits, resilience, and mental health outcomes have not been examined. As such, we aimed to describe the relationships between these traits in a sample enriched in autism spectrum-related quantitative traits during the COVID-19 pandemic. We also aimed to investigate the impact of demographic and social factors on these relationships. Across three independent samples of adults, we assessed resilience factors, autism-related quantitative traits, anxiety symptoms, and depression symptoms during the COVID-19 pandemic. One sample (recruited via the Autism Spectrum Program of Excellence, n = 201) was enriched for autism traits while the other two (recruited via Amazon Mechanical Turk, n = 624 and Facebook, n = 929) drew from the general population. We found resilience factors and quantitative autism-related traits to be inversely related, regardless of the resilience measure used. Additionally, we found that resilience factors moderate the relationship between autism-related quantitative traits and depression symptoms such that resilience appears to be protective. Across the neurodiversity spectrum, resilience factors may be targets to improve mental health outcomes. This approach may be especially important during the ongoing COVID-19 pandemic and in its aftermath.

Association between overcrowded households, multigenerational households, and COVID-19: a cohort study

OBJECTIVES

The role of overcrowded and multigenerational households as a risk factor for COVID-19 remains unmeasured. The objective of this study is to examine and quantify the association between overcrowded and multigenerational households and COVID-19 in New York City (NYC).

STUDY DESIGN

Cohort study.

METHODS

We conducted a Bayesian ecological time series analysis at the ZIP Code Tabulation Area (ZCTA) level in NYC to assess whether ZCTAs with higher proportions of overcrowded (defined as the proportion of the estimated number of housing units with more than one occupant per room) and multigenerational households (defined as the estimated percentage of residences occupied by a grandparent and a grandchild less than 18 years of age) were independently associated with higher suspected COVID-19 case rates (from NYC Department of Health Syndromic Surveillance data for March 1 to 30, 2020). Our main measure was an adjusted incidence rate ratio (IRR) of suspected COVID-19 cases per 10,000 population. Our final model controlled for ZCTA-level sociodemographic factors (median income, poverty status, White race, essential workers), the prevalence of clinical conditions related to COVID-19 severity (obesity, hypertension, coronary heart disease, diabetes, asthma, smoking status, and chronic obstructive pulmonary disease), and spatial clustering.

RESULTS

39,923 suspected COVID-19 cases were presented to emergency departments across 173 ZCTAs in NYC. Adjusted COVID-19 case rates increased by 67% (IRR 1.67, 95% CI = 1.12, 2.52) in ZCTAs in quartile four (versus one) for percent overcrowdedness and increased by 77% (IRR 1.77, 95% CI = 1.11, 2.79) in quartile four (versus one) for percent living in multigenerational housing. Interaction between both exposures was not significant (β_interaction = 0.99, 95% CI: 0.99-1.00).

CONCLUSIONS

Overcrowdedness and multigenerational housing are independent risk factors for suspected COVID-19. In the early phase of the surge in COVID cases, social distancing measures that increase house-bound populations may inadvertently but temporarily increase SARS-CoV-2 transmission risk and COVID-19 disease in these populations.

Influence of methyl jasmonate and salicylic acid on Rhamnetin production in adventitious root cultures of Baccharoides anthelmintica (L.) Moench

We developed adventitious roots from the leaf explants of Baccharoides anthelmintica (L.) Moench (syn. Vernonia anthelmintica) cultured on Murashige and Skoog (MS) medium. We tested MS and White's media fortified with different Indole Butyric Acid concentrations for their effect on root biomass production. MS medium supplemented with 1 mg L^-1 IBA produced the highest biomass of adventitious roots compared to White's medium. HPLC and LC-Q-TOF analyses confirmed the ability of the adventitious roots of B. anthelmintica to produce rhamnetin. When the 15-day old root cultures were treated with 0.6 mM methyl jasmonate, on the 6th-day, rhamnetin content was enhanced to 0.443 mg g^-1DW, which was 1.5 folds compared to untreated roots. Similarly, Salicylic acid also improved rhamnetin production to 0.36 mg g^-1 DW, which was 1.2 folds increment compared to untreated roots. Rhamnetin content in the roots of field-grown plants was 0.112 mg g^-1DW.

