Search

Abstract Autism spectrum disorder (ASD) are neurodevelopmental conditions characterised by deficits in social communication and interaction and repetitive behaviours. Maternal immune activation (MIA) during the mid-pregnancy is a known risk factor for ASD. Although reported in 15% of affected individuals, little is known about the specificity of their clinical profiles. Adaptive skills represent a holistic approach to a person's competencies and reflect specifically in ASD, their strengths and difficulties. In this study, we hypothesised that ASD individual with a history of MIA (MIA+) could be more severely socio-adaptively impaired than those without MIA during pregnancy (MIA-). To answer this question, we considered two independent cohorts of individuals with ASD (PARIS study and FACE ASD) screened for pregnancy history, and used supervised and unsupervised machine learning algorithms. We included 295 mother–child dyads with 14% of them with MIA+. We found that ASD-MIA+ individuals displayed more severe maladaptive behaviors, specifically in their socialization abilities. MIA+ directly influenced individual's socio-adaptive skills, independent of other covariates, including ASD severity. Interestingly, MIA+ affect persistently the socio-adaptive behavioral trajectories of individuals with ASD. The current study has a retrospective design with possible recall bias regarding the MIA event and, even if pooled from two cohorts, has a relatively small population. In addition, we were limited by the number of covariables available potentially impacted socio-adaptive behaviors. Larger prospective study with additional dimensions related to ASD is needed to confirm our results. Specific pathophysiological pathways may explain these clinical peculiarities of ASD- MIA+ individuals, and may open the way to new perspectives in deciphering the phenotypic complexity of ASD and for the development of specific immunomodulatory strategies.

(1) Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is highly associated with various somatic conditions that can be masked by the core symptoms of ASD and thus complicate the diagnosis. Identifying co-occurring somatic disorders is critical for providing effective healthcare and social services for ASD populations and influences their long-term outcomes. A systematic assessment of co-occurring somatic conditions is essential during this ASD diagnostic process. Therefore, this study aimed to identify the organization and content of the initial somatic assessment (ISA). (2) Methods: We conducted a systematic review of the clinical practice guidelines (CPG) for the ASD diagnostic process published between January 2005 and December 2019 in English and French and performed an appraisal following the Appraisal of Guidelines Research and Evaluation, second edition (AGREE-II). (3) Results: We selected 14 CPGs that were heterogeneous in quality, with methodological scores between 32.3 and 91.9. Clinical examinations are the first step in the ISA, and the participation of pediatric, neuropediatric, and genetic specialists was highly recommended by the majority of the CPGs. The recommendations included hearing screening tests (10/14), visual examinations (8/14), and systematic genetic investigations (4/14). The CPGs also described additional investigations that should be conducted based on numerous warning signs. (4) Conclusions: Screening for consensual international warning signs is necessary to perform a comprehensive and systematic ISA during the ASD diagnostic process. A “referral form” could be used to guide clinicians and improve the coordination process. This tool may reinforce epidemiological data on co-occurring somatic disorders in patients with ASD.

In mid-June 2019, the Greenland ice sheet (GrIS) experienced an extreme early-season melt event. This, coupled with an earlier-than-average melt onset and low prior winter snowfall over western Greenland, led to a rapid decrease in surface albedo and greater solar energy absorption over the melt season. The 2019 melt season resulted in significantly more melt than other recent years, even compared to exceptional melt years previously identified in the moderate-resolution imaging spectroradiometer (MODIS) record. The increased solar radiation absorbance in 2019 warmed the surface and increased the rate of meltwater production. We use two decades of satellite-derived albedo from the MODIS MCD43 record to show a significant and extended decrease in albedo in Greenland during 2019. This decrease, early in the melt season and continuing during peak summer insolation, caused increased radiative forcing of the ice sheet of 2.33 Wm−2 for 2019. Radiative forcing is strongly influenced by the dramatic seasonal differences in surface albedo experienced by any location experiencing persistent and seasonal snow-cover. We also illustrate the utility of the newly developed Landsat-8 albedo product for better capturing the detailed spatial heterogeneity of the landscape, leading to a more refined representation of the surface energy budget. While the MCD43 data accurately capture the albedo for a given 500 m pixel, the higher spatial resolution 30 m Landsat-8 albedos more fully represent the detailed landscape variations.

Background: Delirium is an acute and fluctuating disturbance in attention, awareness, and cognition, commonly observed in hospital settings, particularly among older adults, critically ill and surgical patients. Delirium poses significant challenges in patient care, leading to increased morbidity, mortality, prolonged hospital stays, and functional decline. Aim: The aim of this review is to map existing evidence on delirium diagnostic tools suitable for use in patients treated surgically due to hip fracture, to inform clinical practice and enhance patient care protocols in the postoperative setting. Method: We will conduct a scoping review on delirium diagnostic tools used for adult patients in the postoperative setting according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR). Eligibility criteria encompass all languages, publications dates, and study designs, with exception of case‐reports. We will systematically search multiple databases and include unpublished trials, ensuring a comprehensive review based on a predefined protocol. Results: Results will be presented descriptively, with supplementary tables and graphs. Studies will be grouped by design, surgical specialties, and diagnostic tools to identify potential variations. Conclusion: This scoping review will provide an overview of existing delirium diagnostic tools used in the postoperative setting and highlight knowledge‐gaps to support future research. Due to the large number of patients affected by postoperative delirium, evidence mapping is much needed to facilitate evidence‐based practice. [ABSTRACT FROM AUTHOR]