Enhancement of rhamnetin production in Vernonia anthelmintica (L.) Willd. cell suspension cultures by eliciting with methyl jasmonate and salicylic acid

Vernonia anthelmintica (L.) Willd. belongs to the family Asteraceae and has anthelmintic, anti-diabetic, diuretic and anti-asthmatic properties. Present study describes the production of rhamnetin: an O-methylated flavonol with anti-oxidant and anti-inflammatory activities; in cell suspension cultures of V. anthelmintica. Suspension cultures were established from cream coloured friable calli initiated from leaf explants and cultured in liquid MS medium supplemented with combinations of IAA (1.5 mg L-1) and BAP (1.5 mg L-1). After 20 days of cell suspension culture, the initial inoculum size of 0.5 g was increased to 1.05 g 100 mL-1 dry weight at exponential phase. When the culture was treated with 0.8 mM methyl jasmonate for 6 days; 2.2 fold accumulation of rhamnetin production was obtained on a dry weight basis compared to unelicited control. Likewise, the elicitation with salicylic acid 1 mM for 6 days brought about 2.7 fold rhamnetin production compared to unelicited control. The rhamnetin content in dried leaf tissue of field grown plants was found to be 0.143 mg g-1. Elicitation with methyl jasmonate and salicylic acid brought about 7.7 and 9.4 fold increments in rhamnetin production, compared to leaf tissue of field grown plants on a dry weight basis.

Comments on "Fluoride removal from water using activated and MnO2-coated tamarind fruit (Tamarindus indica) shell: batch and column studies"

This response comments on the importance and advantage of employing constraint on isotherm and kinetic models, for the benefit of young scientific researchers.

Chemometric studies of water quality parameters of Sankarankovil block of Tirunelveli, Tamilnadu

The fluoride concentration in ground water was determined in Sankarankovil block of Tirunelveli district of Tamilnadu (India) where it is the only source of drinking water. Various other water quality parameters such as pH, electrical conductivity total hardness and total alkalinity as well as calcium, magnesium, carbonate, bicarbonate and chloride concentrations were also measured. A systematic calculation of correlation coefficient among different physico-chemical parameters was performed. The analytical results indicated considerable variations among the analyzed samples with respect to their chemical composition. Majority of the samples do not comply with Indian as well as WHO water quality standards. The fluoride concentration in the ground water of these villages varied from 0.66 to 3.84 mg l(-1), causes dental fluorosis among people especially children of these villages. The high and low fluoride containing areas were located using isopleth mapping technique. Overall water quality was found unsatisfactory for drinking purposes without any prior treatment except at few locations out of 50 villages.

A new method of marking dentures using microchips

Over the years various methods of denture marking have been reported in the literature. They include surface marking and inclusion techniques using metallic or non-metallic materials, microchips and microlabels. The microchips are preferred because of their small size and aesthetic acceptability. They are not however widely used due to the high cost of manufacture and data incorporation. This article details the procedures involved in inscribing a microchip using the photochemical etching process used in the electronics industry. The resulting microchip was cosmetically appealing, cost effective and was able to satisfy all the forensic requirements for a suitable denture marker.

Ultrasonographic assessment of gall bladder kinetics in the elderly

BACKGROUND

The incidence of gallstones increases with age but the factors that influence gallstone formation in the elderly are poorly understood. Proposed factors include changes in bile composition and hypomotility of the gall bladder. Studies on gall bladder motility in the elderly have provided conflicting results, and none has been reported from India.

AIM

To determine gall bladder contractility in healthy elderly subjects and compare it with that in young healthy volunteers.

METHODS

Thirty healthy elderly (above the age of 60 years) and 30 young volunteers with no abdominal complaints were studied. Using real-time ultrasonography and the ellipsoid method, gall bladder volume was measured after overnight fast and at 10, 20, 30, 40, 50 and 60 minutes after a standard fatty meal. Residual volume, delta volume and ejection fraction were calculated.

RESULTS

Mean fasting gall bladder volume in elderly subjects was higher than that in young subjects (13.5 [5.8] mL vs 10.9 [3.6] mL; p < 0.05). However, there was no difference in the 60-min postprandial residual gall bladder volumes in the two groups. Change in gall bladder volume and ejection fraction were also similar in the two groups.

CONCLUSION

There was no difference in gall bladder emptying between elderly and young subjects though the fasting gall bladder volume was higher in the elderly.

The Optimal Design of Squeeze Film Dampers for Flexible Rotor Systems

Optimization techniques are employed to design squeeze film dampers for minimum transmitted load to the bearing and foundation in the operational speed range. The rotor systems are modeled by finite element formulation. The maximum transmitted load in the operational speed range is the objective function that is minimized using mathematical nonlinear programming (NLP) techniques. The damper design parameters are the radius, length, and radial clearance. Stability of the equilibrium solutions are investigated in the design procedure. Design derivatives have been determined in closed form expressions without resolution of the inherently nonlinear problem. A parametric study of the transmitted force is carried out to show the influence of damper parameters on the response and to demonstrate the merits of applying optimization techniques in damper design. Two numerical examples are presented that illustrate the effectiveness of optimizing squeeze film damper designs for reducing transmitted load.